ArticleMedical science monitor : international medical journal of experimental and clinical research2026
Long-Term Durability and Dynamics of Anti-S-RBD IgG Response in Healthcare Workers: A Comparative Analysis of Homologous and Heterologous SARS-CoV-2 Vaccination Schedules in a 1-Year Serial Cross-Sectional Study.
Article in Medical science monitor : international medical journal of experimental and clinical research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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10 authors.
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Abstract
BACKGROUND The waning of post-vaccination immunity necessitates effective booster strategies, especially for high-risk healthcare workers (HCWs). This study aimed to compare the 1-year antibody response dynamics of homologous and heterologous SARS-CoV-2 vaccination schedules in Turkish HCWs. MATERIAL AND METHODS This prospective, serial cross-sectional study included 307 HCWs grouped by vaccination history reflecting the national vaccination program: homologous inactivated (SSS, 3 doses of CoronaVac), homologous mRNA (BBB, 3 doses of mRNA-BNT162b2), and heterologous mRNA-boosted (SSB, SSBB, SSBBB; where S represents CoronaVac and B represents BNT162b2). Anti-S-RBD IgG levels were measured at 3 time points between December 2021 and September 2022. Statistical analyses were performed using Mann-Whitney U and Kruskal-Wallis tests. RESULTS The SSS group showed significantly lower antibody levels (median: 77.5 AU/mL) compared to all mRNA-containing groups (P<0.001). No significant difference was found between the BBB group and heterologous regimens (P>0.05), indicating an mRNA booster dose achieves a humoral response comparable to a full mRNA series. Antibody levels waned significantly over time in all mRNA-containing groups (P<0.05) but remained stable in the SSS group (P=0.987). Natural infection significantly increased antibody levels only in the SSS group (P=0.014), suggesting a ceiling effect in mRNA-vaccinated individuals. No serious adverse events were reported. CONCLUSIONS Homologous inactivated vaccination results in lower but more stable antibody levels. In contrast, both homologous mRNA and heterologous mRNA-boosted schedules achieve higher, albeit waning, antibody titers. The presence of at least 1 mRNA vaccine dose is the primary driver of high anti-S-RBD IgG levels. These findings support using heterologous mRNA boosters to enhance humoral immunity in individuals primed with inactivated vaccines.
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