The humoral response against the S protein can be elicited through natural infection or immunization, and immune protection against symptomatic SARS-CoV-2 hinges on the levels of neutralizing antibodies [
25]. It is suggested that nAbs against the S protein may be both low in quantity and short duration due to the structural properties of coronaviruses [
26]. Notably, the N-terminal and the receptor-binding domain are considered immunodominant and are the primary targets of nAbs. However, nAbs can also target regions such as the S2 stem helix (SH) and the S2 fusion peptide (FP) [
17,
27]. Antibodies binding to the RBD constitute over 90% of the neutralizing activity in convalescent sera [
7]. nAbs exhibit four main classes based on the location of their epitopes within the Spike protein [
3]. Classes 1 and 2 nAbs primarily target the RBD, including the receptor-binding motif, and can compete with ACE2 binding. Class 3 RBD nAbs bind to regions flanking the ACE2-binding region, while class 4 nAbs are highly conserved in the RBD but do not directly block ACE2-RBD binding [
3]. Various monoclonal antibodies have been identified to bind to the RBM region [
15]. However, there remains limited knowledge regarding the diversity of antibodies produced. The RBM region is pivotal for ACE2 receptor binding and comprises the knob (aa 444-449 and aa 496-505), base (aa 490-494 and aa 450-456), and tip (aa 473-489) [
8]. Many nAbs against SARS-CoV-2 are found to bind to the tip of the RBM, particularly in or around the FNCY patch [
15]. The MST analysis conducted in this study corroborates the significance of these residues in antibody binding affinity. A recent study highlighted the importance of RBD folding to antibody binding and immunization. Most IgG responses were produced for folded RBD; conformational epitopes play major roles in this region [
19] and correlate with high virus neutralization. In the same study, authors reported that out of the 253 COVID-19 patients, 20% lacked RBD-specific IgG antibodies, possibly due to genetic factors such as human leukocyte antigen (HLA) restriction and insufficient T/B-cell responses [
19]. Despite the dominance of conformational epitopes in the RBD, our data showed that immunization also produced in some individuals (~20%) the development of antibodies to linear RBM epitopes. Linear epitopes to RBD showed a low neutralization profile [
19] but have diagnostic significance since many proteins are not designed to be correctly folded in diagnostic tests. Immune evasion by variants of concern is primarily driven by mutations in the S protein that compromise both natural and vaccine-induced immunity. The Omicron variant accumulates mutations in the RBM, including ten mutations in this region. Some of these mutations directly interfere with ACE2 binding, affecting important residues in the RBM, such as those at positions Q493, Q498, N501, and Y505 [
28,
29]. A comparison of the immunogenicity of RBM, RBD, and the entire S protein reveals that the RBM region displays reduced seroreactivity [
15,
20]. However, mouse immunization with RBD or RBM vaccines has induced nAbs [
30,
31]. According to our data, adenovirus vaccines containing Se mRNA, such as Astra-Zeneca-Oxford or combined heterologous mRNA vaccines, seem to induce low titers of anti-RBM antibodies. The diminished sera reactivity observed in our study may be attributed to Major Histocompatibility Complex class II (MHC-II) restriction [
32]. A study examining common MHC-II alleles predicted poor binding for the RBM, suggesting a lack of MHC-II support in T-B cooperation, which impacts the production of nAbs in the general population [
31]. Effective antibody responses necessitate cooperation between a B cell and a CD4 T cell (helper cell) activated by an epitope on the same antigen recognized by the B cell (T-B cooperation). Nonetheless, T-B cooperation is limited by MHC-II molecules [
33]. Thus, studying B and T cell epitopes and the HLA polymorphism in different populations is relevant for vaccine design [
34]. A recent study demonstrated that the HLA profile influences the variability of both humoral and cellular responses to the mRNA vaccine. An association was found between HLA haplotype and high antibody concentration and or low humoral responses to Spike antigens [
35]. Another study revealed that variation in humoral responses against SARS-CoV-2 spike and the RBD at 28 days after the first vaccination (ChAdOx1-S) shows genome-wide significant association with major MHC-II alleles [
36].