Rapid communication Open Access
Like 0


In Navarre, Spain, in May 2022, the seroprevalence of anti-nucleocapsid (N) and anti-spike (S) antibodies of SARS-CoV-2 was 58.9% and 92.7%, respectively. The incidence of confirmed COVID-19 thereafter through July was lower in people with anti-N antibodies (adjusted odds ratio (aOR) = 0.08; 95% confidence interval (CI): 0.05–0.13) but not with anti-S antibodies (aOR = 1.06; 95% CI: 0.47–2.38). Hybrid immunity, including anti-N antibodies induced by natural exposure to SARS-CoV-2, seems essential in preventing Omicron COVID-19 cases.


Article metrics loading...

Loading full text...

Full text loading...



  1. Altarawneh HN, Chemaitelly H, Ayoub HH, Tang P, Hasan MR, Yassine HM, et al. Effects of previous infection and vaccination on symptomatic Omicron infections. N Engl J Med. 2022;387(1):21-34. . Available from: https://www.nejm.org/doi/full/10.1056/NEJMoa2203965 https://doi.org/10.1056/NEJMoa2203965  PMID: 35704396 
  2. World Health Organization (WHO). Interim statement on hybrid immunity and increasing population seroprevalence rates. Geneva: WHO; 1 Jun 2022. Available from: https://www.who.int/news/item/01-06-2022-interim-statement-on-hybrid-immunity-and-increasing-population-seroprevalence-rates
  3. Brandal LT, MacDonald E, Veneti L, Ravlo T, Lange H, Naseer U, et al. Outbreak caused by the SARS-CoV-2 Omicron variant in Norway, November to December 2021. Euro Surveill. 2021;26(50):2101147.  https://doi.org/10.2807/1560-7917.ES.2021.26.50.2101147  PMID: 34915975 
  4. Instituto de Salud Pública y Laboral de Navarra. Informe Epidemiológico Semanal 28/2022 (11 al 17 de julio de 2022). [Weekly epidemiological report 28/2022 (11–17 July 2022)]. Pamplona: Instituto de Salud Pública y Laboral de Navarra; 2022. Spanish. Available from: http://www.navarra.es/NR/rdonlyres/3855C06B-B6A2-4E05-BA57-034AB7947A04/481355/InformeEpidemiologicoSemanal28_2022.pdf
  5. Centro de Coordinación de Alertas y Emergencias Sanitarias. Variantes de SARS-CoV-2 en España: linaje BA.2.12.1, BA.4 y BA.5 de Ómicron. [SARS-CoV-2 variants in Spain: Omicron lineages BA.2.12.1, BA.4 and BA.5]. Madrid: Ministerio de Sanidad; 2022. Spanish. Available from: https://www.sanidad.gob.es/profesionales/saludPublica/ccayes/alertasActual/nCov/documentos/20220628-ERR.pdf
  6. European Centre for Disease Prevention and Control (ECDC). Country overview report: week 28 2022. Stockholm: ECDC; 22 Jul 2022. Available from: https://covid19-country-overviews.ecdc.europa.eu/#weekly_surveillance_summary
  7. European Centre for Disease Prevention and Control (ECDC). Epidemiological update: SARS-CoV-2 Omicron sub-lineages BA.4 and BA.5. Stockholm: ECDC; 2022. Available from: https://www.ecdc.europa.eu/en/news-events/epidemiological-update-sars-cov-2-omicron-sub-lineages-ba4-and-ba5
  8. Consejo Interterritorial del Sistema Nacional de Salud. Principales cambios en las Actualizaciones de la Estrategia de Vacunación frente a COVID-19 en España. [Main changes in the updates of the vaccination strategy against COVID-19 in Spain]. Madrid: Ministerio de Sanidad, Consumo y Bienestar Social. [Accessed: 12 Aug 2022]. Spanish. Available from: https://www.sanidad.gob.es/profesionales/saludPublica/prevPromocion/vacunaciones/covid19/Actualizaciones_Estrategia_Vacunacion/docs/COVID-19_ActualizacionesTablaResumen_EstrategiaVacunacion.pdf
  9. Health Department, Government of Navarre. Encuesta de seroprevalencia de anticuerpos frente al SARS-CoV-2 en pacientes de atención primaria de Navarra. [Seroprevalence of antibodies against SARS-CoV-2 in Navarre]. Pamplona: Departamento de Salud de Navarra; 2022. Spanish. Available from: http://www.navarra.es/NR/rdonlyres/60EC3E70-CD63-4424-9CED-0382BB32D093/481539/Informe_FINAL_SEROPREVALENCIA_SARSCoV2.pdf
  10. Ward H, Whitaker M, Flower B, Tang SN, Atchison C, Darzi A, et al. Population antibody responses following COVID-19 vaccination in 212,102 individuals. Nat Commun. 2022;13(1):907.  https://doi.org/10.1038/s41467-022-28527-x  PMID: 35173150 
  11. Jones JM, Stone M, Sulaeman H, Fink RV, Dave H, Levy ME, et al. Estimated US infection- and vaccine-induced SARS-CoV-2 seroprevalence based on blood donations, July 2020-May 2021. JAMA. 2021;326(14):1400-9.  https://doi.org/10.1001/jama.2021.15161  PMID: 34473201 
  12. Martínez-Baz I, Trobajo-Sanmartín C, Miqueleiz A, Guevara M, Fernández-Huerta M, Burgui C, et al. Product-specific COVID-19 vaccine effectiveness against secondary infection in close contacts, Navarre, Spain, April to August 2021. Euro Surveill. 2021;26(39):2100894.  https://doi.org/10.2807/1560-7917.ES.2021.26.39.2100894  PMID: 34596016 
  13. Hall V, Foulkes S, Insalata F, Kirwan P, Saei A, Atti A, et al. Protection against SARS-CoV-2 after Covid-19 Vaccination and Previous Infection. N Engl J Med. 2022;386(13):1207-20.  https://doi.org/10.1056/NEJMoa2118691  PMID: 35172051 
  14. Nordström P, Ballin M, Nordström A. Risk of SARS-CoV-2 reinfection and COVID-19 hospitalisation in individuals with natural and hybrid immunity: a retrospective, total population cohort study in Sweden. Lancet Infect Dis. 2022;22(6):781-90.  https://doi.org/10.1016/S1473-3099(22)00143-8  PMID: 35366962 
  15. Martínez-Baz I, Miqueleiz A, Casado I, Navascués A, Trobajo-Sanmartín C, Burgui C, et al. Effectiveness of COVID-19 vaccines in preventing SARS-CoV-2 infection and hospitalisation, Navarre, Spain, January to April 2021. Euro Surveill. 2021;26(21):2100438.  https://doi.org/10.2807/1560-7917.ES.2021.26.21.2100438  PMID: 34047271 
  16. Sentís A, Kislaya I, Nicolay N, Meijerink H, Starrfelt J, Martínez-Baz I, et al. Estimation of COVID-19 vaccine effectiveness against hospitalisation in individuals aged ≥ 65 years using electronic health registries; a pilot study in four EU/EEA countries, October 2021 to March 2022. Euro Surveill. 2022;27(30):2200551.  https://doi.org/10.2807/1560-7917.ES.2022.27.30.2200551  PMID: 35904059 
  17. Suarez Castillo M, Khaoua H, Courtejoie N. Vaccine-induced and naturally-acquired protection against Omicron and Delta symptomatic infection and severe COVID-19 outcomes, France, December 2021 to January 2022. Euro Surveill. 2022;27(16):2200250.  https://doi.org/10.2807/1560-7917.ES.2022.27.16.2200250  PMID: 35451363 

Data & Media loading...

Submit comment
Comment moderation successfully completed
This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error