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Older adults are less able to produce a protective antibody response to vaccinations. One factor that contributes to this is immune ageing. Here we examined whether diurnal variations in immune responses might extend to the antibody response to vaccination.

We utilised a cluster-randomised trial design.

24 General Practices (GPs) across the West Midlands, UK who were assigned to morning (9–11 am; 15 surgeries) or afternoon (3–5 pm; 9 surgeries) vaccination times for the annual UK influenza vaccination programme.

276 adults (aged 65+ years and without a current infection or immune disorder or taking immunosuppressant medication).

Participants were vaccinated in the morning or afternoon between 2011 and 2013.

The primary outcome was the change in antibody titres to the three vaccine influenza strains from pre-vaccination to one …