{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T21:22:37Z","timestamp":1791408157178,"version":"4.3.3"},"reference-count":29,"publisher":"Oxford University Press (OUP)","issue":"5","funder":[{"name":"Infectious Disease Clinical Research Program"},{"DOI":"10.13039\/100000005","name":"Department of Defense","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000005","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100007188","name":"Uniformed Services University of the Health Sciences","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100007188","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100013526","name":"Defense Health Program","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100013526","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100010210","name":"US Department of Defense","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100010210","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100009898","name":"Defense Health Agency Immunization Healthcare Division","doi-asserted-by":"publisher","award":["HU0001190002"],"award-info":[{"award-number":["HU0001190002"]}],"id":[{"id":"10.13039\/100009898","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000060","name":"National Institute of Allergy and Infectious Diseases","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000060","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["75N91019D00024"],"award-info":[{"award-number":["75N91019D00024"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["75N91019F00130"],"award-info":[{"award-number":["75N91019F00130"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Inter-Agency","award":["Y1-Al-5072"],"award-info":[{"award-number":["Y1-Al-5072"]}]},{"DOI":"10.13039\/100000098","name":"National Institutes of Health Clinical Center","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000098","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100021671","name":"National Cancer Institute","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100021671","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,12,24]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Influenza is a major cause of morbidity and mortality worldwide. The Pragmatic Assessment of Influenza Vaccine Effectiveness (VE) in the Department of Defense (PAIVED) study compared the relative VE (rVE) of 2 licensed influenza vaccines (cell culture-based inactivated influenza vaccine [ccIIV] and recombinant influenza vaccine [RIV]) to egg-based inactivated influenza vaccine (eIIV).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Between 2018 and 2021, PAIVED randomized (1:1:1) eligible Military Health System beneficiaries to receive eIIV, ccIIV, or RIV during an influenza season. Participants received weekly surveys querying influenza-like illness (ILI); those reporting ILI completed an online symptom diary, were interviewed by research staff, and underwent nasal swab collection. Laboratory-confirmed influenza was the primary outcome. Immunogenicity assessment was conducted in a subset of participants.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 15 432 participants, influenza was identified in 87\/5130 (1.7%) ccIIV recipients, 79\/5154 (1.5%) RIV recipients, and 69\/5148 (1.3%) eIIV recipients during their season of enrollment. rVE of ccIIV compared to eIIV was \u221227% (95% confidence interval [CI], \u221273%, 8%), and rVE of RIV compared to eIIV was \u221214% (95% CI \u221258%, 17%). RIV (N = 375) recipients were more likely to seroconvert (4-fold increase) than those who received eIIV (N = 355) (A\/H1N1: 49.1% vs 29.0%; A\/H3N2: 71.2% vs 30.4%; B\/Victoria 24.5% vs 13.8%; B\/Yamagata 17.1% vs 5.4%; P &amp;lt; .001 for all). ccIIV (N = 357) recipients were more likely to seroconvert only against A\/H3N2 compared with eIIV recipients (44.0% vs 30.4%) (P &amp;lt; .001).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Significant differences in VE were not detected comparing egg-based to non-egg\u2013based influenza vaccines, although immunogenicity differences were observed; low influenza case numbers impacted VE estimate precision.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial Registration<\/jats:title>\n                    <jats:p>ClinicalTrials.gov NCT03734237.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/cid\/ciaf503","type":"journal-article","created":{"date-parts":[[2025,9,10]],"date-time":"2025-09-10T11:52:29Z","timestamp":1757505149000},"page":"e454-e463","source":"Crossref","is-referenced-by-count":7,"title":["Randomized Pragmatic Trial of the Comparative Effectiveness of Chicken Egg-Based Inactivated, Mammalian Cell Culture-Based Inactivated, and Recombinant Protein Quadrivalent Seasonal Influenza Vaccines in United States Military Health System Beneficiaries"],"prefix":"10.1093","volume":"81","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0154-1928","authenticated-orcid":false,"given":"Rhonda E","family":"Colombo","sequence":"first","affiliation":[{"name":"Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences , Bethesda, Maryland ,","place":["USA"]},{"name":"The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc. , Bethesda, Maryland ,","place":["USA"]},{"name":"Department of Medicine, Uniformed Services University of the Health Sciences , Bethesda, Maryland ,","place":["USA"]},{"name":"Department of Medicine, Madigan Army Medical Center , Tacoma, Washington ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0530-384X","authenticated-orcid":false,"given":"Stephanie A","family":"Richard","sequence":"additional","affiliation":[{"name":"Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences , Bethesda, Maryland ,","place":["USA"]},{"name":"The Henry M. 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