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Trial registered on ANZCTR
Registration number
ACTRN12614000374662
Ethics application status
Approved
Date submitted
31/03/2014
Date registered
8/04/2014
Date last updated
10/12/2020
Date data sharing statement initially provided
10/12/2020
Date results provided
10/12/2020
Type of registration
Prospectively registered
Titles & IDs
Public title
Optimising Protection for Pregnant Women with Influenza Vaccination
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Scientific title
Optimising Protection for Pregnant Women with Influenza Vaccination
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Secondary ID [1]
284353
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Nil
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Universal Trial Number (UTN)
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Trial acronym
OptiMum
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Influenza vaccination in obese and non-obese pregnant women
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Condition category
Condition code
Public Health
291878
291878
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0
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Other public health
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Diet and Nutrition
291900
291900
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0
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Obesity
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Infection
291950
291950
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0
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Other infectious diseases
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Approximately 300 pregnant women will be enrolled in this study at the Women’s and Children’s Hospital over two influenza seasons. Whilst recruitment will not be targeting any specific BMI of potential participants, we expect that approximately 150 obese and non-obese participants will be enrolled in 2014 and 2015. This is a prospective cohort study including obese and non-obese pregnant women to assess difference in seroprotective status after a seasonal influenza vaccination given according to standard practice. All pregnant women will be administered 1 (0.5ml) dose of the licensed influenza vaccine into the upper deltoid muscle of the arm.
Group 1: Participants with a BMI >=30kg/m2
Group 2: Participants with a BMI <30kg/m2
All participants will have a follow-up 28 days after vaccination to assess antibody responses.
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Intervention code [1]
289079
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Treatment: Drugs
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Comparator / control treatment
Obese and non obese pregnant women will be compared. All participants will received a standard licensed influenza vaccine (as recommended). Immunogenicity following vaccination will be compared to determine the impact of obesity on immune response.
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Control group
Uncontrolled
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Outcomes
Primary outcome [1]
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Paired sera will be collected pre- and post-vaccination for the assessment of vaccine immunogenicity, using haemagglutination inhibition (HI) against vaccine-related viruses. Samples will be batched, collected and sent frozen to the WHO Collaborating Centre for Reference and Research on Influenza.
HI titres >=40 are accepted as a correlate of protective efficacy for influenza vaccines. The primary outcome will be the proportion with seroprotective HI titres >=40 and differences betwen obese and non obese groups assessed using chi square tests and logistic regression.
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Assessment method [1]
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Timepoint [1]
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end of 2014 and end of 2015
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Primary outcome [2]
291799
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geometric mean anti-influenza virus antibody concentrations will be assessed and reported on paired sera ( pre and post vaccination) via assays conducted by the WHO Collaborating Centre for Reference and Research on Influenza. The proportion achieving a four-fold rise in titres post influenza vaccination between obese and non obese groups will be assessed statistically for differences .
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Assessment method [2]
291799
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Timepoint [2]
291799
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end of 2014 and 2015
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Primary outcome [3]
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Geometric mean anti-influenza virus antibody concentrations will be assessed and reported on paired sera ( pre and post vaccination) via assays conducted by the WHO Collaborating Centre for Reference and Research on Influenza. Geometric mean titres and the mean geometric increase will be assessed statistically using appropriate descriptive and inferential statistics (ie. to compare obese vs non obese groups)
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Assessment method [3]
291800
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Timepoint [3]
291800
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end of 2014 and 2015
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Secondary outcome [1]
307575
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The proportion of women with altered cytokines (elevated or reduced).
Serum cytokines will be measure using a standardised commercial human cytokine assay kit. Proportions with altered cytokines will be reported for obese and non-obese groups with differences assessed using chi square tests.
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Assessment method [1]
307575
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Timepoint [1]
307575
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end of 2014 and 2015
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Secondary outcome [2]
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The average cytokine levels will be reported for :
a) Obese vs non obese women
b) Women achieving haemagglutination inhibition (HI) assay titres >=40 vs women not achieving >=40
Serum cytokines will be measure using a standardised commercial human cytokine assay kit and reported using descriptive statistics
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Assessment method [2]
307576
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Timepoint [2]
307576
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end of 2014 and 2015
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Eligibility
Key inclusion criteria
*Pregnant women aged 18 to 40 years (inclusive) at the time of the vaccination.
*Written informed consent obtained from the participant.
*Ability to understand the information sheet and provide informed consent
*Participants who in the opinion of the study staff can and will comply with the requirements of the protocol (eg return for follow-up visits, blood collection)
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Minimum age
18
Years
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Maximum age
40
Years
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Sex
Females
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Can healthy volunteers participate?
Yes
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Key exclusion criteria
*Any major illness that, in the investigator’s judgment, will substantially increase the risk associated with the subject’s participation in the study, or interfere with the evaluation of the study objectives.
*History of serious medical conditions (eg cardiac, respiratory, renal, hepatic disorders, diabetes mellitus requiring treatment with insulin).
*History of seasonal influenza vaccination within the last six months prior to enrolment.
*History of any immunosuppressive condition (eg HIV infection) or on immunosuppressing medication.
*Any contraindication to influenza immunisation according to the Australian Immunisation Handbook.
*Anaphylaxis following a previous dose of any influenza vaccine
*Anaphylaxis following any vaccine component.
*History of egg allergy.
*History of Gullain Barre syndrome.
*Bleeding diathesis or condition associated with prolonged bleeding that may contraindicate intramuscular injection or blood draw, including participants taking anticoagulant medications or antiplatelet therapy (except for low dose daily aspirin therapy) within 30 days before enrolment.
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Study design
Purpose of the study
Prevention
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Allocation to intervention
Non-randomised trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Single group
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Other design features
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Phase
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Type of endpoint/s
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Statistical methods / analysis
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
10/04/2014
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Actual
9/04/2014
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Date of last participant enrolment
Anticipated
31/07/2015
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Actual
4/10/2016
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Date of last data collection
Anticipated
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Actual
1/11/2016
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Sample size
Target
300
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Accrual to date
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Final
96
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Recruitment in Australia
Recruitment state(s)
SA
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Recruitment hospital [1]
2256
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Womens and Childrens Hospital - North Adelaide
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Recruitment postcode(s) [1]
7923
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5006 - North Adelaide
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Funding & Sponsors
Funding source category [1]
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Charities/Societies/Foundations
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Name [1]
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Women's and Children's Hospital Foundation
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Address [1]
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55 King William Road
North Adelaide
SA 5006
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Country [1]
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Australia
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Primary sponsor type
Hospital
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Name
Women's and Children's Hospital
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Address
72 King William Road
North Adelaide
South Australia 5006
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Country
Australia
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Secondary sponsor category [1]
287684
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None
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Name [1]
287684
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Address [1]
287684
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Country [1]
287684
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
290796
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Women's and Children's Health Network Human Research Ethics Committee
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Ethics committee address [1]
290796
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72 King William Road North Adelaide South Australia 5006
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Ethics committee country [1]
290796
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Australia
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Date submitted for ethics approval [1]
290796
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Approval date [1]
290796
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25/03/2014
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Ethics approval number [1]
290796
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HREC/14/WCHN/3
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Summary
Brief summary
Pregnant women are at greater risk of complications from influenza infection and vaccination provides the best protection against influenza to pregnant women and their infants. Since 2010, the Australian Government has provided free seasonal influenza vaccine to all pregnant women (in any trimester). Whilst there are numerous data suggesting that influenza vaccination during pregnancy is beneficial to the mother and infant, there is limited data on factors that could potentially reduce the effectiveness of the influenza vaccine response in pregnant women. It is possible factors such as body mass index (BMI), may influence the immune response to influenza vaccine. Studies have shown that obese adults are at increased risk of severe disease from influenza and the immune response to some inactivated vaccines is reduced. The main objective of this study is to determine whether there is any relationship between BMI and the effectiveness of influenza vaccination in pregnant women. Approximately 300 pregnant women will be enrolled in this study at Women’s and Children’s Hospital over two influenza seasons (2014 and 2015). Approximately 150 obese and 150 non-obese participants will be enrolled. Licensed 2014 or 2015 seasonal influenza vaccines will be provided to all participants, with the vaccine administered during ultrasound imaging for a subset of pregnant women (n=70) to determine exact location of vaccine deposition. Two blood samples will be collected from all participants during the study (at baseline and at approximately 28 days post vaccination) in order to assess antibody responses to the vaccine. We will also measure cytokines (IL6 + TNFa) to determine associations with obesity and immunogenicity. In addition, for influenza vaccines we don’t know whether the immune response is different for people who receive the influenza vaccine subcutaneously vs intramuscularly. We will investigate whether obesity is associated with a lower likelihood of intramuscular vaccination and the implication of this for immune response. As it is likely that many pregnant women do not receive the influenza vaccine (standard fixed 16mm needle) intramuscularly. This study will inform vaccine policy and guidelines by providing evidence on the impact of BMI on influenza vaccine response for pregnant women.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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A/Prof Helen Marshall
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Address
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Discipline of Paediatrics
Women's and Children's Hospital
72 King William Road
North Adelaide
South Australia 5006
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Country
47326
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Australia
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Phone
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+618 81618115
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Fax
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+618 81617031
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Email
47326
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[email protected]
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Contact person for public queries
Name
47327
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Helen Marshall
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Address
47327
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Discipline of Paediatrics
Women's and Children's Hospital
72 King William Road
North Adelaide
South Australia 5006
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Country
47327
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Australia
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Phone
47327
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+618 81618115
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Fax
47327
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+618 81617031
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Email
47327
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[email protected]
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Contact person for scientific queries
Name
47328
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Helen Marshall
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Address
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Discipline of Paediatrics
Women's and Children's Hospital
72 King William Road
North Adelaide
South Australia 5006
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Country
47328
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Australia
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Phone
47328
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+618 81618115
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Fax
47328
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+618 81617031
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Email
47328
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[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
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No/undecided IPD sharing reason/comment
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What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
Type
Is Peer Reviewed?
DOI
Citations or Other Details
Attachment
Study results article
Yes
Clarke M, Goodchild LM, Evans S, Giles LC, Sulliva...
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Conference poster
No
Poster presented at two scientific conferences - ...
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Other files
No
oral presentation- ESPID, Slovenia, May 2019; Ass...
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Documents added automatically
Source
Title
Year of Publication
DOI
Embase
Body mass index and vaccine responses following influenza vaccination during pregnancy.
2021
https://dx.doi.org/10.1016/j.vaccine.2021.06.065
N.B. These documents automatically identified may not have been verified by the study sponsor.
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