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. Author manuscript; available in PMC: 2025 Mar 6.
Published in final edited form as: Int J Infect Dis. 2024 Oct 10;149:107260. doi: 10.1016/j.ijid.2024.107260

Table 2.

Humoral immune responses pre- and post-vaccination among recipients of quadrivalent inactivated egg-based influenza vaccine (IIV4) and quadrivalent recombinant influenza vaccine (RIV4) measured by hemagglutination inhibition assay against influenza vaccine reference viruses a, Israel, 2019-2020.

Hemagglutination inhibition assay outcome measuresb IIV4
n = 212
RIV4
n = 203
RIV4 vs IIV4 Post-Vaccination
P-value
Pre-vaccination Post-vaccination Pre-vaccination Post-vaccination Difference (95% CI) GMT ratio (95% CI)
Influenza A(H1N1)pdm09
 GMT (95% CI) 44.1 (38.1-51.1) 82.9 (71.6-96.1) 44.5 (38.2-51.7) 178.4 (153.5-207.5) 2.0 (1.7-2.7) <0.001
 Mean-Fold Rise (95% CI) 1.9 (1.5-2.3) 4.0 (3.2-5.0)
 Seroconversion, % (95% CI) 23.8 (18.2-29.5) 52.8 (46.1-59.5) 29.0 (20.1-37.8)
 GMT ≥40, % (95% CI) 68.4 (62.1-74.7) 87.3 (82.8-91.4) 67.0 (60.5-73.5) 95.6 (92.7-98.4) 8.3 (3.0-13.6)
 GMT ≥160, % (95% CI) 20.8 (14.9-25.5) 38.9 (32.4-45.4) 20.6 (15.1-26.0) 66.3 (59.8-72.7) 27.3 (18.2-36.5)
Influenza A(H3N2), Egg-based
 GMT (95% CI) 62.4 (54.7-71.2) 152.8 (133.9-174.3) 60.3 (52.7-69.0) 246.9 (215.8-282.5) 1.6 (1.3-1.9) <0.001
 Mean-Fold Rise (95% CI) 2.4 (2.0-2.9) 4.1 (3.4-5.0)
 Seroconversion, % (95% CI) 34.8 (28.4-41.3) 57.2 (50.5-64.0) 22.4 (13.1-31.8)
 GMT ≥40, % (95% CI) 84.0 (79.0-88.9) 97.2 (94.9-99.4) 75.9 (70.0-81.8) 97.5 (95.4-99.7) 0.37 (−2.7-3.5)
 GMT ≥160, % (95% CI) 26.2 (20.4-32.0) 63.4 (57.1-69.7) 29.2 (23.1-35.3) 80.2 (74.8-85.5) 16.7 (8.5-25.0)
Influenza A(H3N2), Cell-based
 GMT (95% CI) 30.7 (27.2-34.6) 80.8 (71.6-91.1) 31.1 (27.5-35.2) 189.2 (167.3-214.0) 2.3 (2.0-2.8) <0.001
 Mean-Fold Rise (95% CI) 2.6 (2.2-3.1) 6.1 (5.1-7.2)
 Seroconversion, % (95% CI) 41.0 (33.9-47.1) 77.4 (71.8-83.0) 36.9 (28.3-45.6)
 GMT ≥40 (95% CI) 56.1 (49.5-62.8) 88.2 (83.9-92.6) 58.6 (51.9-65.4) 96.1 (93.4-98.7) 7.9 (2.8-13.0)
 GMT ≥160 (95% CI) 2.5 (0.4-4.6) 30.6 (24.4-36.8) 3.7 (1.1-6.3) 65.8 (59.3-72.3) 34.9 (25.8-43.9)
Influenza B(Victoria)
 GMT (95% CI) 54.0 (46.7-62.3) 78.3 (67.9-90.4) 48.5 (41.9-56.2) 90.3 (78.0-104.6) 1.1 (0.9-1.4) 0.175
 Mean-Fold Rise (95% CI) 1.5 (1.2-1.8) 1.9 (1.5-2.3)
 Seroconversion, % (95% CI) 9.0 (5.3-13.0) 18.0 (12.7-23.3) 8.9 (2.3-15.5)
 GMT ≥40, % (95% CI) 70.7 (64.5-76.8) 83.0 (77.8-89.7) 67.1 (60.6-73.6) 82.9 (79.7-89.7) 1.8 (−5.4-9.0)
 GMT ≥160, % (95% CI) 24.2 (18.5-29.9) 34.0 (27.4-40.1) 19.9 (14.4-25.4) 40.1 (33.4-46.9) 6.4 (−2.9-15.7)
Influenza B(Yamagata)
 GMT (95% CI) 68.7 (59.7-79.0) 105.7 (91.9-121.7) 71.7 (62.1-82.7) 196.2 (170.0-226.5) 1.8 (1.4-2.2) <0.001
 Mean-Fold Rise (95% CI) 1.5 (1.3-1.9) 2.7 (2.2-3.4)
 Seroconversion, % (95% CI) 14 (9.3-18.7) 36.6 (30.0-43.3) 22.6 (14.4-30.8)
 GMT ≥40, % (95% CI) 83.0 (78.0-88.1) 90.1 (86.1-94.1) 83.7 (78.7-88.8) 97.0 (94.7-99.4) 7.0 (2.3-11.6)
 GMT ≥160, % (95% CI) 31.6 (25.4-37.8) 50.0 (43.2-56.7) 30.1 (24.0-36.2) 67.1 (60.9-73.4) 17.2 (8.0-26.3)

Abbreviations: IIV4, Quadrivalent inactivated influenza vaccine; RIV4, Quadrivalent recombinant influenza vaccine; GMT, Geometric mean titre;

a

Influenza vaccine reference viruses: A/Brisbane/02/2018 (H1N1)pdm09, A/Kansas/14/2017 (H3N2), B/Colorado/06/2017 (Victoria lineage), and B/Phuket/3073/2013 (Yamagata lineage) vaccine antigens.

b

GMT, Mean-Fold Rise in GMT, and GMT ratios were calculated using linear mixed models adjusting for age, hospital, and immunocompromised status. Statistically significant differences are shown in bold.