Vaccine: X最新文献_第6页

The validation of the Slovak vaccination attitudes examination (VAX) scale and pilot study 斯洛伐克疫苗接种态度检查（VAX）量表和试点研究的验证

IF 2.2 Q3 IMMUNOLOGY

Vaccine: X

Pub Date : 2025-08-27 DOI: 10.1016/j.jvacx.2025.100715

Martin Novák , Jana Zibolenová , Peter Vyšehradský , Romana Ulbrichtová , Eva Malobická , Eliška Štefanová , Ján Mikas , Adriana Mečochová , Henrieta Hudečková , Viera Švihrová

Introduction

The resurgence of vaccine-preventable diseases poses a significant global public health challenge, exacerbated by the rise of anti-vaccination attitudes. The aim of this study was to validate the Slovak version of the Vaccination Attitudes Examination (VAX) questionnaire and to examine the attitudes towards vaccination in Slovakia.

Methods

The VAX scale questionnaire, translated into Slovak and validated, was used for the survey. The VAX scale uses 12 statements assessing anti-vaccination attitudes. Each statement is scored on a 6-point Likert scale, with higher total score indicates more negative attitudes towards vaccinations. Our questionnaire also included demographic questions (age, gender, residence, education level, profession, and economic activity). For validation, the questionnaire was translated into the Slovak using forward and backward translations. The validation survey was conducted on the sample size of 115 participants. Correlation was calculated using Pearson's correlation coefficient, internal consistency was tested. Confirmatory factor analysis (CFA) was performed to assess validity. Subsequently, a pilot study was conducted in March 2023 with a sample size of 473 participants.

Results

The VAX scale demonstrated strong internal consistency (Cronbach's alpha = 0.925) and reliability. The results of the CFA were comparable to findings from other languages versions. The pilot study revealed that parents, non-healthcare professionals, and older individuals exhibited higher anti-vaccination attitudes. In contrast, healthcare professionals had the lowest VAX scores, reflecting more pro-vaccination attitudes.

Conclusion

These findings highlight the need for targeted educational and communication strategies to address vaccine hesitancy. By identifying demographic patterns and potential hotspots of vaccine skepticism, public health initiatives can be better tailored to improve vaccination rates. The validated Slovak VAX scale provides a reliable tool for ongoing assessment and intervention efforts.

疫苗可预防疾病的死灰复燃对全球公共卫生构成重大挑战，反疫苗接种态度的上升加剧了这一挑战。本研究的目的是验证斯洛伐克版本的疫苗接种态度检查（VAX）问卷，并检查斯洛伐克对疫苗接种的态度。方法采用VAX量表问卷，经斯洛伐克文翻译并验证。VAX量表使用12个陈述来评估反对接种疫苗的态度。每个陈述都以6分的李克特量表得分，总分越高表明对疫苗接种的负面态度越强烈。我们的问卷还包括人口统计问题（年龄、性别、居住地、教育水平、职业和经济活动）。为了验证，使用正向和反向翻译将问卷翻译成斯洛伐克文。验证性调查的样本量为115人。采用Pearson相关系数计算相关性，检验内部一致性。验证性因子分析（CFA）评估效度。随后，在2023年3月进行了一项试点研究，样本量为473名参与者。结果VAX量表具有较强的内部一致性（Cronbach’s alpha = 0.925）和信度。CFA的结果与其他语言版本的结果相当。初步研究显示，父母、非卫生保健专业人员和老年人表现出更高的反疫苗接种态度。相比之下，医疗保健专业人员的VAX得分最低，反映出更赞成接种疫苗的态度。结论这些发现突出了有针对性的教育和传播策略来解决疫苗犹豫的必要性。通过确定人口统计模式和疫苗怀疑的潜在热点，可以更好地调整公共卫生举措，以提高疫苗接种率。经过验证的斯洛伐克VAX量表为正在进行的评估和干预工作提供了可靠的工具。

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引用次数: 0

The Canadian National Vaccine Safety (CANVAS) network: Cross-sectional analysis of seasonal influenza vaccine safety in children during the 2013/2014 to 2019/2020 influenza seasons 加拿大国家疫苗安全（CANVAS）网络：2013/2014至2019/2020流感季节儿童季节性流感疫苗安全性的横断面分析

IF 2.2 Q3 IMMUNOLOGY

Vaccine: X

Pub Date : 2025-08-26 DOI: 10.1016/j.jvacx.2025.100711

Jimmy R. Lopez , Otto G. Vanderkooi , James D. Kellner , Louis Valiquette , Gaston De Serres , Karina A. Top , Jennifer Isenor , Matthew P. Muller , Monika Naus , Julie A. Bettinger , for the Canadian Immunization Research Network Investigators

The Canadian National Vaccine Safety (CANVAS) network is a participant-centered, active surveillance system that assesses vaccine safety across Canada. Our study examined the safety profile of influenza vaccines administered to children during seven consecutive influenza seasons, from 2013/2014 to 2019/2020, to establish a baseline for health events in vaccinated and unvaccinated children before the COVID-19 pandemic. Data were collected using an online survey after a 7-day period for vaccinated and unvaccinated participants. Descriptive and inferential analyses explored the association between the influenza vaccine and health events, including associated symptoms. The proportion of health events were comparable in vaccinated and unvaccinated children. Adjusted regression models identified no statistical difference in the occurrence of health events assessed. The most frequently reported symptoms were fever, gastrointestinal symptoms (i.e., nausea/vomiting/diarrhea), and cough. Our findings observed low incidence of health events in both vaccinated and unvaccinated groups in this multi-year study.

加拿大国家疫苗安全（CANVAS）网络是一个以参与者为中心的主动监测系统，评估加拿大各地的疫苗安全性。我们的研究检查了2013/2014年至2019/2020年连续七个流感季节对儿童接种流感疫苗的安全性，以便在COVID-19大流行之前为接种疫苗和未接种疫苗的儿童建立健康事件基线。数据是在接种疫苗和未接种疫苗的参与者7天后通过在线调查收集的。描述性和推断性分析探讨了流感疫苗与健康事件（包括相关症状）之间的关系。在接种疫苗和未接种疫苗的儿童中，健康事件的比例相当。调整后的回归模型发现，在评估的健康事件发生方面没有统计学差异。最常见的报告症状是发烧、胃肠道症状（即恶心/呕吐/腹泻）和咳嗽。我们的研究发现，在这项多年研究中，接种疫苗组和未接种疫苗组的健康事件发生率均较低。

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引用次数: 0

H5N1 highly pathogenic avian influenza vaccination: Seroresponse of mexican poultry in the 2022–2024 H5N1高致病性禽流感疫苗接种：2022-2024年墨西哥家禽的血清反应

IF 2.2 Q3 IMMUNOLOGY

Vaccine: X

Pub Date : 2025-08-23 DOI: 10.1016/j.jvacx.2025.100709

Brenda Aline Maya Badillo , Diana Laura Hernández García , Rodrigo Armando Moreno García , Guillermo Orta Pineda , Carlos Javier Alcázar Ramiro , Juana Castillo Castillo , Mario Solís Hernández , Roberto Navarro López , Armando García López

Since 2021, the activity and impact of the highly pathogenic H5N1 avian influenza virus have intensified worldwide, causing high mortality in wild birds and birds while also infecting various wild and domestic mammals and humans. Particularly, the severe impact on commercial poultry farming has prompted various countries to implement control and mitigation plans to address the damage caused by these viruses. In Mexico, the implementation of vaccination was part of the comprehensive strategies to prevent and control highly pathogenic H5N1 avian influenza outbreaks. For this reason, this work aimed to compare antibody levels in production birds before and after vaccination, examining seroconversion and seroprotection after vaccination in two time periods. Serum samples were taken before and after vaccination in 573 Poultry Production Units during the first vaccination period and 205 Poultry Production Units during the second period across various Mexican states. These samples, later, underwent hemagglutination inhibition tests. With the results obtained from serology, comparisons of medians, calculations of seroconversion and seroprotection, as well as logistic regression analysis were performed. As expected, vaccination led to a statistically higher immune response in birds in most of Mexico's states. However, seroconversion and seroprotection rates remained below 80 % during the first evaluation period. Progenitors and commercial posture birds showed better immune responses to vaccination, particularly with vaccines developed through reverse genetics. These results provide valuable insights into the immune response of Mexican domestic birds under the national strategic plan to control the highly pathogenic influenza A H5N1 virus emergency, which will set a precedent to improve the prevention and control of future outbreaks.

自2021年以来，高致病性H5N1禽流感病毒的活动和影响在世界范围内加剧，造成野生鸟类和鸟类的高死亡率，同时也感染各种野生和家养哺乳动物和人类。特别是，对商业家禽养殖的严重影响促使各国实施控制和缓解计划，以解决这些病毒造成的损害。在墨西哥，实施疫苗接种是预防和控制高致病性H5N1禽流感暴发的综合战略的一部分。因此，本工作旨在比较疫苗接种前后生产禽的抗体水平，在两个时间段检查疫苗接种后的血清转化和血清保护。在墨西哥各州的573个家禽生产单位和205个家禽生产单位的第一次疫苗接种期间和第二次疫苗接种期间，分别在疫苗接种前后采集了血清样本。这些样本随后进行了血凝抑制试验。根据血清学结果，比较中位数，计算血清转换和血清保护，并进行logistic回归分析。正如预期的那样，在墨西哥大多数州，疫苗接种导致了统计上更高的鸟类免疫反应。然而，在第一次评估期间，血清转化率和血清保护率仍低于80%。祖鸟和商业姿态鸟对疫苗接种表现出更好的免疫反应，特别是通过反向遗传学开发的疫苗。这些结果为了解在控制高致病性甲型H5N1病毒紧急情况的国家战略计划下墨西哥家禽的免疫反应提供了有价值的见解，这将为改善未来疫情的预防和控制开创先例。

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引用次数: 0

Influenza vaccine effectiveness against hospitalizations associated with influenza a in Hong Kong children aged 9 months to 17 years, 2024/25 流感疫苗在香港9个月至17岁儿童预防甲型流感相关住院的有效性，2014 /25

IF 2.2 Q3 IMMUNOLOGY

Vaccine: X

Pub Date : 2025-08-21 DOI: 10.1016/j.jvacx.2025.100710

Caitriona Murphy , Mike Y.W. Kwan , Eunice L.Y. Chan , Joshua S.C. Wong , Sheena G. Sullivan , Malik Peiris , Benjamin J. Cowling , So-Lun Lee

Influenza began circulating in Hong Kong in mid-December 2024. As of 12 March 2025, 1279 children were enrolled in a prospective test negative study for influenza vaccine effectiveness (VE). Among 209 influenza-positive cases, 71 % had influenza A(H1N1), 11 % had influenza A(H3N2), 3 % had influenza A with unknown subtype, and 15 % had influenza B. Among the test-negative controls, 53 % had received influenza vaccination since August 2024. End of the winter season VE estimates against hospitalization associated with influenza A(H1N1) was 64.8 % (95 % CI: 38.1 % to 80.3 %) and for influenza A(H3N2) was 59.9 % (95 % CI: −42.0 % to 89.6 %). These findings indicate that influenza vaccination provided protection against hospitalization for influenza A(H1N1) and A(H3N2) in children, highlighting the importance of continued vaccination efforts in Hong Kong.

流感于2024年12月中旬开始在香港传播。截至2025年3月12日，1279名儿童被纳入流感疫苗有效性（VE）的前瞻性试验阴性研究。在209例流感阳性病例中，71%感染甲型H1N1流感，11%感染甲型H3N2流感，3%感染未知亚型甲型流感，15%感染乙型流感。在检测阴性对照中，53%自2024年8月以来接种了流感疫苗。冬季结束时与甲型H1N1流感相关的住院率的VE估计为64.8% (95% CI: 38.1%至80.3%)，与甲型H3N2流感相关的住院率为59.9% （95% CI: - 42.0%至89.6%）。这些研究结果显示，接种流感疫苗可防止儿童因甲型H1N1流感和甲型H3N2流感而住院，突显香港继续接种疫苗的重要性。

引用次数: 0

Attitudes and satisfaction of healthcare professionals towards paediatric influenza vaccination in Spain: A follow-up study 西班牙卫生保健专业人员对儿科流感疫苗接种的态度和满意度：一项随访研究

IF 2.2 Q3 IMMUNOLOGY

Vaccine: X

Pub Date : 2025-08-19 DOI: 10.1016/j.jvacx.2025.100708

Matilde Zornoza-Moreno , Antonio Iofrío de Arce , Jaime J. Pérez-Martín

Background

The Region of Murcia was one the first Spanish regions to implement a universal influenza vaccination campaign for children of 6–59 months during the 2022–2023 season. The main goal of the study was to assess the healthcare professionals (HCPs) attitudes and satisfaction with the second paediatric influenza vaccination campaign in the Region of Murcia, the 2023–2024, and to compare the results with those from the first campaign.

Methods

Cross-sectional, descriptive study carried out during the 2023–2024 vaccination season using an ad-hoc questionnaire to collect information on HCPs (nurses and doctors) attitudes towards influenza vaccination.

Results

Overall, participating HCPs considered that vaccination against influenza in children of 6–59 months was important or very important, with no differences between professional groups, regardless of their own vaccination status. The ease of administration and the general use of the intranasal (LAIV) and intramuscular (IIV) vaccines was good or very good. A higher score of LAIV's general experience was obtained for the 2023–2024 campaign compared with the 2022–2023 campaign (4.7 vs 4.5, p = 0.006). The score for IIV did not change between campaigns (4.0 vs 4.0, p = 0.98). Of all HCPs involved in the 2023–2024 campaign a higher proportion considered that the presence of a doctor was advisable at school vaccination, but not essential compared with the previous one (54.1 % vs 44.7 %, p < 0.001).

Conclusions

Influenza vaccination campaign in the Region of Murcia is highly supported by nurses and doctors. The experience gained during the school vaccination makes vaccination teams feel more confident without a doctor.

穆尔西亚地区是西班牙首批在2022-2023年流感季节对6-59个月大的儿童实施普遍流感疫苗接种运动的地区之一。该研究的主要目的是评估穆尔西亚地区医疗保健专业人员（HCPs）对2023-2024年第二次儿科流感疫苗接种运动的态度和满意度，并将结果与第一次运动的结果进行比较。方法在2023-2024年疫苗接种季节进行横断面描述性研究，使用临时问卷收集HCPs（护士和医生）对流感疫苗接种的态度信息。结果总体而言，参与调查的医护人员认为6-59月龄儿童的流感疫苗接种是重要或非常重要的，无论其自身的疫苗接种情况如何，专业组之间没有差异。鼻内（LAIV）和肌内（iv）疫苗的给药简易性和普遍使用情况良好或非常好。与2022-2023年相比，2023-2024年的LAIV总体经验得分更高（4.7 vs 4.5, p = 0.006）。IIV的得分在不同的运动期间没有变化（4.0 vs 4.0, p = 0.98）。在参与2023-2024年运动的所有HCPs中，较高比例的人认为在学校接种疫苗时医生在场是可取的，但与之前相比不是必需的（54.1%对44.7%,p < 0.001）。结论穆尔西亚地区的流感疫苗接种活动得到了护士和医生的高度支持。在学校疫苗接种期间获得的经验使疫苗接种小组在没有医生的情况下感到更有信心。

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引用次数: 0

The influence of partisanship on the roots of anti-vaccine attitudes in the context of the COVID-19 pandemic 在COVID-19大流行背景下，党派关系对反疫苗态度根源的影响

IF 2.2 Q3 IMMUNOLOGY

Vaccine: X

Pub Date : 2025-08-18 DOI: 10.1016/j.jvacx.2025.100707

Sylvia Iasulaitis , Alan Demetrius Baria Valejo , Leonardo Ribeiro dos Santos

This study identifies the underlying drivers of vaccine hesitancy by analyzing political factors, perceptions of vaccine safety, socioeconomic characteristics, and communication variables. We created a partisanship score using supervised machine learning algorithms with the random forest method to assess the influence of political orientations on the roots of COVID-19 vaccine rejection attitudes. This score was then tested empirically using sociodemographic data from a public opinion survey conducted with a sample of the Brazilian population. Based on the weight of evidence (WoE), the attribute relevance analysis revealed key characteristics of citizens who rejected the COVID-19 vaccine in Brazil, highlighting perceptions of vaccine safety and political variables. The data showed that citizens more loyal to then-president Jair Bolsonaro, a vocal vaccine skeptic, were less likely to get vaccinated. They also demonstrated higher perceptions of vaccine-related risks and were more prone to believing in conspiracy theories and misinformation surrounding the vaccine. The methodology developed in this study can be applied to other populations globally to better understand the roots of anti-vaccine attitudes, particularly the influence of political factors.

本研究通过分析政治因素、对疫苗安全性的认知、社会经济特征和沟通变量，确定了疫苗犹豫的潜在驱动因素。我们使用监督机器学习算法和随机森林方法创建了一个党派得分，以评估政治倾向对COVID-19疫苗拒绝态度根源的影响。这一分数随后通过对巴西人口样本进行民意调查所得的社会人口学数据进行了实证检验。基于证据权重（WoE），属性相关性分析揭示了巴西拒绝COVID-19疫苗的公民的关键特征，突出了对疫苗安全性和政治变量的看法。数据显示，对时任总统雅伊尔·博尔索纳罗（Jair Bolsonaro）更忠诚的公民不太可能接种疫苗。博尔索纳罗是一位直言不讳的疫苗怀疑主义者。他们还表现出对疫苗相关风险的更高认知，更倾向于相信围绕疫苗的阴谋论和错误信息。本研究制定的方法可以应用于全球其他人群，以更好地了解反疫苗态度的根源，特别是政治因素的影响。

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引用次数: 0

Activation of cellular immune responses using a dengue tetravalent subunit DNA vaccine candidate with different cytokines as adjuvants 用不同细胞因子作为佐剂的登革热四价亚单位DNA候选疫苗激活细胞免疫应答

IF 2.2 Q3 IMMUNOLOGY

Vaccine: X

Pub Date : 2025-08-18 DOI: 10.1016/j.jvacx.2025.100705

Luciana de Souza Fernandes , Carine Ribeiro Pessoa , Roberto Sousa Dias , Cynthia Canedo da Silva , Sérgio Oliveira de Paula

Dengue remains a critical public health issue in endemic areas, with four co-circulating serotypes (DENV-1–4) and no widely accessible vaccine in Brazil. DNA vaccines offer logistical and cost advantages, and cytokine adjuvants may enhance immunogenicity. We engineered a tetravalent DNA vaccine encoding EDIII from all four DENV serotypes in the pVAX1 vector. To improve immune response, plasmids encoding GM-CSF, IL-7, and IL-15 were co-administered. Antigen expression was confirmed via PCR, western blot, and immunofluorescence. Immunogenicity was assessed using lymphoproliferation assays, TNF/IL-10 cytokine profiling, flow cytometry for memory T-cell phenotyping, and plaque reduction neutralization tests (PRNT). EDIII expression was confirmed for all four serotypes. Co-administration with GM-CSF or IL-15 increased splenocyte proliferation. Cytokine analysis showed variable results with Th1-skewed responses in IL-7 and GM-CSF groups, while IL-15 induced a Th2-biased profile. Flow cytometry revealed that GM-CSF + IL-15 most effectively expanded central memory and naïve CD4+ and CD8+ T cells. PRNT demonstrated neutralizing activity against DENV-1, DENV-3, and DENV-4, but no neutralization of DENV-2. This tetravalent DNA vaccine elicited modest antigen-specific humoral and cellular responses. GM-CSF and IL-15 improved T-cell memory phenotypes, although the absence of DENV-2 neutralization highlights the need for further optimization. Our results inform us of the difficulties in using immune modulators as genetic adjuvants for DNA vaccine design.

登革热在流行地区仍然是一个严重的公共卫生问题，有四种共同流行的血清型（DENV-1-4），巴西没有广泛获得的疫苗。DNA疫苗具有物流和成本优势，细胞因子佐剂可以增强免疫原性。我们在pVAX1载体中设计了一种编码所有四种DENV血清型EDIII的四价DNA疫苗。为了改善免疫应答，同时给药编码GM-CSF、IL-7和IL-15的质粒。通过PCR、western blot和免疫荧光检测证实抗原表达。免疫原性通过淋巴细胞增殖试验、TNF/IL-10细胞因子谱、记忆t细胞表型的流式细胞术和斑块减少中和试验（PRNT）进行评估。四种血清型均证实了EDIII的表达。与GM-CSF或IL-15合用可增加脾细胞增殖。细胞因子分析显示，IL-7和GM-CSF组的th1偏倚反应不同，而IL-15组则诱导th2偏倚。流式细胞术显示GM-CSF + IL-15最有效地扩展了中枢记忆和naïve CD4+和CD8+ T细胞。PRNT对DENV-1、DENV-3和DENV-4具有中和作用，但对DENV-2无中和作用。这种四价DNA疫苗引起了适度的抗原特异性体液和细胞反应。GM-CSF和IL-15改善了t细胞记忆表型，尽管缺乏DENV-2中和强调需要进一步优化。我们的结果告诉我们使用免疫调节剂作为DNA疫苗设计的遗传佐剂的困难。

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引用次数: 0

Safety and immunogenicity of inactivated Zika virus vaccine by gamma irradiation 伽玛辐照灭活疫苗的安全性和免疫原性

IF 2.2 Q3 IMMUNOLOGY

Vaccine: X

Pub Date : 2025-08-13 DOI: 10.1016/j.jvacx.2025.100706

Pumin Sintara , Puttawat Suphaprueksapong , Suwimol Jetawattana , Witthawat Wiriyarat , Yada Akkhawattanangkul , Komgrid Charngkaew , Nusara Chomanee , Jantip Saelee , Artit Wongsa , Thongkoon Priengprom , Boonrat Tassaneetrithep

Developing the Zika virus (ZIKV) vaccine remains a critical global public health need. This study assessed the safety and immunogenicity of gamma-irradiated Thai ZIKV isolate. Inactivation was confirmed by serial passaging and detection of viral replication using RT-PCR, which demonstrated complete loss of infectivity in ZIKV irradiated with 25 and 50 kGy. Western blotting confirmed that irradiation preserved viral envelope protein antigenicity. BALB/c mice were subcutaneously immunized twice with 25 kGy-irradiated ZIKV, either alone or with alum adjuvant, at two-week intervals. No mortality or local reactions were observed in any group of mice. Antigen-specific IgG and neutralizing antibody titers were measured by ELISA and focus reduction neutralization test, respectively. T cell responses were assessed via intracellular IFN-γ and TNF-α staining by flow cytometry. The irradiated vaccine induced ZIKV-specific antibody and cytokine-producing T cell responses; however, neutralizing antibody titers were low. Mice immunized with irradiated ZIKV combined with alum adjuvant had higher ZIKV-specific antibody titers and T cells producing IFN-γ or TNF-α than those without adjuvant, though differences were not statistically significant. Although the viral integrity and antigenicity remained unchanged, these findings demonstrate that gamma-irradiated ZIKV is non-infectious and immunogenic in mice, supporting its safety profile and the potential for further optimization in future dose-ranging and efficacy studies.

开发寨卡病毒（ZIKV）疫苗仍然是一项关键的全球公共卫生需求。本研究评估了伽玛辐照的泰国ZIKV分离物的安全性和免疫原性。通过连续传代和RT-PCR检测病毒复制，证实了ZIKV在25和50 kGy辐照下完全丧失了传染性。Western blotting证实辐照保存了病毒包膜蛋白的抗原性。BALB/c小鼠皮下接种25 kgy辐照的ZIKV，单独或与明胶佐剂，每隔两周免疫两次。各组小鼠均未见死亡或局部反应。采用ELISA法和减焦中和试验分别测定抗原特异性IgG和中和抗体滴度。流式细胞术检测细胞内IFN-γ和TNF-α染色评价T细胞反应。辐照疫苗诱导寨卡病毒特异性抗体和产生细胞因子的T细胞反应；然而，中和抗体滴度较低。与未接种佐剂的小鼠相比，经辐照的ZIKV联合明铝佐剂免疫的小鼠具有更高的ZIKV特异性抗体滴度和产生IFN-γ或TNF-α的T细胞，但差异无统计学意义。尽管病毒的完整性和抗原性保持不变，但这些发现表明，伽玛辐照的ZIKV在小鼠中是非传染性和免疫原性的，支持其安全性以及在未来剂量范围和疗效研究中进一步优化的潜力。

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引用次数: 0

Does behaviour matters the most in improving urban immunization coverage: exploring behavioural barriers in northern states of India 在提高城市免疫覆盖率方面，行为是否最重要：探索印度北部各邦的行为障碍

IF 2.2 Q3 IMMUNOLOGY

Vaccine: X

Pub Date : 2025-08-07 DOI: 10.1016/j.jvacx.2025.100702

Pritu Dhalaria , Ayushi Agrawal , Jaideep Kumar , Ajeet Kumar Singh , Ashish Maurya , Syed Hassan , Bhupendra Tripathi , Arindam Ray , Sanjay Kapur

Background

Immunization is a crucial public health achievement, yet achieving equitable coverage remains challenging in countries like India. Despite India's notable progress in its Universal Immunization Program (UIP), urban-rural discrepancies persist, especially in densely populated states like Bihar and Uttar Pradesh, with urban areas experiencing slower improvement in coverage.

Data & methodology

This study, conducted in Bihar and Uttar Pradesh, aimed to explore behavioural and social determinants affecting immunization uptake in urban areas. Based on the WHO's Behavioural and Social Drivers of Vaccination (BeSD) model, a comprehensive baseline situation analysis, including 34 in-depth interviews and 27 focus group discussions, was conducted in 12 districts of Bihar and Uttar Pradesh. The assessment covered the perceptions of caregivers, healthcare providers, and key immunization stakeholders.

Results

Findings are categorized within the BeSD model's four domains: Thinking and Feeling, Social Processes, Motivation, and Practical Issues. In the thinking and feeling domain, perceived understanding gaps, the need for awareness, and the role of mass media and social networks emerged as key themes. Social processes illuminate gender dynamics, the dominance of decision-making by male and elderly members, and the impact of domestic violence on vaccination choices. Motivational factors include concerns about vaccine quality, fear of adverse events, and the influence of religious leaders. Practical issues encompass distrust of healthcare personnel, the timing of vaccination sessions, and infrastructural.

Conclusion

The study reveals multifaceted challenges, highlighting the need for targeted urban-specific strategies to address social and behavioural barriers, enhance awareness, and improve infrastructure in urban immunization programs.

免疫接种是一项重要的公共卫生成就，但在印度等国家实现公平覆盖仍然具有挑战性。尽管印度在普及免疫规划（UIP）方面取得了显著进展，但城乡差距仍然存在，特别是在比哈尔邦和北方邦等人口稠密的邦，城市地区的覆盖率改善速度较慢。数据,这项研究在比哈尔邦和北方邦进行，旨在探索影响城市地区免疫接种的行为和社会决定因素。根据世卫组织疫苗接种的行为和社会驱动因素（BeSD）模型，在比哈尔邦和北方邦的12个县进行了全面的基线情况分析，包括34次深度访谈和27次焦点小组讨论。评估涵盖了护理人员、卫生保健提供者和主要免疫利益攸关方的看法。结果：研究结果分为四个领域：思考和感觉、社会过程、动机和实际问题。在思考和感觉领域，感知到的理解差距、意识的需要以及大众媒体和社交网络的作用成为关键主题。社会进程阐明了性别动态、男性和老年成员在决策中的主导地位以及家庭暴力对疫苗接种选择的影响。动机因素包括对疫苗质量的担忧、对不良事件的恐惧以及宗教领袖的影响。实际问题包括对卫生保健人员的不信任、疫苗接种的时间安排和基础设施。结论该研究揭示了多方面的挑战，强调需要有针对性的城市特定战略来解决社会和行为障碍，提高认识，改善城市免疫规划的基础设施。

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引用次数: 0

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

Vaccine: X

Pub 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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