{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T22:07:23Z","timestamp":1789596443510,"version":"build-2803163510"},"reference-count":21,"publisher":"Oxford University Press (OUP)","issue":"11","license":[{"start":{"date-parts":[[2021,1,5]],"date-time":"2021-01-05T00:00:00Z","timestamp":1609804800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"name":"Seqirus Pharmaceuticals"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,12,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Influenza outbreaks in nursing homes pose a threat to frail residents and occur even in vaccinated populations. We conducted a pragmatic cluster-randomized trial comparing adjuvanted trivalent influenza vaccine (aTIV) versus trivalent influenza vaccine (TIV). We report an exploratory analysis to compare the effect of aTIV versus TIV on facility-reported influenza outbreaks.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We evaluated the impact of the intent-to-treat vaccine assignment on outbreaks reported from November 2016 to March 2017. We collected data according to standard CDC definitions for both suspected outbreaks and those with a laboratory-confirmed case and adjusted for facility-level vaccination rates and resident characteristics in nursing homes.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Of 823 randomized nursing homes, 777 (aTIV, n = 387; TIV, n = 390) reported information on influenza outbreaks. Treatment groups had similar characteristics at baseline except for race\/ethnicity: homes assigned to TIV had a higher percentage of African-American residents (18.0% vs 13.7%). There were 133 versus 162 facility-reported suspected influenza outbreaks in aTIV versus TIV facilities, respectively; of these, 115 versus 140 were laboratory confirmed. The aTIV group experienced a 17% reduction in suspected (rate ratio, .83; 95% confidence interval, .65\u20131.05) and laboratory-confirmed (.83; .63\u20131.06) influenza outbreaks. Covariate adjustment increased the estimated reduction for suspected outbreaks to 21% (.79; .61\u2013.99) and 22% for laboratory-confirmed outbreaks (.78; .60\u20131.02).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>In an exploratory analysis of a cluster-randomized trial we observed 17\u201321% fewer outbreaks with aTIV than TIV.<\/jats:p>\n                  <jats:p>Clinical Trials Registration. (NCT02882100).<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/cid\/ciaa1916","type":"journal-article","created":{"date-parts":[[2021,1,4]],"date-time":"2021-01-04T20:34:42Z","timestamp":1609792482000},"page":"e4229-e4236","source":"Crossref","is-referenced-by-count":17,"title":["Adjuvanted Influenza Vaccine and Influenza Outbreaks in US Nursing Homes: Results From a Pragmatic Cluster-Randomized Clinical Trial"],"prefix":"10.1093","volume":"73","author":[{"given":"Stefan","family":"Gravenstein","sequence":"first","affiliation":[{"name":"Division of Geriatrics and Palliative Care, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA"},{"name":"Center on Innovation in Long-Term Services and Supports, Veterans Administration Medical Center, Providence, Rhode Island, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5056-0431","authenticated-orcid":false,"given":"Kevin 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H","family":"Canaday","sequence":"additional","affiliation":[{"name":"University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA"},{"name":"Louis Stokes Veterans Administration Center, Cleveland, Ohio, USA"},{"name":"Department of Medicine, Case Western Reserve University, Cleveland, Ohio, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisa","family":"Han","sequence":"additional","affiliation":[{"name":"Insight Therapeutics, LLC, Norfolk, Virginia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James","family":"Rudolph","sequence":"additional","affiliation":[{"name":"Division of Geriatrics and Palliative Care, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA"},{"name":"Center on Innovation in Long-Term Services and Supports, Veterans Administration Medical Center, Providence, Rhode Island, USA"},{"name":"Department of Health Services, Policy, and Practice, School of Public Health, Brown University, 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