Efficacy of high-dose versus standard-dose influenza vaccine in older adults.

  title={Efficacy of high-dose versus standard-dose influenza vaccine in older adults.},
  author={Carlos A Diazgranados and Andrew J Dunning and Murray Kimmel and Daniel Kirby and John T Treanor and Avi Collins and Richard A Pollak and Janet Christoff and John W. Earl and Victoria A Landolfi and Earl Martin and Sanjay Gurunathan and Richard Nathan and David P. Greenberg and Nadia G. Tornieporth and Michael D. Decker and H. Keipp B. Talbot},
  journal={The New England journal of medicine},
  volume={371 7},
BACKGROUND As compared with a standard-dose vaccine, a high-dose, trivalent, inactivated influenza vaccine (IIV3-HD) improves antibody responses to influenza among adults 65 years of age or older. This study evaluated whether IIV3-HD also improves protection against laboratory-confirmed influenza illness. METHODS We conducted a phase IIIb-IV, multicenter, randomized, double-blind, active-controlled trial to compare IIV3-HD (60 μg of hemagglutinin per strain) with standard-dose trivalent… 

Figures and Tables from this paper

Immunogenicity of high-dose trivalent inactivated influenza vaccine: a systematic review and meta-analysis

High-dose trivalent, inactivated, split-virus influenza vaccine (IIV3-HD) has been available in the US since 2009 and is consistently more immunogenic than IIV3-SD in adults aged ≥ 65 years, and appears more Immunogenic in immunocompromised individuals.

Efficacy and effectiveness of high-dose versus standard-dose influenza vaccination for older adults: a systematic review and meta-analysis

Available evidence suggests HD-IIV3 is more effective than SD-Iiv3 at reducing the clinical outcomes associated with influenza infection in older adults and should be considered for routine use in the 65+ population.

Immunogenicity and safety of high-dose quadrivalent influenza vaccine in Japanese adults ≥65 years of age: a randomized controlled clinical trial

Results add to the evidence that high-dose inactivated influenza vaccines are more immunogenic than standard-dose vaccines in this age group and that intramuscular administration provides greater immunogenicity and lower reactogenicity than subcutaneous administration.

Efficacy of Recombinant Influenza Vaccine in Adults 50 Years of Age or Older

RIV4 provided better protection than standard‐dose IIV4 against confirmed influenza‐like illness among older adults and satisfied prespecified criteria for the primary noninferiority analysis and an exploratory superiority analysis.

A Double-Blind, Randomized Trial of High-Dose vs Standard-Dose Influenza Vaccine in Adult Solid-Organ Transplant Recipients

H vaccine demonstrated significantly better immunogenicity than SD vaccine in adult transplant recipients and may be the preferred influenza vaccine for this population.

Immunogenicity and safety of a quadrivalent high-dose inactivated influenza vaccine compared with a standard-dose quadrivalent influenza vaccine in healthy people aged 60 years or older: a randomized Phase III trial

IIV4-HD provided superior immunogenicity versus IIV4-SD and was well tolerated in adults aged ≥60 y, as was previously assessed for adults aged ≤65 y.

[High-dose trivalent influenza vaccine. Efficacy and effectiveness].

The available evidence on the efficacy and effectiveness of the IIV3-HD influenza vaccine in the elderly is reviewed, with information from randomized clinical trials, as well as observational studies of real-world clinical practice and in systematic reviews/meta-analyses.



Randomized, double-blind controlled phase 3 trial comparing the immunogenicity of high-dose and standard-dose influenza vaccine in adults 65 years of age and older.

The results suggest that the high-dose vaccine may provide improved protective benefits for older adults, and there was a statistically significant increase in the level of antibody response induced by HD influenza vaccine, compared with that induced by SD vaccine.

Effectiveness of Adjuvanted Influenza Vaccination in Elderly Subjects in Northern Italy

Risk of hospitalization for influenza or pneumonia was 25% lower for ATIV relative to TIV, and ATIV is likely to be even more protective than this result suggests.

The efficacy of influenza vaccination in elderly individuals. A randomized double-blind placebo-controlled trial.

In the elderly, influenza vaccination may halve the incidence of serological and clinical influenza (in periods of antigenic drift), which is less pronounced for self-reported influenza.

The Efficacy of Influenza Vaccine in Elderly Persons

The meta-analysis confirms the findings of several recent studies on the effectiveness of influenza vaccination in elderly persons and should heighten physician awareness and encourage the universal annual use of influenza vaccine in elderly Persons.