Vaccines最新文献

Background: Healthcare workers (HCWs) are pivotal in influenza containment, serving as both high-risk individuals and vaccine advocates. However, influenza vaccination coverage among Chinese HCWs remains suboptimal. Existing research is often constrained by limited geographic representativeness or non-robust designs. This study provides a robust, nationwide assessment of influenza vaccine uptake and recommendation behaviors among HCWs in China. Methods: A multicenter cross-sectional survey was conducted in late 2025 across four Chinese provinces (Shanghai, Shandong, Chongqing, and Hubei). A total of 390 frontline HCWs-only those defined as directly engaged in influenza management and prevention-from 48 hospitals (primary, secondary, and tertiary levels) completed validated electronic questionnaires. A multinomial logistic regression model was employed to identify determinants of personal vaccine uptake behavior among HCWs. Results: Overall influenza knowledge was moderate, with notable gaps in recognizing typical symptoms (29.23%), southern China's peak season (31.03%), and optimal vaccination timing (55.38%). A striking "recommendation-uptake disparity" was observed: while 93.6% of HCWs recommended the vaccine to patients, only 22.3% received it annually themselves. A multinomial regression revealed that being a nurse (vs. doctor: OR = 3.11, 95% CI: 1.28-7.53) or female (vs. male: OR = 3.08, 95% CI: 1.28-7.44) was positively associated with annual vaccination, whereas clinical technicians (vs. doctors: OR = 0.18, 95% CI: 0.03-0.94) showed lower odds. Primary barriers to personal vaccination included inconvenience (49.5%), perceived high cost (16.2%), and efficacy concerns (19.5%). Conclusions: This study highlights a significant gap between high recommendation rates and low personal uptake among HCWs in China. The findings underscore the need for multifaceted interventions, including workplace-based reminder systems, free vaccination policies, and tailored education, to optimize coverage and strengthen the role of HCWs in national influenza prevention.

Background: Large urban centers in low- and middle-income countries (LMICs) often have persistent pockets of under-immunized children, despite higher overall vaccination coverage than rural areas. Lahore, a megacity in Pakistan, had the lowest rate of fully immunized children in Punjab province as of 2022 (70%), partly due to challenges in its urban slums. In 2023, an innovative intervention was implemented, utilizing Pakistan's extensive polio eradication workforce to identify and reach children who were missing routine vaccinations. Objective: The objective was to assess changes in routine immunization coverage during a pre-post evaluation period in which polio campaign workers were engaged to support routine immunization among under-immunized urban populations in Lahore. Methods: A special outreach strategy engaged polio vaccination teams to conduct door-to-door visits of children aged 12-23 months, recording each child's routine immunization status. These data were integrated into the electronic health system and provided to Expanded Programme on Immunization (EPI) staff for targeted follow-up. Two cross-sectional household surveys of caregivers of children aged 12-23 months were conducted: a 2022 baseline survey and a 2023 follow-up survey conducted six months after implementation. Both surveys used two-stage cluster sampling and WHO-standard immunization coverage methods, with vaccination status verified using cards or caregiver recall. Results: A total of 773 children were surveyed at baseline and 780 at endline. Full immunization coverage increased from 69.8% (CI: 64.13-74.98) to 85.1% (CI: 81.01-88.51). Partial immunization declined from 26.9% (CI: 22.37-31.92) to 14.5% (CI: 11.27-18.50), and the proportion of children not vaccinated at all dropped from 3.3% (CI: 1.92-5.60) to 0.3% (CI: 0.11-0.98). Penta-3 coverage improved from 83.2% (CI: 78.65-87.04) to 94.1% (CI: 91.15-96.07), and Measles 1 from 76.9% (CI: 71.80-81.40) % to 92.1% (CI: 88.71-94.56). Immunization card retention increased from 69.9% (CI: 64.15-75.16) to 84% (CI:81.19-86.94). Improvements were observed across all socio-demographic groups, with a higher impact in peri-urban clusters and low socio-economic groups, and all remained statistically significant. Conclusions: Our findings showed improvements in routine immunization coverage in urban Lahore between 2022 and 2023. This period coincided with district-wide implementation of a polio worker outreach strategy as well as the broader post-COVID-19 recovery of immunization services. This study lacked a control group; therefore, the findings indicate a temporal association occurring during the post COVID-19 recovery period, rather than definitive evidence of causal impact. Nonetheless, integrating the workforce of the polio program into routine immunization could be a promising programmatic strategy to close immunization gaps in urban areas.

The authors would like to make the following correction to the published paper [...].

Background: The U.S. Food and Drug Administration (FDA) conducted a benefit-risk assessment for Moderna's COVID vaccine mRNA-1273 prior to its full approval, announced 31 January 2022. The FDA's assessment focused on males 18-64 years old because its risk analysis was limited to vaccine-attributable myocarditis/pericarditis (VAM/P), given the excess risk among males. The FDA's analysis concluded that vaccine benefits outweighed risks, even for 18-25-year-old males (those at highest VAM/P risk). We reanalyze the FDA's benefit-risk assessment using information available through the third week of January 2022 and focusing on 18-25-year-old males.

Methods: We develop a benefit-risk model, extending the FDA's, that can stratify benefits and risks of vaccination by prior-infection and comorbidity status. We use the FDA's framework but apply our model to account for benefits derived from prior COVID infection, while also accounting for finer age stratification in COVID-hospitalization rates, incidental hospitalizations (those of patients who test positive for COVID but receive treatment for something else), more realistic projections of Omicron-infection rates, and more accurate VAM/P rates.

Results: With hospitalizations as the principal endpoint of the analysis (those prevented by vaccination vs. those caused by VAM/P), our model finds vaccine risks outweighed benefits for 18-25-year-old males, except in scenarios projecting implausibly high Omicron-infection prevalence. Our assessment suggests that mRNA-1273 vaccination of 18-25-year-old males generated between 8% and 52% more hospitalizations for VAM/P compared to COVID hospitalizations prevented (over a five-month period of vaccine protection assumed by the FDA). The preceding assessment uses model inputs based on data available at the time of the FDA's mRNA-1273 assessment. Moreover, these inputs as well as model outputs are validated by subsequently available data.

Conclusions: The outcome of a vaccine benefit-risk assessment may be dramatically impacted by accounting for the benefits derived from prior infection by the vaccine-targeted disease. To increase public confidence in vaccines and thereby reduce vaccine hesitancy, public-health agencies should employ benefit-risk models capable of supporting stratification of vaccination recommendations not only based on age and sex but also on prior-infection and comorbidity status.

Background: Tick-borne encephalitis (TBE) is a severe viral infection of the central nervous system transmitted by tick bites. Vaccination represents the only effective preventive measure, yet data on TBE vaccine effectiveness in Italy are lacking. This study aimed to evaluate TBE vaccine effectiveness and vaccination coverage in the province of Udine, an endemic area in the Friuli Venezia Giulia region of Northern Italy. Methods: We conducted a case-control study using linked anonymized health databases of the region, including vaccination, laboratory, and hospital admission records from 2017 to 2025. Cases were defined as residents hospitalized with a diagnosis of TBE (ICD-9-CM 063.x or 321.2) and a positive anti-TBE IgM result in serum or cerebrospinal fluid. Controls were residents tested for anti-TBE IgM during the same period but not hospitalized for TBE. Vaccination history was retrieved from the regional vaccination registry. Vaccine effectiveness was estimated through logistic regression models comparing vaccinated and unvaccinated individuals. Results: Between 2017 and 2025, 21 confirmed TBE hospitalizations were recorded (mean annual incidence: 0.45/100,000 inhabitants). The mean hospital stay was 13.8. Among 6065 individuals tested for anti-TBE IgM, 95.2% of cases and 81.8% of controls were unvaccinated. The estimated odds ratio of TBE hospitalization for individuals with ≥3 vaccine doses versus unvaccinated was 0.11 (95% CI: 0.02-0.88). Vaccination coverage in 2025 reached about 10% of the provincial population, with markedly higher coverage (up to 34%) in mountain districts compared with lowland areas (<5%). Conclusions: Although limited by small sample size, this study provides the first real-world evidence of TBE vaccine effectiveness in an Italian endemic area. Vaccination is an effective preventive measure. Given the regional epidemiology and expected increase in tick activity due to climate change, strengthening vaccination uptake and public awareness in endemic districts is strongly recommended.

As Guest Editors of the Special Issue "Trust, Willingness, and Associated Factors towards COVID-19 Vaccine Uptake" [...].

Background/Objectives: Sabin strain-based inactivated poliovirus vaccine (sIPV) is increasingly used in China's routine immunization program and is often administered concomitantly with other childhood vaccines. However, large-scale real-world evidence on the safety of concomitant sIPV vaccination remains limited. This study evaluated the safety of sIPV administered standalone or concomitantly with other routine vaccines using provincial surveillance data. Methods: A retrospective observational study was conducted using data from the China National Adverse Events Following Immunization Surveillance System and the Anhui Provincial Immunization Information Management System. All sIPV doses administered between 1 November 2023 and 31 July 2025 were included. AEFI reporting rates per 100,000 doses were calculated. Descriptive analyses were performed by demographic characteristics and dose number. Multivariable negative binomial regression models were used to assess the association between vaccination mode and AEFI incidence, with dose-stratified analyses when appropriate. Results: Among the 303,526 sIPV doses analyzed (135,550 standalone and 167,976 concomitant), 188 AEFI cases were reported, yielding an overall reporting rate of 61.94 per 100,000 doses. Most AEFI were mild, self-limited general reactions, mainly fever and local injection-site reactions. Only two serious AEFI were reported, both resolving without sequelae. After adjustment for confounders, no significant difference in overall AEFI incidence was observed between standalone and concomitant vaccination (aRR = 0.97, 95% CI: 0.64-1.47). AEFI reporting was associated with age and region, while no consistent dose-related trend was identified. Conclusions: sIPV showed a favorable safety profile when administered standalone or concomitantly with other routine vaccines in real-world settings. Concomitant vaccination did not increase AEFI risk, supporting the continued use of sIPV in routine immunization programs.

Background/objectives: Maternal immunization against respiratory syncytial virus (RSV) is an emerging strategy to protect infants during early life when they are most vulnerable to severe RSV infection. However, little is known about the willingness to receive maternal RSV vaccination in China, where the vaccine has not yet been officially approved for marketing. This study aimed to assess the willingness to receive maternal RSV vaccination among women who are currently pregnant and those planning pregnancy in Guangzhou, and to identify the key determinants influencing vaccination willingness.

Methods: A cross-sectional survey was conducted in April 2025 among 406 women at Guangzhou Women and Children's Medical Center, China. Participants completed a self-administered questionnaire covering predisposing factors, enabling resources, health behaviors and awareness, and need factors. Logistic regression analyses were used to identify factors associated with vaccine willingness. A nomogram prediction model was constructed based on significant predictors.

Results: Overall, 67.2% (n = 273) of participants reported willingness to receive maternal RSV vaccination. Younger maternal age, higher levels of social support, moderate or high perceived RSV risk, a history of HPV vaccination, and having medical insurance were independently associated with higher willingness to vaccinate. A predictive nomogram incorporating these factors demonstrated good discrimination (AUC = 0.753) and calibration. Age-stratified analysis revealed differing concerns across age groups, with vaccine safety and neonatal protection being the most cited factors influencing decision-making.

Conclusions: This study provides the first evidence on maternal RSV vaccination willingness in southern China and highlights several psychosocial and demographic factors influencing vaccine intentions. The nomogram offers a practical tool to estimate individual willingness and guide targeted communication. These findings have implications for future maternal RSV vaccine application strategies in China.

The development of safe, effective, and durable vaccines remains a central goal in preventing infectious diseases in humans and animals [...].

Spatial transcriptomics (ST) enables genome-wide gene expression profiling while preserving tissue architecture, bridging the gap between bulk, single-cell, and histological analyses. Originating in 2016 and rapidly evolving since, ST has transformed infectious disease research by mapping host-pathogen interactions directly within intact tissues. Current platforms fall into two categories: sequencing-based methods (Visium, GeoMx, Stereo-seq) offering whole-transcriptome coverage at modest resolution and imaging-based platforms (Xenium, CosMx, MERFISH) providing single-cell or subcellular detail with targeted gene panels. These technologies reveal spatially organized immune responses, local tissue remodeling, and pathogen niches across viruses, bacteria, and parasites. In viral infection, ST uncovered heterogeneity in COVID-19 lung microenvironments, spatial immune activation in lymphoid tissues, and variant-specific inflammatory patterns. In bacterial disease, ST delineated granuloma architecture in tuberculosis and mapped vaccine-induced lung responses in Shigella studies. Parasitic infection studies identified localized inflammatory hotspots and microenvironmental control of T-cell differentiation in malaria. Despite powerful insights, ST faces constraints including RNA quality limitations, tradeoffs between resolution and transcript breadth, high cost, and analytical complexity. Nonetheless, ST increasingly informs vaccine design by identifying tissue-specific immune programs and protective microenvironments and is poised to become a standard tool for infectious disease biology.