{"doi":"10.1172/jci176411","title":"Contralateral second dose improves antibody responses to a 2-dose mRNA vaccination regimen","abstract":"BACKGROUNDVaccination is typically administered without regard to site of prior vaccination, but this factor may substantially affect downstream immune responses.METHODSWe assessed serological responses to initial COVID-19 vaccination in baseline seronegative adults who received second-dose boosters in the ipsilateral or contralateral arm relative to initial vaccination. We measured serum SARS-CoV-2 spike-specific Ig, receptor-binding domain-specific (RBD-specific) IgG, SARS-CoV-2 nucleocapsid-specific IgG, and neutralizing antibody titers against SARS-CoV-2.D614G (early strain) and SARS-CoV-2.B.1.1.529 (Omicron) at approximately 0.6, 8, and 14 months after boosting.RESULTSIn 947 individuals, contralateral boosting was associated with higher spike-specific serum Ig, and this effect increased over time, from a 1.1-fold to a 1.4-fold increase by 14 months (P < 0.001). A similar pattern was seen for RBD-specific IgG. Among 54 pairs matched for age, sex, and relevant time intervals, arm groups had similar antibody levels at study visit 2 (W2), but contralateral boosting resulted in significantly higher binding and neutralizing antibody titers at W3 and W4, with progressive increase over time, ranging from 1.3-fold (total Ig, P = 0.007) to 4.0-fold (pseudovirus neutralization to B.1.1.529, P < 0.001).CONCLUSIONSIn previously unexposed adults receiving an initial vaccine series with the BNT162b2 mRNA COVID-19 vaccine, contralateral boosting substantially increases antibody magnitude and breadth at times beyond 3 weeks after vaccination. This effect should be considered during arm selection in the context of multidose vaccine regimens.FUNDINGM.J. Murdock Charitable Trust, OHSU Foundation, NIH.","journal":"Journal of Clinical Investigation","year":2024,"id":430871,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":17,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9552,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2024-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":333943,"name":"Archana Thomas","orcid":"0000-0002-5943-5004","position":1,"is_corresponding":false},{"id":1234722,"name":"Abram E. Estrada","orcid":null,"position":2,"is_corresponding":false},{"id":1234723,"name":"Hiro A.P. Ross","orcid":null,"position":3,"is_corresponding":false},{"id":630440,"name":"David X. Lee","orcid":"0000-0003-0375-250X","position":4,"is_corresponding":false},{"id":772851,"name":"Steven C. Kazmierczak","orcid":"0000-0002-4668-4634","position":5,"is_corresponding":false},{"id":314328,"name":"Mark K. Slifka","orcid":"0000-0001-8205-6136","position":6,"is_corresponding":false},{"id":103755,"name":"David C. Montefiori","orcid":"0000-0003-0856-6319","position":7,"is_corresponding":false},{"id":279586,"name":"William B. Messer","orcid":"0000-0002-4381-6347","position":8,"is_corresponding":false},{"id":535084,"name":"Marcel E. Curlin","orcid":"0000-0003-3481-3889","position":9,"is_corresponding":false},{"id":1234721,"name":"Sedigheh Fazli","orcid":null,"position":0,"is_corresponding":true}],"reference_count":42,"raw_metadata":null,"created_at":"2026-07-19T01:59:20.861374Z","pmid":"38227381","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}