AI Article Synopsis

  • - This study compared the effectiveness and immune response of a recombinant influenza vaccine (RIV) to a standard-dose inactivated influenza vaccine (SD IIV) among frontline workers and students aged 18-64 during the 2022-2023 influenza season.
  • - A total of 3,988 participants were enrolled; 20 cases of confirmed influenza were found in the RIV group compared to 28 in the SD IIV group, suggesting a 29% relative vaccine effectiveness for RIV, though not statistically significant.
  • - The RIV showed stronger immune responses for two out of four vaccine strains at one month and three out of four at six months post-vaccination, indicating potential for better and longer-lasting protection

Article Abstract

Background: Immunogenicity studies suggest that recombinant influenza vaccine (RIV) may provide better protection against influenza than standard-dose inactivated influenza vaccines (SD IIV). This randomized trial evaluated the relative vaccine effectiveness (VE) and immunogenicity of RIV versus SD IIV in frontline workers and students aged 18-64 years.

Methods: Participants were randomized to receive RIV or SD IIV and followed for reverse-transcription polymerase chain reaction (RT-PCR)-confirmed influenza during the 2022-2023 influenza season. Sera were collected from a subset of participants before and at 1 and 6 months postvaccination and tested by hemagglutination inhibition for A/H1N1, A/H3N2, B/Yamagata, and B/Victoria and against cell-grown vaccine reference viruses for A/H1N1 and A/H3N2.

Results: Overall, 3988 participants were enrolled and vaccinated (25% of the trial sample size goal); RT-PCR-confirmed influenza occurred in 20 of 1963 RIV recipients and 28 of 1964 SD IIV recipients. Relative VE was 29% (95% confidence interval [CI], -26% to 60%). In the immunogenicity substudy (n = 118), the geometric mean titer ratio (GMTR) comparing RIV to SD IIV at 1 month was 2.3 (95% CI, 1.4-3.7) for cell-grown A/H1N1, 2.1 (95% CI, 1.3-3.4) for cell-grown A/H3N2, 1.1 (95% CI, .7-1.6) for B/Victoria, and 1.4 (95% CI, .9-2.0) for B/Yamagata. At 6 months, GMTRs were >1 against A/H1N1, A/H3N2, and B/Yamagata.

Conclusions: Relative VE of RIV compared to SD IIV did not reach statistical significance, but RIV elicited more robust humoral immune responses to 2 of 4 vaccine viruses at 1 month and 3 of 4 viruses at 6 months after vaccination, suggesting possible improved and sustained immune protection from RIV. NCT05514002.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11482004PMC
http://dx.doi.org/10.1093/ofid/ofae559DOI Listing

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