Two cohorts, HIVE in Michigan and EPI-HK in Hong Kong, measured influenza antibody titres from 2020 to 2023. Sera came from 57 HIVE participants (173 samples) and 60 EPI-HK participants (259 samples), none infected or vaccinated. Haemagglutination inhibition and microneutralisation assays against vaccine strains gave two-year fold changes, adjusted for age and baseline titre. In HIVE, H1N1 titres fell: A/Brisbane 0.70, A/Idaho 0.40, A/Michigan 0.43; H3N2 and B changed little. In EPI-HK, H1N1 varied in direction, while A/Cambodia fell to 0.44 and A/Singapore to 0.48. Numbers were small and limited to uninfected, unvaccinated participants, so results may not generalise.
Why it is interesting: Antibody titres did not decline uniformly during a period of reduced influenza transmission. The strain-specific pattern informs how immunity gaps are assessed after suppressed circulation.
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