Influenza was diagnosed using rapid influenza diagnostic tests, which are immunoassays that can identify the presence of influenza A and B viral nucleoprotein antigens. The questionnaires provided prior to vaccine administration, including those analyzed in this study, were sequentially numbered before distribution and managed by the Infection Control Office of each hospital, independent of the study organizer. Each Infection Control Office confirmed the identity of the participants who contracted influenza during the 2018–2019 and 2019–2020 winter seasons among those vaccinated in 2018 and 2019, respectively. Individuals affected by influenza were matched to the numbers on the questionnaires to confirm the incidence of influenza during each season.

Using the abovementioned method, participant characteristics, presence or absence of adverse reactions, and incidence of influenza were blinded from researchers to protect the participants’ privacy.

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