Therapeutic Advances in Vaccines and Immunotherapy最新文献

Background: Human papillomavirus (HPV) continues to pose a significant threat to public health, serving as the primary cause of cervical cancer. To address this issue, a vaccine has been developed to decrease the incidence of cervical cancer. However, the practice and its associated factors with the uptake of the vaccine have not been well studied in this particular region. Consequently, this study aims to evaluate the practice of HPV vaccination and its associated factors among female adolescent students in the Eastern Zone of Tigray, North Ethiopia, 2024.

Methods: A cross-sectional study design was conducted from September 2023 to January 2024 at primary schools of the Eastern Zone, Tigray, Ethiopia. Data related to HPV vaccination practice and its associated factors were collected from 634 female adolescent primary school students. The collected data were checked for completeness daily, coded, entered, and cleaned using Epinfo version 7.2.3 then exported and analyzed using SPSS version 24. Bivariate and multivariate logistic regression analyses were used to assess the association between dependent and independent variables. The corresponding variables with a p-value (p < 0.05) with a 95% confidence interval were considered statistically significant.

Result: Among the 634 participants, 61.7% received the quadrivalent Gardasil HPV vaccine. Of these, 52.1% (330/634) demonstrated good knowledge, with an adjusted odds ratio (AOR) of 1.931 (95% confidence interval (CI), 1.364-2.735) and a p-value < 0.000. Moreover, participants who had a positive attitude toward HPV vaccination, with (AOR = 1.529, 95% CI = 1.049-2.230; p-value < 0.027) and participants who expressed their agreement for taking the HPV vaccine (AOR = 1.816, 95% CI = 1.046-3.152; p-value < 0.034) were factors associated with female adolescent students' practice of the HPV vaccination.

Conclusion and recommendation: The results indicated that the majority of study participants received one dose of the HPV vaccine. The study further reveals several factors associated with HPV vaccination among female adolescent students, including a positive attitude toward the vaccine and good knowledge about its benefits. Health authorities are recommended to promote the HPV vaccine through mass media in schools, religious institutions, and healthcare facilities to increase practice among adolescent females.

Background: Human papillomaviruses are the most common sexually transmitted infections, and persistent infection can lead to cervical cancer. In line with WHO recommendations to prevent cervical cancer, human papillomavirus vaccination is considered mandatory. Despite various challenges influencing decision-making for HPV vaccination, including HPV vaccine hesitancy, efforts are made to promote its uptake.

Methods: A community-based cross-sectional study was conducted from March 1 to April 30 among 400 parents of adolescents. A simple random sampling technique was used to select study participants. A structured questionnaire was employed for data collection, and the data were gathered through interviews. Subsequently, the data were entered into EPI data 3.1 statistical software and analyzed using SPSS version 25. The association between variables was analyzed using bivariate and multivariable logistic regression models, and a p-value <0.05 at 95% confidence interval was considered statistically significant.

Results: A total of 400 participants were included with a response rate of 99.3%. The prevalence of HPV vaccine hesitancy among parents of daughters was 54%. Multivariable logistic regression showed that educational status (Adjusted Odds Ratio (AOR) = 0.8, 95% CI: (0.69-0.93)), effectiveness of HPV vaccine (AOR = 1.9, 95% CI: (1.14-3.17)), knowledge (AOR = 0.5, 95% CI: (0.13-0.75)), and obtained information (AOR = 3.1, 95% CI: (2.24-4.29)) were significantly associated with human papillomavirus vaccine hesitancy.

Conclusion: This study demonstrates that parents' hesitance to vaccinate their daughters with the human papillomavirus vaccine was high. Parents' hesitance to vaccinate their daughters with the human papillomavirus vaccine was strongly associated with the effectiveness of the HPV vaccine, obtained information about the HPV vaccine, knowledge, and educational status.

Background: Since the introduction of the SARS-CoV-2 vaccine, the incidence of complications associated with pediatric infection has markedly declined. However, there is a notable decline in vaccination coverage among younger age groups. The objective of this study was to identify the factors associated with hesitancy to receive the SARS-CoV-2 vaccine in parents of children aged 3-15 years in a Latin American context.

Methods: A cross-sectional, analytical study was conducted between February and May 2023. Parents of children between the ages of 3 and 15, residing in the metropolitan region of Chile, were surveyed via an online or in-person questionnaire. Univariate analysis and a multivariate logistic regression model were performed.

Results: Five hundred thirty-nine surveys were completed; 61.6% of parents were aged between 21 and 40 years, 42.3% had completed higher education, 79.4% had paid employment, and 98.1% were fully vaccinated. Age distribution of children was 36.9% for 3-5 years, 42.4% for 6-11 years, and 20.8% for 12-15 years. 87.4% was vaccinated. In the univariate analysis, vaccine hesitancy was observed in 9%, associated mainly with children 3-5 years, fewer doses in parents' vaccination schedule, lacking risk perception and concerns about safety, and not knowing where to access pediatric vaccine formulations against COVID-19. In the multivariate analysis, the younger age, lacking risk perception, and concerns about the vaccine's effectiveness were associated with vaccine hesitancy.

Conclusion: Addressing hesitancy toward COVID-19 vaccines is of utmost importance. Educational interventions should be implemented to inform parents about the importance and effectiveness of COVID-19 vaccination in children, with special emphasis on parents of younger children, to increase vaccination coverage.

Background: Vaccines against COVID-19 were viewed as a way out to the ongoing pandemic and were given the emergency use authorization in India to initiate mass vaccination in January 2021. This study aimed to investigate the serious adverse events following immunizations (AEFIs) reported for COVID-19 vaccines and to identify predictors of mortality among these cases from India.

Methods: A secondary data analysis was conducted on the causality assessment reports for the 2708 serious AEFIs published by the National AEFI Committee under the Immunization Division, Ministry of Health and Family Welfare, Government of India. The analysis included all 21 reports published up until May 2023. The primary outcome variable analyzed was the survival/death status of each AEFI case, with various covariates from the published documents considered in the analysis.

Results: The majority of the serious AEFIs assessed were either coincidental (1220, 45%) or undetermined/unclassifiable (781, 28.8%). The majority of the serious AEFIs were reported among recipients of Covishield (1891, 69.8%) followed by Covaxin (347, 12.8%). Among these, 1114 (42.1%) died while the remaining 1594 (58.9%) were hospitalized and recovered. Systematically, AEFIs involving the cardiovascular system (696, 31.3%) were the most common, followed by those affecting the respiratory system (288, 13%) and neuropsychiatric system (295, 13.3%) which had a significant association with age (p < 0.001) and gender (p < 0.001). On multivariable analysis, females (p = 0.001), younger age groups (p < 0.001), AEFIs whose causality was determined and classified (p < 0.001), AEFI involving gastrointestinal and neuropsychiatric system (p < 0.001), AEFIs reported from North and Western India (p = 0.001) and those occurring during the winter season (p < 0.05) had significantly lower odds of mortality.

Conclusion: Among the cohort of serious AEFIs reported, older age, male sex, undetermined or unclassifiable causality classification, and involvement of the cardiovascular system were associated with significantly higher odds of mortality and require close monitoring following vaccination.

Immune-related neuromuscular disorders are rare and potentially life-threatening adverse events of immune checkpoint inhibitors (ICIs) used in the treatment of cancer. They tend to have a chronic course that usually leads to the permanent discontinuation of immunotherapy. We present a case of pembrolizumab-induced myasthenia gravis that only involved the diaphragm. The patient is a 71-year-old female with a history of stage IV lung adenocarcinoma under maintenance therapy with pemetrexed and pembrolizumab after a complete response to first-line chemo-immunotherapy. She complained of orthopnea since the previous month and was admitted due to hypoxemic respiratory failure. Radiology showed decreased lung volumes and atelectatic areas in both lower lung fields. A subsequent bronchoscopy ruled out infection and cancer recurrence. Pulmonary function tests revealed a mixed disorder with a severe reduction in maximal inspiratory pressure and a large drop in vital capacity in the supine versus the sited position. Ultrasonography of the diaphragm confirmed bilateral diaphragmatic dysfunction, and the patient was initiated on non-invasive ventilation (NIV) during sleep, which led to symptom relief. A neurological physical examination did not reveal any other muscle involvement. Laboratory tests for myasthenic syndromes showed an elevated titer of the anti-acetylcholine receptor antibody, which confirmed the diagnosis of myasthenia gravis. The patient was subsequently treated with corticosteroids, pyridostigmine, and intravenous immunoglobulin and was gradually able to wean off supplemental oxygen. On follow-up, her chest X-ray and spirometry had improved, but she continued sleeping on NIV. Pembrolizumab was stopped, and she is still free of cancer after 9 months. Clinicians treating cancer patients with immunotherapy should be aware of this rare complication and perform timely investigations in any case of orthopnea in the course of ICI therapy to offer specialized management.

Background: Respiratory syncytial virus (RSV) poses a significant respiratory health risk to senior citizens, contributing substantially to hospitalizations and mortality. With the recent approval of three RSV vaccines for the elderly, it is critical to understand the factors that can shape the RSV vaccination attitudes to inform public health strategies that can enhance uptake among this vulnerable population.

Objectives: This study aimed to investigate the potential factors that could influence the attitudes toward RSV vaccination among senior citizens in Arab countries.

Design: A multinational cross-sectional study, adhering to STROBE guidelines, was conducted using a survey instrument previously validated through exploratory factor analysis to assess attitudes toward the newly approved RSV vaccine.

Methods: A self-administered online survey was distributed conveniently among senior citizens mainly across five Arab countries. The survey collected data on demographics, vaccination history, and key constructs related to RSV vaccine attitude, including "Fear," "Information," "Accessibility," "Benefits," and "Conspiracy."

Results: A total of 483 participants were included in the study, with the majority from five Arab countries: Jordan (n = 239, 49.5%), Kuwait (n = 74, 15.3%), Egypt (n = 68, 14.1%), Saudi Arabia (n = 51, 10.6%), and the UAE (n = 23, 4.8%), alongside participants from other Arab nations (n = 28, 5.8%). Among the respondents, 51.1% (n = 247) expressed acceptance of the RSV vaccine, 22.4% (n = 108) were hesitant, and 26.5% (n = 128) exhibited refusal. Multivariate analysis identified perceived benefits (β = 0.484, p < 0.001), information needs (β = 0.229, p < 0.001), and previous vaccination history (β = 0.087, p = 0.016) as significant positive predictors of vaccine acceptance. Conversely, stronger conspiracy beliefs (β = -0.083, p = 0.035) were associated with vaccine resistance. Fear and accessibility were not significant predictors of vaccine attitudes.

Conclusion: The findings showed that perceived benefits, access to reliable information, previous vaccination history, and conspiracy beliefs are essential to promote RSV vaccine acceptance among Arab seniors. These factors are recommended to improve RSV vaccine uptake in this vulnerable population.

Dengue is a mosquito-borne flaviviral disease that is endemic to tropical and subtropical regions, affecting hundreds of millions of people worldwide. Although it was once considered a neglected disease, the incidence and mortality rates of dengue have surged over the past decade, in part due to the expanding distribution of the Aedes spp. vector facilitated by changing climatic factors. While most infections are asymptomatic or cause mild flu-like symptoms, some cases can develop into severe forms, leading to serious complications. The burden of the disease is gradually shifting from primarily affecting children, whose immune systems are immature, to increasingly impacting the older population, who typically experience waning immune responsiveness and comorbidities. With no specific treatment available, the development of a prophylactic vaccine is crucial for long-term control and prevention. School-age children are the primary target group for immunization programs of the two recently licensed dengue vaccines. However, there is limited information on the efficacy of either vaccine among the elderly or of two further immunogenic preparations currently undergoing clinical trials. This review gives an update on dengue vaccine implementation and provides recommendations for the vaccination of persons aged 60 years and above.

Given the surge in mpox outbreaks in 2022 and the advancements in domestic and international vaccine research, the effectiveness of smallpox vaccines in providing cross-protection against mpox remains crucial. Having learned from the COVID-19 pandemic, it is significant to continue evaluating existing vaccines to ensure their safety and efficacy. Developing new vaccines for widespread use against mpox and its emerging strains also serves as a preventive strategy in the ongoing battle against this dynamic infection. Here's an opportunity to control human-to-human transmission, give short deadlines, and avoid vaccine disparity. Public health systems must take decisive action to prevent the global spread of mpox, particularly among vulnerable groups. This action should include strengthening global surveillance, improving vaccine access, and ensuring equitable distribution, particularly in resource-poor settings, to prevent future outbreaks. This review aims to assess recent advancements and barriers in mpox vaccine development, emphasizing cross-protection and equitable vaccine distribution in resource-poor settings.