{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,3]],"date-time":"2026-05-03T02:18:09Z","timestamp":1777774689402,"version":"3.51.4"},"reference-count":43,"publisher":"Oxford University Press (OUP)","issue":"4","funder":[{"name":"CDC\u2019s Achieving Public Health Impact","award":["200\u20132014-F-60406"],"award-info":[{"award-number":["200\u20132014-F-60406"]}]},{"DOI":"10.13039\/100008769","name":"Abt Associates","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100008769","id-type":"DOI","asserted-by":"publisher"}]},{"name":"US CDC"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,4,29]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Adult studies have shown that quadrivalent recombinant influenza vaccines (RIV4) induce a higher antibody response than quadrivalent egg-based inactivated influenza vaccines (IIV4).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Healthcare personnel (HCP) from a 2018\u20132019 cohort study that assessed IIV4 immunogenicity in Israel were recruited into a 2019\u20132020 randomized trial of RIV4 and IIV4. 2018\u20132019 low titer low responders (LTLRs) had pre-vaccination hemagglutination inhibition antibody titers \u22641:40 and &amp;lt;4-foldrise post-vaccination. We assessed whether RIV4 versus IIV4 receipt in the 2019\u20132020 season improved response among 2018\u20132019 LTLRs using logistic regression adjusted for employment hospital.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of 228 HCP classified as 2018\u20132019 LTLRs, 2019\u20132020 RIV4 recipients were 3.6 (95% CI: 1.2\u201311.4) and 8.3 (95% CI: 3.0\u201326.3) times as likely to become a non-LTLR against influenza A(H1N1)pdm09 and cell-derived A(H3N2) vaccine components compared to IIV4 recipients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>RIV4 had improved immunogenicity against influenza A viruses among previously classified low vaccine responder HCP, highlighting how recombinant influenza vaccines could improve antibody responses against influenza A for HCP at risk for poor influenza antibody response.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/infdis\/jiaf605","type":"journal-article","created":{"date-parts":[[2025,12,2]],"date-time":"2025-12-02T12:48:21Z","timestamp":1764679701000},"page":"e1011-e1021","source":"Crossref","is-referenced-by-count":0,"title":["Improved Immune Response Against Influenza A Viruses With Receipt of a Recombinant Influenza Vaccine in Healthcare Personnel With Prior Low Antibody Response to Egg-Based Influenza Vaccines, Israel, 2019\u20132020"],"prefix":"10.1093","volume":"233","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4479-897X","authenticated-orcid":false,"given":"Kelsey M","family":"Sumner","sequence":"first","affiliation":[{"name":"Influenza Division, Centers for Disease Control and Prevention , Atlanta, Georgia ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5532-7276","authenticated-orcid":false,"given":"Mark","family":"Katz","sequence":"additional","affiliation":[{"name":"Clalit Research Institute, Innovation Division, Clalit Health Services , Tel Aviv ,","place":["Israel"]},{"name":"School of Public Health, University of Michigan , Ann Arbor, Michigan ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3393-9853","authenticated-orcid":false,"given":"Avital","family":"Hirsch","sequence":"additional","affiliation":[{"name":"Clalit Research Institute, Innovation Division, Clalit Health Services , Tel Aviv ,","place":["Israel"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alon","family":"Peretz","sequence":"additional","affiliation":[{"name":"Rabin Medical Center, Clalit Health Services, Beilinson Campus , Petah Tikva ,","place":["Israel"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Greenberg","sequence":"additional","affiliation":[{"name":"Soroka University Medical Center , Clalit Health Services, Be\u2019er Sheva ,","place":["Israel"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emily T","family":"Martin","sequence":"additional","affiliation":[{"name":"School of Public Health, University of Michigan , Ann Arbor, Michigan ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8512-2538","authenticated-orcid":false,"given":"Rachel","family":"Truscon","sequence":"additional","affiliation":[{"name":"School of Public Health, University of Michigan , Ann Arbor, Michigan ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1579-2074","authenticated-orcid":false,"given":"Laura J","family":"Edwards","sequence":"additional","affiliation":[{"name":"Abt Associates , Inc. 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