Vacunas (English Edition)最新文献

Evolution of vaccination schedules in Spain: 50 years after the first schedule (1975) 西班牙疫苗接种时间表的演变：第一个时间表（1975年）后的50年

Vacunas (English Edition)

Pub Date : 2025-10-01 DOI: 10.1016/j.vacune.2025.500426

Fernando Moraga-Llop

The year 2025 marks the 50th anniversary of the first vaccination schedule implemented in Spain, drawn up by the General Directorate of Health, which included vaccines against five diseases. This schedule was based on the national vaccination campaigns carried out from 1963 onwards against polio and was inspired by the 1973 Barcelona city schedule. At the end of 1979, the transfer of public health matters to the Autonomous Communities began, and they started to publish their own calendars. In 1995, the Interterritorial Council of the National Health System approved its first calendar, which was published as the 1996 Vaccination Calendar, applicable up to the age of 14 and including eight vaccines, with the aim of unifying criteria and methods of action in the different vaccination programmes of each autonomous community. In 2019, the first common lifelong vaccination schedule appeared, with the incorporation of 3 age bands from 14 years of age onwards. The 2025 schedule protects against 18 diseases and is the most complete in Europe, with excellent coverage in children; and the schedule of Catalonia, Ceuta and Melilla is superior, as it protects against 19 diseases, as it includes the hepatitis A vaccine.

2025年是西班牙实施第一个疫苗接种计划50周年，该计划由卫生总局制定，其中包括预防五种疾病的疫苗。这一时间表是根据1963年以来开展的针对小儿麻痹症的全国疫苗接种运动制定的，并受到1973年巴塞罗那市时间表的启发。1979年底，公共卫生事务开始向自治区移交，自治区开始出版自己的日历。1995年，全国卫生系统领土间理事会核准了其第一个日历，并公布为1996年接种日历，适用于14岁以下，包括8种疫苗，目的是统一每个自治区不同疫苗接种方案的标准和行动方法。2019年，出现了第一个共同的终身疫苗接种计划，其中包括从14岁起的3个年龄组。2025年计划预防18种疾病，在欧洲是最全面的，对儿童的覆盖率很高；加泰罗尼亚、休达和梅利利亚的时间表更优越，因为它可以预防19种疾病，因为它包括甲型肝炎疫苗。

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引用次数: 0

Vaccines: A global perspective 疫苗：全球视角

Vacunas (English Edition)

Pub Date : 2025-10-01 DOI: 10.1016/j.vacune.2025.500457

Cristina García-Mauriño , Quique Bassat

Vaccines are among the most effective and cost-efficient tools in public health. Vaccine schedules have evolved in recent years to incorporate new immunizations. The WHO's Expanded Programme on Immunisation (EPI) recommends universal vaccines for 13 diseases and, depending on the context, for an additional 17 diseases. Over the past 50 years, global immunization efforts are estimated to have saved approximately 154 million lives, of which 146 million (95%) are children under the age of five.

Since 1974, child mortality has decreased from 92 to 25 per 1,000 live births, with estimates suggesting that 40 percent of this reduction is attributable to vaccines, though there are regional variations: 21 percent in the Western Pacific, 41 percent in America, and 52 percent in Africa.

Despite this impact, significant inequalities in access to vaccines persist between the global north and south. Since 2000, Gavi, the Vaccine Alliance, has supported 73 low- and middle-income countries, facilitating equitable access to new or underused vaccines. However, challenges remain, such as underfunding and low local production in many countries in the global south, as evidenced during the COVID-19 pandemic.

We are currently experiencing an exceptional moment in science. The great challenge is to ensure that these advancements reach the regions that need them most as a priority.

疫苗是公共卫生领域最有效和最具成本效益的工具之一。近年来，疫苗接种计划不断发展，纳入了新的免疫接种。世卫组织扩大免疫规划（EPI）建议为13种疾病接种通用疫苗，并根据具体情况，为另外17种疾病接种通用疫苗。在过去50年中，全球免疫工作估计挽救了约1.54亿人的生命，其中1.46亿（95%）是五岁以下儿童。自1974年以来，儿童死亡率已从每1 000名活产婴儿中有92人死亡降至25人死亡，据估计，这一降幅的40%可归因于疫苗，尽管存在区域差异：西太平洋为21%，美洲为41%，非洲为52%。尽管有这种影响，但全球南北之间在获得疫苗方面仍然存在严重的不平等。自2000年以来，全球疫苗免疫联盟支持了73个低收入和中等收入国家，促进公平获得新疫苗或未充分使用的疫苗。然而，挑战依然存在，如在2019冠状病毒病大流行期间，全球南方许多国家的资金不足和当地产量低。我们目前正经历着科学上的一个特殊时刻。最大的挑战是确保这些进步能够优先惠及最需要这些进步的地区。

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引用次数: 0

Impact of vaccination against human papillomavirus: Towards cervical cancer elimination 接种人乳头瘤病毒疫苗的影响：迈向消除子宫颈癌

Vacunas (English Edition)

Pub Date : 2025-10-01 DOI: 10.1016/j.vacune.2025.500485

Laia Alemany, Maria Brotons

Certain human papillomavirus (HPV) genotypes are a necessary cause of cervical cancer and are linked to the etiology of a fraction of anogenital and head and neck carcinomas. Currently, twelve HPV types have been classified as definitively carcinogenic by the International Agency for Research on Cancer, of which HPV16 is the most carcinogenic genotype. The carcinogenic classification of HPVs is based on extensive epidemiological studies and biological evidence conducted over the past decades and thanks to the strong collaboration between scientists seeking to uncover the etiology of cervical cancer. HPVs 16, 18, 31, 33, 35, 45, 52, and 58 are responsible for more than 90% of cervical cancers. Since 2006, three effective prophylactic vaccines have been approved in Europe, and have demonstrated to be immunogenic, safe, efficacious and effective. The demonstration of HPV as a necessary cause of cervical cancer has also led to the refinement of screening strategies, such as the introduction of primary HPV testing. Comprehensive cancer research, from etiology to prevention, has had a significant impact on global public health policies, so much so that in 2020 the World Health Organization launched the campaign to eliminate cervical cancer, a possible milestone never before considered in the field of oncology.

某些人类乳头瘤病毒（HPV）基因型是宫颈癌的必要原因，并与部分肛门生殖器癌和头颈部癌的病因有关。目前，国际癌症研究机构已将12种HPV类型确定为致癌物，其中HPV16是最具致癌性的基因型。人类乳头状瘤病毒的致癌分类是基于过去几十年进行的广泛的流行病学研究和生物学证据，并得益于寻求揭示宫颈癌病因的科学家之间的强有力合作。hpv 16、18、31、33、35、45、52和58是90%以上宫颈癌的病因。自2006年以来，欧洲已批准了三种有效的预防性疫苗，并已证明具有免疫原性、安全性、有效性和有效性。人类乳头瘤病毒作为宫颈癌的必要原因的证明也导致了筛查策略的改进，例如引入原发性人类乳头瘤病毒检测。从病因到预防的全面癌症研究对全球公共卫生政策产生了重大影响，以至于世界卫生组织在2020年发起了消除宫颈癌的运动，这可能是肿瘤学领域从未考虑过的一个里程碑。

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引用次数: 0

Vaccination as a strategy to control SARS-CoV-2 pandemic 疫苗接种作为控制SARS-CoV-2大流行的策略

Vacunas (English Edition)

Pub Date : 2025-10-01 DOI: 10.1016/j.vacune.2025.500429

José Antonio Navarro-Alonso

Once COVID-19 vaccines produced on messenger RNA or adenovirus vector platforms became available, the incidence of SARS-CoV-2 infections, particularly hospitalizations among the highly vulnerable population, began to decline. The vaccination strategies in Spain were agreed upon within the Ministry of Health among a group of professionals from various fields and were widely accepted by the population.

一旦在信使RNA或腺病毒载体平台上生产的COVID-19疫苗可用，SARS-CoV-2感染的发生率，特别是高度脆弱人群的住院率开始下降。西班牙的疫苗接种战略是在卫生部内部由来自不同领域的一组专业人员商定的，并为民众广泛接受。

引用次数: 0

Poliomyelitis: The paradigm of an eliminated disease. Sequelae and challenges to eradication 脊髓灰质炎：一种被消灭的疾病的范例。后遗症和根除的挑战

Vacunas (English Edition)

Pub Date : 2025-10-01 DOI: 10.1016/j.vacune.2025.500484

José Tuells , José Antonio Hurtado-Sánchez

Polio represents one of the most emblematic cases in the history of public health. Its greatest impact occurred during the first half of the 20th century, with devastating epidemic outbreaks that caused half a million cases annually with tens of thousands of deaths, in addition to leaving many survivors permanently paralyzed. The scientific community responded in an exemplary manner by studying polio until they developed two effective vaccines: an inactivated vaccine (Salk, 1955) and an attenuated vaccine (Sabin, 1962). A global response was immediately organized based on international cooperation, well-defined immunization strategies, and epidemiological surveillance. The mass vaccination effort carried out since 1988 through the Global Polio Eradication Initiative (GPEI) managed to reduce cases by 99.9%. Currently, the wild polio virus only persists in Afghanistan and Pakistan, and the GPEI's “Eradication Strategy 2022–2026” has been implemented with the hope of certifying its complete eradication in the coming years. Two significant challenges remain: controlling outbreaks caused by vaccine-derived polioviruses and increasing low immunization coverage in certain regions.

小儿麻痹症是公共卫生史上最具代表性的病例之一。它的最大影响发生在20世纪上半叶，毁灭性的流行病爆发，每年造成50万例病例，数万人死亡，此外还使许多幸存者永久瘫痪。科学界以模范的方式作出反应，研究小儿麻痹症，直到研制出两种有效的疫苗：一种灭活疫苗（Salk， 1955年）和一种减毒疫苗（Sabin， 1962年）。根据国际合作、明确的免疫战略和流行病学监测，立即组织了全球应对行动。1988年以来通过全球根除脊髓灰质炎行动开展的大规模疫苗接种工作使病例减少了99.9%。目前，野生脊髓灰质炎病毒仅在阿富汗和巴基斯坦存在，GPEI的“2022-2026年根除战略”已经实施，希望在未来几年内证明其完全根除。仍然存在两项重大挑战：控制由疫苗衍生脊髓灰质炎病毒引起的疫情，以及提高某些地区低免疫覆盖率。

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引用次数: 0

Challenges towards global measles and rubella elimination 全球消除麻疹和风疹的挑战

Vacunas (English Edition)

Pub Date : 2025-10-01 DOI: 10.1016/j.vacune.2025.500430

Núria Torner

Measles and rubella are two vaccine-preventable viral diseases. Vaccination with the measles and rubella containing vaccines (MMR) has significantly reduced the incidence of these diseases, but measles remains a major cause of morbidity and mortality worldwide. Eliminating these diseases requires maintaining high levels of immunity in the population and a comprehensive approach to vaccination programs and primary health care. The WHO has established strategic plans for the elimination of measles and rubella, achieving significant progress in vaccination coverage and reducing cases and deaths. Although vaccination is a highly effective public health intervention, vaccine hesitancy has increased in recent years due to several factors, especially since the COVID-19 pandemic. Pressure from anti-vaccine movements on social media, psychological stress, mental health issues, and a lack of education among health professionals are some of the factors contributing to this hesitancy. To address this problem, which the WHO identified as one of the world's top public health challenges in 2019, a comprehensive and coordinated approach involving all sectors of society is needed to achieve the goal of global elimination.

麻疹和风疹是两种疫苗可预防的病毒性疾病。接种含麻疹和风疹疫苗（MMR）大大降低了这些疾病的发病率，但麻疹仍然是全世界发病率和死亡率的主要原因。消除这些疾病需要在人群中保持高水平的免疫力，并对疫苗接种规划和初级卫生保健采取综合办法。世卫组织制定了消除麻疹和风疹的战略计划，在疫苗接种覆盖率和减少病例和死亡方面取得了重大进展。尽管疫苗接种是一项非常有效的公共卫生干预措施，但近年来，由于若干因素，特别是自COVID-19大流行以来，疫苗犹豫有所增加。来自社交媒体上的反疫苗运动、心理压力、心理健康问题以及卫生专业人员缺乏教育的压力是造成这种犹豫的一些因素。世卫组织将这一问题确定为2019年全球最大的公共卫生挑战之一，为了解决这一问题，需要采取全面和协调的方法，让社会各界参与进来，以实现全球消除的目标。

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引用次数: 0

Impact of hepatitis B virus immunization 乙型肝炎病毒免疫的影响

Vacunas (English Edition)

Pub Date : 2025-10-01 DOI: 10.1016/j.vacune.2025.500482

Jaime Jesús Pérez Martín , Victoria Uroz Martínez

Hepatitis B virus (HBV) infection remains a global public health issue due to its potential for chronicity and severe complications such as cirrhosis and hepatocellular carcinoma. Since its introduction in the 1980s, vaccination against HBV has proven to be a highly effective tool in preventing acute infection, chronic disease, and vertical transmission. This article reviews the impact of hepatitis B vaccination globally and in Spain, based on data from epidemiological surveillance, seroprevalence studies, and cancer registries. Remarkable reductions in the incidence of chronic infection and hepatocellular carcinoma have been observed in countries that implemented the vaccine early, such as Taiwan, China, and Iran. In Spain, vaccination began in risk groups in 1982, was extended to adolescents in the 1990s, and to infants from 2002. Vaccination coverage has exceeded 93% in infants for over two decades. The incidence of acute hepatitis B has decreased significantly since 1997, and seroepidemiological studies show a marked decline in infection among individuals under 40 years old. A significant reduction in vertical transmission and hepatocellular carcinoma incidence has also been documented in Spanish men aged 35–39 years. Although systematic vaccination has had a substantial impact on the HBV disease burden, challenges remain regarding surveillance in unvaccinated or vulnerable populations, especially in the context of migration movements.

乙型肝炎病毒（HBV）感染仍然是一个全球公共卫生问题，因为它可能导致慢性和严重并发症，如肝硬化和肝细胞癌。自20世纪80年代引入以来，乙肝疫苗已被证明是预防急性感染、慢性疾病和垂直传播的一种非常有效的工具。本文根据流行病学监测、血清阳性率研究和癌症登记的数据，回顾了全球和西班牙乙型肝炎疫苗接种的影响。在西班牙，1982年开始在危险人群中接种疫苗，1990年代扩大到青少年，2002年扩大到婴儿。二十多年来，婴儿的疫苗接种覆盖率超过93%。自1997年以来，急性乙型肝炎的发病率显著下降，血清流行病学研究表明，40岁以下人群的感染率显著下降。在35-39岁的西班牙男性中，垂直传播和肝细胞癌的发病率也有显著降低。尽管系统的疫苗接种对乙型肝炎病毒疾病负担产生了重大影响，但在未接种疫苗或脆弱人群的监测方面仍然存在挑战，特别是在移民流动的背景下。

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引用次数: 0

Impact of conjugate vaccines on the evolution of invasive pneumococcal disease (IPD) in Spain 结合疫苗对西班牙侵袭性肺炎球菌病（IPD）演变的影响

Vacunas (English Edition)

Pub Date : 2025-10-01 DOI: 10.1016/j.vacune.2025.500452

Covadonga Pérez-García , Mirella Llamosí , Inés Pareja-Cerbán , Aída Úbeda , Erick Joan Vidal-Acántara , Jose Yuste , Mirian Domenech , Julio Sempere

Invasive pneumococcal disease (IPD) is a public health problem with high morbidity and mortality, especially in children and older adults. Despite pneumococcal conjugate vaccines (PCV), serotype replacement and antibiotic resistance are important challenges. This study analyses the evolution of IPD in Spain during the last 15 years, assessing the impact of vaccination in serotype distribution and antimicrobial resistance to penicillin and erythromycin. Since the introduction of PCV13, IPD cases by vaccine serotypes have decline in pediatric population. However, an increase of non-vaccine serotypes such as 8 and 24F was observed. In adults, we also found a reduction on IPD cases by vaccine serotype due to herd immunity. The COVID-19 pandemic diminished pneumococcal transmission in 2020–2021, but in 2023 we recovered pre-pandemic levels. In the last years, we have observed an increase of cases by serotype 3 in children and adults which is worrisome. From the antibiotic resistance perspective, the use of PCVs have also decline the circulation of vaccine serotypes associated with antibiotic resistance, although an increase by serotypes 11A and 24F has been observed in the last years. The use of broader vaccines and epidemiological surveillance are essential aspects necessary to improve prevention strategies.

侵袭性肺炎球菌病（IPD）是一个高发病率和死亡率的公共卫生问题，特别是在儿童和老年人中。尽管肺炎球菌结合疫苗（PCV），血清型替代和抗生素耐药性是重要的挑战。本研究分析了西班牙过去15年IPD的演变，评估了疫苗接种对血清型分布和对青霉素和红霉素耐药性的影响。自引入PCV13以来，按疫苗血清型划分的IPD病例在儿科人群中有所下降。然而，观察到非疫苗血清型如8和24F的增加。在成人中，我们还发现由于群体免疫，不同疫苗血清型的IPD病例减少。2019冠状病毒病大流行在2020-2021年减少了肺炎球菌传播，但在2023年恢复了大流行前的水平。在过去几年中，我们观察到儿童和成人血清3型病例有所增加，这令人担忧。从抗生素耐药性的角度来看，pcv的使用也减少了与抗生素耐药性相关的疫苗血清型的流通，尽管在过去几年中观察到血清型11A和24F有所增加。使用更广泛的疫苗和流行病学监测是改进预防战略的必要方面。

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引用次数: 0

Meningococcus: Impact of meningococcal vaccination in Spain 脑膜炎球菌：在西班牙接种脑膜炎球菌疫苗的影响

Vacunas (English Edition)

Pub Date : 2025-10-01 DOI: 10.1016/j.vacune.2025.500451

Josep Marès Bermúdez

Meningococcal disease is an extremely serious disease, responsible for most sepsis and meningitis, produced in our area by 4 serogroups: B, C, W, and Y. It is endemic, can present epidemic outbreaks unpredictably, and is preventable with effective and safe vaccines. In Spain, systematic childhood vaccination with conjugated meningococcal C vaccine began in 2000, with an extremely favorable impact, reducing over 95% of the disease burden caused by this serogroup during the 25 years of the program. In 2020, the conjugated ACWY vaccine was included at 12 years of age to address the observed increase in cases due to serogroup W, with a favorable impact currently leading to the absence of cases in vaccination cohorts. In 2023, systematic vaccination against serogroup B was instituted in children under 1 year, following a national study confirming a 71% vaccine effectiveness against serogroup B disease and a global effectiveness for meningococcal disease, regardless of serogroup, of 76%. The achievements underscore the importance of maintaining and strengthening meningococcal vaccination programs in the future to continue safeguarding public health.

脑膜炎球菌病是一种极其严重的疾病，导致大多数败血症和脑膜炎，在我们地区由4个血清群：B、C、W和y产生。它是地方性的，可出现不可预测的流行病爆发，可通过有效和安全的疫苗预防。在西班牙，2000年开始系统地接种C型脑膜炎球菌结合疫苗的儿童疫苗，产生了极为有利的影响，在该规划实施的25年期间，减少了该血清群造成的95%以上的疾病负担。2020年，在12岁时纳入了ACWY结合疫苗，以解决由于血清W群导致的病例增加的问题，目前的有利影响导致疫苗接种队列中没有病例。2023年，在一项国家研究证实疫苗对B血清群疾病的有效性为71%，对脑膜炎球菌病（不论血清群）的全球有效性为76%之后，对1岁以下儿童进行了系统的B血清群疫苗接种。这些成就强调了在未来维持和加强脑膜炎球菌疫苗接种规划以继续保障公众健康的重要性。

引用次数: 0

Hepatitis A: Impact of vaccination 甲型肝炎：疫苗接种的影响

Vacunas (English Edition)

Pub Date : 2025-10-01 DOI: 10.1016/j.vacune.2025.500428

Angela Domínguez , Núria Soldevila , Lluís Salleras

Hepatitis A has a worldwide distribution, with incidence varying according to the level of endemicity. High endemicity countries are those with a prevalence of infection in the general population greater than 50% and an annual incidence greater than 150 cases/100,000 inhabitants, while very low endemicity countries corresponds to a prevalence of infection at the age of 30 years less than 50% and an annual incidence of less than 5 cases/100,000.

Population impact of the universal vaccination strategy has been demonstrated in multiple contexts, with a decrease in the incidence of cases observed not only in those age groups that receive vaccination but also in unvaccinated population.

Although elimination targets for viral hepatitis are primarily quantified for hepatitis B and C, which cause the majority of deaths, WHO's global health strategy targets the five viruses (A, B, C, D, and E) that cause hepatitis. Interventions include ensuring high sanitation levels and water and food security, as well as vaccination against hepatitis A.

The single-dose vaccination strategy implemented in some countries has proven to be cost-effective. Currently, the biggest obstacle to universal vaccination in low-endemicity countries is its cost. It would be important to consider the indirect protective effect of vaccination to estimate the true impact of universal vaccination.

甲型肝炎在世界范围内分布，发病率根据流行程度而变化。高流行国家是指一般人群感染流行率大于50%，年发病率大于150例/10万居民的国家，而极低流行国家对应的是30岁感染流行率低于50%，年发病率低于5例/10万居民的国家。普遍疫苗接种战略对人口的影响已在多种情况下得到证明，不仅在接受疫苗接种的年龄组，而且在未接种疫苗的人群中也观察到病例发生率的下降。尽管病毒性肝炎的消除目标主要针对造成大多数死亡的乙型和丙型肝炎进行量化，但世卫组织的全球卫生战略针对的是导致肝炎的五种病毒（甲、乙、丙、丁和戊）。干预措施包括确保高卫生水平以及水和粮食安全，以及预防甲型肝炎疫苗接种。在一些国家实施的单剂疫苗接种战略已被证明具有成本效益。目前，在低流行国家普及疫苗接种的最大障碍是费用。为了估计普遍接种疫苗的真正影响，考虑疫苗接种的间接保护作用是很重要的。

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引用次数: 0