In what is believed to be one of the largest studies of its kind, Johns Hopkins Medicine researchers have shown that antibody levels against SARS-CoV-2 (the COVID-19 virus) stay more durable—that is, remain higher over an extended period of time—in people who were infected by the virus and then received protection from two doses of messenger RNA (mRNA) vaccine compared with those who only got immunized.
“This finding adds to our understanding of how immunity against SARS-CoV-2 works, and builds upon an earlier study by our team that showed the mRNA vaccines yielded a robust antibody response, even if a person did not develop significant symptoms following vaccination or did not have a prior SARS-CoV-2 infection,” says study senior author Aaron Milstone, M.D., M.H.S., professor of pediatrics at the Johns Hopkins University School of Medicine and pediatric epidemiologist at Johns Hopkins Children’s Center.
The two mRNA vaccines evaluated in the study introduce the body’s immune system to S1, a protein subunit that’s a component of the spikes found on the surface of SARS-CoV-2. The spikes enable the virus to latch onto healthy cells and infect them. Immunoglobulin G antibodies, elicited by S1 from the vaccines stimulating the immune system, neutralize the virus particles, preventing infection by SARS-CoV-2, or at least reducing the severity of the disease.
For their latest study, the researchers followed 1,960 Johns Hopkins Medicine health care workers who had received both doses of either the Pfizer/BioNTech or Moderna vaccines, including 73 people who had a positive SARS-CoV-2 polymerase chain reaction (PCR) test result before the first vaccine dose. The 73 were divided into two groups—those who were infected at 90 days or closer to the first vaccine dose, and those whose exposure to the virus was more than 90 days before the initial shot.
After adjusting for vaccine type, age and sex, antibody levels were compared for those with and without prior SARS-CoV-2 infection at one, three and six months following the second vaccine dose. In addition, antibody levels were compared at one and three months following the second dose between the two groups with prior SARS-CoV-2 infection.
“We found that health care workers with prior SARS-CoV-2 infection followed by two doses of mRNA vaccine—therefore, three independent exposures to the S1 spike protein—developed higher antibody levels than those with vaccination alone,” says study lead author Diana Zhong, M.D., an infectious diseases fellow at the Johns Hopkins University School of Medicine. “The relative differences were 14% higher at 1 month following the second vaccine dose, 19% at three months and 56% at six months.”
Zhong adds that the study participants with a PCR-confirmed SARS-CoV-2 infection more than 90 days before their initial vaccination had adjusted antibody levels 9% (one month following the second vaccine dose) and 13% (three months following the second vaccine dose) higher than those who were exposed to the virus less than or equal to the 90-day mark.
“This suggests that a longer interval between infection and first vaccine dose may enhance the antibody response,” says Milstone.
Milstone says further investigation is needed to determine whether increased post-vaccination durability in previously infected people is attributable to the number of exposures to the virus, the interval between exposures, or the interplay between natural or vaccine-derived immunity.
The study team at Johns Hopkins Medicine was co-led by Zhong and Shaoming Xiao. Along with them and Milstone, the team includes Amanda Debes, Emily Egbert, Patrizio Caturegli and Elizabeth Colantuoni.

News
Specially engineered antibody delivers RNA therapy to treatment-resistant tumors
Elias Quijano, PhD; Diana Martinez-Saucedo, PhD; Zaira Ianniello, PhD; and Natasha Pinto-Medici, PhD, there are 25 other contributors, most from Yale's Department of Therapeutic Radiology and from the departments of genetics, molecular biophysics and [...]
Vaccinated women face fewer cervical cancer risks
New data from Denmark shows the HPV vaccine’s powerful long-term impact, while also revealing why cervical cancer screening is still essential. A Danish study published in the journal Eurosurveillance reports that women who received the human [...]
3D-printed implant offers a potential new route to repair spinal cord injuries
A research team at RCSI University of Medicine and Health Sciences has developed a 3-D printed implant to deliver electrical stimulation to injured areas of the spinal cord, offering a potential new route to [...]
Nanocrystals Carrying Radioisotopes Offer New Hope for Cancer Treatment
The Science Scientists have developed tiny nanocrystal particles made up of isotopes of the elements lanthanum, vanadium, and oxygen for use in treating cancer. These crystals are smaller than many microbes and can carry isotopes of [...]
New Once-a-Week Shot Promises Life-Changing Relief for Parkinson’s Patients
A once-a-week shot from Australian scientists could spare people with Parkinson’s the grind of taking pills several times a day. The tiny, biodegradable gel sits under the skin and releases steady doses of two [...]
Weekly injectable drug offers hope for Parkinson’s patients
A new weekly injectable drug could transform the lives of more than eight million people living with Parkinson's disease, potentially replacing the need for multiple daily tablets. Scientists from the University of South Australia [...]
Most Plastic in the Ocean Is Invisible—And Deadly
Nanoplastics—particles smaller than a human hair—can pass through cell walls and enter the food web. New research suggest 27 million metric tons of nanoplastics are spread across just the top layer of the North [...]
Repurposed drugs could calm the immune system’s response to nanomedicine
An international study led by researchers at the University of Colorado Anschutz Medical Campus has identified a promising strategy to enhance the safety of nanomedicines, advanced therapies often used in cancer and vaccine treatments, [...]
Nano-Enhanced Hydrogel Strategies for Cartilage Repair
A recent article in Engineering describes the development of a protein-based nanocomposite hydrogel designed to deliver two therapeutic agents—dexamethasone (Dex) and kartogenin (KGN)—to support cartilage repair. The hydrogel is engineered to modulate immune responses and promote [...]
New Cancer Drug Blocks Tumors Without Debilitating Side Effects
A new drug targets RAS-PI3Kα pathways without harmful side effects. It was developed using high-performance computing and AI. A new cancer drug candidate, developed through a collaboration between Lawrence Livermore National Laboratory (LLNL), BridgeBio Oncology [...]
Scientists Are Pretty Close to Replicating the First Thing That Ever Lived
For 400 million years, a leading hypothesis claims, Earth was an “RNA World,” meaning that life must’ve first replicated from RNA before the arrival of proteins and DNA. Unfortunately, scientists have failed to find [...]
Why ‘Peniaphobia’ Is Exploding Among Young People (And Why We Should Be Concerned)
An insidious illness is taking hold among a growing proportion of young people. Little known to the general public, peniaphobia—the fear of becoming poor—is gaining ground among teens and young adults. Discover the causes [...]
Team finds flawed data in recent study relevant to coronavirus antiviral development
The COVID pandemic illustrated how urgently we need antiviral medications capable of treating coronavirus infections. To aid this effort, researchers quickly homed in on part of SARS-CoV-2's molecular structure known as the NiRAN domain—an [...]
Drug-Coated Neural Implants Reduce Immune Rejection
Summary: A new study shows that coating neural prosthetic implants with the anti-inflammatory drug dexamethasone helps reduce the body’s immune response and scar tissue formation. This strategy enhances the long-term performance and stability of electrodes [...]
Scientists discover cancer-fighting bacteria that ‘soak up’ forever chemicals in the body
A family of healthy bacteria may help 'soak up' toxic forever chemicals in the body, warding off their cancerous effects. Forever chemicals, also known as PFAS (per- and polyfluoroalkyl substances), are toxic chemicals that [...]
Johns Hopkins Researchers Uncover a New Way To Kill Cancer Cells
A new study reveals that blocking ribosomal RNA production rewires cancer cell behavior and could help treat genetically unstable tumors. Researchers at the Johns Hopkins Kimmel Cancer Center and the Department of Radiation Oncology and Molecular [...]