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PLoS One . High rates of SARS-CoV-2 reinfection in residents of long term care facilities despite robust spike-specific immunity following serial v

tetano

Editor, Senior Moderator
PLoS One


. 2026 Aug 14;21(8):e0354079.
doi: 10.1371/journal.pone.0354079. eCollection 2026.
High rates of SARS-CoV-2 reinfection in residents of long term care facilities despite robust spike-specific immunity following serial vaccination

Gokhan Tut[SUP] 1 [/SUP], Tara Lancaster[SUP] 1 [/SUP], Panagiota Sylla[SUP] 1 [/SUP], David Bone[SUP] 1 [/SUP], Christopher Bentley[SUP] 1 [/SUP], Azar Jadir[SUP] 1 [/SUP], Rachel Bruton[SUP] 1 [/SUP], Katie Spencer[SUP] 1 [/SUP], Soumyajit Mallick[SUP] 1 [/SUP], Ahmed Elzaidi[SUP] 1 [/SUP], Alexander Dowell[SUP] 1 [/SUP], Mary Wu[SUP] 2 [/SUP], Ruth Harvey[SUP] 3 [/SUP], Edward Carr[SUP] 4 5 6 [/SUP], Rupert Beale[SUP] 4 5 6 [/SUP], Maria Krutikov[SUP] 7 [/SUP], Oliver Stirrup[SUP] 8 [/SUP], Borscha Azmi[SUP] 7 [/SUP], Andrew Hayward[SUP] 9 [/SUP], Andrew Copas[SUP] 8 [/SUP], Laura Shallcross[SUP] 7 [/SUP], Paul Moss[SUP] 1 [/SUP]; Crick COVID Immunity Pipeline


Affiliations
Abstract

Older adult residents of long-term care facilities (LTCFs) suffered high rates of mortality during the initial stages of the COVID-19 pandemic but their clinical risk has decreased markedly following vaccination. Here we determined humoral and cellular immunity following delivery of a 5th vaccine dose, an mRNA spike B1:BA.1 bivalent vaccine, to care home residents. The delivery of a 5th vaccine elicited a plateau of spike-specific immunity that remained broadly stable over 100 days in almost all people. Despite this, 15% of residents had a primary infection and 30% became reinfected during 6-months of follow up. These findings reveal that serial vaccine delivery can establish robust systemic spike-specific immune responses in frail older people but that this does not reliably prevent SARS-CoV-2 reinfection. As such, additional approaches should be considered to reduce reinfection risk in this vulnerable population group.


 
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