Expert Review of Vaccines最新文献

Background: Vaccines are one of the most effective healthcare tools to prevent morbidity and mortality from infectious diseases.

Research design and methods: A decision tree model was used to evaluate the public health and economic impact of the Greek pediatric national immunization program (NIP) over the lifetime of the 2022 Greek birth cohort. The model included nine Greek NIP routine vaccines for children aged 2 months to 11 years, targeting 14 vaccine-preventable diseases: diphtheria, hepatitis A, hepatitis B, Haemophilus influenzae type B, measles, meningococcal disease, mumps, pertussis, pneumococcal disease, poliomyelitis, rotavirus, rubella, tetanus, and varicella. The outcomes (discounted 3% annually) included estimated disease cases and deaths averted, life-years (LYs) and quality-adjusted life-years (QALYs) gained, total costs averted (2022 euros), and benefit-cost ratios (BCR) from healthcare-sector and societal perspectives.

Results: The Greek pediatric NIP prevented 447,221 disease cases and 242 deaths, resulting in 6,682 LYs and 9,741 total QALYs gained for the 2022 birth cohort. Costs averted were €23.2 million (BCR = 1.3) from the healthcare-sector perspective; costs averted from the societal perspective were €201.4 million (BCR = 3.1), plus €514.0 million in value of QALYs gained (BCR = 8.5).

Conclusion: The Greek pediatric NIP provides extensive public health and economic benefits for Greece by reducing morbidity and mortality from vaccine-preventable diseases.

Background: In China, low awareness of the herpes zoster vaccine (HZV) hinders vaccination uptake among older adults. This study aimed to investigate HZV awareness rates and associated factors among older urban Chinese adults to inform targeted interventions.

Research design and methods: A cross-sectional survey on the awareness of HZV was conducted from December 2024 to January 2025 among adults aged ≥60 years in 6 cities of China. Univariate and multivariable logistic analyses were performed to evaluate the factors related to the rate of awareness of HZV, including the interaction between income and education.

Results: The overall awareness rate was low at 43.4%. Awareness was significantly associated with self-reported health status, monthly income, educational level, and preretirement occupation (all p < 0.05). A significant synergistic effect was observed, where individuals with both high education and high income demonstrated markedly higher awareness levels.

Conclusions: The awareness of HZV among older adults in urban China is inadequate and inequitably distributed. Significant disparities in awareness, which were linked to socioeconomic status and occupational history, were identified. These findings pinpoint specific, underserved populations that should be prioritized for targeted health education strategies to bridge the knowledge gap and promote informed decision-making regarding HZ vaccination.

Objectives: Immunocompromised (IC) patients are at increased risk of herpes zoster (HZ; i.e. shingles) and subsequent complications which can significantly impact quality of life. While current evidence indicates a strong disease presence of HZ in Türkiye, literature on the management of HZ in this population is lacking.

Methods: We conducted a survey with 6 disease experts from various medical specialties in Türkiye to understand their opinions on the burden of HZ and the challenges faced by IC patients, in order to establish a comprehensive and evidence-based expert consensus.

Results: Experts agreed that the burden of HZ is significant among IC patients in Türkiye. However, they identified a need for increased local epidemiological data to better understand the health impact of HZ in Türkiye. Improved dissemination of information regarding HZ to physicians was also highlighted to increase awareness of HZ.

Conclusions: Strategies to enhance current practices and increase vaccine coverage should include incorporation of HZ vaccination into official guidelines and recommendations, with full or partial reimbursement for HZ vaccination in IC patients. Setting up official or society-initiated online platforms could also support ongoing collaboration and provide continuously updated guidelines reflecting the latest advances in HZ vaccination and disease management.

Introduction: Recombinant Zoster Vaccine (RZV) is recommended for Herpes Zoster (HZ) prevention in high-risk patients over 18 years of age.

Research design and methods: This is a prospective population-based study conducted over a three-year period in a Southern Italian General Hospital. The study population was represented by RZV recipients with diverse chronic comorbidities. Adverse Events Following Immunization (AEFIs), baseline disease flares and post-vaccination HZ episodes were evaluated through sequential follow-ups conducted 7 days, 3 months, and 3-38 months post-vaccination, respectively.

Results: Study population included 787 RZV recipients, mostly affected by onco-hematological, cardiovascular and rheumatological disorders. The AEFIs reporting rate was 44.15%. The most frequent symptoms were injection site pain/itching (37.19%), asthenia/malaise (12.74%) and fever (10.30%). Three serious AEFIs with consistent causal association with vaccination were recorded (0.22%), all of which underwent full recovery. Sixteen patients (2.37%) experienced a baseline condition flare-up within 3 months (mean interval 33.88 ± 24.88 days). Multiple baseline disorders (OR:1.97; 95%CI:1.37-2.83; p-value < 0.001) and rheumatological conditions (OR:11.67; 95%CI:2.00-68.27; p-value < 0.01) increased flare risk, while male sex decreased it. Twenty-six vaccinees manifested HZ post-vaccination (cumulative incidence rate 5.05/100,000 person-days), with particularly increased incidence in patients with recurrent/severe HZ history (IRR:14.35; 95%CI:5.64-34.04; p-value < 0.001).

Conclusion: The study demonstrates RZV safety and HZ protection in vulnerable patients, consistently with available evidence.

Background: Vaccine hesitancy among healthcare workers (HCWs) is a global concern, needing reliable tools to measure HCW vaccine confidence. We adapted and validated the 10-item 'iPro-VC-Be' tool for the Nigerian context.

Research design and methods: We conducted a 3-step process. First, contextual adaptation using expert round-table discussions and cognitive interviews with HCWs in Oyo and Jigawa States (12/2023-05/2024). Second, translation and back-translation to Hausa, Igbo and Yoruba, including HCW group discussions (05/2024). Finally, testing validity in all languages, using a test-retest approach (06/2024-09/2024).

Results: Sixty-four participants contributed to adaptation, 25 researchers and 39 HCWs supported translations, 435 HCWs completed the first survey, and 263 completed the re-test. Of the 10 iPro-VC-Be items, 3 were unchanged, 6 had language edits, and 1 was replaced. The Cronbach's alpha indicated good internal reliability, and overall the intraclass correlation coefficient indicated moderate re-test reliability. Confirmatory factor analysis supported goodness of fit across multiple indices, but one negatively framed item performed poorly. Items assessing confidence in vaccines and trust in government were significantly associated with HCW vaccine uptake.

Conclusion: The adapted iPro-VC-Be was valid, however, we recommend using a shorter 6-item version for Nigeria that does not include items linked to immunization resources.

Introduction: Traditional live-attenuated or inactivated vaccines have limitations, including risks associated with uncontrolled replication, reduced immunogenicity, or production complexities. To address these issues, alternative platforms such as virus-like particles (VLPs) have been developed.

Areas covered: VLPs are self-assembling structures composed of viral proteins that mimic native viruses but are noninfectious. This review provides an overview of their structure, design and manufacture that make them an attractive platform for vaccine development. We then discuss the clinical development of some recently approved VLP vaccines and those widely used in immunization programs, summarizing the clinical trial data that underpins their efficacy and safety profiles. Additionally, we explore VLP vaccines in late-stage clinical development for respiratory syncytial virus and human metapneumovirus.

Expert opinion: VLPs are a versatile and promising platform for vaccine development. Their ability to mimic native viruses while eliminating the risks associated with live vaccines positions them as an attractive platform for vaccine design. Currently approved VLP vaccines demonstrate that they can provide effective protection against a wide range of diseases. Advances in VLP design and production are likely to lead to highly effective vaccines, significantly contributing to global immunization efforts.

Introduction: Non-survey-based data sources (e.g. electronic health records, administrative claims) have been used to estimate vaccination coverage among US adults. However, these data sources were not collected for research or surveillance purposes and may have substantial limitations. The objectives of this narrative review were to: 1) identify published studies that used non-survey-based data sources to estimate adult vaccination coverage for one or more routinely recommended vaccines; and 2) summarize the strengths and limitations of these data sources for coverage assessments.

Areas covered: Thirty-four publications derived from 9 data sources were reviewed: 16 publications were in a general population (i.e. defined by age), 12 were among pregnant women, and 6 were among individuals with chronic health conditions. While several data sources used continuous health insurance enrollment to define the study population, doing so limited generalizability to stably insured populations. Methods for obtaining race and ethnicity data were complex and potentially subject to bias. None of the reviewed studies presented any formal assessment of vaccine data validity.

Expert opinion: While multiple non-survey-based data sources have been used to assess adult vaccination coverage in the United States, important limitations exist, including related to generalizability, data validity, and risk of bias.

Introduction: The World Health Organization has recommended two pre-erythrocytic malaria vaccines targeting Plasmodium falciparum. However, there is currently no vaccine available for Plasmodium vivax, the second leading cause of malaria. To eliminate malaria, transmission-blocking vaccines (TBVs) that can prevent infection of mosquitoes from humans would be helpful.

Areas covered: This review summarizes the identification of targets, progress, and prospects in developing malaria TBVs. We searched PubMed for studies published up to 11 April 2025, using the terms ['Pfs25' OR 'Pfs230' OR 'Pfs48/45' OR 'Pvs25' OR 'Pvs230' OR 'Pvs48/45' OR 'AnAPN1'] AND ['malaria transmission-blocking vaccine'].

Expert opinion: After over 30 years of research and development, Pfs230 for P. falciparum and Pvs25 for P. vivax are the most advanced candidates for transmission-blocking vaccines.

Background: Clinical trials have compared new pneumococcal conjugative vaccines (PCVs; PCV15 and PCV20) to an established PCV (PCV13) in a routine 2 + 1 schedule. This study performed an indirect comparison of PCV15 vs. PCV20 immune responses in healthy infants and toddlers.

Research design and methods: Pooled, matching-adjusted PCV15 trials were indirectly compared to the analogous PCV20 trial for IgG response rate difference (RRD) and geometric mean concentration ratio (GMR) at the post-primary series (PPS) and post-toddler dose (PTD) timepoints.

Results: At PPS, PCV15 was non-inferior for RRD and GMR as compared to PCV20 for all PCV13 serotypes. Moreover, PCV15 was superior to PCV20 for the RRDs of serotypes 1, 3, 4, 5, 6B, 9V, and 23F and GMRs of serotypes 3, 4, 5, 6B, 9V, and 23F at PPS. At PTD, RRDs were comparable for all PCV13 serotypes, except serotype 3, for which PCV15 was superior. PCV15 was superior for the GMRs of serotypes 3, 6B, and 23F, and comparable for the remaining serotypes at PTD. RRDs for serotypes 22F and 33F were non-inferior at both PPS and PTD.

Conclusion: In a 2 + 1 schedule, PCV15 demonstrates immunogenicity comparable or superior to PCV20 across PCV13 serotypes, especially for serotype 3.