Key finding
HD-IIV was associated with reduced hospitalization for any cardiorespiratory disease compared with SD-IIV.
This study compared high-dose and standard-dose influenza vaccines in older adults with diabetes, finding that HD-IIV reduced hospitalizations for various diseases.
Evidence strength
Moderate confidence
Study type
RCTs
Follow-up
Extended (5–20+ y)
Quick read
The essential study design details in one scan.
Population
Older Adults (65+), Female, Male, Europe (EU & UK), with T2 Diabetes
Intervention
High-dose inactivated influenza vaccine (HD-IIV), Standard-dose inactivated influenza vaccine (SD-IIV)
Study type
RCTs
Follow-up
Extended (5–20+ y)
Primary outcome
Hospitalization for any cardiorespiratory disease
Comparator
Standard-Dose Inactivated Influenza Vaccine (SD-IIV)
Plain-language summary
A plain-language read of the study's main message and where it applies.
Study focus
This study compared high-dose and standard-dose influenza vaccines in older adults with diabetes, finding that HD-IIV reduced hospitalizations for various diseases.
Given the increased risk of severe influenza complications in older adults with diabetes, the findings highlight the potential benefits of using a high-dose vaccine to reduce hospitalizations. This could lead to better health outcomes and lower healthcare costs for this vulnerable population.
The study did not provide clear evidence on the effectiveness of HD-IIV versus SD-IIV for all outcomes. Statistical significance was not achieved for several outcomes, indicating uncertainty. The generalizability of the findings may be limited to the specific population studied.
Published in
Publication details and source links for this paper.
Anne BN, Niklas DJ, Daniel M, et al. High-Dose vs Standard-Dose Influenza Vaccine in Older Adults with Diabetes. JAMA Internal Medicine. 2026;186(3):311-320. doi:10.1001/jamainternmed.2025.7286
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HD-IIV was associated with reduced hospitalization for any cardiorespiratory disease compared with SD-IIV.
HD-IIV was associated with reduced hospitalization for any cardiovascular disease compared with SD-IIV.
HD-IIV was associated with reduced hospitalization for influenza compared with SD-IIV.
Evidence network
Understand where this research contributes within the broader evidence network.
This study contributes evidence to High-dose inactivated influenza vaccine (HD-IIV), Standard-dose inactivated influenza vaccine (SD-IIV) and Hospitalization for any cardiorespiratory disease, Hospitalization for any cardiovascular disease, Hospitalization for influenza.
This study contributes evidence to
Primary intervention
High-dose inactivated influenza vaccine (HD-IIV)
Primary outcomes
Intervention and outcome relationships this study adds to the evidence network.
Editorial context
See why this paper is useful beyond its individual results.
Evidence network role
This section describes how the study fits into the current evidence network. It does not determine whether an intervention works on its own.
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Related topics
6
Evidence pairs
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Related studies
Core evidence
The primary outcomes reported in this study.
High-dose inactivated influenza vaccine (HD-IIV) → Hospitalization for any cardiorespiratory disease
High-dose inactivated influenza vaccine (HD-IIV) → Hospitalization for any cardiorespiratory disease
Evidence profile
High-dose inactivated influenza vaccine (HD-IIV) → Hospitalization for any cardiovascular disease
High-dose inactivated influenza vaccine (HD-IIV) → Hospitalization for any cardiovascular disease
Evidence profile
High-dose inactivated influenza vaccine (HD-IIV) → Hospitalization for influenza
High-dose inactivated influenza vaccine (HD-IIV) → Hospitalization for influenza
Evidence profile
Standard-dose inactivated influenza vaccine (SD-IIV) → Hospitalization for any cardiorespiratory disease
Standard-dose inactivated influenza vaccine (SD-IIV) → Hospitalization for any cardiorespiratory disease
Evidence profile
Standard-dose inactivated influenza vaccine (SD-IIV) → Hospitalization for any cardiovascular disease
Standard-dose inactivated influenza vaccine (SD-IIV) → Hospitalization for any cardiovascular disease
Evidence profile
Standard-dose inactivated influenza vaccine (SD-IIV) → Hospitalization for influenza
Standard-dose inactivated influenza vaccine (SD-IIV) → Hospitalization for influenza
Evidence profile
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Relationships organized using the Dediabetes Evidence Intelligence™ framework.
This study contributes to evidence on High-dose inactivated influenza vaccine (HD-IIV) and Hospitalization for any cardiorespiratory disease, High-dose inactivated influenza vaccine (HD-IIV) and Hospitalization for any cardiovascular disease.
This study contributes to the evidence on the following intervention-outcome relationships.
Curated evidence collections and hubs this study is part of.
All studies on High-dose inactivated influenza vaccine (HD-IIV)
Contributes to High-dose inactivated influenza vaccine (HD-IIV) evidence base.
All studies measuring Hospitalization for any cardiorespiratory disease
Measures Hospitalization for any cardiorespiratory disease as a key outcome.
All studies measuring Hospitalization for any cardiovascular disease
Measures Hospitalization for any cardiovascular disease as a key outcome.
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Published within the last 2 years.
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1 results
1 results
1 results
1 results
1 results
Generated from the study's connected evidence using Evidence Intelligence™.
High-dose inactivated influenza vaccine (HD-IIV) appears to improve Hospitalization for influenza.
ConsensusScore™: Results are consistent across studies.
Ranked evidence signals
Hospitalization for influenza
EvidenceScore™ Emerging | EvidenceScore™ 51.8 | strong positive | ConsensusScore™ Consistent | 1 study
Why this answer: This answer is based on a single supporting study.
Limitations
High-dose inactivated influenza vaccine (HD-IIV) appears to improve Hospitalization for any cardiorespiratory disease.
ConsensusScore™: Consistency cannot yet be determined from the available evidence.
Ranked evidence signals
Hospitalization for any cardiorespiratory disease
EvidenceScore™ Emerging | EvidenceScore™ 51.8 | strong positive | ConsensusScore™ Unclear | 1 study
Why this answer: This answer is based on a single supporting study.
Limitations
High-dose inactivated influenza vaccine (HD-IIV) appears to improve Hospitalization for any cardiovascular disease.
ConsensusScore™: Consistency cannot yet be determined from the available evidence.
Ranked evidence signals
Hospitalization for any cardiovascular disease
EvidenceScore™ Emerging | EvidenceScore™ 51.8 | strong positive | ConsensusScore™ Unclear | 1 study
Why this answer: This answer is based on a single supporting study.
Limitations
Current evidence does not show a clear benefit of Standard-dose inactivated influenza vaccine (SD-IIV) for Hospitalization for influenza.
ConsensusScore™: Results are consistent across studies.
Ranked evidence signals
Hospitalization for influenza
EvidenceScore™ Limited | EvidenceScore™ 34.3 | neutral | ConsensusScore™ Consistent | 1 study
Why this answer: This answer is based on a single supporting study.
Limitations
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