Trial Outcomes & Findings for Recombinant Influenza Vaccine Versus Standard Egg-Based Inactivated Influenza Vaccine in Adults 18-64 Years (NCT NCT05514002)

NCT ID: NCT05514002

Last Updated: 2026-07-30

Results Overview

Number of participants with RT-PCR-confirmed influenza infection during the influenza circulation period. Relative vaccine effectiveness (rVE) was calculated as (1 - hazard ratio comparing RIV vs SD-IIV) × 100%.

Recruitment status

COMPLETED

Study phase

PHASE4

Target enrollment

3988 participants

Primary outcome timeframe

From ≥14 days after vaccination through end of surveillance (up to 16 weeks)

Results posted on

2026-07-30

Participant Flow

A randomized, participant- and investigator-blinded, active-comparator trial conducted during the 2022-2023 Northern Hemisphere influenza season at 7 geographic sites in the United States. Participants were randomized 1:1 to receive recombinant influenza vaccine (RIV) or standard-dose inactivated influenza vaccine (SD IIV).

Participant milestones

Participant milestones
Measure
Quadrivalent Recombinant Influenza Vaccine (RIV4)
Participants received a single 0.5 mL intramuscular dose of quadrivalent recombinant influenza vaccine (Flublok Quadrivalent, Sanofi Pasteur) during the 2022-2023 influenza season.
Quadrivalent Standard-Dose Egg-Based Inactivated Influenza Vaccine (SD-IIV4)
Participants received a single 0.5 mL intramuscular dose of quadrivalent standard-dose egg-based inactivated influenza vaccine (Fluzone Quadrivalent, Sanofi Pasteur) during the 2022-2023 influenza season.
Overall Study
STARTED
1995
1993
Overall Study
COMPLETED
1976
1976
Overall Study
NOT COMPLETED
19
17

Reasons for withdrawal

Reasons for withdrawal
Measure
Quadrivalent Recombinant Influenza Vaccine (RIV4)
Participants received a single 0.5 mL intramuscular dose of quadrivalent recombinant influenza vaccine (Flublok Quadrivalent, Sanofi Pasteur) during the 2022-2023 influenza season.
Quadrivalent Standard-Dose Egg-Based Inactivated Influenza Vaccine (SD-IIV4)
Participants received a single 0.5 mL intramuscular dose of quadrivalent standard-dose egg-based inactivated influenza vaccine (Fluzone Quadrivalent, Sanofi Pasteur) during the 2022-2023 influenza season.
Overall Study
Lost to Follow-up
19
17

Baseline Characteristics

Participants in the modified intention-to-treat population with non-missing age data. Age categories sum to the overall number analyzed for each arm.

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Quadrivalent Recombinant Influenza Vaccine (RIV4)
n=1976 Participants
Participants received a single 0.5 mL intramuscular dose of quadrivalent recombinant influenza vaccine (Flublok Quadrivalent, Sanofi Pasteur) during the 2022-2023 influenza season.
Quadrivalent Standard-Dose Egg-Based Inactivated Influenza Vaccine (SD-IIV4)
n=1976 Participants
Participants received a single 0.5 mL intramuscular dose of quadrivalent standard-dose egg-based inactivated influenza vaccine (Fluzone Quadrivalent, Sanofi Pasteur) during the 2022-2023 influenza season.
Total
n=3952 Participants
Total of all reporting groups
Age, Customized
18-49 years
1645 Participants
n=20 Participants • Participants in the modified intention-to-treat population with non-missing age data. Age categories sum to the overall number analyzed for each arm.
1646 Participants
n=20 Participants • Participants in the modified intention-to-treat population with non-missing age data. Age categories sum to the overall number analyzed for each arm.
3291 Participants
n=40 Participants • Participants in the modified intention-to-treat population with non-missing age data. Age categories sum to the overall number analyzed for each arm.
Age, Customized
50-64 years
331 Participants
n=20 Participants • Participants in the modified intention-to-treat population with non-missing age data. Age categories sum to the overall number analyzed for each arm.
330 Participants
n=20 Participants • Participants in the modified intention-to-treat population with non-missing age data. Age categories sum to the overall number analyzed for each arm.
661 Participants
n=40 Participants • Participants in the modified intention-to-treat population with non-missing age data. Age categories sum to the overall number analyzed for each arm.
Sex/Gender, Customized
Female
1255 Participants
n=20 Participants
1221 Participants
n=20 Participants
2476 Participants
n=40 Participants
Sex/Gender, Customized
Male
684 Participants
n=20 Participants
722 Participants
n=20 Participants
1406 Participants
n=40 Participants
Sex/Gender, Customized
Transgender/Other
12 Participants
n=20 Participants
12 Participants
n=20 Participants
24 Participants
n=40 Participants
Sex/Gender, Customized
None of these
25 Participants
n=20 Participants
21 Participants
n=20 Participants
46 Participants
n=40 Participants
Race/Ethnicity, Customized
American Indian or Alaska Native
14 Participants
n=20 Participants
15 Participants
n=20 Participants
29 Participants
n=40 Participants
Race/Ethnicity, Customized
Asian
390 Participants
n=20 Participants
392 Participants
n=20 Participants
782 Participants
n=40 Participants
Race/Ethnicity, Customized
Black or African American
232 Participants
n=20 Participants
228 Participants
n=20 Participants
460 Participants
n=40 Participants
Race/Ethnicity, Customized
Native Hawaiian or Other Pacific Islander
1 Participants
n=20 Participants
3 Participants
n=20 Participants
4 Participants
n=40 Participants
Race/Ethnicity, Customized
White
1173 Participants
n=20 Participants
1175 Participants
n=20 Participants
2348 Participants
n=40 Participants
Race/Ethnicity, Customized
Multiracial
73 Participants
n=20 Participants
75 Participants
n=20 Participants
148 Participants
n=40 Participants
Race/Ethnicity, Customized
Declined/missing race
93 Participants
n=20 Participants
88 Participants
n=20 Participants
181 Participants
n=40 Participants
Race/Ethnicity, Customized
Hispanic or Latino/a
301 Participants
n=20 Participants
299 Participants
n=20 Participants
600 Participants
n=40 Participants
Race/Ethnicity, Customized
Not Hispanic or Latino/a
1633 Participants
n=20 Participants
1641 Participants
n=20 Participants
3274 Participants
n=40 Participants
Race/Ethnicity, Customized
Declined/missing ethnicity
42 Participants
n=20 Participants
36 Participants
n=20 Participants
78 Participants
n=40 Participants
Region of Enrollment
United States
1976 participants
n=20 Participants
1976 participants
n=20 Participants
3952 participants
n=40 Participants

PRIMARY outcome

Timeframe: From ≥14 days after vaccination through end of surveillance (up to 16 weeks)

Population: Analytic modified intention-to-treat population. Participants were excluded if they tested influenza-positive within 14 days after vaccination or did not respond to surveillance contacts beyond 14 days after vaccination. The resulting analysis population included 1,963 participants in the recombinant influenza vaccine group and 1,964 participants in the standard-dose inactivated influenza vaccine group.

Number of participants with RT-PCR-confirmed influenza infection during the influenza circulation period. Relative vaccine effectiveness (rVE) was calculated as (1 - hazard ratio comparing RIV vs SD-IIV) × 100%.

Outcome measures

Outcome measures
Measure
Quadrivalent Recombinant Influenza Vaccine (RIV4)
n=1963 Participants
Participants received a single 0.5 mL intramuscular dose of quadrivalent recombinant influenza vaccine (Flublok Quadrivalent, Sanofi Pasteur) during the 2022-2023 influenza season.
Quadrivalent Standard-Dose Egg-Based Inactivated Influenza Vaccine (SD-IIV4)
n=1964 Participants
Participants received a single 0.5 mL intramuscular dose of quadrivalent standard-dose egg-based inactivated influenza vaccine (Fluzone Quadrivalent, Sanofi Pasteur) during the 2022-2023 influenza season.
RT-PCR-Confirmed Influenza Infection
RT-PCR-confirmed influenza
20 participants
28 participants
RT-PCR-Confirmed Influenza Infection
No RT-PCR-confirmed influenza
1943 participants
1936 participants

SECONDARY outcome

Timeframe: Up to 14 days after onset of influenza illness

Population: Participants with RT-PCR-confirmed influenza illness who completed outcome assessments. Twenty participants in the recombinant influenza vaccine group and 25 participants in the standard-dose inactivated influenza vaccine group were included in this analysis.

Number of days from onset of influenza illness until return to usual health, defined as two consecutive days reporting return to usual health on the FLU-PRO Plus instrument.

Outcome measures

Outcome measures
Measure
Quadrivalent Recombinant Influenza Vaccine (RIV4)
n=20 Participants
Participants received a single 0.5 mL intramuscular dose of quadrivalent recombinant influenza vaccine (Flublok Quadrivalent, Sanofi Pasteur) during the 2022-2023 influenza season.
Quadrivalent Standard-Dose Egg-Based Inactivated Influenza Vaccine (SD-IIV4)
n=25 Participants
Participants received a single 0.5 mL intramuscular dose of quadrivalent standard-dose egg-based inactivated influenza vaccine (Fluzone Quadrivalent, Sanofi Pasteur) during the 2022-2023 influenza season.
Time to Return to Usual Health Following Influenza Illness
10.5 days
Standard Deviation 3.3
10.9 days
Standard Deviation 2.7

Adverse Events

Quadrivalent Recombinant Influenza Vaccine (RIV4)

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

Quadrivalent Standard-Dose Egg-Based Inactivated Influenza Vaccine (SD-IIV4)

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

Serious adverse events

Adverse event data not reported

Other adverse events

Adverse event data not reported

Additional Information

Fatimah S. Dawood, MD

Centers for Disease Control and Prevention

Phone: 404.639.0431

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place