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

A quadrivalent high-dose inactivated influenza vaccine (IIV4-HD) is licensed for adults 6565 y of age based on immunogenicity and efficacy studies. However, IIV4-HD has not been evaluated in adults aged 60\u201364 y. This study compared immunogenicity and safety of IIV4-HD with a standard-dose quadrivalent influenza vaccine (IIV4-SD) in adults aged 6560 y. This Phase III, randomized, modified double-blind, active-controlled study enrolled 1,528 participants aged 6560 y, randomized 1:1 to a single injection of IIV4-HD or IIV4-SD. Hemagglutination inhibition (HAI) geometric mean titers (GMTs) were measured at baseline and D 28 and seroconversion assessed. Safety was described for 180 d after vaccination. The primary immunogenicity objective was superiority of IIV4-HD versus IIV4-SD, for all four influenza strains 28 d post vaccination in participants aged 60\u201364 and 6565 y. IIV4-HD induced a superior immune response versus IIV4-SD in terms of GMTs in participants aged 60\u201364 y and those aged 6565 y for all four influenza strains. IIV4-HD induced higher GMTs in those aged 60\u201364 y than those aged 6565 y. Seroconversion rates were higher for IIV4-HD versus IIV4-SD in each age-group for all influenza strains. Both vaccines were well tolerated in participants 6560 y of age, with no safety concerns identified. More solicited reactions were reported with IIV4-HD than with IIV4-SD. IIV4-HD provided superior immunogenicity versus IIV4-SD and was well tolerated in adults aged 6560 y. IIV4-HD is assumed to offer improved protection against influenza compared with IIV4-SD in adults aged 6560 y, as was previously assessed for adults aged 6565 y

The Regulatory Gift: Politics, regulation and governance

Abstract: This article introduces the ‘regulatory gift’ as a conceptual framework for understanding a particular form of government-led deregulation that is presented as central to the public interest. Contra to theories of regulatory capture, government corruption, ‘insider’ personal interest or profit-seeking theories of regulation, the regulatory gift describes reform which is overtly designed by Government to reduce or reorient regulators’ functions to the advantage of the regulated and in line with market objectives on a potentially macro (rather than industry-specific) scale. As a conceptual framework, the regulatory gift is intended to be applicable across regulated sectors of democratic states and in this article the empirical sections evidence the practice of regulatory gifting in contemporary UK politics. Specifically, this article analyses the UK Public Bodies Act (2011), affecting some 900 regulatory public bodies and its correlative legislation, the Regulator’s Code (2014), the Deregulation Act (2015) and the Enterprise Bill (2016). The article concludes that whilst the regulatory gift may, in some cases, be aligned with the public interest - delivering on cost reduction, enhancing efficiency and stimulating innovation - this will not always be the case. As the case study of the regulatory body, the UK Human Fertilisation and Embryology Authority (HFEA) demonstrates, despite the explicit claims made by legislators, the regulatory gift has the potential to significantly undermine the public interest