People who have had three exposures to the COVID spike protein enjoy high quality protection against the virus in all its known forms, according to a detailed German study.
The researchers said three doses of vaccine or a dose of infection and two doses of vaccine would be equally effective.
In the research, the Omicron variant showed the most "pronounced evasion" of antibodies – but the researchers conclude that after three exposures to the spike protein there was "high level neutralising activity".
The research, reported in *Nature Communications*, was a long-term study of 171 people undertaken in Munich, involving Ludwig-Maximilians-Universitaet (LMU), Helmholtz Munich and Technical University of Munich.
Researcher Professor Percy Knolle, from the Technical University, said: "This longitudinal study is particularly exciting, because we can follow how the immune response evolves over time against the virus and after vaccination.
"The immunity built up or strengthened by means of vaccination is key to effective protection against future variants of the virus. A recent breakthrough infection – as irritating and undesirable as it is – has in fact the same effect as an additional vaccination on this important arm of the immune system."
Fellow researcher Professor Oliver Keppler, from LMU, said: "In all cases, the neutralization activity reached similarly high levels and this was paralleled by an increased binding strength of the antibodies."
Three exposures to the spike protein of SARS-CoV-2 by either infection or vaccination elicit superior neutralizing immunity to all variants of concern. *Nature Medicine* 28 January 2022
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