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
- 1Centers for Disease Control and Prevention
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.
MethodsWe 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.
ResultsAmong 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.
ConclusionsRIV provided better protection than ccIIV against influenza A illness in adults during the U.S. 2024-2025 season.
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BibTeX
@misc{sumner2026comparative,
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}},
author = {K. M. Sumner and E. K. Noble and L. B. Grant and J. R. Meeker and V. Murugan and L. Nordstrom and S. L. House and R. Presti and E. B. Walter and O. L. Williams and E. A. Saade and D. H. Canaday and K. V. Williams and R. Zimmerman and F. L. Gross and S. Valencia and B. M. Gurbaxani and N. M. Lewis and Z.-N. Li and V. Mishin and L. Gubareva and B. Zhou and M. Z. Levine and B. M. Flannery and S. Ellington and US Flu VE Network Collaborators},
howpublished = {medRxiv},
year = {2026},
month = oct,
doi = {10.64898/2026.10.01.26364413},
url = {https://www.medrxiv.org/content/10.64898/2026.10.01.26364413v1},
note = {CC0},
}
RIS
TY - UNPB
TI - 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
AU - K. M. Sumner
AU - E. K. Noble
AU - L. B. Grant
AU - J. R. Meeker
AU - V. Murugan
AU - L. Nordstrom
AU - S. L. House
AU - R. Presti
AU - E. B. Walter
AU - O. L. Williams
AU - E. A. Saade
AU - D. H. Canaday
AU - K. V. Williams
AU - R. Zimmerman
AU - F. L. Gross
AU - S. Valencia
AU - B. M. Gurbaxani
AU - N. M. Lewis
AU - Z.-N. Li
AU - V. Mishin
AU - L. Gubareva
AU - B. Zhou
AU - M. Z. Levine
AU - B. M. Flannery
AU - S. Ellington
AU - US Flu VE Network Collaborators
PY - 2026
DA - 2026/10/01
PB - medRxiv
DO - 10.64898/2026.10.01.26364413
UR - https://www.medrxiv.org/content/10.64898/2026.10.01.26364413v1
AB - 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. MethodsWe 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. ResultsAmong 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. ConclusionsRIV provided better protection than ccIIV against influenza A illness in adults during the U.S. 2024-2025 season.
ER -