Pub Date : 2025-10-28DOI: 10.1016/j.jvacx.2025.100743
Danushka K. Wijesundara , Alexandra Playford , Kimberley Bruce , Andrea Corner , David A. Muller
The Vaccine Innovation Priority Strategy has identified microarray patch (MAP) devices as a top global priority for advancing equitable vaccine distribution. However, understanding the intrinsic immune-enhancing mechanisms of MAPs remains critical to guiding their optimisation. In this study, we focus on the immunological impact of MAP application, demonstrating that MAPs more effectively recruit antigen-presenting cells, particularly key dendritic cell (DC) subsets, including migratory DCs and lymphatic sinus DCs, to the draining lymph nodes compared to intradermal and intramuscular needle-and-syringe delivery. To facilitate this analysis, we developed a fluosphere-based method that allowed precise tracking of antigen-engaged DCs. This approach highlights that MAPs do not merely serve as an alternative delivery platform, but actively enhance early innate immune engagement by targeting multiple DC subsets known to drive robust and rapid adaptive responses. Together, these findings establish a practical framework to dissect MAP-specific immune mechanisms and support their refinement.
{"title":"Tracking antigen presenting cells to uncover the intrinsic immunostimulatory properties of microarray vaccine patches using a fluosphere-based assay","authors":"Danushka K. Wijesundara , Alexandra Playford , Kimberley Bruce , Andrea Corner , David A. Muller","doi":"10.1016/j.jvacx.2025.100743","DOIUrl":"10.1016/j.jvacx.2025.100743","url":null,"abstract":"<div><div>The Vaccine Innovation Priority Strategy has identified microarray patch (MAP) devices as a top global priority for advancing equitable vaccine distribution. However, understanding the intrinsic immune-enhancing mechanisms of MAPs remains critical to guiding their optimisation. In this study, we focus on the immunological impact of MAP application, demonstrating that MAPs more effectively recruit antigen-presenting cells, particularly key dendritic cell (DC) subsets, including migratory DCs and lymphatic sinus DCs, to the draining lymph nodes compared to intradermal and intramuscular needle-and-syringe delivery. To facilitate this analysis, we developed a fluosphere-based method that allowed precise tracking of antigen-engaged DCs. This approach highlights that MAPs do not merely serve as an alternative delivery platform, but actively enhance early innate immune engagement by targeting multiple DC subsets known to drive robust and rapid adaptive responses. Together, these findings establish a practical framework to dissect MAP-specific immune mechanisms and support their refinement.</div></div>","PeriodicalId":43021,"journal":{"name":"Vaccine: X","volume":"28 ","pages":"Article 100743"},"PeriodicalIF":2.2,"publicationDate":"2025-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145645586","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}
Pub Date : 2025-10-27DOI: 10.1016/j.jvacx.2025.100741
Saba Sohail , Jiayuan Wang , Ding Quan Ng, Keri Hurley-Kim
Background
Vaccine disparities in the United States contribute to downstream health inequities. Until late 2024, pneumococcal conjugate vaccine (PCV) and/or pneumococcal polysaccharide vaccine (PPSV) was only recommended for those adults under 65 with certain chronic conditions. Prior studies have shown that, unlike other vaccines, PCV/PPSV uptake is comparable or even higher among non-Hispanic (NH) Black individuals under 65 compared to NH-White individuals. One proposed explanation is a higher burden of chronic disease and multimorbidity in NH-Black populations.
Methods
We used data from the National Institutes of Health All of Us database to examine this pattern. Eligible participants (N = 87,005) were ≥ 18 years old, completed the Personal and Family Health survey, consented to electronic health record (EHR) access, and had ≥1 chronic disease indication for PCV/PPSV between ages 18–64. Vaccination was defined as ≥1 EHR-recorded PCV/PPSV dose between ages 18–64.
Results
Overall, 14,495 participants (17 %) had received PCV/PPSV. The cohort was majority female (59.8 %), NH-White (64.3 %), with a mean age of 54.5 years; most had private insurance (50.8 %). Vaccination prevalence was highest among NH-Black participants (18.8 %), followed by NH-White (17.1 %), Other (15.6 %), Hispanic (13.2 %), and Asian (12.5 %).Multivariate regression adjusting for sociodemographic and chronic disease burden found higher odds of vaccination among NH-Black individuals (AOR = 1.10, 95 % CI: 1.03–1.17) and lower odds among Hispanic individuals (AOR = 0.75, 95 % CI: 0.69–0.82, p < 0.001) compared to NH-White participants. Greater chronic disease burden partially explained but did not fully account for these disparities.
Conclusions
These findings demonstrate the importance of further research to evaluate humanistic and/or health systems factors that contribute to the racial/ethnic trends in pneumococcal vaccination in younger adults, as variations in sociodemographics, rates of comorbidities, and rates of multimorbidity do not fully explain the observed pattern.
{"title":"Effect of chronic disease rates and diagnoses on young adult pneumococcal vaccination status in the All of Us database","authors":"Saba Sohail , Jiayuan Wang , Ding Quan Ng, Keri Hurley-Kim","doi":"10.1016/j.jvacx.2025.100741","DOIUrl":"10.1016/j.jvacx.2025.100741","url":null,"abstract":"<div><h3>Background</h3><div>Vaccine disparities in the United States contribute to downstream health inequities. Until late 2024, pneumococcal conjugate vaccine (PCV) and/or pneumococcal polysaccharide vaccine (PPSV) was only recommended for those adults under 65 with certain chronic conditions. Prior studies have shown that, unlike other vaccines, PCV/PPSV uptake is comparable or even higher among non-Hispanic (NH) Black individuals under 65 compared to NH-White individuals. One proposed explanation is a higher burden of chronic disease and multimorbidity in NH-Black populations.</div></div><div><h3>Methods</h3><div>We used data from the National Institutes of Health All of Us database to examine this pattern. Eligible participants (<em>N</em> = 87,005) were ≥ 18 years old, completed the Personal and Family Health survey, consented to electronic health record (EHR) access, and had ≥1 chronic disease indication for PCV/PPSV between ages 18–64. Vaccination was defined as ≥1 EHR-recorded PCV/PPSV dose between ages 18–64.</div></div><div><h3>Results</h3><div>Overall, 14,495 participants (17 %) had received PCV/PPSV. The cohort was majority female (59.8 %), NH-White (64.3 %), with a mean age of 54.5 years; most had private insurance (50.8 %). Vaccination prevalence was highest among NH-Black participants (18.8 %), followed by NH-White (17.1 %), Other (15.6 %), Hispanic (13.2 %), and Asian (12.5 %).Multivariate regression adjusting for sociodemographic and chronic disease burden found higher odds of vaccination among NH-Black individuals (AOR = 1.10, 95 % CI: 1.03–1.17) and lower odds among Hispanic individuals (AOR = 0.75, 95 % CI: 0.69–0.82, <em>p</em> < 0.001) compared to NH-White participants. Greater chronic disease burden partially explained but did not fully account for these disparities.</div></div><div><h3>Conclusions</h3><div>These findings demonstrate the importance of further research to evaluate humanistic and/or health systems factors that contribute to the racial/ethnic trends in pneumococcal vaccination in younger adults, as variations in sociodemographics, rates of comorbidities, and rates of multimorbidity do not fully explain the observed pattern.</div></div>","PeriodicalId":43021,"journal":{"name":"Vaccine: X","volume":"27 ","pages":"Article 100741"},"PeriodicalIF":2.2,"publicationDate":"2025-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145417290","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}
In this study, we used baculovirus to express hemagglutinin (HA) and neuraminidase (NA) to prepare a novel genotype of H3N2 canine influenza virus particles (VLPs). The effectiveness of the H3N2 VLP vaccine was evaluated by detecting HI antibodies, the antiviral protection rate, antibody persistence and anatomical examination of the lungs.A challenge model has been established in a previous study for the study of canine influenza virus-like particle vaccines. A/Canine/Shanghai/0103/2019, with a challenge dose of 106 EID50, infects 10-week-old healthy beagle dogs through nasal instillation and can cause severe clinical symptoms. Using a single dose of VLP vaccine for beagle dogs, the vaccine was tested at titers of 26 intranasally and 26 intramuscularly. One week after a single immunization, the HI titer promptly reached 28 among the immunized groups. The duration of antibody can persist for four months. We differentiated between CD4+ and CD8+ T cells in the peripheral blood. Four weeks after the single immunization, all beagles except those in the noninfected and nonimmunized groups were intranasally challenged with live H3N2 virus (1 × 106 EID50). All immunized beagles shed no virus at d 1–4 post-challenge. After the challenge, the placebo control beagles shed the virus on d 1 post-challenge (105.85±0.071 EID50). An anatomical examination of the lungs revealed that visible lesions were rarely detected in the lungs of the nasal immunization group, and the lungs were as healthy as those of the noninfected and nonimmunized groups were. The lung surfaces presented visible bleeding spots in the intramuscular immunization group and placebo-control group. Their effectiveness will provide a scientific basis for the promotion and use of these products.
{"title":"Robust and sustained immunity in beagles following one single nasal administration of H3N2 canine influenza virus-like particle","authors":"Fei-fei Ge , Li-ping Shen , De-quan Yang, Hai-xiao Shen, Xin Li, Jian Liu, Jian Wang, Hongjin Zhao","doi":"10.1016/j.jvacx.2025.100739","DOIUrl":"10.1016/j.jvacx.2025.100739","url":null,"abstract":"<div><div>In this study, we used baculovirus to express hemagglutinin (HA) and neuraminidase (NA) to prepare a novel genotype of H3N2 canine influenza virus particles (VLPs). The effectiveness of the H3N2 VLP vaccine was evaluated by detecting HI antibodies, the antiviral protection rate, antibody persistence and anatomical examination of the lungs.A challenge model has been established in a previous study for the study of canine influenza virus-like particle vaccines. A/Canine/Shanghai/0103/2019, with a challenge dose of 10<sup>6</sup> EID<sub>50</sub>, infects 10-week-old healthy beagle dogs through nasal instillation and can cause severe clinical symptoms. Using a single dose of VLP vaccine for beagle dogs, the vaccine was tested at titers of 2<sup>6</sup> intranasally and 2<sup>6</sup> intramuscularly. One week after a single immunization, the HI titer promptly reached 2<sup>8</sup> among the immunized groups. The duration of antibody can persist for four months. We differentiated between CD4+ and CD8+ T cells in the peripheral blood. Four weeks after the single immunization, all beagles except those in the noninfected and nonimmunized groups were intranasally challenged with live H3N2 virus (1 × 10<sup>6</sup> EID<sub>50</sub>). All immunized beagles shed no virus at d 1–4 post-challenge. After the challenge, the placebo control beagles shed the virus on d 1 post-challenge (10<sup>5.85±0.071</sup> EID<sub>50</sub>). An anatomical examination of the lungs revealed that visible lesions were rarely detected in the lungs of the nasal immunization group, and the lungs were as healthy as those of the noninfected and nonimmunized groups were. The lung surfaces presented visible bleeding spots in the intramuscular immunization group and placebo-control group. Their effectiveness will provide a scientific basis for the promotion and use of these products.</div></div>","PeriodicalId":43021,"journal":{"name":"Vaccine: X","volume":"27 ","pages":"Article 100739"},"PeriodicalIF":2.2,"publicationDate":"2025-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145325796","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}
Pub Date : 2025-10-15DOI: 10.1016/j.jvacx.2025.100738
Giovanni Genovese , Elisabetta Genovese , Domenico Santoro , Flavia Pennisi , Giuseppe Trimarchi , Raffaele Squeri , Daniela Lo Giudice , Cristina Genovese
Background
Chronic kidney disease is (CKD) a highly prevalent condition worldwide, with an increasing prevalence in the general population. Effective vaccination strategies are crucial in this population to prevent hepatitis B virus (HBV)-related complications. This study aimed to evaluate the effectiveness of different HBV vaccines in patients with CKD undergoing dialysis, focusing on seroconversion rates and overall immune response.
Methods
A non-concurrent prospective cohort study was conducted on 160 outpatient long-term dialysis patients at the G. Martino Hospital in Messina. Patients were vaccinated with either FENDRIX (HB-AS04), HBVAXPRO 40 mg, or a combination, and their immune responses were assessed one month after the completion of the vaccination course.
Results
The study achieved 100 % vaccination coverage. The overall seroconversion rate was 62.5 %, with mean anti-HBs titers of 604.15 mIU/mL (±437.23 SD) across the cohorts. No significant differences were observed between responders and non-responders concerning demographic, clinical, and biochemical characteristics.
Conclusion
The study confirms the effectiveness of HBV vaccines in patients with CKD, though with a lower and delayed response compared to the general population. Establishing a diagnostic-therapeutic care pathway that integrates vaccination from the early stages of CKD is essential to improve outcomes in this high-risk group.
{"title":"Real-world effectiveness of hepatitis B vaccination in dialysis patients","authors":"Giovanni Genovese , Elisabetta Genovese , Domenico Santoro , Flavia Pennisi , Giuseppe Trimarchi , Raffaele Squeri , Daniela Lo Giudice , Cristina Genovese","doi":"10.1016/j.jvacx.2025.100738","DOIUrl":"10.1016/j.jvacx.2025.100738","url":null,"abstract":"<div><h3>Background</h3><div>Chronic kidney disease is (CKD) a highly prevalent condition worldwide, with an increasing prevalence in the general population. Effective vaccination strategies are crucial in this population to prevent hepatitis B virus (HBV)-related complications. This study aimed to evaluate the effectiveness of different HBV vaccines in patients with CKD undergoing dialysis, focusing on seroconversion rates and overall immune response.</div></div><div><h3>Methods</h3><div>A non-concurrent prospective cohort study was conducted on 160 outpatient long-term dialysis patients at the G. Martino Hospital in Messina. Patients were vaccinated with either FENDRIX (HB-AS04), HBVAXPRO 40 mg, or a combination, and their immune responses were assessed one month after the completion of the vaccination course.</div></div><div><h3>Results</h3><div>The study achieved 100 % vaccination coverage. The overall seroconversion rate was 62.5 %, with mean anti-HBs titers of 604.15 mIU/mL (±437.23 SD) across the cohorts. No significant differences were observed between responders and non-responders concerning demographic, clinical, and biochemical characteristics.</div></div><div><h3>Conclusion</h3><div>The study confirms the effectiveness of HBV vaccines in patients with CKD, though with a lower and delayed response compared to the general population. Establishing a diagnostic-therapeutic care pathway that integrates vaccination from the early stages of CKD is essential to improve outcomes in this high-risk group.</div></div>","PeriodicalId":43021,"journal":{"name":"Vaccine: X","volume":"27 ","pages":"Article 100738"},"PeriodicalIF":2.2,"publicationDate":"2025-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145325792","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}
Pub Date : 2025-10-15DOI: 10.1016/j.jvacx.2025.100737
Zhe Zheng , Mitra Yousefi , Danielle MacCormac , Jennifer M. Radin , Tianyu Sun , Amanda Wilson , Rohan Shah , Michelle Skornicki , Paige Sheridan , Astra Toyip , Katherine Mues , Daina Esposito , Andre Araujo , Evan Anderson
Background
COVID-19 remains a public health concern, causing an estimated 50,000 deaths and 827,000 hospitalizations in the United States during the 2023–2024 season. As SARS-CoV-2 continues to evolve, assessing COVID-19 vaccine effectiveness (VE) remains essential. This study evaluated the effectiveness of Moderna's 2023–2024 mRNA-1273 vaccine formulation targeting the XBB.1.5 variant in preventing COVID-19 associated hospitalizations and medically attended COVID-19 in the US.
Methods
This non-interventional, matched retrospective cohort study used US administrative claims data (September 2023–February 2024). Individuals vaccinated with mRNA-1273 XBB.1.5 were matched to individuals who did not receive an updated 2023–2024 COVID-19 vaccine. COVID-19 associated hospitalizations and medically attended COVID-19 outcomes were identified 7 days after the index date. Subpopulations of interest included age group, immunocompromised individuals, and those received a BA.4/BA.5 vaccine in the prior season. VE was estimated using 1 minus hazard ratios.
Results
Among 900,194 mRNA-1273 vaccinated and matched unexposed individuals, median follow-up for COVID-19 associated hospitalizations was 111 days (vaccinated) and 99 days (unexposed). Overall, VE against COVID-19 associated hospitalizations was 56 % (95 % CI: 52 %–60 %). VE ranged from 52 % (95 % CI: 43 %–59 %) in immunocompromised individuals to 62 % (95 % CI: 35 %–78 %) in those aged 50–64 years. For medically attended COVID-19, VE was 24 % (95 % CI: 22 %–25 %).
Conclusions
mRNA-1273 XBB.1.5 demonstrates significant incremental protection against COVID-19 associated hospitalizations and medically attended COVID-19 relative to those who did not receive 2023–2024 COVID-19 vaccination. These findings reinforce the need for vaccination efforts to reduce the burden of COVID-19.
{"title":"Effectiveness of 2023–2024 mRNA-1273 XBB.1.5 vaccine against COVID-19 associated hospitalizations and medically attended COVID-19 in the United States","authors":"Zhe Zheng , Mitra Yousefi , Danielle MacCormac , Jennifer M. Radin , Tianyu Sun , Amanda Wilson , Rohan Shah , Michelle Skornicki , Paige Sheridan , Astra Toyip , Katherine Mues , Daina Esposito , Andre Araujo , Evan Anderson","doi":"10.1016/j.jvacx.2025.100737","DOIUrl":"10.1016/j.jvacx.2025.100737","url":null,"abstract":"<div><h3>Background</h3><div>COVID-19 remains a public health concern, causing an estimated 50,000 deaths and 827,000 hospitalizations in the United States during the 2023–2024 season. As SARS-CoV-2 continues to evolve, assessing COVID-19 vaccine effectiveness (VE) remains essential. This study evaluated the effectiveness of Moderna's 2023–2024 mRNA-1273 vaccine formulation targeting the XBB.1.5 variant in preventing COVID-19 associated hospitalizations and medically attended COVID-19 in the US.</div></div><div><h3>Methods</h3><div>This non-interventional, matched retrospective cohort study used US administrative claims data (September 2023–February 2024). Individuals vaccinated with mRNA-1273 XBB.1.5 were matched to individuals who did not receive an updated 2023–2024 COVID-19 vaccine. COVID-19 associated hospitalizations and medically attended COVID-19 outcomes were identified 7 days after the index date. Subpopulations of interest included age group, immunocompromised individuals, and those received a BA.4/BA.5 vaccine in the prior season. VE was estimated using 1 minus hazard ratios.</div></div><div><h3>Results</h3><div>Among 900,194 mRNA-1273 vaccinated and matched unexposed individuals, median follow-up for COVID-19 associated hospitalizations was 111 days (vaccinated) and 99 days (unexposed). Overall, VE against COVID-19 associated hospitalizations was 56 % (95 % CI: 52 %–60 %). VE ranged from 52 % (95 % CI: 43 %–59 %) in immunocompromised individuals to 62 % (95 % CI: 35 %–78 %) in those aged 50–64 years. For medically attended COVID-19, VE was 24 % (95 % CI: 22 %–25 %).</div></div><div><h3>Conclusions</h3><div>mRNA-1273 XBB.1.5 demonstrates significant incremental protection against COVID-19 associated hospitalizations and medically attended COVID-19 relative to those who did not receive 2023–2024 COVID-19 vaccination. These findings reinforce the need for vaccination efforts to reduce the burden of COVID-19.</div></div>","PeriodicalId":43021,"journal":{"name":"Vaccine: X","volume":"27 ","pages":"Article 100737"},"PeriodicalIF":2.2,"publicationDate":"2025-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145474094","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}
Dengue virus infection continues to pose a major global health challenge, affecting approximately 3.9 billion individuals annually. Unfortunately, the efficacy and safety profiles of currently licensed dengue vaccines remain debatable. This highlights the need for a next-generation vaccine that provides protection against all DENV serotypes. In this study, the immunogenicity of five DENV proteins was evaluated, including the envelope domain III proteins of all four dengue virus serotypes and C-terminally truncated NS1 protein of DENV-2, loaded into N, N, N-trimethyl chitosan nanoparticles. We demonstrated, here, that sequential immunization with these encapsidated immunogens elicited antibody responses known to correlate with protection against all four DENV serotypes. These responses facilitated the elimination of both infected cells and virus particles through a multifaceted mechanism. Moreover, the immunization induced functional cytotoxic T cell responses to all tested immunogens. These findings indicate that immunization with the designed immunogens induces robust and protective immune responses against all four DENV serotypes. This form of immunogens offers a promising, safe and effective subunit dengue vaccine candidate.
{"title":"Immunogenicity of five Encapsidated DENV antigens supports their potential as a safe and protective subunit vaccine candidate","authors":"Mathurin Seesen , Tuksin Jearanaiwitayakul , Nattika Nantachit , Phissinee Jakaew , Jitra Limthongkul , Panya Sunintaboon , Sukathida Ubol","doi":"10.1016/j.jvacx.2025.100740","DOIUrl":"10.1016/j.jvacx.2025.100740","url":null,"abstract":"<div><div>Dengue virus infection continues to pose a major global health challenge, affecting approximately 3.9 billion individuals annually. Unfortunately, the efficacy and safety profiles of currently licensed dengue vaccines remain debatable. This highlights the need for a next-generation vaccine that provides protection against all DENV serotypes. In this study, the immunogenicity of five DENV proteins was evaluated, including the envelope domain III proteins of all four dengue virus serotypes and C-terminally truncated NS1 protein of DENV-2, loaded into <em>N, N, N</em>-trimethyl chitosan nanoparticles. We demonstrated, here, that sequential immunization with these encapsidated immunogens elicited antibody responses known to correlate with protection against all four DENV serotypes. These responses facilitated the elimination of both infected cells and virus particles through a multifaceted mechanism. Moreover, the immunization induced functional cytotoxic T cell responses to all tested immunogens. These findings indicate that immunization with the designed immunogens induces robust and protective immune responses against all four DENV serotypes. This form of immunogens offers a promising, safe and effective subunit dengue vaccine candidate.</div></div>","PeriodicalId":43021,"journal":{"name":"Vaccine: X","volume":"27 ","pages":"Article 100740"},"PeriodicalIF":2.2,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145333453","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}
Pub Date : 2025-10-13DOI: 10.1016/j.jvacx.2025.100736
Kevin E. Tololiu , Arie A. Kurnianto , Wirda Y. Dulahu , Ferenc Kocsor , Krisztina Csokasi
Background
Despite the effectiveness of vaccination in decreasing the mortality rate, pain related to needle procedures contribute to the children's incompliance vaccination uptake. Digital technology, as a widely used distracting tool, requires investigation for its efficacy and consistency. This study aims to see and compare the effectiveness of each digital intervention in reducing pain in children's vaccination.
Method
A systematic review and meta-analysis were conducted from five databases: Cochrane Library, APAPsychNet, Embase, EBSCO, and PubMed from June to September 2024. Two group trials using any digital intervention to reduce children's vaccination pain were included. A classical meta-analysis using random effects was applied to measure the effect size of pain level between intervention and control for overall and per category of digital interventions.
Result
11 of 1665 records were analysed. Digital intervention showed an overall pain education during vaccination (SMD = −0.54, 95 % CI: −1.06, −0.02, I2 = 92.2 %, P = 0.04). All groups, including robots and mobile/computer technologies, showed more pain reduction than the control group. However, only virtual reality studies showed a statistically significant difference (SMD = −0.74, 95 % CI: −1.41, −0.08, I2 = 88.4 %, P = 0.03).
Conclusion
Digital interventions have enormous potential in reducing needle-related pain. While virtual reality has a prominent effect due to its immersive nature, robots have viable efficacy by considering the interaction and realistic presentation. Mobile technologies' flexibility enables customization to children's needs and synergy with combined interventions.
{"title":"A meta-analysis of digital interventions to reduce vaccination-related pain in children","authors":"Kevin E. Tololiu , Arie A. Kurnianto , Wirda Y. Dulahu , Ferenc Kocsor , Krisztina Csokasi","doi":"10.1016/j.jvacx.2025.100736","DOIUrl":"10.1016/j.jvacx.2025.100736","url":null,"abstract":"<div><h3>Background</h3><div>Despite the effectiveness of vaccination in decreasing the mortality rate, pain related to needle procedures contribute to the children's incompliance vaccination uptake. Digital technology, as a widely used distracting tool, requires investigation for its efficacy and consistency. This study aims to see and compare the effectiveness of each digital intervention in reducing pain in children's vaccination.</div></div><div><h3>Method</h3><div>A systematic review and meta-analysis were conducted from five databases: Cochrane Library, APAPsychNet, Embase, EBSCO, and PubMed from June to September 2024. Two group trials using any digital intervention to reduce children's vaccination pain were included. A classical meta-analysis using random effects was applied to measure the effect size of pain level between intervention and control for overall and per category of digital interventions.</div></div><div><h3>Result</h3><div>11 of 1665 records were analysed. Digital intervention showed an overall pain education during vaccination (SMD = −0.54, 95 % CI: −1.06, −0.02, I<sup>2</sup> = 92.2 %, <em>P</em> = 0.04). All groups, including robots and mobile/computer technologies, showed more pain reduction than the control group. However, only virtual reality studies showed a statistically significant difference (SMD = −0.74, 95 % CI: −1.41, −0.08, I<sup>2</sup> = 88.4 %, <em>P</em> = 0.03).</div></div><div><h3>Conclusion</h3><div>Digital interventions have enormous potential in reducing needle-related pain. While virtual reality has a prominent effect due to its immersive nature, robots have viable efficacy by considering the interaction and realistic presentation. Mobile technologies' flexibility enables customization to children's needs and synergy with combined interventions.</div></div>","PeriodicalId":43021,"journal":{"name":"Vaccine: X","volume":"27 ","pages":"Article 100736"},"PeriodicalIF":2.2,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145325795","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}
Vaccine hesitancy, amplified by digital misinformation, represents a growing threat to global health. This case demonstrates its lethal consequences through rapid-onset subacute sclerosing panencephalitis (SSPE) in an unvaccinated 3.5-year-old girl whose parents refused measles-mumps-rubella (MMR) vaccination due to pandemic-amplified misinformation. A developmentally normal preschooler, vaccinated only at birth (BCG, oral polio vaccine, and hepatitis B vaccine), presented with head-drop seizures progressing to myoclonus and speech loss within weeks. Comprehensive diagnostic workup confirmed SSPE through fulfillment of Dyken's criteria, including characteristic clinical presentation, elevated measles-specific IgG in both CSF (titer 1:256 by ELISA) and serum (titer 1:128) with elevated CSF/serum antibody index (1.8), periodic complexes on EEG, symmetric white matter lesions on MRI, and exclusion of alternative infectious/autoimmune etiologies. Despite immunomodulatory therapy (intravenous immunoglobulins and ribavirin), she progressed to vegetative state by week 12, expiring at 4 months post-onset. Parental refusal of both vaccination and life-saving interventions reflected profound medical mistrust. Neuroimaging revealed rapid progression to diffuse atrophy within 6 weeks. MR spectroscopy showed marked reduction in N-acetylaspartate (NAA) and elevated lactate. This progression from symptom onset to death in 4 months represents one of the most rapid SSPE courses documented, highlighting the vulnerability of unvaccinated children and demonstrating how digital misinformation enables preventable tragedies. The case demands: (1) nuanced strategies to combat health misinformation, (2) heightened vigilance for fulminant SSPE in unvaccinated children, and (3) urgent reinforcement of measles vaccination programs. When vaccination rates decline, children become the tragic casualties of misinformation.
{"title":"Fatal measles complication in the misinformation era: A case of catastrophically rapid SSPE in an unvaccinated child","authors":"Ali Manafi Anari , Ladan Teymoorzadeh , Ramez Nasiri , Sajjad Narimani","doi":"10.1016/j.jvacx.2025.100733","DOIUrl":"10.1016/j.jvacx.2025.100733","url":null,"abstract":"<div><div>Vaccine hesitancy, amplified by digital misinformation, represents a growing threat to global health. This case demonstrates its lethal consequences through rapid-onset subacute sclerosing panencephalitis (SSPE) in an unvaccinated 3.5-year-old girl whose parents refused measles-mumps-rubella (MMR) vaccination due to pandemic-amplified misinformation. A developmentally normal preschooler, vaccinated only at birth (BCG, oral polio vaccine, and hepatitis B vaccine), presented with head-drop seizures progressing to myoclonus and speech loss within weeks. Comprehensive diagnostic workup confirmed SSPE through fulfillment of Dyken's criteria, including characteristic clinical presentation, elevated measles-specific IgG in both CSF (titer 1:256 by ELISA) and serum (titer 1:128) with elevated CSF/serum antibody index (1.8), periodic complexes on EEG, symmetric white matter lesions on MRI, and exclusion of alternative infectious/autoimmune etiologies. Despite immunomodulatory therapy (intravenous immunoglobulins and ribavirin), she progressed to vegetative state by week 12, expiring at 4 months post-onset. Parental refusal of both vaccination and life-saving interventions reflected profound medical mistrust. Neuroimaging revealed rapid progression to diffuse atrophy within 6 weeks. MR spectroscopy showed marked reduction in <em>N</em>-acetylaspartate (NAA) and elevated lactate. This progression from symptom onset to death in 4 months represents one of the most rapid SSPE courses documented, highlighting the vulnerability of unvaccinated children and demonstrating how digital misinformation enables preventable tragedies. The case demands: (1) nuanced strategies to combat health misinformation, (2) heightened vigilance for fulminant SSPE in unvaccinated children, and (3) urgent reinforcement of measles vaccination programs. When vaccination rates decline, children become the tragic casualties of misinformation.</div></div>","PeriodicalId":43021,"journal":{"name":"Vaccine: X","volume":"27 ","pages":"Article 100733"},"PeriodicalIF":2.2,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145268223","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}
Pub Date : 2025-09-29DOI: 10.1016/j.jvacx.2025.100735
Xiaoyi Fu
Vaccines have emerged as a prominent strategy for the prevention and treatment of diseases. Adjuvants, as immune enhancers and delivery systems, play a crucial role in improving the efficiency and effectiveness of vaccines. Adjuvants can be categorized into three groups based on their mechanisms: immune enhancers, delivery systems, and a combination of both. While aluminum salt-based adjuvants have been the long-standing choice for many commercial vaccines, the adjuvant landscape in FDA-approved vaccines has evolved. Emulsions, liposomes, virus-like particles (VLPs), and newer platforms have been integrated into specialized vaccine formulations. In the context of modern vaccine platforms, the need for optimized adjuvant-delivery systems is increasing. For messenger RNA (mRNA) vaccines, lipid nanoparticles (LNPs) serve as efficient delivery vehicles, enhancing mRNA stability and cellular uptake. Additionally, LNPs can also function as immune-activating adjuvants, which further enhance the immune response. Similarly, viral vector vaccines leverage adjuvants that improve immune activation, while DNA vaccines benefit from adjuvants that promote both antigen stability and uptake. Emerging systems, such as bacterial outer membrane vesicles (OMVs), programmable nanoparticles (responsive to pH, enzymes, or light), and cell membrane-coated systems (e.g., red blood cell or macrophage membranes), offer advanced ways to enhance vaccine delivery and immune responses. These systems also enable better targeting and control of immune activation, addressing challenges in immune memory and long-lasting vaccine efficacy. However, the development of adjuvant systems also faces safety concerns, including the potential for excessive immune activation and toxicity in certain populations. Overall, this review discusses the current and evolving landscape of adjuvant-delivery systems for vaccines, with an emphasis on systems that support diverse vaccine platforms and optimize immune balance, biocompatibility, and long-term immunity, crucial for the success of future vaccine development.
{"title":"Current landscape and challenges in adjuvant and antigen delivery systems for vaccine","authors":"Xiaoyi Fu","doi":"10.1016/j.jvacx.2025.100735","DOIUrl":"10.1016/j.jvacx.2025.100735","url":null,"abstract":"<div><div>Vaccines have emerged as a prominent strategy for the prevention and treatment of diseases. Adjuvants, as immune enhancers and delivery systems, play a crucial role in improving the efficiency and effectiveness of vaccines. Adjuvants can be categorized into three groups based on their mechanisms: immune enhancers, delivery systems, and a combination of both. While aluminum salt-based adjuvants have been the long-standing choice for many commercial vaccines, the adjuvant landscape in FDA-approved vaccines has evolved. Emulsions, liposomes, virus-like particles (VLPs), and newer platforms have been integrated into specialized vaccine formulations. In the context of modern vaccine platforms, the need for optimized adjuvant-delivery systems is increasing. For messenger RNA (mRNA) vaccines, lipid nanoparticles (LNPs) serve as efficient delivery vehicles, enhancing mRNA stability and cellular uptake. Additionally, LNPs can also function as immune-activating adjuvants, which further enhance the immune response. Similarly, viral vector vaccines leverage adjuvants that improve immune activation, while DNA vaccines benefit from adjuvants that promote both antigen stability and uptake. Emerging systems, such as bacterial outer membrane vesicles (OMVs), programmable nanoparticles (responsive to pH, enzymes, or light), and cell membrane-coated systems (e.g., red blood cell or macrophage membranes), offer advanced ways to enhance vaccine delivery and immune responses. These systems also enable better targeting and control of immune activation, addressing challenges in immune memory and long-lasting vaccine efficacy. However, the development of adjuvant systems also faces safety concerns, including the potential for excessive immune activation and toxicity in certain populations. Overall, this review discusses the current and evolving landscape of adjuvant-delivery systems for vaccines, with an emphasis on systems that support diverse vaccine platforms and optimize immune balance, biocompatibility, and long-term immunity, crucial for the success of future vaccine development.</div></div>","PeriodicalId":43021,"journal":{"name":"Vaccine: X","volume":"27 ","pages":"Article 100735"},"PeriodicalIF":2.2,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145221120","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}
Pub Date : 2025-09-25DOI: 10.1016/j.jvacx.2025.100731
Yongping Xie, Xin Cong, Yan Li, Lisu Huang
Respiratory syncytial virus (RSV) is a leading cause of acute lower respiratory tract infections in children under 5 years of age worldwide. Currently, there are no approved curative treatments, and clinical management remains primarily focused on symptomatic support. As a result, preventive strategies are crucial for controlling RSV infections. Recent advancements have been made in the development of monoclonal antibody therapies aimed at protecting infants and young children from RSV. This review explores the application and real-world outcomes of passive immunization strategies in various international settings, particularly in developed countries, with a focus on their effectiveness and safety. The findings are intended to offer insights into the potential use of RSV passive immunization agents in developing countries.
{"title":"Real-world data and clinical management experience in passive immunization for respiratory syncytial virus prevention in children","authors":"Yongping Xie, Xin Cong, Yan Li, Lisu Huang","doi":"10.1016/j.jvacx.2025.100731","DOIUrl":"10.1016/j.jvacx.2025.100731","url":null,"abstract":"<div><div>Respiratory syncytial virus (RSV) is a leading cause of acute lower respiratory tract infections in children under 5 years of age worldwide. Currently, there are no approved curative treatments, and clinical management remains primarily focused on symptomatic support. As a result, preventive strategies are crucial for controlling RSV infections. Recent advancements have been made in the development of monoclonal antibody therapies aimed at protecting infants and young children from RSV. This review explores the application and real-world outcomes of passive immunization strategies in various international settings, particularly in developed countries, with a focus on their effectiveness and safety. The findings are intended to offer insights into the potential use of RSV passive immunization agents in developing countries.</div></div>","PeriodicalId":43021,"journal":{"name":"Vaccine: X","volume":"27 ","pages":"Article 100731"},"PeriodicalIF":2.2,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145221121","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}
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