Geometric mean titer, range, and IQR for anti-spike IgG, anti-RBD IgG, anti-N IgG, and virus neutralizing capacity, by spike exposure and binned time periods—Georgia, December 2020– July 2022, n = 37.

*Spike exposure is defined as exposure to the viral spike protein due to either a SARS-CoV-2 infection(s) or a dose(s) of an mRNA COVID-19 vaccine receipt. The primary series was considered as two spike exposures. †A SARS-CoV-2 infected participant was defined as a participant with infection documented in the electronic health record or confirmed by laboratory testing using real-time reverse-transcriptase polymerase chain reaction (rRT-PCR), point of care BinaxNOW™ COVID-19 Ag Card antigen test (BinaxNOW), or seroconversion as indicated by the presence of anti-nucleocapsid antibody (anti-N) IgG titer to SARS-CoV-2 above the cut-off for seropositivity using Meso Scale Discovery (MSD) immunoassay (MSD; Rockville, MD, USA). ‡An infection-naïve participant was defined as having an absence of a documented SARS-CoV-2 infection and negative SARS-CoV-2 laboratory test results, including seronegative for anti-N antibody. §Hybrid immunity was defined as the immune protection in individuals who have had one or more doses of an mRNA COVID-19 vaccine and have evidence of at least one SARS-CoV-2 infection before or after vaccination initiation. (XLSX)