The magnitude and timing of recalled immunity after breakthrough infection is shaped by SARS-CoV-2 variants.

Vaccination against SARS-CoV-2 protects from infection and improves clinical outcomes in breakthrough infections, likely reflecting residual vaccine-elicited immunity and recall of immunological memory. Here, we define the early kinetics of spike-specific humoral and cellular immunity after vaccination of seropositive individuals and after Delta or Omicron breakthrough infection in vaccinated individuals. Early longitudinal sampling revealed the timing and magnitude of recall, with the phenotypic activation of B cells preceding an increase in neutralizing antibody titers.

Establishment and recall of SARS-CoV-2 spike epitope-specific CD4 T cell memory.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and vaccination elicit CD4 T cell responses to the spike protein, including circulating follicular helper T (cT) cells that correlate with neutralizing antibodies. Using a novel HLA-DRB1*15:01/S tetramer to track spike-specific CD4 T cells, we show that primary infection or vaccination induces robust S-specific CXCR5 and cT cell memory responses. Secondary exposure induced recall of CD4 T cells with a transitory CXCR3 phenotype, and drove expansion of cT cells transiently expressing ICOS, CD38 and PD-1.