{
  "abstract": "BackgroundRecombinant (RIV) and cell culture-based inactivated (ccIIV) influenza vaccines could improve seasonal influenza prevention; however, evidence is limited in how protection may differ among non-egg-based vaccines.\n\nMethodsWe conducted a randomized trial of RIV versus ccIIV to compare vaccine immunogenicity in adults aged 18 to 64 years during the 2024-25 influenza season (ClinicalTrials.gov, NCT06518577). Active surveillance for influenza-like illness was conducted for six months post-vaccination and cumulative incidence of influenza by vaccine type was compared to estimate relative vaccine efficacy. Participants were tested for influenza by reverse-transcription polymerase chain reaction or rapid antigen tests. Immunogenicity was evaluated by hemagglutination inhibition (HAI), virus microneutralization (MN), and neuraminidase inhibition (NAI) assays in a subset of blood specimens collected pre-vaccination and one-month post-vaccination.\n\nResultsAmong the 591 participants, 25 cases of influenza A were detected; 2.4% cumulative incidence among RIV recipients versus 6.1% among ccIIV recipients. The probability of influenza was 61% lower with RIV than ccIIV (95% confidence interval: 7 to 84). Among 151 participants, post-vaccination HAI and MN titers vaccine components were higher among RIV recipients while NAI titers were higher among ccIIV recipients.\n\nConclusionsRIV provided better protection than ccIIV against influenza A illness in adults during the U.S. 2024-2025 season.",
  "abstract_shown": true,
  "affiliations": [
    "Centers for Disease Control and Prevention"
  ],
  "article_type": "PUBLISHAHEADOFPRINT",
  "arxiv": null,
  "author_total": 26,
  "authors": [
    {
      "name": "K. M. Sumner"
    },
    {
      "affs": [
        0
      ],
      "name": "E. K. Noble"
    },
    {
      "name": "L. B. Grant"
    },
    {
      "name": "J. R. Meeker"
    },
    {
      "name": "V. Murugan"
    },
    {
      "name": "L. Nordstrom"
    },
    {
      "name": "S. L. House"
    },
    {
      "name": "R. Presti"
    },
    {
      "name": "E. B. Walter"
    },
    {
      "name": "O. L. Williams"
    },
    {
      "name": "E. A. Saade"
    },
    {
      "name": "D. H. Canaday"
    },
    {
      "name": "K. V. Williams"
    },
    {
      "name": "R. Zimmerman"
    },
    {
      "name": "F. L. Gross"
    },
    {
      "name": "S. Valencia"
    },
    {
      "name": "B. M. Gurbaxani"
    },
    {
      "name": "N. M. Lewis"
    },
    {
      "name": "Z.-N. Li"
    },
    {
      "name": "V. Mishin"
    },
    {
      "name": "L. Gubareva"
    },
    {
      "name": "B. Zhou"
    },
    {
      "name": "M. Z. Levine"
    },
    {
      "name": "B. M. Flannery"
    },
    {
      "name": "S. Ellington"
    },
    {
      "name": "US Flu VE Network Collaborators"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/fptysrdbbeez8.bib",
  "cited_by": 0,
  "doi": "10.64898/2026.10.01.26364413",
  "fulltext_url": "https://www.medrxiv.org/content/10.64898/2026.10.01.26364413v1.full",
  "id": "fptysrdbbeez8",
  "issns": [],
  "landing_url": "https://www.medrxiv.org/content/10.64898/2026.10.01.26364413v1",
  "language": null,
  "licence": "CC0-1.0",
  "licence_label": "CC0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/publicdomain/zero/1.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "medrxiv",
      "epidemiology"
    ],
    [
      "openalex",
      "2713|Influenza Virus Research Studies"
    ]
  ],
  "openalex": "W7216287551",
  "pdf_url": "https://www.medrxiv.org/content/10.64898/2026.10.01.26364413v1.full.pdf",
  "pmcid": null,
  "pmid": null,
  "published": "2026-10-01",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/fptysrdbbeez8.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:19:56Z",
      "native_id": "10.64898/2026.10.01.26364413",
      "source": "medrxiv",
      "url": "https://www.medrxiv.org/content/10.64898/2026.10.01.26364413v1"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "medrxiv:epidemiology",
      "subfield": "epidemiology-public-health"
    }
  ],
  "title": "Comparative immunogenicity and relative vaccine efficacy of recombinant and cell culture-based influenza vaccines: Results from a randomized trial of adults in the United States, 2024-2025",
  "title_text": "Comparative immunogenicity and relative vaccine efficacy of recombinant and cell culture-based influenza vaccines: Results from a randomized trial of adults in the United States, 2024-2025",
  "type": "preprint",
  "updated_at": "2026-10-30T12:19:56Z",
  "url": "https://research.draconitic.com/paper/fptysrdbbeez8",
  "venue": "medRxiv",
  "versions": []
}