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RIV4 in Nursing Home Residents

Trial question
What is the effect of recombinant influenza vaccine immunization in nursing homes residents?
Study design
Multi-center
Open label
RCT
Population
Characteristics of study participants
63.0% female
37.0% male
N = 144565
144565 patients (91077 female, 53488 male).
Inclusion criteria: older adults aged ≥ 65 years residing in nursing homes for > 100 days before the start of influenza season.
Key exclusion criteria: hospital-based facilities; enhanced influenza vaccine in the previous influenza season.
Interventions
N=72005 recombinant influenza vaccine (recombinant quadrivalent influenza vaccine during 2019-2020 and/or 2020-2021 influenza seasons).
N=72560 standard influenza vaccine (egg-based quadrivalent inactivated influenza vaccine during 2019-2020 and/or 2020-2021 influenza seasons).
Primary outcome
Respiratory-related hospitalizations
1.93%
1.96%
2.0 %
1.5 %
1.0 %
0.5 %
0.0 %
Recombinant influenza vaccine
Standard influenza vaccine
No significant difference ↔
No significant difference in respiratory-related hospitalizations (1.93% vs. 1.96%; HR 1.01, 95% CI 0.62 to 2.17).
Secondary outcomes
No significant difference in hospitalization from any cause (15.5% vs. 16%; HR 0.98, 95% CI 0.79 to 1.45).
No significant difference in death from any cause (18.7% vs. 19.1%; HR 0.98, 95% CI 0.79 to 2.01).
No significant difference in hospitalization related to pneumonia and influenza (0.8% vs. 0.8%; HR 0.98, 95% CI 0.41 to 2.47).
Conclusion
In older adults aged ≥ 65 years residing in nursing homes for > 100 days before the start of influenza season, recombinant influenza vaccine was not superior to standard influenza vaccine with respect to a respiratory-related hospitalizations.
Reference
Kevin W McConeghy, H Edward Davidson, David H Canaday et al. Recombinant vs Egg-Based Quadrivalent Influenza Vaccination for Nursing Home Residents: A Cluster Randomized Trial. JAMA Netw Open. 2025 Jan 2;8(1):e2452677.
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