Evidence map›Paper›PMID 42081247›Full record

Trial reportJAMA network open2026

Adjuvanted vs High-Dose Influenza Vaccines in Older US Adults: A Cluster Randomized Crossover Study.

Amber Hsiao, Thomas Leong, Bruce Fireman, John Hansen, Ousseny Zerbo, Karen B Jacobson, Lauren D Liao, Mendel D M Haag, Ian McGovern, Bin Zhang and 2 more

Registry-linked trialAbstract readRandomized Controlled Trial
In one paragraph

Trial report in JAMA network open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06029933 (Relative Vaccine Effectiveness of Adjuvanted Inactivated Influenza Vaccine), which is not on this map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT06029933 recruitingnot on this map

Relative Vaccine Effectiveness of Adjuvanted Inactivated Influenza Vaccine (aIIV) vs High-Dose Inactivated Influenza Vaccine (HD-IIV) for Prevention of Lab-Confirmed Influenza Among Adults ≥65 Years of Age in the United States

TypeobservationalSponsorKaiser PermanenteRan2023 to 2028Enrolled1,500,000ConditionsInfluenza, Community-acquired Pneumonia, Cardiovascular EventsArmsAdjuvanted Quadrivalent Inactivated Influenza Vaccine (aIIV4), High-Dose Quadrivalent Inactivated Influenza Vaccine (HD-IIV4)
3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Amber HsiaoKaiser Permanente Vaccine Study Center, Oakland, California.
Thomas LeongKaiser Permanente Vaccine Study Center, Oakland, California.
Bruce FiremanKaiser Permanente Vaccine Study Center, Oakland, California.
John HansenKaiser Permanente Vaccine Study Center, Oakland, California.
Ousseny ZerboKaiser Permanente Vaccine Study Center, Oakland, California.
Karen B JacobsonKaiser Permanente Vaccine Study Center, Oakland, California.
Lauren D LiaoKaiser Permanente Vaccine Study Center, Oakland, California.
Mendel D M HaagCSL Seqirus, Amsterdam, the Netherlands.
Ian McGovernCSL Seqirus, Waltham, Massachusetts.
Bin ZhangCSL Seqirus, Waltham, Massachusetts.
Juliet DangCSL Seqirus, Summit, New Jersey.
Nicola P KleinKaiser Permanente Vaccine Study Center, Oakland, California.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Importance: In the US, adjuvanted or higher-dose influenza vaccines are preferentially recommended for annual use among adults aged 65 years or older. Adjuvanted and high-dose influenza vaccines have not been compared in a pragmatic randomized study. Objective: To assess the relative vaccine effectiveness (rVE) of adjuvanted vs high-dose inactivated influenza vaccine against polymerase chain reaction (PCR)-confirmed influenza in older adults at Kaiser Permanente Northern California (KPNC). Design, Setting, and Participants: In this cluster randomized crossover study, during the 2023 to 2024 influenza season, 65 KPNC facilities were cluster randomized such that approximately half of facilities administered adjuvanted and half high-dose influenza vaccine on the first week of the vaccination season (and thereafter every facility crossed over and alternated formulations weekly). Using Cox proportional hazards regression on a calendar time scale, the rVE of adjuvanted vs high-dose vaccine was estimated for each outcome as 1 minus the hazard ratio, adjusted for age, sex, race and ethnicity, comorbidities, and health care utilization. Study participants included all adults 65 years or older who were vaccinated with adjuvanted or high-dose inactivated influenza vaccine during routine care at a KPNC facility between August 17, 2023, and April 16, 2024. Exposures: Adjuvanted or high-dose inactivated influenza vaccine receipt during the 2023 to 2024 influenza season. Individuals were considered vaccinated 14 days after immunization. Main Outcomes and Measures: The primary outcome was PCR-confirmed influenza in any clinical setting. Secondary outcomes were PCR-confirmed influenza with hospitalization or emergency department visits and hospitalization for community-acquired pneumonia. Outcomes were assessed starting October 1, 2023, or 14 days after vaccination, whichever came later. Results: This study included 429 595 individuals from the 2023 to 2024 influenza season (mean [SD] age, 75 [7] years; 236 857 [55.1%] female; 86 287 [20.1%] Asian, 22 910 [5.3%] Black, 53 820 [12.5%] Hispanic, 1123 [0.3%] American Indian or Alaska Native, 2562 [0.6%] Pacific Islander, 252 709 [58.8%] White, 1638 [0.4%] multiracial, and 8546 [2.0%] unknown race), of whom 212 875 (49.6%) received adjuvanted and 216 720 (50.4%) received high-dose influenza vaccine. There were 836 cases of PCR-confirmed influenza (3.9 per 1000 persons) identified after adjuvanted and 867 cases (4.0 per 1000 persons) after high-dose vaccine. The rVE of adjuvanted compared with high-dose influenza vaccine was 1.5% (95% CI, -8.4% to 10.5%) against influenza, 9.1% (95% CI, -4.0% to 20.4%) against influenza with hospitalization or emergency department visits, and 1.0% (95% CI, -11.4% to 12.0%) against hospitalizations for community-acquired pneumonia. Conclusion and Relevance: In the first season of a large, ongoing study in adults 65 years or older, adjuvanted and high-dose influenza vaccines did not differ in effectiveness against laboratory-confirmed influenza during the 2023 to 2024 influenza season. Consistent with Advisory Committee on Immunization Practices recommendations, these results support the equivalency of adjuvanted and high-dose influenza vaccines for adults 65 years or older. Trial Registration: ClinicalTrials.gov Identifier: NCT06029933.

Indexed as

Adjuvants, ImmunologicAdjuvants, VaccineInfluenza, HumanInfluenza VaccinesVaccine EfficacyAgedAged, 80 and overCaliforniaCross-Over StudiesFemaleHumansMaleProportional Hazards ModelsVaccines, InactivatedAdjuvants, ImmunologicAdjuvants, VaccineInfluenza VaccinesVaccines, Inactivated

Identifiers

PMID42081247
PMCPMC13139963

What OpenQuestion holds

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.