Human Vaccines & Immunotherapeutics最新文献

There has been a considerable controversy about vaccination practices of children with special health-care needs (CSHCNs) in China. We aim to describe current vaccination recommendations, immunization status, and vaccination safety of CSHCNs in Wuxi. We conducted a cross-sectional study of CSHCNs aged <18 y visiting the vaccination consultation clinic (VCC) at Wuxi Children's Hospital in 2020-2023. Demographic information was collected from Electronic Medical Records, vaccination data was obtained from Vaccination Integrated Service Management Information System of Jiangsu Province, China. Safety monitoring data was acquired from China National Adverse Events Following Immunization Information System (CNAEFIS). Descriptive data were presented as percentages, and Poisson test was used to compare the cumulative incidence of AEFIs between groups. Four thousand one hundred and twenty-two participants were included and the majority (73.0%) were under 12 months. The top three diseases consulted were those relating to the certain conditions originating in the perinatal period, developmental anomalies, and diseases of the blood or blood-forming organs. Only 6.1% had previously received all age-eligible vaccine doses before seeking evaluation. According to the vaccination guidance issued by the VCC, 59.9% were recommended to continue vaccine normally, partial vaccination was recommended for 37.2%, and 4.1% were advised to delay. A total of 3927 CSHCNs received 62,744 vaccine doses after consultation. None had serious adverse events and the cumulative incidence of AEFIs was higher than the general population of children. Specialist consultation is helpful to improve the vaccine uptake. Further research on strategies to improve the vaccination coverage of CSHCNs is warranted.

People with underlying diseases are at-increased-risk of suffering from herpes zoster (HZ). However, the economic impact of HZ on these populations is not well described. This study aimed to quantify the clinical and economic impact of HZ in patients with comorbidities (diabetes, chronic obstructive pulmonary disease, heart disease, kidney disease, asthma) and immune disorders (inflammatory bowel disease, rheumatoid arthritis, systemic lupus erythematosus, multiple sclerosis, psoriasis, COVID-19 and psoriatic arthritis) in Spain. This is an observational, retrospective case-control study using the BIG-PAC electronic records from 01 Jan 2014 to 31 Aug 2021. Healthcare resource use and costs over 12 months following HZ diagnosis were compared between patients and controls, matched by propensity scores. The total annual economic burden was estimated using HZ-related costs per patient and HZ crude incidence over the study period, together with the estimated prevalence of each comorbidity in the Spanish population aged ≥18 y. Mean incremental costs per HZ episode were €1,108 in patients with comorbidities and €1,203 in patients with immune disorders. Indirect costs accounted for 4.7% and 22.9% of incremental costs in people with comorbidities and immune disorders, respectively. Mean annual crude HZ incidence rates were 613.6 cases per 100,000 people with comorbidities and 659.0 cases per 100,000 people with autoimmune disorders. Total annual costs due to HZ in these populations were estimated at €121 million. HZ may cause a significant economic burden in Spain from a societal perspective in patients with underlying conditions, highlighting the importance of improving vaccination programs.

This study examined whether COVID-19 Vaccine Hesitancy (VH) and COVID-19-related factors interact to influence COVID-19 booster doses uptake among university students in Canada, from a syndemic perspective. A cross-sectional survey was conducted among 4453 students at the University of Waterloo in 2024. VH was measured toward both COVID-19 primary and booster doses. Change in VH scores were computed to capture shifts in hesitancy over time. Logistic regression models assessed the main effects of VH and COVID-19-related factors on booster uptake. Interactions were tested using additive and multiplicative scales. Increased VH was associated with a 23% decrease in booster uptake. Younger ages, not being hospitalized due to COVID-19, not receiving the influenza vaccine, noncompliance with COVID-19 guidelines, and belief in conspiracy theories predicted lower booster uptake. Significant interactions were found between change in VH scores and COVID-19 diagnosis and hospitalization history, guideline adherence, and conspiracy beliefs. For students who did not receive booster doses, the change in VH was greater among those who reported following public health guidance than those who did not. Similarly, for students who did not receive booster doses, the change in VH was greater among those who reported not believing in conspiracy theories compared to those who did. The findings support a syndemic model, indicating that VH and COVID-19-related experiences jointly influence booster uptake. Targeted interventions such as rebuilding trust, addressing misinformation, and reducing stigma may improve booster uptake even if not all barriers are addressed. Further research is needed to examine these interactions.

Heterologous boosting with aerosolized or intramuscular Ad5-nCoV following a two-dose CoronaVac prime has been shown to induce higher antibody levels than a homologous CoronaVac booster. However, no specific modeling has been reported to characterize the kinetics of antibody waning for these heterologous regimens. By integrating longitudinal serological data from three randomized trials conducted in Jiangsu, China (NCT04892459, NCT04952727, NCT05043259), we applied linear mixed-effects models to establish both exponential and power-law decay models for neutralizing antibodies, including live-virus neutralizing antibodies against the prototype, Delta, and Omicron BA.1 variants, and pseudovirus neutralizing antibodies against Omicron BA.4/5 variant, respectively. The findings showed that the power-law model exhibited a superior fit over the exponential model across all antibody types (all ΔAICc < 0). According to the power-law model (at day 90), the half-lives of live-virus neutralizing antibodies against the wild-type SRAS-CoV-2 strain was 195 d (95% CI: 185-210) in the aerosolized Ad5-nCoV group, 226 d (220-252) in the intramuscular Ad5-nCoV group, versus 230 d (95% CI: 222-257) in the three-dose CoronaVac group. For the Omicron BA.1 variant, the half-life was 314 d (248-453) in the aerosolized Ad5-nCoV group, 168 d (159-180) in the intramuscular Ad5-nCoV group, compared to 196 d (174-230) in the three-dose CoronaVac group. Our model indicated that the heterologous booster with Ad5-nCoV after two-dose CoronaVac, particularly the aerosolized Ad5-nCoV, induces longer-lasting neutralizing antibodies than three-dose CoronaVac, preferably characterized by power-law decay models.

Globally, childhood immunization remains a major public health concern, with 19.4 million children not fully vaccinated in 2018, the majority from low- and middle-income countries. Ethiopia, in particular, reports alarmingly low immunization coverage, with nearly one million children unvaccinated and vaccine-preventable diseases accounting for approximately 16% of childhood mortality. This study aimed to examine the spatiotemporal distribution and associated factors of immunization among children aged 12-23 months in Ethiopia. Data were obtained from four rounds of the Ethiopia Demographic and Health Survey (EDHS) conducted between 2000 and 2016, comprising a sample of 6767 children. Spatial analysis was performed using ArcGIS, and statistical analysis was carried out using SAS software. The spatial partial proportional odds model was used due to the violation of the proportional odds assumption. Full immunization coverage showed a gradual increase from 14.6% in 2000 to 39.4% in 2016. Spatial clustering of immunization coverage was observed in all survey years, indicating nonrandom distribution across regions. Children born to mothers with primary education were significantly more likely to be fully vaccinated than those whose mothers had no education. The model identified several significant predictors of immunization status, including region, residence, maternal education, religion, household wealth, maternal employment, place of delivery, antenatal care, and health worker visits. A significant negative spatial auto-covariance suggested that areas with low coverage were often surrounded by higher-coverage zones. Targeted interventions, particularly in identified hotspot areas, and increased public health education are recommended, along with further research using recent data.

CAR T cell therapy is a promising immunotherapy for hematologic malignancies, yet early prediction of outcomes and adverse events remains difficult, especially in small real-world cohorts. We retrospectively analyzed 14 adult patients with diffuse large B-cell lymphoma (DLBCL) treated with CAR T cells in Slovenia, assessing IL-6 increase rates and established predictive metrics including EASIX-C, CAR-HEMATOTOX, and IBPS on Day -5 (pre-lymphodepletion) and Day 0 (infusion). Contrary to our expectation, an inverse correlation was observed between the increase rate of IL-6 and the occurrence of severe cytopenias, indicating higher IL-6 increase rate leads to less severe cytopenias. The EASIX-C score showed higher predictive values when calculated on Day 0, contrary to the CAR-HEMATOTOX score, whose higher predictive values were observed on Day -5. The IBPS predictive values showed mixed results when comparing Day -5 to Day 0. We observed 50% response rate and 29% remission rate. The results highlight the utility of predictive scores, with unexpected findings on IL-6 suggesting further study is necessary.

In November 2017, Guangzhou implemented a self-paid two-dose varicella vaccination program. This study evaluated the program's impact on varicella incidence trends across the general population and specific age groups. An interrupted time-series analysis was conducted using surveillance data from January 2011 to December 2024. The pre-intervention period spanned 2011-2017, and the post-intervention period 2018-2024. Seasonal-trend decomposition and segmented regression were employed to analyze changes in level and trend of varicella incidence. A total of 225,497 varicella cases were reported between 2011 and 2024. The annual incidence rate decreased by 28.1% from the pre-intervention to post-intervention period, from 126.80 to 91.14 per 100,000 population. Prior to intervention, there was no evidence of a monthly change in varicella incidence (0.3%; t = 2.27, P = .294). Significant upward trends were observed among 10-14-y-olds and ≥20-y-olds (0.6% monthly increase, both P < .01). Post-intervention, a significant monthly decrease of 1.8% was observed overall (t = -9.956, P < .001). The most pronounced reduction occurred in 4-6-y-olds (3.8% monthly decrease), followed by 7-9-y-olds (3.0%), 0-3-y-olds (2.3%), 10-14-y-olds (1.9%), ≥20-y-olds (1.1%), and 15-19-y-olds (0.5%). Varicella incidence exhibited consistent seasonal variation, with a primary peak occurring from October to January. The two-dose varicella vaccination program was associated with a significant reduction in varicella incidence across all age groups in Guangzhou, demonstrating both direct protection among vaccinated children and indirect herd effects in older populations. These findings support incorporating the two-dose varicella vaccine into routine national immunization programs.

Human papillomavirus (HPV) is a major public health concern affecting both sexes. China adopted a gender-neutral HPV vaccination strategy, expanding recommendations to include males. College students, a high-risk group for HPV exposure, were a priority target for vaccination campaigns. This study compares how four message frames (control, personal health risks, partner risks, both risks) influenced HPV vaccination intention, decisional readiness, and perceived responsibility among Chinese male college students. We conducted a quasi-experimental pre-post survey among 612 male students from three Chinese universities (December 2024-January 2025). Participants were randomly assigned to four message-framing groups. Demographic distributions were compared using Chi-square and Kruskal-Wallis tests. Intervention effects were analyzed via McNemar's tests and multivariable logistic regression. Among participants, 41.8% (n = 256) were unaware of male eligibility for HPV vaccination. Post-intervention, all groups showed improvements in vaccination intention, decisional readiness, and perceived responsibility. Both risk groups consistently exhibited the largest effect sizes across all outcomes (p < .001). For example, vaccination intention in both risk groups increased from 7.2% pre-intervention to 21.6% post-intervention (p < .001). Compared to the control message frame, none of the other frames showed a pairwise significant difference after adjusting for baseline characteristics (adjusted p > .017). The low baseline awareness of male HPV vaccine eligibility highlighted the urgency of targeted education. These findings directly informed China's upcoming gender-neutral HPV vaccination strategy.

Two new RSV immunization products exist for infants: a prenatal vaccine (RSVpreF) and a long-acting monoclonal antibody for infants (nirsevimab). While both showed promise in clinical trials, implementation has varied across jurisdictions. Before rollout in Canada, we conducted an anonymized, online survey with a nationally representative sample of 1,015 expectant and recent birth parents. The primary outcome was product acceptability (disagree, undecided, agree). Odds ratios (ORs) and 95% confidence intervals (CIs) identified factors associated with agreement or indecision versus disagreement. Approximately 49% (n = 499) were expecting; 51% (n = 516) had a baby in the past year. Overall, 72% (n = 727) agreed to receive a product: 61% (n = 624) for RSVpreF and 60% (n = 608) for nirsevimab. RSVpreF agreement was higher among older parents (e.g., OR = 3.64; 95% CI, 1.99-6.67 for age 25-34 versus 18-24 years), those with a university degree (OR = 3.65; 95% CI, 2.01-6.64 versus high school), higher income (OR = 2.31; 95% CI, 1.01-5.28 for ≥$150k versus <$40k), or receipt/intention for Tdap (OR = 3.76; 95% CI, 2.37-5.96 versus no receipt/intention) or influenza (OR = 2.04; 95% CI, 1.29-3.21) vaccines. Agreement was higher among parents of children without a high-risk medical condition compared to those with (OR = 2.32; 95% CI, 1.44-3.72). Similar trends were observed for nirsevimab, with lower agreement also noted among those who self-researched antibodies (OR = 0.51; 95% CI, 0.30-0.88 versus not). As most respondents rated product safety (76%), effectiveness (71%), and disease severity risk (70%) as important in decision-making, providing clear information on these, alongside communications targeted to subgroups with lower agreement, may optimize uptake as programs rollout.

Streptococcus pneumoniae is a leading cause of bacteremia, bacterial meningitis, and pneumonia. In India, there is an unmet need for an expanded valent pneumococcal conjugate vaccine (PCV) to protect older adults. This phase 3, single-arm study evaluated the safety and immunogenicity of 20-valent PCV (PCV20) in adults ≥18 y of age in India. Participants were enrolled into two age groups (18‒49 and ≥50 y old) and received a single dose of PCV20. Immunogenicity endpoints included geometric mean fold rises (GMFRs) in pneumococcal serotype-specific opsonophagocytic activity (OPA) titers from before to 1 month after vaccination. Safety endpoints included percentages of participants reporting local reactions and systemic events within 7 d after vaccination and adverse events (AEs) and serious AEs within 1 month after vaccination. All 400 participants (200 in each age group) received a single dose of PCV20. OPA geometric mean titers substantially increased from baseline to 1 month after PCV20 vaccination for all 20 serotypes. Overall, GMFRs ranged from 5.9 (serotype 14) to 49.8 (23F) for PCV13 serotypes and from 5.4 (11A) to 75.7 (12F) for the 7 additional PCV20 serotypes. Most local reactions and systemic events were mild or moderate in severity and transient. Overall, 2.3% of participants reported any AE through 1 month after vaccination. No related, immediate, severe, or serious AEs were reported. Consistent with previous trials, PCV20 elicited robust immune responses to all 20 serotypes following a single dose and was well tolerated with an acceptable safety profile in Indian adults ≥18 y of age. NCT05875727.