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Estimating historical disease burden and the impact of vaccination by influenza type and subtype in the United States, 2016–2020 估算2016-2020年美国流感类型和亚型疫苗接种的历史疾病负担和影响
IF 2.2 Q3 IMMUNOLOGY Pub Date : 2025-10-01 Epub Date: 2025-08-07 DOI: 10.1016/j.jvacx.2025.100700
Sinead E. Morris , Sarabeth M. Mathis , Jessie R. Chung , Brendan Flannery , Alissa O'Halloran , Charisse N. Cummings , Shikha Garg , Peng-Jun Lu , Tammy A. Santibanez , Carrie Reed , Matthew Biggerstaff , A. Danielle Iuliano
Seasonal influenza causes substantial morbidity and mortality in the United States. The U.S. Centers for Disease Control and Prevention (CDC) uses a compartmental framework to estimate the annual disease burden and burden prevented by vaccination for all influenza types and subtypes combined. However, these estimates do not capture underlying shifts in disease burden caused by different circulating influenza virus types or subtypes. We demonstrate an extension of the current framework to estimate disease burden and burden prevented by vaccination for influenza A virus subtypes A(H1N1) and A(H3N2), and influenza type B viruses. We applied this method to data from the 2016/17 to 2019/20 seasons that included age- and virus-specific hospitalizations and vaccine effectiveness estimates, and age-specific vaccination coverage estimates. We estimated the number of symptomatic illnesses, medically-attended illnesses, hospitalizations, and deaths caused by each virus, and the corresponding number prevented by vaccination. Disease burden and vaccine-prevented disease burden varied substantially by season, age, and virus type or subtype. The greatest disease burden was estimated in 2017/18, whereas 2019/20 had the greatest burden prevented by vaccination. Influenza A viruses contributed most to disease burden in all seasons. Vaccination against influenza B viruses prevented the largest percentage of hospitalizations among children and adults <65 years, whereas vaccination against A(H1N1) prevented the largest percentage of hospitalizations among adults ≥65 years. Overall, our results highlight complex variability in influenza disease burden by season, age, and virus type and subtype. These findings can be used to improve our understanding of the factors impacting influenza disease burden each season and to enhance communications of the value of influenza vaccination.
季节性流感在美国造成大量发病率和死亡率。美国疾病控制和预防中心(CDC)使用分区框架来估计所有流感类型和亚型的年度疾病负担和通过接种疫苗预防的负担。然而,这些估计并未反映由不同流行流感病毒类型或亚型引起的疾病负担的潜在变化。我们展示了当前框架的扩展,以估计疾病负担和通过接种甲型流感病毒亚型A(H1N1)和A(H3N2)以及乙型流感病毒预防的负担。我们将这种方法应用于2016/17至2019/20季节的数据,包括年龄和病毒特异性住院率和疫苗有效性估计,以及年龄特异性疫苗接种覆盖率估计。我们估计了由每种病毒引起的有症状疾病、医疗护理疾病、住院和死亡的数量,以及通过接种疫苗预防的相应数量。疾病负担和疫苗预防疾病负担因季节、年龄和病毒类型或亚型而有很大差异。据估计,2017/18年的疾病负担最大,而2019/20年通过疫苗接种预防的疾病负担最大。甲型流感病毒对所有季节的疾病负担贡献最大。在儿童和65岁以上的成年人中,接种乙型流感疫苗预防住院的比例最大,而接种甲型H1N1流感疫苗预防≥65岁的成年人住院的比例最大。总的来说,我们的结果强调了流感疾病负担在季节、年龄、病毒类型和亚型方面的复杂变异性。这些发现可用于提高我们对每个季节影响流感疾病负担的因素的理解,并加强流感疫苗接种价值的宣传。
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引用次数: 0
Knowledge, attitudes, and practices towards hepatitis A virus immunization in Jordan: A nationwide cross-sectional study 约旦对甲型肝炎病毒免疫的知识、态度和做法:一项全国性的横断面研究
IF 2.2 Q3 IMMUNOLOGY Pub Date : 2025-08-01 Epub Date: 2025-07-26 DOI: 10.1016/j.jvacx.2025.100696
Jehad A. Yasin , Fares A. Qtaishat , Mohammad-Amer A. Tamimi , Leen A. Alkuttob , Muaath I. Alsufi , Ramez M. Odat , Yazeed H. Heqail , Areen Hatamleh , Diala Walid Abu-Hassan

Background

Hepatitis A virus (HAV) is an RNA virus transmitted via the fecal-oral route, often through contaminated water and poor sanitation. Although the HAV vaccine was included in Jordan's vaccination program in 2020 to address rising infection rates, there is limited research on the population's knowledge, attitudes, and practices regarding HAV.

Aim

To assess knowledge, attitudes, and practices towards hepatitis A and its vaccine among Jordanian adults, identify their predictors, and inform future educational interventions.

Methods

This observational cross-sectional study utilized data from Jordanians in all regions of the country. Data collection was conducted via an online Arabic survey to collect information regarding demographics, HAV knowledge, immunization attitudes, and practices.

Results

Data were collected from 716 participants. Female participants resembled 60.3 % of participants, with a mean age of 31.18 years old. Participants deemed doctors as a trustworthy source of knowledge, however, only 46.51 % would consult them for information regarding HAV and its vaccine. The findings highlighted lower HAV vaccination knowledge and poorer attitudes in participants from the southern region of the country (p < 0.001). Higher knowledge scores were positively correlated with attitudes towards immunization (p < 0.001). Females demonstrated significantly higher attitude scores compared with males, as shown by the Mann-Whitney U Test (p = 0.001) and regression coefficients. Positive attitudes towards vaccination positively influenced immunization willingness, while age had a negative influence (p < 0.05).

Conclusion

The study offered valuable insight on the gaps in HAV knowledge among Jordanians, emphasizing the need for targeted educational interventions. Future research should identify additional cultural and socioeconomic factors that may play a role in HAV knowledge and attitudes.
甲型肝炎病毒(HAV)是一种通过粪-口途径传播的RNA病毒,通常通过受污染的水和恶劣的卫生条件传播。尽管为了应对不断上升的感染率,约旦在2020年将甲肝疫苗纳入了疫苗接种规划,但关于民众对甲肝的知识、态度和做法的研究有限。目的评估约旦成年人对甲型肝炎及其疫苗的知识、态度和做法,确定其预测因素,并为未来的教育干预提供信息。方法:这项观察性横断面研究利用了来自全国所有地区的约旦人的数据。数据收集是通过在线阿拉伯语调查进行的,以收集有关人口统计、甲型肝炎知识、免疫态度和做法的信息。结果共收集了716名参与者的数据。女性参与者与60.3%的参与者相似,平均年龄为31.18岁。然而,只有46.51%的受访者认为医生是值得信赖的知识来源,他们会向医生咨询有关甲肝病毒及其疫苗的信息。调查结果强调,来自该国南部地区的参与者对甲肝疫苗接种的了解程度较低,态度较差(p <;0.001)。较高的知识得分与免疫态度呈正相关(p <;0.001)。根据Mann-Whitney U检验(p = 0.001)和回归系数,女性的态度得分明显高于男性。对疫苗接种的积极态度正向影响免疫接种意愿,而年龄有负向影响(p <;0.05)。结论该研究对约旦人在艾滋病知识方面的差距提供了有价值的见解,强调了有针对性的教育干预的必要性。未来的研究应确定可能在甲型肝炎知识和态度中发挥作用的其他文化和社会经济因素。
{"title":"Knowledge, attitudes, and practices towards hepatitis A virus immunization in Jordan: A nationwide cross-sectional study","authors":"Jehad A. Yasin ,&nbsp;Fares A. Qtaishat ,&nbsp;Mohammad-Amer A. Tamimi ,&nbsp;Leen A. Alkuttob ,&nbsp;Muaath I. Alsufi ,&nbsp;Ramez M. Odat ,&nbsp;Yazeed H. Heqail ,&nbsp;Areen Hatamleh ,&nbsp;Diala Walid Abu-Hassan","doi":"10.1016/j.jvacx.2025.100696","DOIUrl":"10.1016/j.jvacx.2025.100696","url":null,"abstract":"<div><h3>Background</h3><div>Hepatitis A virus (HAV) is an RNA virus transmitted via the fecal-oral route, often through contaminated water and poor sanitation. Although the HAV vaccine was included in Jordan's vaccination program in 2020 to address rising infection rates, there is limited research on the population's knowledge, attitudes, and practices regarding HAV.</div></div><div><h3>Aim</h3><div>To assess knowledge, attitudes, and practices towards hepatitis A and its vaccine among Jordanian adults, identify their predictors, and inform future educational interventions.</div></div><div><h3>Methods</h3><div>This observational cross-sectional study utilized data from Jordanians in all regions of the country. Data collection was conducted via an online Arabic survey to collect information regarding demographics, HAV knowledge, immunization attitudes, and practices.</div></div><div><h3>Results</h3><div>Data were collected from 716 participants. Female participants resembled 60.3 % of participants, with a mean age of 31.18 years old. Participants deemed doctors as a trustworthy source of knowledge, however, only 46.51 % would consult them for information regarding HAV and its vaccine. The findings highlighted lower HAV vaccination knowledge and poorer attitudes in participants from the southern region of the country (<em>p</em> &lt; 0.001). Higher knowledge scores were positively correlated with attitudes towards immunization (p &lt; 0.001). Females demonstrated significantly higher attitude scores compared with males, as shown by the Mann-Whitney <em>U</em> Test (<em>p</em> = 0.001) and regression coefficients. Positive attitudes towards vaccination positively influenced immunization willingness, while age had a negative influence (<em>p</em> &lt; 0.05).</div></div><div><h3>Conclusion</h3><div>The study offered valuable insight on the gaps in HAV knowledge among Jordanians, emphasizing the need for targeted educational interventions. Future research should identify additional cultural and socioeconomic factors that may play a role in HAV knowledge and attitudes.</div></div>","PeriodicalId":43021,"journal":{"name":"Vaccine: X","volume":"25 ","pages":"Article 100696"},"PeriodicalIF":2.2,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144750614","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}
引用次数: 0
A multi-centre, single arm, Phase 3 study to assess the safety and reactogenicity of biological Es Vi-capsular polysaccharide-CRM197 conjugate typhoid vaccine in ≥6 months old infants to ≤45 years old adults. 一项多中心、单组、3期研究,评估生物Es vi -荚膜多糖- crm197结合伤寒疫苗在≥6个月婴儿至≤45岁成人中的安全性和反应原性。
IF 2.7 Q3 IMMUNOLOGY Pub Date : 2025-08-01 Epub Date: 2025-05-24 DOI: 10.1016/j.jvacx.2025.100669
Subhash Thuluva , Ramesh V. Matur , Subbareddy Gunneri , Vijay Yerroju , Rammohan Reddy Mogulla , Chirag Dhar , Raju Esanakarra , Savita Verma , Manish Narang , Madhukar Pandey

Background

Typhoid fever is a serious bacterial infection caused by Salmonella Typhi, with a significant burden in low- and middle-income countries, particularly in Sub-Saharan Africa and South/Southeast Asia. To mitigate its spread, the World Health Organization (WHO) advocates for typhoid vaccination programs that particularly target high-risk populations. However, unconjugated polysaccharide vaccines have shown limited efficacy in children under two years of age.
Biological E has developed a typhoid conjugate vaccine, TYPHIBEV®, which incorporates the Vi-polysaccharide conjugated to the CRM197 carrier protein. TYPHIBEV®’s safety and immunogenicity were evaluated in Phase 1 and Phase 2/3 clinical trials involving infants, children, adolescents, and adults, compared to an established licensed vaccine. This Phase 3 study was specifically designed to assess the safety profile of TYPHIBEV® in the target population aged ≥6 months to ≤45 years.

Methods

A multi-centre, single-arm, non-comparative Phase 3 study was conducted to evaluate the safety, tolerability and reactogenicity of a single intramuscular dose of Biological E's Vi-capsular Polysaccharide-CRM197 Conjugate Typhoid Vaccine. A total of 1770 subjects were enrolled into three age subsets; infants and toddlers, ≥6 months to <2 years of age; children and adolescents, ≥2 years to <18 years of age; and adults, ≥18 years to ≤45 years of age (n = 590 in each age group). A single dose of THPHIBEV® was administered, and all the subjects were followed up for a period of 42 days. Solicited local and systemic AEs were recorded up until 7 days post-vaccination. Unsolicited AEs, serious AEs (SAEs), and medically attended AEs (MAAEs) were recorded throughout the study duration.

Findings

A total of 114 AEs were recorded in 101 (5.71 %) participants. A majority of these AEs were solicited in nature with general disorders and administration site conditions reported in 5.42 % of participants. The most commonly reported AEs were injection site pain and pyrexia. All MAAEs (1.30 % subjects) were solicited and pyrexia (0.85 % of subjects) was the most common reason for medical attention. No severe or serious AEs and/or deaths were reported throughout the study. None of the subjects discontinued the study due to an AE.

Conclusions

TYPHIBEV® was found to be safe and well tolerated across different age groups and the safety profile was comparable to other TCVs in terms of reported solicited and unsolicited AEs. No severe or serious AEs were reported during the entire study period.
伤寒是由伤寒沙门氏菌引起的一种严重细菌感染,在低收入和中等收入国家,特别是在撒哈拉以南非洲和南亚/东南亚造成重大负担。为了减轻其传播,世界卫生组织(WHO)提倡针对高危人群的伤寒疫苗接种计划。然而,非共轭多糖疫苗对两岁以下儿童的疗效有限。bioere公司开发了一种伤寒结合疫苗TYPHIBEV®,该疫苗结合了与CRM197载体蛋白结合的vi -多糖。TYPHIBEV®的安全性和免疫原性在涉及婴儿、儿童、青少年和成人的1期和2/3期临床试验中进行了评估,与已建立的许可疫苗进行了比较。该iii期研究旨在评估TYPHIBEV®在年龄≥6个月至≤45岁的目标人群中的安全性。方法采用多中心、单臂、非对照的3期临床试验,评价单次肌注bio E公司生产的v -荚膜多糖- crm197伤寒疫苗的安全性、耐受性和反应原性。共有1770名受试者被分为三个年龄组;婴幼儿,≥6个月至2岁;儿童和青少年,≥2岁至18岁;成人≥18岁至≤45岁(每个年龄组n = 590)。给予单剂量THPHIBEV®,所有受试者随访42天。征求的局部和全身不良反应被记录到疫苗接种后7天。在整个研究期间,记录了主动不良事件、严重不良事件(SAEs)和医疗不良事件(maae)。101例(5.71%)患者共发生114例ae。这些ae中的大多数是在性质上征求的,5.42%的参与者报告了一般疾病和给药场所条件。最常见的不良反应是注射部位疼痛和发热。所有maae(1.30%的受试者)都被征求,发热(0.85%的受试者)是最常见的就医原因。在整个研究过程中未报告严重或严重的不良反应和/或死亡。没有受试者因AE而中止研究。结论:styphibev®在不同年龄组均具有安全性和良好的耐受性,其安全性与其他tcv在报告的主动和非主动ae方面相当。在整个研究期间没有严重或严重不良事件的报告。
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引用次数: 0
One-month evaluation of safety and immunogenicity of a Vi-DT typhoid conjugate vaccine (Bio-TCV®) in Indonesian subjects 6 months to 45 years: A phase III randomized clinical trial 6个月至45岁印度尼西亚受试者中Vi-DT伤寒结合疫苗(Bio-TCV®)一个月的安全性和免疫原性评估:一项III期随机临床试验
IF 2.7 Q3 IMMUNOLOGY Pub Date : 2025-08-01 Epub Date: 2025-05-20 DOI: 10.1016/j.jvacx.2025.100661
Bernie Endyarni Medise , I. Gusti Ayu Trisna Windiani , Dominicus Husada , Rini Sekartini , Hartono Gunardi , Angga Wirahmadi , Dwiyanti Puspitasari , Leny Kartina , I. Gusti Agung Ngurah Sugitha Adnyana , I. Gusti Lanang Sidiartha , I. Made Dwi Lingga Utama , I. Ketut Agus Somia , Iris Rengganis , Sukamto Koesnoe , Hindra Irawan Satari , Soedjatmiko Soedjatmiko , Sri Rezeki Hadinegoro , Ismoedijanto Ismoedijanto , Parwati Setiono Basuki , Gatot Soegiarto , Sushant Sahastrabuddhe

Background

Typhoid fever typically affects children and young adults and is a considerable cause of morbidity and mortality. Vaccination is the most effective preventive strategy to control typhoid fever in the short to medium term. However, in most endemic countries do not have a typhoid vaccine that is suitable for children below 2 years old.

Methods

This is a randomized, observer blinded phase III trial using Vi-DT typhoid conjugate vaccine and an already WHO licensed prequalified (PQed) typhoid conjugate vaccine (Typbar TCV) as control. About 936 healthy subjects were recruited and divided into 3 age groups: infants group aged 6–24 months, children group aged 2–11 years, adolescents and adults group aged 12–45 years, and followed up till 28 days post vaccination. Blood sample was taken at pre-vaccination and at 28th day post vaccination to evaluate immunogenicity.

Results

The most common immediate local reaction was pain in all age groups, followed by redness. The most common immediate systemic reaction in the infant group was irritability while in the adults and children group was muscle pain. The intensity of reactions was mostly mild and moderate. Severe reactions were in the form of pain and fever. Reactions mostly resolved within 48 h. Seroconversion at 28 days in the Vi-DT group was higher in both adults and children compared to the PQed typhoid conjugate vaccine, Typbar-TCV (p = 1.000; p = 0.250), respectively. The Geometric Mean Titer (GMT) in the Vi-DT group was higher in adults (p = 0134), whereas the PQed typhoid conjugate vaccine Typbar-TCV demonstrated a higher GMT in children and infants (p = 0.277; p = 0.884), respectively.

Conclusion

Vi-DT typhoid conjugate vaccine (Bio-TCV®) is safe and immunogenic in subjects 6 months to 45 years old.
Clinical trial registration number.
NCT04051268, registration date: 09/08/2019.
伤寒通常影响儿童和年轻人,是发病率和死亡率的重要原因。在中短期内,预防接种是控制伤寒最有效的预防策略。然而,在大多数流行国家,没有适合两岁以下儿童的伤寒疫苗。方法:这是一项随机、观察盲法的III期试验,使用Vi-DT伤寒结合疫苗和已经获得世卫组织许可的预审伤寒结合疫苗(Typbar TCV)作为对照。招募健康受试者936人,分为6-24月龄婴儿组、2-11岁儿童组、12-45岁青少年及成人组,随访至接种后28天。接种前和接种后第28天分别采血评价免疫原性。结果各年龄组患者最常见的直接局部反应是疼痛,其次是发红。婴儿组最常见的直接全身反应是易怒,而成人和儿童组是肌肉疼痛。反应强度多为轻度和中度。严重的反应表现为疼痛和发烧。反应大多在48小时内消退。与PQed伤寒结合疫苗Typbar-TCV相比,成人和儿童在28天时的血清转化率更高(p = 1.000;P = 0.250)。Vi-DT组的几何平均滴度(GMT)在成人中较高(p = 0134),而PQed伤寒结合疫苗typbartcv在儿童和婴儿中显示较高的GMT (p = 0.277;P = 0.884)。结论6个月~ 45岁人群接种6 - dt型伤寒结合疫苗(Bio-TCV®)是安全的,具有免疫原性。临床试验注册号。NCT04051268,报名日期:2019年8月9日。
{"title":"One-month evaluation of safety and immunogenicity of a Vi-DT typhoid conjugate vaccine (Bio-TCV®) in Indonesian subjects 6 months to 45 years: A phase III randomized clinical trial","authors":"Bernie Endyarni Medise ,&nbsp;I. Gusti Ayu Trisna Windiani ,&nbsp;Dominicus Husada ,&nbsp;Rini Sekartini ,&nbsp;Hartono Gunardi ,&nbsp;Angga Wirahmadi ,&nbsp;Dwiyanti Puspitasari ,&nbsp;Leny Kartina ,&nbsp;I. Gusti Agung Ngurah Sugitha Adnyana ,&nbsp;I. Gusti Lanang Sidiartha ,&nbsp;I. Made Dwi Lingga Utama ,&nbsp;I. Ketut Agus Somia ,&nbsp;Iris Rengganis ,&nbsp;Sukamto Koesnoe ,&nbsp;Hindra Irawan Satari ,&nbsp;Soedjatmiko Soedjatmiko ,&nbsp;Sri Rezeki Hadinegoro ,&nbsp;Ismoedijanto Ismoedijanto ,&nbsp;Parwati Setiono Basuki ,&nbsp;Gatot Soegiarto ,&nbsp;Sushant Sahastrabuddhe","doi":"10.1016/j.jvacx.2025.100661","DOIUrl":"10.1016/j.jvacx.2025.100661","url":null,"abstract":"<div><h3>Background</h3><div>Typhoid fever typically affects children and young adults and is a considerable cause of morbidity and mortality. Vaccination is the most effective preventive strategy to control typhoid fever in the short to medium term. However, in most endemic countries do not have a typhoid vaccine that is suitable for children below 2 years old.</div></div><div><h3>Methods</h3><div>This is a randomized, observer blinded phase III trial using Vi-DT typhoid conjugate vaccine and an already WHO licensed prequalified (PQed) typhoid conjugate vaccine (Typbar TCV) as control. About 936 healthy subjects were recruited and divided into 3 age groups: infants group aged 6–24 months, children group aged 2–11 years, adolescents and adults group aged 12–45 years, and followed up till 28 days post vaccination. Blood sample was taken at pre-vaccination and at 28th day post vaccination to evaluate immunogenicity.</div></div><div><h3>Results</h3><div>The most common immediate local reaction was pain in all age groups, followed by redness. The most common immediate systemic reaction in the infant group was irritability while in the adults and children group was muscle pain. The intensity of reactions was mostly mild and moderate. Severe reactions were in the form of pain and fever. Reactions mostly resolved within 48 h. Seroconversion at 28 days in the Vi-DT group was higher in both adults and children compared to the PQed typhoid conjugate vaccine, Typbar-TCV (<em>p</em> = 1.000; <em>p</em> = 0.250), respectively. The Geometric Mean Titer (GMT) in the Vi-DT group was higher in adults (<em>p</em> = 0134), whereas the PQed typhoid conjugate vaccine Typbar-TCV demonstrated a higher GMT in children and infants (<em>p</em> = 0.277; <em>p</em> = 0.884), respectively.</div></div><div><h3>Conclusion</h3><div>Vi-DT typhoid conjugate vaccine (Bio-TCV®) is safe and immunogenic in subjects 6 months to 45 years old.</div><div>Clinical trial registration number.</div><div><span><span>NCT04051268</span><svg><path></path></svg></span>, registration date: 09/08/2019.</div></div>","PeriodicalId":43021,"journal":{"name":"Vaccine: X","volume":"25 ","pages":"Article 100661"},"PeriodicalIF":2.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144167410","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}
引用次数: 0
Comparative effectiveness of live attenuated influenza vaccine (LAIV) and inactivated influenza vaccine (IIV) in children over multiple influenza seasons (2019–2023) 2019-2023年多个流感季节儿童流感减毒活疫苗(LAIV)与灭活疫苗(iv)效果比较
IF 2.7 Q3 IMMUNOLOGY Pub Date : 2025-08-01 Epub Date: 2025-05-24 DOI: 10.1016/j.jvacx.2025.100666
Allyn Bandell , George Kassianos , Oliver Dibben , Georges El Azzi
Vaccine effectiveness (VE) of quadrivalent live attenuated influenza vaccine (LAIV4) and quadrivalent inactivated influenza vaccine (IIV4) in children in 13 European countries and the US during the 2019–2023 influenza seasons was evaluated from published literature, congress presentations, public health websites, and personal communications with investigators.
A meta-analysis was performed by assessing LAIV4 and/or IIV4 VE in children (N = 34–1679) across included studies during the 2019/20–2022/23 seasons. VE estimates against influenza infection (all strains) for LAIV4 were 61.9 % (95 % confidence interval [CI]: 53.0–69.1) and for IIV4 were 45.7 % (33.2–55.8). Overall VE (95 % CI) for individual strains for the 2022/23 season for LAIV4 were 75.7 % (52.0–87.7) and for IIV4 were 58.5 % (38.2–72.1).
Overall, LAIV4 and IIV4 VE in children was moderate and comparable. Annual vaccination with LAIV4 or IIV4 remains the best way to protect children against influenza infection.
根据已发表的文献、会议报告、公共卫生网站以及与调查人员的个人交流,评估了2019-2023年流感季节期间,13个欧洲国家和美国儿童使用四价流感减毒活疫苗(lai4)和四价灭活疫苗(IIV4)的疫苗有效性(VE)。通过评估2019/20-2022/23季节纳入研究的儿童(N = 34-1679) lai4和/或IIV4 VE进行荟萃分析。LAIV4对流感感染(所有菌株)的VE估计为61.9%(95%可信区间[CI]: 53.0-69.1), IIV4为45.7%(33.2-55.8)。LAIV4和IIV4的总体VE (95% CI)分别为75.7%(52.0 ~ 87.7)和58.5%(38.2 ~ 72.1)。总体而言,LAIV4和iiv4ve在儿童中是中等和可比性的。每年接种lai4或IIV4疫苗仍然是保护儿童免受流感感染的最佳方式。
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引用次数: 0
A narrative review of pneumococcal serotypes causing invasive disease in North Africa and the Middle East 北非和中东引起侵袭性疾病的肺炎球菌血清型的叙述性回顾
IF 2.2 Q3 IMMUNOLOGY Pub Date : 2025-08-01 Epub Date: 2025-07-10 DOI: 10.1016/j.jvacx.2025.100688
Hammam Haridy , Ghassan Dbaibo , Prakash Jeena , Amina Al-Jardani

Introduction

Invasive pneumococcal disease (IPD) poses an enormous burden for developing countries. The introduction of pneumococcal conjugate vaccines (PCVs) has resulted in global declines in invasive pneumococcal disease (IPD), and the World Health Organization recommends PCV inclusion in all national immunization programs (NIPs). This review assesses the pneumococcal serotypes causing IPD in North Africa and the Middle East and the potential prevention of IPD by different serotype-specific PCVs.

Methods

A search was conducted in PubMed for articles published from 2012 to 2025 evaluating the serotypes causing IPD in North Africa and the Middle East.

Results

Of 263 articles retrieved, the 30 that met inclusion criteria investigated IPD in 10 countries from 1994 through 2022: Algeria, Iran, Jordan, Kuwait, Lebanon, Morocco, Oman, Qatar, Saudi Arabia, and Tunisia. The studies showed that the serotypes most responsible for IPD varied widely over time and across countries and often demonstrated an inverse relationship to vaccine uptake. The most common IPD-causing serotypes were 14 (≤57.0 %), 19A (≤46.2 %) and 19F (≤30.8 %), but the prevalence of serotypes 14, 19A, and 19F tended to decline after the introduction of 7-valent PCV and 13-valent PCV (PCV13) into NIPs. In contrast, percentages of IPD caused by non-vaccine serotypes remained high in some countries.

Discussion

Although limited data and variable results made major serotype distribution trends difficult to determine, IPD caused by PCV13 serotypes clearly declined after vaccine introduction whereas IPD caused by serotypes not included in the available vaccines tended to remain high or increase.

Conclusion

In North Africa and the Middle East, improved IPD serotype surveillance is needed. The introduction of higher valency vaccines into regional NIPs may alleviate IPD burden.
侵袭性肺炎球菌病(IPD)给发展中国家带来了巨大的负担。肺炎球菌结合疫苗(PCV)的引入导致全球侵袭性肺炎球菌疾病(IPD)的下降,世界卫生组织建议将PCV纳入所有国家免疫规划(NIPs)。本综述评估了北非和中东地区引起IPD的肺炎球菌血清型,以及不同血清型特异性pcv预防IPD的可能性。方法在PubMed检索2012 - 2025年发表的评价北非和中东地区IPD血清型的文章。在检索到的263篇文章中,符合纳入标准的30篇文章调查了1994年至2022年间10个国家的IPD:阿尔及利亚、伊朗、约旦、科威特、黎巴嫩、摩洛哥、阿曼、卡塔尔、沙特阿拉伯和突尼斯。这些研究表明,随着时间的推移和国家的不同,导致IPD的血清型差异很大,而且往往与疫苗摄取呈反比关系。引起ipd最常见的血清型为14型(≤57.0%)、19A型(≤46.2%)和19F型(≤30.8%),但在将7价PCV和13价PCV (PCV13)引入NIPs后,14、19A和19F型的患病率呈下降趋势。相反,在一些国家,由非疫苗血清型引起的IPD的百分比仍然很高。虽然有限的数据和可变的结果使主要血清型分布趋势难以确定,但PCV13血清型引起的IPD在疫苗引入后明显下降,而未包括在现有疫苗中的血清型引起的IPD趋于保持高水平或增加。结论北非和中东地区需要加强IPD血清型监测。将高价疫苗引入区域国家免疫规划可减轻IPD负担。
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引用次数: 0
Serological evaluation of the immune protection conferred by the canine parvovirus vaccine: A comparative study of a recommended brief protocol and WSAVA protocols 犬细小病毒疫苗免疫保护的血清学评价:推荐的简要方案和WSAVA方案的比较研究
IF 2.7 Q3 IMMUNOLOGY Pub Date : 2025-08-01 Epub Date: 2025-05-22 DOI: 10.1016/j.jvacx.2025.100667
Idbarka Abdellatif , Kadim Oumaima , Soulhi Imane , Piro Mohammed , Amrani Nadia , Azrib Rahma , Kadiri Ahlam , Daden Reda , El Allali Khalid
Canine parvovirus (CPV) is a highly contagious and often fatal viral disease in puppies, with high morbidity and mortality rates. Despite vaccination, failures have been reported, especially with the short protocol (BP) recommended by some pharmaceutical companies, which may not align with the World Small Animal Veterinary Association (WSAVA) 2024 guidelines.
This study aimed to evaluate the effectiveness of immunity in puppies vaccinated with the BP protocol and assess whether boosters based on the WSAVA guidelines would improve immunity. Experiment 1 involved unvaccinated puppies receiving the WSAVA vaccination protocol, with four vaccinations at 15-day intervals. Experiment 2 assessed puppies vaccinated with the BP protocol, followed by two additional booster doses administered two weeks apart.
In Experiment 1, puppies receiving the WSAVA protocol had insufficient maternal antibodies (32.00 ± 14.99) at 12–16 weeks. After four vaccinations, antibody titers significantly increased to 256.00 ± 79.43 by day 45 (p = 0.0166). In Experiment 2, puppies vaccinated with the BP protocol showed antibody titers of 32.00 ± 32.57 at 5 months, below the protective threshold. Two additional boosters raised antibody titers to 512.00 ± 245.0 at day 45 (p = 0.0154). These results indicate that the BP protocol alone does not provide adequate immunity but that Additional boosters can improve immunity. The WSAVA vaccination protocol effectively protects against CPV, while the BP protocol requires additional boosters to meet protective standards. Implementing WSAVA-guideline-based boosters is essential to improve CPV protection in puppies.
犬细小病毒(Canine parvovirus, CPV)是一种在幼犬中具有高度传染性和致命性的病毒性疾病,具有很高的发病率和死亡率。尽管接种了疫苗,但仍有失败的报道,特别是一些制药公司推荐的短方案(BP),这可能不符合世界小动物兽医协会(WSAVA) 2024年的指导方针。本研究旨在评估接种BP方案的幼犬的免疫效果,并评估基于WSAVA指南的增强剂是否会提高免疫力。实验1让未接种疫苗的幼犬接受WSAVA疫苗接种方案,每隔15天接种4次疫苗。实验2评估了接种了BP方案的幼犬,然后每隔两周进行两次额外的加强剂量。在实验1中,接受WSAVA方案的幼犬在12-16周时母体抗体不足(32.00±14.99)。接种4次疫苗后,第45天抗体滴度显著提高至256.00±79.43 (p = 0.0166)。在实验2中,接种BP方案的幼犬在5个月时抗体滴度为32.00±32.57,低于保护阈值。另外两种增强剂在第45天将抗体滴度提高到512.00±245.0 (p = 0.0154)。这些结果表明,单独的BP方案不能提供足够的免疫力,但额外的增强剂可以提高免疫力。WSAVA疫苗接种方案有效地预防CPV,而BP方案需要额外的增强剂来达到保护标准。实施基于wsava指南的增强剂对于提高幼犬CPV保护至关重要。
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引用次数: 0
Efficacy test of a Mycoplasma hyorhinis mRNA-LNP vaccine candidate 一种缩支原体mRNA-LNP候选疫苗的效力试验
IF 2.7 Q3 IMMUNOLOGY Pub Date : 2025-08-01 Epub Date: 2025-06-28 DOI: 10.1016/j.jvacx.2025.100684
Eszter Zsófia Nagy , Levente Szeredi , Hiromi Muramatsu , Noémi Nagy , Dénes Grózner , Zsuzsa Kreizinger , Kinga M. Sulyok , Bandana Pangabam , Lilla Tóth , Rachel H.J. Jun , Dorottya Földi , Enikő Wehmann , Miklós Tenk , Norbert Pardi , Miklós Gyuranecz

Background

Mycoplasma (M.) hyorhinis is a widespread bacterium that frequently causes polyserositis and arthritis in post-weaning pigs. Currently, prevention and treatment strategies rely on mitigating risk factors and administering antibiotics, as no vaccines are commercially available in Europe. Developing a safe and efficacious vaccine could provide a long-term solution, reducing the economic impact of M. hyorhinis infections. Therefore, the present study aimed to develop a M. hyorhinis mRNA-LNP vaccine candidate.

Materials and methods

The selected antigens were highly conserved proteins involved in bacterial adhesion. The mRNAs encoding these proteins were produced using established protocols and subsequently encapsulated in lipid nanoparticles through a self-assembly technique. For the in vivo efficacy assessment, three-week-old piglets were immunized with the candidate vaccine, and the injection site was monitored daily. At six weeks of age, the animals were challenged intravenously on two consecutive days. The clinical examinations were performed daily, while blood samples were collected weekly for a M. hyorhinis-specific antibody ELISA and Porcine Interferon gamma (Porcine IFN-γ) ELISA. Three weeks post-challenge, the animals were euthanized for gross and histopathological examinations. Additionally, body temperatures were recorded daily, and the body weights of the animals were measured upon arrival and then at six and nine weeks of age.

Results

After the challenge, the vaccinated group showed significantly higher IgG antibody titers than the positive control. Similarly, the vaccinated group's average daily weight gain was higher than the one of the challenge group. However, the vaccine candidate failed to confer sufficient protection against the clinical signs, pathological and histopathological lesions.

Discussion

Overall, a single dose of mRNA-LNP vaccine candidate was ineffective in preventing the disease caused by M. hyorhinis. Future research should focus on optimizing the vaccine formulation by incorporating additional antigens or adjuvants, implementing a two-dose immunization, or exploring alternative routes of administration.
支原体(m.h orhinis)是一种广泛存在的细菌,经常引起断奶后猪的多浆液炎和关节炎。目前,预防和治疗战略依赖于减轻风险因素和使用抗生素,因为欧洲没有商业化的疫苗。开发一种安全有效的疫苗可以提供一种长期的解决方案,减少喉支原体感染的经济影响。因此,本研究旨在开发一种猪分枝杆菌mRNA-LNP候选疫苗。材料与方法所选抗原为与细菌黏附有关的高度保守蛋白。编码这些蛋白质的mrna使用既定的方案产生,随后通过自组装技术封装在脂质纳米颗粒中。为评估体内有效性,对3周龄仔猪进行候选疫苗免疫,并每天监测注射部位。在六周龄时,连续两天对这些动物进行静脉注射。每天进行临床检查,每周采集血样进行猪嗜血杆菌特异性抗体ELISA和猪干扰素γ(猪IFN-γ) ELISA检测。三周后,对动物实施安乐死,进行大体和组织病理学检查。此外,每天记录体温,并在动物到达后以及6周龄和9周龄时测量体重。结果攻毒后,免疫组IgG抗体滴度明显高于阳性对照组。同样,接种疫苗组的平均每日体重增加高于挑战组。然而,该候选疫苗未能对临床症状、病理和组织病理学病变提供足够的保护。综上所述,单剂量mRNA-LNP候选疫苗在预防猪支原体引起的疾病方面是无效的。未来的研究应侧重于通过加入额外的抗原或佐剂、实施两剂免疫或探索其他给药途径来优化疫苗配方。
{"title":"Efficacy test of a Mycoplasma hyorhinis mRNA-LNP vaccine candidate","authors":"Eszter Zsófia Nagy ,&nbsp;Levente Szeredi ,&nbsp;Hiromi Muramatsu ,&nbsp;Noémi Nagy ,&nbsp;Dénes Grózner ,&nbsp;Zsuzsa Kreizinger ,&nbsp;Kinga M. Sulyok ,&nbsp;Bandana Pangabam ,&nbsp;Lilla Tóth ,&nbsp;Rachel H.J. Jun ,&nbsp;Dorottya Földi ,&nbsp;Enikő Wehmann ,&nbsp;Miklós Tenk ,&nbsp;Norbert Pardi ,&nbsp;Miklós Gyuranecz","doi":"10.1016/j.jvacx.2025.100684","DOIUrl":"10.1016/j.jvacx.2025.100684","url":null,"abstract":"<div><h3>Background</h3><div><em>Mycoplasma (M.) hyorhinis</em> is a widespread bacterium that frequently causes polyserositis and arthritis in post-weaning pigs. Currently, prevention and treatment strategies rely on mitigating risk factors and administering antibiotics, as no vaccines are commercially available in Europe. Developing a safe and efficacious vaccine could provide a long-term solution, reducing the economic impact of <em>M. hyorhinis</em> infections. Therefore, the present study aimed to develop a <em>M. hyorhinis</em> mRNA-LNP vaccine candidate.</div></div><div><h3>Materials and methods</h3><div>The selected antigens were highly conserved proteins involved in bacterial adhesion. The mRNAs encoding these proteins were produced using established protocols and subsequently encapsulated in lipid nanoparticles through a self-assembly technique. For the <em>in vivo</em> efficacy assessment, three-week-old piglets were immunized with the candidate vaccine, and the injection site was monitored daily. At six weeks of age, the animals were challenged intravenously on two consecutive days. The clinical examinations were performed daily, while blood samples were collected weekly for a <em>M. hyorhinis</em>-specific antibody ELISA and Porcine Interferon gamma (Porcine IFN-γ) ELISA. Three weeks post-challenge, the animals were euthanized for gross and histopathological examinations. Additionally, body temperatures were recorded daily, and the body weights of the animals were measured upon arrival and then at six and nine weeks of age.</div></div><div><h3>Results</h3><div>After the challenge, the vaccinated group showed significantly higher IgG antibody titers than the positive control. Similarly, the vaccinated group's average daily weight gain was higher than the one of the challenge group. However, the vaccine candidate failed to confer sufficient protection against the clinical signs, pathological and histopathological lesions.</div></div><div><h3>Discussion</h3><div>Overall, a single dose of mRNA-LNP vaccine candidate was ineffective in preventing the disease caused by <em>M. hyorhinis</em>. Future research should focus on optimizing the vaccine formulation by incorporating additional antigens or adjuvants, implementing a two-dose immunization, or exploring alternative routes of administration.</div></div>","PeriodicalId":43021,"journal":{"name":"Vaccine: X","volume":"25 ","pages":"Article 100684"},"PeriodicalIF":2.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144518435","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}
引用次数: 0
Factors affecting influenza vaccine uptake among healthcare providers at a tertiary hospital in Mysuru, India: a questionnaire-based survey 影响印度迈苏尔一家三级医院医护人员接种流感疫苗的因素:一项基于问卷的调查
IF 2.7 Q3 IMMUNOLOGY Pub Date : 2025-08-01 Epub Date: 2025-07-10 DOI: 10.1016/j.jvacx.2025.100687
Naviya Kafle , Jantine van Wijlick , P. Chaithra Poonacha , P. Priyanka , Jiten Choudhury , N. Onkar Yadav , R. Nisarga , Rebecca D. Kehm , Logan Stuck , Christopher Pell , Anil S. Bilimale

Background

Despite the annual burden of seasonal influenza in India and previous experiences with pandemics, influenza vaccination rates remain low among the general population and healthcare workers (HCWs). Although health authorities recommend vaccination for high-risk groups, including, awareness and coverage among these groups remain inadequate. Drawing on a cross-sectional questionnaire-based survey, this article examines influenza vaccine uptake and related socio-demographics, attitudes and practices among HCWs in a tertiary hospital in Mysuru, South India.

Methods

A team of trained research assistants administered a questionnaire-based survey to 427 HCWs (response rate: 99 %). Statistical analyses, including bivariate and multivariate logistic regression, were performed.

Results

Among the 427 HCWs surveyed, the influenza vaccination rate was 14 %, despite 82 % awareness rate. Vaccination rates varied significantly based on job roles, with physicians and physicians in training exhibiting the highest rates, and nurses and other health workers reporting zero vaccination rates. Regression analysis revealed that HCWs that perceived influenza as a serious disease were 2.77 times more likely to be vaccinated compared to those who perceived it as not serious or indicated being unsure, after adjusting for age, gender and position (95 % CI: 1.26 to 6.06).

Conclusions

Influenza vaccination uptake among HCWs in Mysuru was low, particularly among nurses. The disease was often perceived as low risk. Targeted interventions, designed with collaboration with target groups to adapt to their needs, are crucial. Efforts to raise awareness about the risks of influenza and to enhance vaccine accessibility would further support increased uptake.
背景尽管印度每年都有季节性流感的负担,而且以前也有过流感大流行的经验,但普通人群和卫生保健工作者(HCWs)的流感疫苗接种率仍然很低。尽管卫生当局建议高危人群接种疫苗,但这些人群的认识和覆盖率仍然不足。根据一项基于横断面问卷的调查,本文研究了印度南部迈苏尔一家三级医院卫生保健员的流感疫苗接种情况和相关的社会人口统计学、态度和做法。方法一组训练有素的研究助理对427名卫生保健工作者进行问卷调查(回复率:99%)。统计分析,包括双变量和多变量逻辑回归。结果接受调查的427名卫生保健员中,流感疫苗接种率为14%,而知晓率为82%。疫苗接种率因工作角色而有很大差异,医生和接受培训的医生的接种率最高,而护士和其他卫生工作者的接种率为零。回归分析显示,在调整年龄、性别和职位后,将流感视为严重疾病的医护人员接种疫苗的可能性是认为流感不严重或表示不确定的医护人员的2.77倍(95% CI: 1.26至6.06)。结论Mysuru市卫生保健工作者的流感疫苗接种率较低,尤其是护士。这种疾病通常被认为是低风险的。与目标群体合作设计、适应其需要的有针对性的干预措施至关重要。提高对流感风险的认识和提高疫苗可及性的努力将进一步支持提高接种率。
{"title":"Factors affecting influenza vaccine uptake among healthcare providers at a tertiary hospital in Mysuru, India: a questionnaire-based survey","authors":"Naviya Kafle ,&nbsp;Jantine van Wijlick ,&nbsp;P. Chaithra Poonacha ,&nbsp;P. Priyanka ,&nbsp;Jiten Choudhury ,&nbsp;N. Onkar Yadav ,&nbsp;R. Nisarga ,&nbsp;Rebecca D. Kehm ,&nbsp;Logan Stuck ,&nbsp;Christopher Pell ,&nbsp;Anil S. Bilimale","doi":"10.1016/j.jvacx.2025.100687","DOIUrl":"10.1016/j.jvacx.2025.100687","url":null,"abstract":"<div><h3>Background</h3><div>Despite the annual burden of seasonal influenza in India and previous experiences with pandemics, influenza vaccination rates remain low among the general population and healthcare workers (HCWs). Although health authorities recommend vaccination for high-risk groups, including, awareness and coverage among these groups remain inadequate. Drawing on a cross-sectional questionnaire-based survey, this article examines influenza vaccine uptake and related socio-demographics, attitudes and practices among HCWs in a tertiary hospital in Mysuru, South India.</div></div><div><h3>Methods</h3><div>A team of trained research assistants administered a questionnaire-based survey to 427 HCWs (response rate: 99 %). Statistical analyses, including bivariate and multivariate logistic regression, were performed.</div></div><div><h3>Results</h3><div>Among the 427 HCWs surveyed, the influenza vaccination rate was 14 %, despite 82 % awareness rate. Vaccination rates varied significantly based on job roles, with physicians and physicians in training exhibiting the highest rates, and nurses and other health workers reporting zero vaccination rates. Regression analysis revealed that HCWs that perceived influenza as a serious disease were 2.77 times more likely to be vaccinated compared to those who perceived it as not serious or indicated being unsure, after adjusting for age, gender and position (95 % CI: 1.26 to 6.06).</div></div><div><h3>Conclusions</h3><div>Influenza vaccination uptake among HCWs in Mysuru was low, particularly among nurses. The disease was often perceived as low risk. Targeted interventions, designed with collaboration with target groups to adapt to their needs, are crucial. Efforts to raise awareness about the risks of influenza and to enhance vaccine accessibility would further support increased uptake.</div></div>","PeriodicalId":43021,"journal":{"name":"Vaccine: X","volume":"25 ","pages":"Article 100687"},"PeriodicalIF":2.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144714585","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}
引用次数: 0
Parental approval and perceptions of the HPV vaccine in indigenous boys from a rural community after their inclusion in the immunization program in Peru 秘鲁农村社区土著男孩被纳入免疫规划后,父母对HPV疫苗的认可和看法
IF 2.7 Q3 IMMUNOLOGY Pub Date : 2025-08-01 Epub Date: 2025-06-09 DOI: 10.1016/j.jvacx.2025.100674
Yuliana Mercedes De La Cruz-Ramirez , Augusto Felix Olaza-Maguiña , Santiago Angel Cortez-Orellana
The Peruvian health authorities approved HPV vaccination in boys from 9 to 13 years old in April 2023. The main objective of this research was to determine the percentage of parental approval and perceptions of the HPV vaccine in indigenous boys from a Peruvian rural community. A cross-sectional study was developed with 126 parents from Tumpa community, to whom the staff of the health center of said community requested the respective vaccination authorization between April and December 2023. A questionnaire was administered by the authors of this research between January and July 2024, prior informed consent declaration. It was evidenced that 56.3 % of parents rejected the HPV vaccine. The protection it provides against various types of cancer and the fear of future diseases in their boys due to said vaccine were the main positive and negative perceptions, respectively. With the exception of marital status and work status, a statistically significant association was found between the parental approval of the HPV vaccine and the sociodemographic characteristics and perceptions of parents. It was concluded that the percentage of parental approval of the HPV vaccine in indigenous boys was only 43.7 %, so educational activities that address the identified characteristics and perceptions should be promoted.
秘鲁卫生当局于2023年4月批准对9至13岁男孩接种人乳头瘤病毒疫苗。本研究的主要目的是确定秘鲁农村社区土著男孩中父母对HPV疫苗的认可和看法的百分比。对来自Tumpa社区的126名家长进行了一项横断面研究,该社区卫生中心的工作人员在2023年4月至12月期间向他们申请了相应的疫苗接种授权。本研究的作者在2024年1月至7月期间进行了问卷调查,事先知情同意声明。有证据表明,56.3%的家长拒绝接种HPV疫苗。疫苗提供的预防各种癌症的保护和对男孩将来因该疫苗而患病的恐惧分别是主要的积极和消极看法。除婚姻状况和工作状况外,父母对HPV疫苗的认可与父母的社会人口学特征和看法之间存在统计学上显著的关联。结论是,土著男孩中父母批准HPV疫苗的比例仅为43.7%,因此应促进针对已确定的特征和观念的教育活动。
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引用次数: 0
期刊
Vaccine: X
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