{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T07:21:31Z","timestamp":1790925691573,"version":"4.1.0"},"reference-count":57,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2025,3,13]],"date-time":"2025-03-13T00:00:00Z","timestamp":1741824000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"DFG, German Research Foundation","award":["EXC2151\u2014390873048"],"award-info":[{"award-number":["EXC2151\u2014390873048"]}]},{"name":"DFG, German Research Foundation","award":["FKZ01KA1611"],"award-info":[{"award-number":["FKZ01KA1611"]}]},{"name":"DFG, German Research Foundation","award":["TTU 09.703\/09.715"],"award-info":[{"award-number":["TTU 09.703\/09.715"]}]},{"name":"DFG, German Research Foundation","award":["TI 07.005"],"award-info":[{"award-number":["TI 07.005"]}]},{"name":"DFG, German Research Foundation","award":["TTU 03.815"],"award-info":[{"award-number":["TTU 03.815"]}]},{"name":"DFG, German Research Foundation","award":["TMA2018SF-2451-ASTAWOL"],"award-info":[{"award-number":["TMA2018SF-2451-ASTAWOL"]}]},{"name":"German Federal Ministry of Education and Research (BMBF)","award":["EXC2151\u2014390873048"],"award-info":[{"award-number":["EXC2151\u2014390873048"]}]},{"name":"German Federal Ministry of Education and Research (BMBF)","award":["FKZ01KA1611"],"award-info":[{"award-number":["FKZ01KA1611"]}]},{"name":"German Federal Ministry of Education and Research (BMBF)","award":["TTU 09.703\/09.715"],"award-info":[{"award-number":["TTU 09.703\/09.715"]}]},{"name":"German Federal Ministry of Education and Research (BMBF)","award":["TI 07.005"],"award-info":[{"award-number":["TI 07.005"]}]},{"name":"German Federal Ministry of Education and Research (BMBF)","award":["TTU 03.815"],"award-info":[{"award-number":["TTU 03.815"]}]},{"name":"German Federal Ministry of Education and Research (BMBF)","award":["TMA2018SF-2451-ASTAWOL"],"award-info":[{"award-number":["TMA2018SF-2451-ASTAWOL"]}]},{"name":"German Center for Infection Research","award":["EXC2151\u2014390873048"],"award-info":[{"award-number":["EXC2151\u2014390873048"]}]},{"name":"German Center for Infection Research","award":["FKZ01KA1611"],"award-info":[{"award-number":["FKZ01KA1611"]}]},{"name":"German Center for Infection Research","award":["TTU 09.703\/09.715"],"award-info":[{"award-number":["TTU 09.703\/09.715"]}]},{"name":"German Center for Infection Research","award":["TI 07.005"],"award-info":[{"award-number":["TI 07.005"]}]},{"name":"German Center for Infection Research","award":["TTU 03.815"],"award-info":[{"award-number":["TTU 03.815"]}]},{"name":"German Center for Infection Research","award":["TMA2018SF-2451-ASTAWOL"],"award-info":[{"award-number":["TMA2018SF-2451-ASTAWOL"]}]},{"name":"European and Developing Countries Clinical Trial Partnership (EDCTP2) program","award":["EXC2151\u2014390873048"],"award-info":[{"award-number":["EXC2151\u2014390873048"]}]},{"name":"European and Developing Countries Clinical Trial Partnership (EDCTP2) program","award":["FKZ01KA1611"],"award-info":[{"award-number":["FKZ01KA1611"]}]},{"name":"European and Developing Countries Clinical Trial Partnership (EDCTP2) program","award":["TTU 09.703\/09.715"],"award-info":[{"award-number":["TTU 09.703\/09.715"]}]},{"name":"European and Developing Countries Clinical Trial Partnership (EDCTP2) program","award":["TI 07.005"],"award-info":[{"award-number":["TI 07.005"]}]},{"name":"European and Developing Countries Clinical Trial Partnership (EDCTP2) program","award":["TTU 03.815"],"award-info":[{"award-number":["TTU 03.815"]}]},{"name":"European and Developing Countries Clinical Trial Partnership (EDCTP2) program","award":["TMA2018SF-2451-ASTAWOL"],"award-info":[{"award-number":["TMA2018SF-2451-ASTAWOL"]}]},{"name":"European Union","award":["EXC2151\u2014390873048"],"award-info":[{"award-number":["EXC2151\u2014390873048"]}]},{"name":"European Union","award":["FKZ01KA1611"],"award-info":[{"award-number":["FKZ01KA1611"]}]},{"name":"European Union","award":["TTU 09.703\/09.715"],"award-info":[{"award-number":["TTU 09.703\/09.715"]}]},{"name":"European Union","award":["TI 07.005"],"award-info":[{"award-number":["TI 07.005"]}]},{"name":"European Union","award":["TTU 03.815"],"award-info":[{"award-number":["TTU 03.815"]}]},{"name":"European Union","award":["TMA2018SF-2451-ASTAWOL"],"award-info":[{"award-number":["TMA2018SF-2451-ASTAWOL"]}]},{"name":"University of Bonn","award":["EXC2151\u2014390873048"],"award-info":[{"award-number":["EXC2151\u2014390873048"]}]},{"name":"University of Bonn","award":["FKZ01KA1611"],"award-info":[{"award-number":["FKZ01KA1611"]}]},{"name":"University of Bonn","award":["TTU 09.703\/09.715"],"award-info":[{"award-number":["TTU 09.703\/09.715"]}]},{"name":"University of Bonn","award":["TI 07.005"],"award-info":[{"award-number":["TI 07.005"]}]},{"name":"University of Bonn","award":["TTU 03.815"],"award-info":[{"award-number":["TTU 03.815"]}]},{"name":"University of Bonn","award":["TMA2018SF-2451-ASTAWOL"],"award-info":[{"award-number":["TMA2018SF-2451-ASTAWOL"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Vaccines"],"abstract":"<jats:p>Background\/Objectives: Although the COVID-19 pandemic has largely concluded, the varied trajectories it has followed in different regions of the world remain incompletely understood. Intensive research is needed to fully grasp its course and the implications for future global health challenges. Notably, the milder trajectory of the COVID-19 pandemic in Sub-Saharan Africa has defied initial predictions. An emerging body of evidence suggests that, in addition to the continent\u2019s younger average age and the lower prevalence of relevant comorbidities, co-infections with helminths may have also impressively shaped the pandemic\u2019s milder trajectory in the region. Indeed, helminths are renowned for their ability to modulate human immune responses, which, while potentially beneficial in limiting excessive inflammation, could also diminish vaccine efficacy and impede viral clearance. This study investigated different aspects of the intricate interactions between COVID-19 and Lymphatic Filariasis (LF), a helminth infection caused by parasitic worms such as Wuchereria bancrofti, Brugia malayi, and Brugia timori and endemic to various regions in Sub-Saharan Africa and the tropics. Methods: For this purpose, samples of a larger and ongoing clinical trial (ethical approval codes: CHRPE\/AP\/525\/17 and 325\/21; trial registration number ISRCTN14042737) were collected from 222 individuals from endemic areas of Ghana, along with comprehensive clinical and demographic data. The samples include LF patients (n = 222) grouped according to their Lymphoedema (LE) stages, as well as COVID-19 vaccinated (n = 81) and non-vaccinated individuals (n = 141). All vaccinated participants received the COVID-19 vaccine ChAdOx1-S (also known as Vaxzevria) developed by the University of Oxford and AstraZenca. The expressions of SARS-CoV-2 and filarial-specific antibodies (IgG, IgA) were accessed using ELISA, while Luminex-based immunoassays were employed to measure the expression of SARS-CoV-2 variant-specific neutralizing antibodies. The interplay between vaccine responses and demographic factors was analyzed using group comparisons with the Kruskal-Wallis or Mann-Whitney U tests. Results: The results indicate that a remarkable portion of unvaccinated individuals (56% IgA seropositive, 39% IgG seropositive) developed antibodies against SARS-CoV-2 despite no confirmed infection. Notably, the study identified a robust antibody response to COVID-19 vaccination, which was independent of the degree of LF pathology or parasitic status. An important observation was the reduced SARS-CoV-2 antibody response in individuals seropositive for Ascaris lumbricoides (p = 0.0264), highlighting an interaction between roundworm infection and COVID-19. Conclusions: The study concludes that the ChAdOx1-S COVID-19 vaccine (AstraZeneca) triggers a strong immune response in LF patients; however, filarial and\/or soil-transmitted helminth seropositivity might influence the COVID-19 infection-induced response. These findings emphasize the complexity of infectious disease dynamics in co-infected populations and the need to decipher parasite-induced immunomodulatory mechanisms on COVID-19 vaccination.<\/jats:p>","DOI":"10.3390\/vaccines13030312","type":"journal-article","created":{"date-parts":[[2025,3,13]],"date-time":"2025-03-13T10:16:45Z","timestamp":1741861005000},"page":"312","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Robust COVID-19 Vaccine Responses Despite Filarial Co-Infection: Insights from a Lymphatic Filariasis Cohort in Ghana"],"prefix":"10.3390","volume":"13","author":[{"given":"Julia","family":"Meyer","sequence":"first","affiliation":[{"name":"Institute of Medical Microbiology, Immunology and Parasitology (IMMIP), University Hospital Bonn, 53127 Bonn, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer","family":"Nadal","sequence":"additional","affiliation":[{"name":"Institute of Medical Microbiology, Immunology and Parasitology (IMMIP), University Hospital Bonn, 53127 Bonn, Germany"},{"name":"Institute for Medical Biometry, Informatics, and Epidemiology (IMBIE), University Hospital Bonn, 53127 Bonn, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linda","family":"Batsa Debrah","sequence":"additional","affiliation":[{"name":"Department of Clinical Microbiology, School of Medicine and Dentistry, Kwame Nkrumah University of Science and Technology (KNUST), Kumasi 00233, Ghana"},{"name":"Kumasi Centre for Collaborative Research in Tropical Medicine (KCCR), Kwame Nkrumah University of Science and Technology (KNUST), Kumasi 00233, Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander Yaw","family":"Debrah","sequence":"additional","affiliation":[{"name":"Kumasi Centre for Collaborative Research in Tropical Medicine (KCCR), Kwame Nkrumah University of Science and Technology (KNUST), Kumasi 00233, Ghana"},{"name":"Faculty of Allied Health Sciences, Kwame Nkrumah University of Science and Technology (KNUST), Kumasi 00233, Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jubin","family":"Osei-Mensah","sequence":"additional","affiliation":[{"name":"Kumasi Centre for Collaborative Research in Tropical Medicine (KCCR), Kwame Nkrumah University of Science and Technology (KNUST), Kumasi 00233, Ghana"},{"name":"Department of Pathobiology, School of Veterinary Medicine, Kwame Nkrumah University of Science and Technology (KNUST), Kumasi 00233, Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8972-1757","authenticated-orcid":false,"given":"Derrick","family":"Adu Mensah","sequence":"additional","affiliation":[{"name":"Kumasi Centre for Collaborative Research in Tropical Medicine (KCCR), Kwame Nkrumah University of Science and Technology (KNUST), Kumasi 00233, Ghana"},{"name":"Department of Medical Laboratory Technology, Royal Ann College of Health, Kumasi 00233, Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8991-3345","authenticated-orcid":false,"given":"Patricia Jebett","family":"Korir","sequence":"additional","affiliation":[{"name":"Institute of Medical Microbiology, Immunology and Parasitology (IMMIP), University Hospital Bonn, 53127 Bonn, Germany"},{"name":"Bonn-Cologne Site, German Center for Infectious Disease Research (DZIF), 53113 Bonn, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3648-2649","authenticated-orcid":false,"given":"Janina M.","family":"Kuehlwein","sequence":"additional","affiliation":[{"name":"Institute of Medical Microbiology, Immunology and Parasitology (IMMIP), University Hospital Bonn, 53127 Bonn, Germany"},{"name":"Bonn-Cologne Site, German Center for Infectious Disease Research (DZIF), 53113 Bonn, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ute","family":"Klarmann-Schulz","sequence":"additional","affiliation":[{"name":"Institute of Medical Microbiology, Immunology and Parasitology (IMMIP), University Hospital Bonn, 53127 Bonn, Germany"},{"name":"Bonn-Cologne Site, German Center for Infectious Disease Research (DZIF), 53113 Bonn, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8671-3831","authenticated-orcid":false,"given":"Achim","family":"Hoerauf","sequence":"additional","affiliation":[{"name":"Institute of Medical Microbiology, Immunology and Parasitology (IMMIP), University Hospital Bonn, 53127 Bonn, Germany"},{"name":"Bonn-Cologne Site, German Center for Infectious Disease Research (DZIF), 53113 Bonn, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomabu","family":"Adjobimey","sequence":"additional","affiliation":[{"name":"Institute of Medical Microbiology, Immunology and Parasitology (IMMIP), University Hospital Bonn, 53127 Bonn, Germany"},{"name":"Laboratoire de Biologie Int\u00e9grative Pour l\u2019Innovation Th\u00e9rapeutique (BioInov), Facult\u00e9 des Sciences et Techniques (FAST), Universit\u00e9 d\u2019Abomey Calavi, Abomey Calavi BP 526, Benin"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,3,13]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"m1379","DOI":"10.1136\/bmj.m1379","article-title":"Social distancing in covid-19: What are the mental health implications?","volume":"369","author":"Venkatesh","year":"2020","journal-title":"BMJ"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"104860","DOI":"10.1016\/j.healthpol.2023.104860","article-title":"Illustrating the impact of commercial determinants of health on the global COVID-19 pandemic: Thematic analysis of 16 country case studies","volume":"134","author":"Freeman","year":"2023","journal-title":"Health Policy"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1002\/acr.25169","article-title":"Global Perspective on the Impact of the COVID-19 Pandemic on Rheumatology and Health Equity","volume":"76","author":"Hsieh","year":"2024","journal-title":"Arthritis Care Res."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"115516","DOI":"10.1016\/j.psychres.2023.115516","article-title":"Understanding the mental health impact of COVID-19 in the elderly general population: A scoping review of global literature from the first year of the pandemic","volume":"329","author":"Lau","year":"2023","journal-title":"Psychiatry Res."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"3755","DOI":"10.1097\/MS9.0000000000000945","article-title":"The WHO has terminated global public health emergency for COVID-19 by the IHR Emergency Committee recommendation: Potential impact analysis","volume":"85","author":"Rahman","year":"2023","journal-title":"Ann. Med. Surg."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"511","DOI":"10.1177\/10105395241250120","article-title":"COVID-19 Pandemic and Its Global Impact on the Accessibility and Provision of Maternal and Child Health Care Services","volume":"36","author":"Shaikh","year":"2024","journal-title":"Asia Pac. J. Public Health"},{"key":"ref_7","unstructured":"WHO (2025, January 11). WHO COVID-19 Deaths Dashbord, Available online: https:\/\/data.who.int\/dashboards\/covid19\/deaths?n=c."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1107","DOI":"10.1038\/s41418-022-01015-x","article-title":"Immune response in COVID-19: What is next?","volume":"29","author":"Li","year":"2022","journal-title":"Cell Death Differ."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1270","DOI":"10.1007\/s10900-020-00920-x","article-title":"Prevalence and Associated Risk Factors of Mortality Among COVID-19 Patients: A Meta-Analysis","volume":"45","author":"Noor","year":"2020","journal-title":"J. Community Health"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"12493","DOI":"10.18632\/aging.103579","article-title":"Epidemiological, comorbidity factors with severity and prognosis of COVID-19: A systematic review and meta-analysis","volume":"12","author":"Fang","year":"2020","journal-title":"Aging"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"6317","DOI":"10.1038\/s41467-020-19741-6","article-title":"Male sex identified by global COVID-19 meta-analysis as a risk factor for death and ITU admission","volume":"11","author":"Peckham","year":"2020","journal-title":"Nat. Commun."},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Herrera-Esposito, D., and de Los Campos, G. (2022). Age-specific rate of severe and critical SARS-CoV-2 infections estimated with multi-country seroprevalence studies. BMC Infect. Dis., 22.","DOI":"10.1186\/s12879-022-07262-0"},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Oliveira, E., Parikh, A., Lopez-Ruiz, A., Carrilo, M., Goldberg, J., Cearras, M., Fernainy, K., Andersen, S., Mercado, L., and Guan, J. (2021). ICU outcomes and survival in patients with severe COVID-19 in the largest health care system in central Florida. PLoS ONE, 16.","DOI":"10.1371\/journal.pone.0249038"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"363","DOI":"10.1038\/s41577-020-0311-8","article-title":"The trinity of COVID-19: Immunity, inflammation and intervention","volume":"20","author":"Tay","year":"2020","journal-title":"Nat. Rev. Immunol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1036","DOI":"10.1016\/j.cell.2020.04.026","article-title":"Imbalanced Host Response to SARS-CoV-2 Drives Development of COVID-19","volume":"181","author":"Liu","year":"2020","journal-title":"Cell"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"910","DOI":"10.1016\/j.immuni.2020.05.002","article-title":"Immunology of COVID-19: Current State of the Science","volume":"52","author":"Vabret","year":"2020","journal-title":"Immunity"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"iqaa004","DOI":"10.1093\/oxfimm\/iqaa004","article-title":"Innate immunology in COVID-19-a living review. Part I: Viral entry, sensing and evasion","volume":"1","author":"Coveney","year":"2020","journal-title":"Oxf. Open Immunol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"424","DOI":"10.1002\/jmv.25685","article-title":"Coronavirus infections and immune responses","volume":"92","author":"Li","year":"2020","journal-title":"J. Med. Virol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"863","DOI":"10.1159\/000516038","article-title":"The Immune Responses against Coronavirus Infections: Friend or Foe?","volume":"182","author":"Vafaeinezhad","year":"2021","journal-title":"Int. Arch. Allergy Immunol."},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Okuyama, R. (2023). mRNA and Adenoviral Vector Vaccine Platforms Utilized in COVID-19 Vaccines: Technologies, Ecosystem, and Future Directions. Vaccines, 11.","DOI":"10.3390\/vaccines11121737"},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Adjobimey, T., Meyer, J., Sollberg, L., Bawolt, M., Berens, C., Kovacevic, P., Trudic, A., Parcina, M., and Hoerauf, A. (2022). Comparison of IgA, IgG, and Neutralizing Antibody Responses Following Immunization With Moderna, BioNTech, AstraZeneca, Sputnik-V, Johnson and Johnson, and Sinopharm\u2019s COVID-19 Vaccines. Front. Immunol., 13.","DOI":"10.3389\/fimmu.2022.917905"},{"key":"ref_22","unstructured":"Edouard Mathieu, H.R., Rod\u00e9s-Guirao, L., Appel, C., Giattino, C., Hasell, J., Macdonald, B., Dattani, S., Beltekian, D., Ortiz-Ospina, E., and Roser, M. (2025, January 11). Coronavirus Pandemic (COVID-19). Available online: https:\/\/ourworldindata.org\/covid-vaccinations."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1177","DOI":"10.12688\/f1000research.74363.1","article-title":"Explaining the unexpected COVID-19 trends and potential impact across Africa","volume":"10","author":"Quashie","year":"2021","journal-title":"F1000Research"},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Bwire, G., Ario, A.R., Eyu, P., Ocom, F., Wamala, J.F., Kusi, K.A., Ndeketa, L., Jambo, K.C., Wanyenze, R.K., and Talisuna, A.O. (2022). The COVID-19 pandemic in the African continent. BMC Med., 20.","DOI":"10.1186\/s12916-022-02367-4"},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"Habibzadeh, F. (2023). Malaria and the incidence of COVID-19 in Africa: An ecological study. BMC Infect. Dis., 23.","DOI":"10.1186\/s12879-023-08032-2"},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Adjobimey, T., Meyer, J., Hennenfent, A., Bara, A.J., Lagnika, L., Kocou, B., Adjagba, M., Laleye, A., Hoerauf, A., and Parcina, M. (2023). Negative association between ascaris lumbricoides seropositivity and Covid-19 severity: Insights from a study in Benin. Front. Immunol., 14.","DOI":"10.3389\/fimmu.2023.1233082"},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Adjobimey, T., Meyer, J., Terkes, V., Parcina, M., and Hoerauf, A. (2022). Helminth antigens differentially modulate the activation of CD4(+) and CD8(+) T lymphocytes of convalescent COVID-19 patients in vitro. BMC Med., 20.","DOI":"10.1186\/s12916-022-02441-x"},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Tan, L.Y., Komarasamy, T.V., and Balasubramaniam, V.R. (2021). Hyperinflammatory Immune Response and COVID-19: A Double Edged Sword. Front. Immunol., 12.","DOI":"10.3389\/fimmu.2021.742941"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"e12939","DOI":"10.1111\/pim.12939","article-title":"The effect of helminth infection on vaccine responses in humans and animal models: A systematic review and meta-analysis","volume":"44","author":"Natukunda","year":"2022","journal-title":"Parasite Immunol."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"474","DOI":"10.1186\/s13071-021-04980-3","article-title":"Recombinant antigens used as diagnostic tools for lymphatic filariasis","volume":"14","author":"Pastor","year":"2021","journal-title":"Parasit. Vectors"},{"key":"ref_31","unstructured":"WHO (2024). WHO Lymphatic Filariasis."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"338","DOI":"10.1111\/pim.12081","article-title":"Immunology of lymphatic filariasis","volume":"36","author":"Babu","year":"2014","journal-title":"Parasite Immunol."},{"key":"ref_33","unstructured":"WHO (2025, January 11). Soil-Transmitted Helminth Infections, Available online: https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/soil-transmitted-helminth-infections."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"66","DOI":"10.4269\/ajtmh.24-0313","article-title":"Adherence to Hygiene Protocols and Doxycycline Therapy in Ameliorating Lymphatic Filariasis Morbidity in an Endemic Area Post-Interruption of Disease Transmission in Ghana","volume":"111","author":"Debrah","year":"2024","journal-title":"Am. J. Trop. Med. Hyg."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"12283","DOI":"10.1073\/pnas.1400472111","article-title":"History of vaccination","volume":"111","author":"Plotkin","year":"2014","journal-title":"Proc. Natl. Acad. Sci. USA"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"1595","DOI":"10.1016\/S0140-6736(20)32137-1","article-title":"SARS-CoV-2 immunity: Review and applications to phase 3 vaccine candidates","volume":"396","author":"Poland","year":"2020","journal-title":"Lancet"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"2027160","DOI":"10.1080\/21645515.2022.2027160","article-title":"The efficacy and effectiveness of the COVID-19 vaccines in reducing infection, severity, hospitalization, and mortality: A systematic review","volume":"18","author":"Mohammed","year":"2022","journal-title":"Hum. Vaccines Immunother."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"1293","DOI":"10.1016\/S1473-3099(22)00320-6","article-title":"Global impact of the first year of COVID-19 vaccination: A mathematical modelling study","volume":"22","author":"Watson","year":"2022","journal-title":"Lancet Infect. Dis."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"666","DOI":"10.1016\/j.jaci.2016.07.007","article-title":"Regulation of the host immune system by helminth parasites","volume":"138","author":"Maizels","year":"2016","journal-title":"J. Allergy Clin. Immunol."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"1384","DOI":"10.1093\/infdis\/174.6.1384","article-title":"Perspective: Prospects for development of vaccines against human helminth infections","volume":"174","author":"McCarthy","year":"1996","journal-title":"J. Infect. Dis."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1016\/j.parepi.2016.12.003","article-title":"Soil transmitted helminth infections are not associated with compromised antibody responses to previously administered measles and tetanus vaccines among HIV-1 infected, ART na\u00efve Kenyan adults","volume":"2","author":"Storey","year":"2017","journal-title":"Parasite Epidemiol. Control"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"3966","DOI":"10.1038\/s41467-021-24062-3","article-title":"Temporal trends of SARS-CoV-2 seroprevalence during the first wave of the COVID-19 epidemic in Kenya","volume":"12","author":"Adetifa","year":"2021","journal-title":"Nat. Commun."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"79","DOI":"10.1126\/science.abe1916","article-title":"Seroprevalence of anti-SARS-CoV-2 IgG antibodies in Kenyan blood donors","volume":"371","author":"Uyoga","year":"2021","journal-title":"Science"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"99","DOI":"10.1016\/S0140-6736(20)32661-1","article-title":"Safety and efficacy of the ChAdOx1 nCoV-19 vaccine (AZD1222) against SARS-CoV-2: An interim analysis of four randomised controlled trials in Brazil, South Africa, and the UK","volume":"397","author":"Voysey","year":"2021","journal-title":"Lancet"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"1116","DOI":"10.1038\/s41591-021-01363-0","article-title":"Author Correction: T cell and antibody responses induced by a single dose of ChAdOx1 nCoV-19 (AZD1222) vaccine in a phase 1\/2 clinical trial","volume":"27","author":"Ewer","year":"2021","journal-title":"Nat. Med."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"467","DOI":"10.1016\/S0140-6736(20)31604-4","article-title":"Safety and immunogenicity of the ChAdOx1 nCoV-19 vaccine against SARS-CoV-2: A preliminary report of a phase 1\/2, single-blind, randomised controlled trial","volume":"396","author":"Folegatti","year":"2020","journal-title":"Lancet"},{"key":"ref_47","doi-asserted-by":"crossref","unstructured":"Hvidt, A.K., Baerends, E.A.M., Sogaard, O.S., Staerke, N.B., Raben, D., Reekie, J., Nielsen, H., Johansen, I.S., Wiese, L., and Benfield, T.L. (2022). Comparison of vaccine-induced antibody neutralization against SARS-CoV-2 variants of concern following primary and booster doses of COVID-19 vaccines. Front. Med., 9.","DOI":"10.3389\/fmed.2022.994160"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"1205","DOI":"10.1038\/s41591-021-01377-8","article-title":"Neutralizing antibody levels are highly predictive of immune protection from symptomatic SARS-CoV-2 infection","volume":"27","author":"Khoury","year":"2021","journal-title":"Nat. Med."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"e1399","DOI":"10.1093\/cid\/ciac428","article-title":"Doxycycline Treatment of Mansonella perstans-Infected Individuals Affects Immune Cell Activation and Causes Long-term T-cell Polarization","volume":"76","author":"Aniagyei","year":"2023","journal-title":"Clin. Infect. Dis."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"517","DOI":"10.1093\/cid\/civ363","article-title":"Doxycycline Leads to Sterility and Enhanced Killing of Female Onchocerca volvulus Worms in an Area With Persistent Microfilaridermia After Repeated Ivermectin Treatment: A Randomized, Placebo-Controlled, Double-Blind Trial","volume":"61","author":"Debrah","year":"2015","journal-title":"Clin. Infect. Dis."},{"key":"ref_51","doi-asserted-by":"crossref","unstructured":"Dhar, R., Kirkpatrick, J., Gilbert, L., Khanna, A., Madhavdas Modi, M., Chawla, R.K., Dalal, S., Nagarjuna Maturu, V., Stern, M., and Keppler, O.T. (2023). Doxycycline for the prevention of progression of COVID-19 to severe disease requiring intensive care unit (ICU) admission: A randomized, controlled, open-label, parallel group trial (DOXPREVENT.ICU). PLoS ONE, 18.","DOI":"10.1371\/journal.pone.0280745"},{"key":"ref_52","doi-asserted-by":"crossref","unstructured":"Johannesen, C.K., Rezahosseini, O., Gybel-Brask, M., Kristensen, J.H., Hasselbalch, R.B., Pries-Heje, M.M., Nielsen, P.B., Knudsen, A.D., Fogh, K., and Norsk, J.B. (2021). Risk Factors for Being Seronegative following SARS-CoV-2 Infection in a Large Cohort of Health Care Workers in Denmark. Microbiol. Spectr., 9.","DOI":"10.1128\/Spectrum.00904-21"},{"key":"ref_53","doi-asserted-by":"crossref","unstructured":"Ding, J., Liu, C., Wang, Z., Guo, H., Zhang, K., Ma, L., Wang, B., Zhao, H., Song, M., and Guan, X. (2022). Characteristics and Prognosis of Antibody Non-responders With Coronavirus Disease 2019. Front. Med., 9.","DOI":"10.3389\/fmed.2022.813820"},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1007\/s15010-021-01664-z","article-title":"Waning antibody responses in COVID-19: What can we learn from the analysis of other coronaviruses?","volume":"50","author":"Hamady","year":"2022","journal-title":"Infection"},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"e12","DOI":"10.1016\/S2666-5247(20)30014-8","article-title":"Africa\u2019s struggle with inadequate COVID-19 testing","volume":"1","author":"Adepoju","year":"2020","journal-title":"Lancet Microbe"},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"100082","DOI":"10.1016\/j.hpopen.2022.100082","article-title":"Challenges and difficulties faced in low- and middle-income countries during COVID-19","volume":"3","author":"Abdulla","year":"2022","journal-title":"Health Policy Open"},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"1489","DOI":"10.1016\/j.cell.2020.05.015","article-title":"Targets of T Cell Responses to SARS-CoV-2 Coronavirus in Humans with COVID-19 Disease and Unexposed Individuals","volume":"181","author":"Grifoni","year":"2020","journal-title":"Cell"}],"container-title":["Vaccines"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2076-393X\/13\/3\/312\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T16:53:07Z","timestamp":1760028787000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2076-393X\/13\/3\/312"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,3,13]]},"references-count":57,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2025,3]]}},"alternative-id":["vaccines13030312"],"URL":"https:\/\/doi.org\/10.3390\/vaccines13030312","relation":{},"ISSN":["2076-393X"],"issn-type":[{"value":"2076-393X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,3,13]]}}}