Abstract
WHAT IS ALREADY KNOWN ABOUT THIS TOPIC? Both the decline in immunity over time and the evolution of the virus play a role in the level of protection offered by a prior infection. WHAT IS ADDED BY THIS REPORT? Point estimates indicated variations in protection levels based on the initial infecting variant and the reinfecting variant. There was a consistent correlation between real-world protection, antigenic distance, and humoral immunity levels. Specifically, shorter antigenic distances and higher humoral immunity levels corresponded to enhanced real-world protection. WHAT ARE THE IMPLICATIONS FOR PUBLIC HEALTH PRACTICE? Our findings suggest that virological and immunological studies could help identify and assess the epidemic risk posed by new variants before they become dominant. Prompt incorporation of the latest variants into the antigen components of the coronavirus disease 2019 (COVID-19) vaccines can significantly contribute to effective epidemic prevention and control measures.