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In previous studies, high-dose influenza vaccine provided better protection than standard-dose vaccine against laboratory-confirmed influenza in Medicare-eligible individuals. To study high-dose vaccine effectiveness in a high-risk, frail population, investigators conducted an industry-supported trial assessing respiratory-related hospital admissions in long-stay nursing home residents aged 65 years and older. They cluster-randomized 823 nursing homes in 38 U.S. states to facility-wide use of standard-dose or high-dose (4 times more antigen) vaccine for the 2013–2014 influenza season. Half of the nursing homes were also given free standard-dose vaccine for staff.
Among more than 38,000 patients for whom Medicare hospital claims were availabl…