Vaccine: X最新文献

{"title":"Post-emergency use authorization active safety surveillance study of the Pfizer-BioNTech coronavirus disease 2019 (COVID-19) vaccine in the Veterans Affairs health system: Findings from a three-year, comprehensive safety assessment program","authors":"Kofi Asomaning ,&nbsp;Mei Sheng Duh ,&nbsp;Maral DerSarkissian ,&nbsp;Cynthia de Luise ,&nbsp;Catherine Nguyen ,&nbsp;Mu Cheng ,&nbsp;Angela Lax ,&nbsp;Tracy Guo ,&nbsp;Marianne Cunnington ,&nbsp;Pierre Cremieux ,&nbsp;Yinong Young-Xu ,&nbsp;Caroline Korves ,&nbsp;Jurandir Dalle Lucca","doi":"10.1016/j.jvacx.2026.100791","DOIUrl":"10.1016/j.jvacx.2026.100791","url":null,"abstract":"<div><h3>Background</h3><div>This non-interventional, active safety surveillance study conducted signal detection/evaluation analyses for the primary series, monovalent booster doses, and Omicron BA.4/BA.5-adapted bivalent booster dose of the Pfizer-BioNTech COVID-19 vaccine among Veterans Health Administration (VHA) enrollees.</div></div><div><h3>Methods</h3><div>Repeated longitudinal, cohort study analyses using data from the VHA Corporate Data Warehouse were conducted. Among individuals who received ≥1 Pfizer-BioNTech COVID-19 vaccination between 12/11/2020–06/30/2023, an active comparator design was used to monitor the occurrence of 48 safety events of interest in this population compared to individuals with seasonal influenza vaccines during the 2014/2015–2018/2019 influenza seasons. In addition, a self-controlled risk interval design was used to compare the occurrence of safety events of interest during post-vaccination risk versus control intervals among individuals experiencing the safety event of interest.</div></div><div><h3>Results</h3><div>The Pfizer-BioNTech COVID-19 vaccine sample comprised 1,652,514 individuals, the majority of whom were male (89.8%) with an average age of 64.0 years (median = 67.4); it included 59.7% White non-Hispanic and 22.0% Black individuals. The seasonal influenza vaccine sample included 4,104,220 individuals, and baseline demographic and clinical characteristics were generally similar between the Pfizer-BioNTech COVID-19 and seasonal influenza vaccine samples (standardized differences &lt;10%). After signal detection analyses, further investigation was warranted for cerebrovascular non hemorrhagic stroke, other acute demyelinating disease, Guillain-Barré syndrome, anaphylaxis, acute myocardial infarction, arrhythmia, coronary artery disease, myocarditis, stress cardiomyopathy, microangiopathy, chilblain-like lesions, hemorrhagic disease, pulmonary embolism, optic neuritis, heart failure and cardiogenic shock, acute kidney injury, deep vein thrombosis, and severe COVID-19 disease. However, no safety events remained after signal evaluation analysis (including for myocarditis/pericarditis), regardless of the vaccine dose.</div></div><div><h3>Conclusions</h3><div>There was no increased risk of any of the 48 safety events of interest evaluated following Pfizer-BioNTech COVID-19 vaccination in the VHA population.</div></div>","PeriodicalId":43021,"journal":{"name":"Vaccine: X","volume":"29 ","pages":"Article 100791"},"PeriodicalIF":2.2,"publicationDate":"2026-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146079247","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cost-effectiveness analysis of 20-valent pneumococcal conjugate vaccine in the Portuguese paediatric national immunisation programme","authors":"Cátia Mota ,&nbsp;An Ta ,&nbsp;Elizabeth Vinand ,&nbsp;Rita Teixeira ,&nbsp;Aleksandar Ilic ,&nbsp;Sophie Warren","doi":"10.1016/j.jvacx.2026.100789","DOIUrl":"10.1016/j.jvacx.2026.100789","url":null,"abstract":"<div><h3>Background</h3><div>Since the introduction of the 13-valent pneumococcal conjugate vaccine (PCV13) for paediatric use in Portugal, pneumococcal disease incidence among children has declined. With the availability of 20-valent PCV (PCV20) and 15-valent PCV (PCV15) and the Portuguese Board of Health's decision to implement PCV20 2 + 1 into the National Immunisation Programme (NIP), the cost-effectiveness of PCV20 under 2 + 1 and 3 + 1 schedules was assessed versus PCV13 2 + 1 and PCV15 2 + 1 in Portugal.</div></div><div><h3>Methods</h3><div>Using a Portuguese National Health Service (NHS) perspective, a Markov model with annual cycles estimated health and cost impacts of PCV20 versus PCV13 and PCV15 over 10 years, with both cost and benefits discounted at 4%. Direct effects were based on PCV13 effectiveness and 7-valent PCV efficacy studies; indirect effects were sourced from PCV13 impact studies. Epidemiologic, utility, and cost inputs were from Portuguese data, where available. Sensitivity and scenario analyses tested result robustness.</div></div><div><h3>Results</h3><div>The base case showed that PCV20 2 + 1 was dominant versus both PCV13 and PCV15. PCV20 2 + 1 was estimated to avert 1884 invasive pneumococcal disease (IPD) cases, 54,768 hospitalised pneumonia cases, 222,497 otitis media (OM) cases, and 8737 deaths versus PCV13 2 + 1, resulting in a quality-adjusted life year (QALY) gain of 109,092 and cost-saving of €237,294,966. PCV20 2 + 1 averted 1653 IPD cases, 42,182 hospitalised pneumonia cases, 202,735 OM cases, and 6594 deaths versus PCV15 2 + 1, resulting in a QALY gain of 83,799 and cost-saving of €199,695,659. Pairwise comparisons of PCV20 3 + 1 versus PCV13 2 + 1 and PCV15 2 + 1, including sensitivity and scenario analyses, consistently showed cost-saving results, aligning with findings from PCV20 2 + 1 analysis.</div></div><div><h3>Conclusions</h3><div>PCV20 (both 2 + 1 and 3 + 1) was estimated to be cost saving and more effective versus PCV13 and PCV15. Switching from PCV13 to PCV20 in the Portuguese paediatric NIP could yield considerable clinical and economic benefits from NHS perspective.</div></div>","PeriodicalId":43021,"journal":{"name":"Vaccine: X","volume":"29 ","pages":"Article 100789"},"PeriodicalIF":2.2,"publicationDate":"2026-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146079246","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identifying factors associated with acceptance of the fourth COVID-19 vaccine dose: A multicentre cross-sectional study in Indonesia","authors":"Muh. Akbar Bahar ,&nbsp;Abd. Rafik Mohi ,&nbsp;Ikhwan Yuda Kusuma ,&nbsp;Dezső Csupor ,&nbsp;Muh. Nasrum Massi","doi":"10.1016/j.jvacx.2026.100784","DOIUrl":"10.1016/j.jvacx.2026.100784","url":null,"abstract":"<div><h3>Background</h3><div>Although the World Health Organization declared the end of COVID-19 as a global health emergency in May 2023, COVID-19 remains a public health concern due to continued transmission, variants, and waning immunity. However, the number of individuals who have received a complete series of COVID-19 vaccinations in developing countries, such as Indonesia, is still limited.</div></div><div><h3>Objective</h3><div>This study aimed to explore the factors influencing the acceptance of the fourth dose of the COVID-19 vaccine in Indonesia.</div></div><div><h3>Methods</h3><div>A multicentre cross-sectional study using an online questionnaire was conducted from June to September 2023 among the Indonesian population aged 18 years and older. The validated self-administered questionnaire consists of three parts: sociodemographic variables, clinical history, and domains of the Health Belief Model (perceived severity, perceived susceptibility, perceived clinical barriers, perceived barriers to access to booster vaccination and perceived benefits of booster vaccine). Multivariate logistic regression was employed to estimate adjusted odds ratios (ORs) and 95% confidence intervals (CIs) for independent variables associated with acceptance of the fourth dose of the COVID-19 vaccine.</div></div><div><h3>Results</h3><div>Of 1850 eligible participants, only 11% had received the fourth dose of the COVID-19 vaccine. The independent determinants of the acceptance of the fourth dose of the COVID-19 vaccine were as follows: age groups 26–35 years (OR: 1.73, 95%CI: 1.00–3.01), 36–45 years (OR: 2.65, 95%CI: 1.35–5.21), and over 45 years (OR: 3.68, 95%CI: 2.05–6.63); working as a healthcare worker (OR: 2.03, 95%CI: 1.11–3.69); having a chronic disease (OR: 1.71, 95%CI: 1.07–2.73); history of COVID-19 infection (OR: 1.64, 95%CI: 1.12–2.41); perceived susceptibility to COVID-19 (OR: 1.31, 95%CI: 1.09–1.57); and perceived benefits of the booster vaccine (OR: 1.27, 95%CI: 1.04–1.56).</div></div><div><h3>Conclusion</h3><div>The acceptance of the fourth COVID-19 vaccine booster in Indonesia remained low, despite substantial evidence demonstrating its effectiveness and safety, particularly in protecting vulnerable populations. Vaccine coverage could be improved by campaigns based on key determinants of acceptance such as age, chronic disease, COVID-19 infection history and perceptions of vulnerability to infection and benefits of the vaccine.</div></div>","PeriodicalId":43021,"journal":{"name":"Vaccine: X","volume":"29 ","pages":"Article 100784"},"PeriodicalIF":2.2,"publicationDate":"2026-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146038878","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Barriers and facilitators to pneumococcal vaccination in rural community pharmacy: A qualitative study","authors":"Leticia E.B. Vieira ,&nbsp;Grace T. Marley ,&nbsp;Tessa J. Hastings ,&nbsp;Salisa C. Westrick ,&nbsp;Ashley H. Chinchilla ,&nbsp;Tyler C. Melton ,&nbsp;Delesha M. Carpenter","doi":"10.1016/j.jvacx.2026.100786","DOIUrl":"10.1016/j.jvacx.2026.100786","url":null,"abstract":"<div><h3>Background</h3><div>Inadequate pneumococcal vaccine uptake in rural U.S. communities remains a significant barrier to effective pneumococcal disease prevention. Community pharmacists are well-positioned to expand vaccine coverage by offering and administering pneumococcal vaccines, but face unique challenges in rural pharmacy settings.</div></div><div><h3>Objective</h3><div>To explore pharmacist-reported barriers and facilitators to pneumococcal vaccination in rural community pharmacies.</div></div><div><h3>Methods</h3><div>Qualitative interviews were conducted with twenty rural pharmacists from a practice-based research network (a collaborative group of community pharmacies engaged in applied research to improve pharmacy practice) across seven U.S. states. Pharmacists were purposefully sampled based on their state and the number of pneumococcal vaccines administered at their pharmacy in the previous year. Interviews assessed factors influencing pneumococcal vaccination across levels of the Social Ecological Framework. Interviews continued until thematic saturation was reached, and iterative thematic analysis of de-identified interview transcripts was conducted until no new themes emerged.</div></div><div><h3>Results</h3><div>Barriers and facilitators to pneumococcal vaccination were identified across all socioecological levels. At the individual level, themes included pharmacists' attitudes, training, and rapport with patients, as well as patients' attitudes, knowledge, and out-of-pocket costs. At the organizational level, themes were related to the pharmacy workflow, staff, time constraints, immunization area, and vaccine stocking costs. Community-level themes involved local physicians, social influences, and factors specific to rural areas. Policy-level themes encompassed vaccination guidelines, states' immunization registries, reimbursement, and immunization regulations.</div></div><div><h3>Conclusion</h3><div>Pneumococcal vaccination in rural community pharmacies is influenced by multilevel factors, including individual, organizational, community, and policy factors. Effective interventions will require training initiatives for pharmacists, resources to improve patients' vaccine knowledge and attitudes, organizational strategies to streamline immunization workflow, and policy changes to advance pharmacy-based immunization services that account for rural community needs.</div></div>","PeriodicalId":43021,"journal":{"name":"Vaccine: X","volume":"29 ","pages":"Article 100786"},"PeriodicalIF":2.2,"publicationDate":"2026-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146038877","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The journey towards mRNA vaccine technology transfer: From knowledge to implementation","authors":"Caryn Fenner ,&nbsp;António Lima Grilo ,&nbsp;Ike James ,&nbsp;Claudia Nannei ,&nbsp;Martin Friede ,&nbsp;Charles Gore ,&nbsp;Marie Paule Kieny ,&nbsp;Petro Terblanche","doi":"10.1016/j.jvacx.2026.100787","DOIUrl":"10.1016/j.jvacx.2026.100787","url":null,"abstract":"<div><div>Coronavirus disease 2019 (COVID-19) vaccines were less accessible in low- and middle-income countries (LMICs) than in high-income countries during the pandemic. As a result, vaccine distribution initiatives such as COVID-19 Vaccines Global Access and the African Union's African Vaccine Acquisition Trust were established to guarantee equitable access to COVID-19 vaccines in LMICs. Yet these initiatives alone did not suffice to reverse the inequity.</div><div>As a response, the World Health Organization and the Medicines Patent Pool launched the messenger RNA (mRNA) Technology Transfer Programme in June 2021 to support sustainable mRNA vaccine production in LMICs. Afrigen Biologics and Vaccines (Afrigen) in Cape Town, South Africa became the heart of a global collaborative network embarking on a challenging yet innovative journey to develop its first mRNA vaccine, AfriVac 2121, amidst a global pandemic. The World Health Organization also selected 15 manufacturing partners from LMICs in Africa, Europe, South America, and Asia to join the program and receive the mRNA vaccine manufacturing platform.</div><div>In this article, we outline the establishment of the programme, its technology transfer strategy, and the progress made in equipping partners with the capacity to implement mRNA technology. We describe the development of the manufacturing platform and pre-clinical validation, and we reflect on the key successes and challenges encountered along the way.</div><div>Despite the obstacles, the program has laid the groundwork for a globally distributed, locally driven mRNA vaccine manufacturing ecosystem, and fully equipped the main hub at Afrigen for mRNA vaccine development and manufacturing. Our work underscores the imperative need for sustained investment in technology access, global collaboration, local expertise and infrastructure to ensure equitable access to life-saving vaccines.</div></div>","PeriodicalId":43021,"journal":{"name":"Vaccine: X","volume":"29 ","pages":"Article 100787"},"PeriodicalIF":2.2,"publicationDate":"2026-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146038876","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Influence of religious affiliation and political news on parental vaccination intent during COVID-19 pandemic","authors":"Jake Stevens,&nbsp;Kallysta Strong,&nbsp;Ella Madsen,&nbsp;Jeffrey Glenn,&nbsp;Erik J. Nelson","doi":"10.1016/j.jvacx.2026.100781","DOIUrl":"10.1016/j.jvacx.2026.100781","url":null,"abstract":"<div><h3>Background</h3><div>In May 2021, COVID-19 vaccines became available for adolescents aged 12–15. However, safety concerns, misinformation, and politicization surrounding the vaccine left some parents hesitant to vaccinate their children. This study analyzes how media sources and religious affiliation were associated with parental COVID-19 vaccination intent.</div></div><div><h3>Methods</h3><div>We conducted a cross-sectional analysis of 5552 parents in the May 2021 COVID-19 Rapid Research Response Survey of the Adolescent Brain Cognitive Development (ABCD) study, which collected data on parental intention to vaccinate their children against COVID-19 just before the FDA approved the first vaccine for children aged 12–15. Parental vaccination intent was analyzed by media sources, religious affiliation, and other sociodemographic factors. We also fit a log-binomial regression model to examine the impact of media sources and religious affiliation on parental vaccination intent, controlling for sociodemographic factors.</div></div><div><h3>Results</h3><div>We found that, compared to parents consuming balanced media sources, parents consuming right-leaning media sources were less likely to plan to vaccinate their children [PR = 0.53 (0.47, 0.6)], while parents consuming left-leaning media sources were not significantly different from parents consuming balanced media [PR = 1.06 (0.99, 1.12)]. We also found differences in vaccination intent by religious affiliation. Compared to Christian parents, Agnostic/Atheist parents were more likely to plan to vaccinate their children [PR = 1.41 (1.35, 1.47)], as were Jewish parents [PR = 1.32 (1.22, 1.43)], and parents with no religious affiliation [(PR = 1.18 (1.14, 1.23)].</div></div><div><h3>Conclusions</h3><div>Our study highlights the multifaceted factors influencing vaccine hesitancy among parents of adolescents during the COVID-19 pandemic. To create effective public health strategies for future outbreaks, it is crucial to better understand the complex interplay of religious affiliation and media bias with vaccine hesitancy.</div></div>","PeriodicalId":43021,"journal":{"name":"Vaccine: X","volume":"29 ","pages":"Article 100781"},"PeriodicalIF":2.2,"publicationDate":"2026-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145980700","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A qualitative exploration of stakeholders' views on vaccines for the elderly in South Africa","authors":"Mncengeli Sibanda ,&nbsp;Rosemary J. Burnett ,&nbsp;Brian Godman ,&nbsp;Edina Amponsah-Dacosta ,&nbsp;Johanna C. Meyer","doi":"10.1016/j.jvacx.2026.100779","DOIUrl":"10.1016/j.jvacx.2026.100779","url":null,"abstract":"<div><h3>Background and objectives</h3><div>Advancements in healthcare and living standards have led to increased life expectancy globally, including in South Africa. Despite considerable evidence from high-income countries that vaccination is a cost-effective strategy for healthy ageing, South Africa currently does not have a formal policy for vaccination of the elderly. This study explored the opinions, experiences and recommendations of South African stakeholders (experts and key opinion leaders) in the field of vaccines and healthy ageing.</div></div><div><h3>Methodology</h3><div>Online qualitative in-depth interviews with 16 stakeholders (vaccinologists, infectious disease specialists, policymakers, geriatricians and epidemiologists) were conducted. Interviews were recorded, transcribed, coded and analysed thematically using NVivo 12.0™ software.</div></div><div><h3>Results</h3><div>The overarching unanimous theme was that a national immunisation programme for the elderly (NIPE) is warranted. Aligned to this were the themes: (i) Immunisation schedule for the elderly; (ii) Health system NIPE readiness; and (iii) Strategies ensuring adequate vaccine uptake by the elderly. Participants recommended a coordinated NIPE, which could build on the successes of the Expanded Programme on Immunisation of South Africa (EPI-SA) and the recent COVID-19 vaccination programme. The NIPE should ideally be integrated into the existing primary healthcare (PHC) system programmes for the elderly. Concurrently, interventions to increase access to vaccines and reduce vaccine hesitancy among the elderly and their healthcare providers must be implemented.</div></div><div><h3>Conclusion</h3><div>A NIPE needs to be prioritised, understood, communicated, and implemented within EPI-SA and integrated into the PHC system. This should be accompanied by the requisite logistical and financial support for such a programme. The NIPE should build on the success and achievements of EPI-SA and the COVID-19 vaccination programme. Interventions that increase vaccine access and address vaccine hesitancy should also be implemented to enhance uptake by the elderly.</div></div>","PeriodicalId":43021,"journal":{"name":"Vaccine: X","volume":"29 ","pages":"Article 100779"},"PeriodicalIF":2.2,"publicationDate":"2026-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145941381","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Longitudinal survey of 6-monthly booster vaccination-induced antibody responses to equine influenza A virus (H3N8) in Standardbred trotting horses in training","authors":"Eva Wattrang ,&nbsp;Helena Back ,&nbsp;Louise Treiberg Berndtsson ,&nbsp;Siamak Zohari ,&nbsp;Janet Daly","doi":"10.1016/j.jvacx.2026.100778","DOIUrl":"10.1016/j.jvacx.2026.100778","url":null,"abstract":"<div><div>Vaccination is an established and important tool in preventing the impact of influenza in the horse population but the frequency of booster vaccinations after the primary course of vaccinations to maintain protective antibody levels is still under debate. The aim of this field study was to monitor equine influenza antibody levels over the course of 13 months during which horses were given two booster vaccinations.</div><div>Fifty-six vaccinated Standardbred trotters in training were monitored with monthly blood samples. The horses were routinely vaccinated with a commercial equine influenza vaccine 6 months apart, V1 and V2. Antibodies to vaccine strain A/equine/Borlänge/91 (Bor/91) were quantified by ELISA in all samples and also measured by single radial haemolysis (SRH) in samples obtained before and after V1.</div><div>Mean titres against Bor/91 determined by ELISA were at the lowest level in the month prior to V1. All horses sampled immediately before and after V1 had an increase in titre except two ≥ 4-year-old horses. The antibody titres declined rapidly in the 3 months after V1. The boosting effect of V2 was lower compared to that of V1 and six horses with high pre-vaccination titres did not respond to V2, irrespective of age. Titres estimated by ELISA correlated well with antibody levels determined by SRH, which showed that while many of the horses would be unprotected before V1, antibody levels were boosted to protective levels after vaccination.</div><div>Antibody responses were higher in horses with low antibody levels at booster vaccination compared to those with already high antibody levels.</div></div>","PeriodicalId":43021,"journal":{"name":"Vaccine: X","volume":"29 ","pages":"Article 100778"},"PeriodicalIF":2.2,"publicationDate":"2026-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145941343","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real-world estimation of the pneumococcal vaccination coverage among high-risk population in the unified health system in Brazil: an administrative database analysis","authors":"Daniela V. Pachito ,&nbsp;Paulo H.R.F. Almeida ,&nbsp;Ricardo Macarini Ferreira ,&nbsp;Rodrigo F. Alexandre ,&nbsp;Ana Paula N. Burian","doi":"10.1016/j.jvacx.2026.100780","DOIUrl":"10.1016/j.jvacx.2026.100780","url":null,"abstract":"<div><h3>Background</h3><div>Immunization against pneumococcal disease (PD) for individuals with certain coexisting health conditions is recommended by the National Immunization Program (NIP) in the Unified Health System (SUS) in Brazil. There are uncertainties regarding the size of the population at risk and the proportion of high-risk individuals assessed at the Reference Centers for Special Immunobiologicals (<em>Centros de Referência para Imunobiológicos Especiais</em>, CRIE). Objectives were to assess the high-risk population size from a claims database, to estimate the vaccination coverage rate, and to assess the proportion of complete, incomplete and non-conforming vaccination schemes.</div></div><div><h3>Methods</h3><div>ICD-10 and procedure codes related to high-risk health conditions were defined, together with proxies of disease activity and severity. Data from the outpatient information system of medium-to-high complexity levels of care, and the information system of immunobiologicals were analyzed. Encrypted identifiers were used to count distinct individuals from November 2021 to October 2023. Complete vaccination scheme was defined as at least one PCV13 and two or more PPS23 doses; incomplete vaccination scheme as one PCV13 and less than two PPS23 doses; and non-conform vaccination scheme as more than one PCV13 and less than two PPS23 doses.</div></div><div><h3>Results</h3><div>The estimated size of the high-risk population was 1,609,181 individuals. Coverage rate for having received at least one dose of PCV13 was estimated at 45.5 % and for the complete vaccination scheme at 3.5 %. Most vaccination schemes were incomplete or non-conform.</div></div><div><h3>Conclusion</h3><div>A small proportion of high-risk individuals were considered as having received the complete pneumococcal vaccination scheme, possibly due to issues such as the high complexity of the vaccination scheme, and limited access to CRIE, due to the continental size of Brazil and the concentration of CRIE in large cities. These findings should be interpreted with caution, considering the inherent limitations of the data sources used.</div></div>","PeriodicalId":43021,"journal":{"name":"Vaccine: X","volume":"28 ","pages":"Article 100780"},"PeriodicalIF":2.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145925825","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Countrywide analysis of vaccination rates in Ecuador from 2014 to 2024: Trends, inequalities and public health implications","authors":"Carolina Villacreses,&nbsp;Juan S. Izquierdo-Condoy,&nbsp;Jorge Vasconez-Gonzalez,&nbsp;María Gabriela Dávila-Rosero,&nbsp;Andrea Tello-De-la-Torre,&nbsp;Andres López-Cortes,&nbsp;Esteban Ortiz-Prado","doi":"10.1016/j.jvacx.2025.100770","DOIUrl":"10.1016/j.jvacx.2025.100770","url":null,"abstract":"<div><h3>Background</h3><div>National vaccination coverages are a key public health indicator and a cornerstone of disease prevention. In Ecuador, coverage rates have varied across age groups, highlighting both advancements and ongoing challenges. This study aims to analyze national vaccination coverage trends, identify regional disparities, and discuss possible factors influencing immunization rates in the country.</div></div><div><h3>Methods</h3><div>A nationwide descriptive analysis of vaccination coverage in Ecuador was conducted using official coverage data from 2014 to 2024, derived from aggregate counts reported by health facilities and census-based population estimates, despite limitations due to the absence of a fully functional electronic immunization registry. The study examined vaccine administration across different age groups, including children under one year, children aged 12 to 59 months, school-age children (5 to 15 years), and adults. Descriptive statistics were applied to assess coverage trends over multiple years, and variations by geographic region were analyzed.</div></div><div><h3>Results</h3><div>Vaccination coverage in Ecuador showed marked fluctuations from after 2014 up to 2024. BCG coverage dropped from 90 % pre-pandemic to 75 % in 2021, peaked at 98 % in 2023, then declined to 85 % in 2024. Hepatitis B birth dose fell to 47 % in 2016, recovering to 72 % by 2024. HPV1 dropped from 98 % (2018) to 28 % (2021), rebounding to 82 % in 2023; HPV2 remained lower at 52 %. Adult Td coverage was consistently low (9 % in 2021; 40 % in 2024). Booster doses also declined during the pandemic. Regional disparities persisted, with some areas exceeding 90 % while others remained below 70 %.</div></div><div><h3>Conclusions</h3><div>The national analysis of vaccination coverage in Ecuador highlights both progress and persistent gaps. While early childhood vaccines show high coverage, deficiencies remain in booster doses, adolescent immunization, and adult vaccination. Strengthening outreach, improving equitable access, and addressing regional disparities are essential to sustain immunization rates and prevent vaccine-preventable diseases. In addition, it is necessary to gain a better understanding of the problems and barriers that affect vaccination coverage to design tailored interventions. Further studies are needed to understand the causes of vaccination gaps between rural and urban areas, so as to develop strategies that reduce these inequalities.</div></div>","PeriodicalId":43021,"journal":{"name":"Vaccine: X","volume":"28 ","pages":"Article 100770"},"PeriodicalIF":2.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145925707","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}