{
  "abstract": "Background: Age is a crucial factor in COVID-19 risk and severity, however its role in humoral immunity is unclear. This study compares associations between age and immune response following COVID-19 vaccination and SARS-CoV-2 infection. Methods: Data from the Arizona Healthcare, Emergency Response, and Other Essential Workers study (AZ-HEROES), a prospective cohort, were used to create two analytic groups: 1) a post-vaccination cohort including individuals who received two doses of the monovalent ancestral mRNA COVID-19 vaccine without prior SARS-CoV-2 infection; and 2) a post-infection cohort including unvaccinated individuals after primary infection. The analysis included data from September 2020 to April 2023. Children (<18 years) and adults (18 + years) were compared using linear regression, with immune response measured using log-transformed area under the curve (AUC) for receptor-binding domain (RBD) and spike protein subunit (S2). Finer age groups (<12, 12−17, 18−50, 50+) were also described. Adjusted models controlled for chronic conditions, medications, days since vaccination or infection, recent exposure to SARS-CoV-2 (post-vaccination only), strain type (post-infection only), and sociodemographic variables. Results: The post-vaccination analysis included 749 participants, while the post-infection analysis included 203 participants. Participants were predominantly non-Hispanic White adults, with median ages of 43 and 40 years in the post-vaccination and post-infection cohorts, respectively. Most reported no chronic conditions. In adjusted post-vaccination analysis, adults had 7% higher RBD AUC (95% CI: 1.01–1.13) and 20% higher S2 AUC (95% CI: 1.13, 1.28) than children, although these results were attenuated when restricted to individuals taking the BNT162b2 vaccine only. Post-infection, adults had 22% higher S2 AUC (95% CI: 1.05, 1.40), while RBD differences were not significant. By finer age breakdown, adolescents (12−17 years) had stronger responses than children younger than 12 post-vaccination, with 26% higher RBD AUC (95% CI: 1.13–1.40) and 29% higher S2 AUC (95% CI: 1.14–1.46). Conclusions: COVID-19 immune responses differ between children and adults, with adolescents exhibiting stronger immune response to vaccination than children younger than 12, however vaccine dosage may play a role in this observed difference. Age-related differences after infection were limited to S2 antibody responses.",
  "abstract_shown": true,
  "affiliations": [
    "Epidemiology and Biostatistics Department, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, Arizona, United States of America",
    "Department of Immunobiology, University of Arizona, Tucson, Arizona, United States of America",
    "Department of Community, Environment and Policy, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, Arizona, United States of America",
    "Family and Community Medicine, College of Medicine – Tucson, University of Arizona, Tucson, Arizona, United States of America",
    "University of Arizona Genetics Core, Office for Research, Innovation and Impact, University of Arizona, Tucson, Arizona, United States of America"
  ],
  "article_type": "Research Article",
  "arxiv": null,
  "author_total": 9,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Brooke A. Hawkes"
    },
    {
      "affs": [
        1
      ],
      "name": "James Hollister"
    },
    {
      "affs": [
        2
      ],
      "name": "Cynthia Porter"
    },
    {
      "affs": [
        3
      ],
      "name": "Zoe L. Lyski"
    },
    {
      "affs": [
        4
      ],
      "name": "Jefferey L. Burgess"
    },
    {
      "name": "Karen Lutrick"
    },
    {
      "name": "Shawn C. Beitel"
    },
    {
      "name": "Ryan S. Sprissler"
    },
    {
      "name": "Katherine D. Ellingson"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/1wfyqv4shzf01.bib",
  "cited_by": 0,
  "doi": "10.1371/journal.pone.0356178",
  "fulltext_url": null,
  "id": "1wfyqv4shzf01",
  "issns": [
    "1932-6203"
  ],
  "landing_url": "https://doi.org/10.1371/journal.pone.0356178",
  "language": null,
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "journal",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2725|SARS-CoV-2 and COVID-19 Research"
    ],
    [
      "plos",
      "/Biology and life sciences/Biochemistry/Proteins/Immune system proteins/Antibodies"
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      "/Biology and life sciences/Microbiology/Medical microbiology/Microbial pathogens/Viral pathogens/Coronaviruses/SARS coronavirus/SARS CoV 2"
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      "/Biology and life sciences/Organisms/Viruses/RNA viruses/Coronaviruses/SARS coronavirus/SARS CoV 2"
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      "/Biology and life sciences/Organisms/Viruses/Viral pathogens/Coronaviruses/SARS coronavirus/SARS CoV 2"
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      "/Medicine and health sciences/Medical conditions/Infectious diseases/Infectious disease control/Vaccines"
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      "plos",
      "/Medicine and health sciences/Medical conditions/Infectious diseases/Viral diseases/COVID 19"
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      "plos",
      "/Medicine and health sciences/Pathology and laboratory medicine/Pathogens/Microbial pathogens/Viral pathogens/Coronaviruses/SARS coronavirus/SARS CoV 2"
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  "openalex": "W7206177497",
  "pdf_url": null,
  "pmcid": null,
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  "published": "2026-09-02",
  "publisher": "Public Library of Science",
  "ris": "https://research.draconitic.com/paper/1wfyqv4shzf01.ris",
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    {
      "first_seen": "2026-10-30T12:18:02Z",
      "native_id": "10.1371/journal.pone.0356178",
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      "url": "https://doi.org/10.1371/journal.pone.0356178"
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  "subjects": [
    {
      "field": "biology",
      "origin": "plos:immunology",
      "subfield": "immunology"
    }
  ],
  "title": "Age-specific humoral immune response to SARS-CoV-2: A comparative analysis of antibody levels in children and adults after vaccination with primary series or infection",
  "title_text": "Age-specific humoral immune response to SARS-CoV-2: A comparative analysis of antibody levels in children and adults after vaccination with primary series or infection",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:18:02Z",
  "url": "https://research.draconitic.com/paper/1wfyqv4shzf01",
  "venue": "PLOS One",
  "versions": []
}