Vaccine-Elicited Antibody Responses to Influenza A(H3N2) Subclade K

# Vaccine-Elicited Antibody Responses to Influenza A(H3N2) Subclade K *Published: 2026 Apr 14* reported receiving a National Institutes of Health (NIH) contract (75N93021C00014). Dr van Bakel reported receiving an NIH contract (75N93021C00014). Dr Mostafa reported research collaboration with Hologic, QIAGEN, and Diasorin; receiving honoraria from bioMérieux, Bio-Rad, and Diasorin; and an NIH contract (75N93021C000045). Dr Pekosz reported receiving an NIH contract (75N93021C000045). Dr Collier reported having contracts with Pfizer and Sanofi outside the submitted work and receiving a Massachusetts Consortium on Pathogen Readiness Award and a William F. Milton Fund at Harvard University Award during the conduct of the study. Dr Barouch reported receiving grants from MassCPR during the conduct of the study; funding from the Massachusetts Consortium on Pathogen Readiness and philanthropic sources; grants from Biomedical Advanced Research and Development Authority, Defense Advanced Research Projects Agency, Gates Foundation, Henry M. Jackson Foundation, MassCPR, National Cancer Institute, National Institute of Allergy and Infectious Diseases, Ragon Institute, South African Medical Research Council, Walter Reed Army Institute of Research, Alkermes, CureVac, Gilead, Gritstone, GSK, Hookipa, Intima, Janssen, Legend, Leyden Labs, Musk Foundation, Novavax, Pfizer, Pharm-Olam, Sanofi, SIGA, and Zentalis; and personal fees from Avidea, Bavarian Nordic, Celsion/Imunon, Laronde, Meissa, SQZ, Sterne Kessler, and Vector Sciences outside the submitted work. No other disclosures were reported. 45. JAMA. 2026 Apr 14;335(14):1219-1231. doi: 10.1001/jama.2026.1327. A Decision-Support System to Personalize Antidepressant Treatment in Major Depressive Disorder: A Randomized Clinical Trial. Cipriani A(1)(2)(3), Fernandes KBP(4)(5), Mulsant BH(6)(7)(8), Efthimiou O(9)(10), Williams N(11), Mort S(11), Elgarf R(1)(2), Liu Q(1)(2)(12), Haque N(1)(2), Potts J(1)(2), Ede R(3), Fox R(11), Liboni M(13), Nesi Cavicchioli DA(13), Simon J(1)(14), Smith KA(1)(2)(3), Zangani C(1)(2)(3), Li Z(1)(2), Taylor U(15), Husain MI(6)(7), Cipriani M(16), Carpaneze Dalaqua PV(4), Leite EF(13), Aliano Gâmbaro G(4)(5), Nabhan Silveira D(4), Manfredin Vila L(13), Liboni Cavicchioli F(4), Furukawa TA(17), Naci H(18), Ostinelli EG(1)(2); PETRUSHKA Team. Collaborators: Adinda AT, Ahmed N, Aronica R, Batista E, Benjamin J, Binnian I, Carson R, Collins H, Cook J, Delahay R, De Crescenzo F, Engonidou L, Gilbody S, Hong J, Hughes O, Jaquiery M, Johnston B, Lewis G, Paggi A, Rizzopesci N, Sealy P, Shah N, Shaw R, Singh I, Stevens K, Tanna J, Tomlinson A, Wainwright L, Wooding N, Yu LM, Kloiber S, Mueller D, Kim HK, Jones BDM, Ortiz A, Blumberger D, Salanti G, Araújo SP, Bignardi PR, Camargo BG, Colado Simões AN, de Vasconcelos JP, Fernandes BBP, Gobbi IL, Haber RSA, Jacovetti RC, Liboni AB, Martins CCS, Oliveira AP, Ramos GGA, Rodrigues CBN, Santos RHM, Silva LFR, Tassi GG, Tomazini VF. Author information: (1)Department of Psychiatry, University of Oxford, Oxford, England. (2)Oxford Precision Psychiatry Lab, NIHR Oxford Health Biomedical Research Centre, Oxford, England. (3)NIHR Oxford Health Clinical Research Facility, Oxford Health NHS Foundation Trust, Oxford, England. (4)School of Medicine, Pontifícia Universidade Católica do Paraná, Londrina, Brazil. (5)Graduate Program of Health Sciences, Pontifícia Universidade Católica do Paraná, Curitiba, Brazil. (6)Department of Psychiatry, Temerty School of Medicine, University of Toronto, Toronto, Ontario, Canada. (7)Centre for Addiction and Mental Health, Toronto, Ontario, Canada. (8)Royal Ottawa Hospital, Ottawa, Ontario, Canada. (9)Institute of Primary Health Care, University of Bern, Bern, Switzerland. (10)Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland. (11)Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, England. (12)School of Engineering, Mathematics, and Technology, University of Bristol, Bristol, England. (13)Health Sciences Center, Londrina State University, Londrina, Brazil. (14)Department of Health Economics, Medical University of Vienna, Vienna, Austria. (15)NIHR South Central Regional Research Delivery Network, Southampton, England. (16)Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts. (17)Office of Institutional Advancement and Communications, Kyoto University, Kyoto, Japan. (18)Department of Health Policy, London School of Economics and Political Science, London, England. Comment in JAMA. 2026 Apr 14;335(14):1212-1214. doi: 10.1001/jama.2026.0816. ## IMPORTANCE Antidepressants for moderate to severe major depressive disorder may be discontinued prematurely because the prescribed antidepressant is not always the most appropriate medication for an individual. Guidelines have recommended more precise targeting of antidepressant treatment. ## OBJECTIVE To evaluate the efficacy of a web-based tool to personalize antidepressant treatment. DESIGN, SETTING, AND PARTICIPANTS This multicenter, randomized clinical trial included persons between the ages of 18 and 74 years with major depressive disorder. The trial was conducted at 47 sites in 3 countries (Brazil, Canada, and the UK). The first participant was screened on November 29, 2022, and the last follow-up visit occurred on January 15, 2025. INTERVENTION: A total of 540 participants were randomized (1:1) to an evidence-based clinical decision-support system (PETRUSHKA tool; n = 271) or usual care (n = 269). MAIN OUTCOMES AND MEASURES The primary outcome was treatment discontinuation due to any cause at 8 weeks. The secondary outcomes included treatment discontinuation up to 24 weeks due to adverse events and changes in depressive symptoms (measured with the 9-item Patient Health Questionnaire [PHQ-9]; range, 0-27; higher scores indicate more severe depression) and anxiety symptoms (measured with the 7-item Generalized Anxiety Disorder [GAD-7] questionnaire; range, 0-21; higher scores indicate more severe symptoms). ## RESULTS Of the 520 eligible participants, 493 were included in the primary analysis (median age, 35 [IQR, 25 to 48] years; 58% female; PHQ-9 mean score, 16.6 [SD, 5.1]; GAD-7 mean score, 11.5 [SD, 4.1]). At 8 weeks, 41 of 241 participants (17%) in the PETRUSHKA group discontinued the prescribed antidepressant due to any cause vs 69 of 252 (27%) in the usual care group (adjusted relative risk, 0.62 [95% CI, 0.44 to 0.88]; P = .007). At 8 weeks, 22 of 241 participants (9%) in the PETRUSHKA group discontinued the prescribed antidepressant due to adverse events vs 39 of 252 (16%) in the usual care group (adjusted relative risk, 0.59 [95% CI, 0.36 to 0.97]; P = .04). For the assessment of depressive symptoms at 24 weeks, the mean PHQ-9 score was 7.1 (SD, 5.4) in the PETRUSHKA group vs 9.2 (SD, 6.5) in the usual care group (n = 129 in each group; adjusted between-group mean difference, -1.92 [95% CI, -3.06 to -0.78]; P < .001). For the assessment of anxiety symptoms at 24 weeks, the mean GAD-7 score was 4.6 (SD, 4.1) in the PETRUSHKA group (n = 133) vs 5.8 (SD, 4.9) in the usual care group (n = 126) (adjusted between-group mean difference, -1.39 [95% CI, -2.26 to -0.52]; P = .002). CONCLUSIONS AND RELEVANCE Compared with usual care, use of the PETRUSHKA tool increased the number of patients still taking their antidepressant at 8 weeks and improved depressive and anxiety symptoms at 24 weeks. However, lack of a double-blind design and the large amount of missing data limit the validity of these results. ## TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT05608330. DOI: 10.1001/jama.2026.1327 PMCID: PMC12961600 DOI: 10.1001/jama.2026.2173