Human Vaccines & Immunotherapeutics最新文献

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.

Healthcare professionals (HCPs) perform an essential role in facilitating dengue vaccine uptake, as they are trusted sources of vaccine information and their perspectives shape both patient acceptance and peer adoption. This study assessed HCPs' Knowledge, Attitudes, and Practices (KAP) regarding dengue vaccination, and identified factors influencing their likelihood to recommend the vaccine to patients ('recommendation') and to encourage colleagues to do the same ('advocacy'). A cross-sectional survey of 815 HCPs in Argentina, Brazil, Colombia, Indonesia, Malaysia, and Thailand was conducted. Globally, composite scores were lower for Knowledge (56%) than Attitudes (70%) and Practices (72%). In multivariate analysis, "Perceived ease of recommending dengue vaccines" (recommendation: regression coefficient 0.30, p < .001; advocacy: regression coefficient 0.23, p < .001) and "Urgency to protect against dengue" (recommendation: regression coefficient 0.37, p < .001; advocacy: regression coefficient 0.23, p < .001) were associated with both recommendation and advocacy. In contrast, "Awareness of severity and risk" (regression coefficient 0.24, p = .015) and "Confidence in available dengue vaccines" (regression coefficient 0.34, p < .001) were associated only with recommendation to patients. These findings highlight the need for targeted educational strategies and behavioral interventions to strengthen physician confidence, address barriers to recommending dengue vaccines, and support peer-to-peer advocacy. Such efforts are essential to improving vaccine uptake and maximizing the public health impact of dengue vaccination.

The success of dengue vaccination programs is heavily reliant on endorsement from healthcare professionals (HCPs). This survey of 815 HCPs from Argentina, Brazil, Colombia, Indonesia, Malaysia, and Thailand aimed to identify factors associated with HCPs' willingness to recommend dengue vaccination to patients. Survey responses were mapped to six subthemes within a Capabilities, Opportunities, and Motivations behavioral framework; composite scores were calculated and correlated with willingness to recommend the dengue vaccine. Psychological Capability, Reflective Motivation, and Automatic Motivation emerged as urgent priorities based on moderate correlation with willingness to recommend the vaccine (correlation coefficients 0.50, 0.56, and 0.45, respectively) and moderate scores (57‒58%). Physical Capability was categorized as a critical strength, while Physical and Social Opportunities were lesser priorities. Targeted interventions - including HCP education, risk communication, and peer-led advocacy - are likely to improve recommendation behaviors. Addressing both individual and external drivers is essential for enabling HCPs to recommend dengue vaccination effectively.

Herpes zoster (HZ) is a vaccine-preventable disease with increasing incidence and hospitalization burden, particularly among older adults and immunocompromised individuals, who have an increased risk. In 2021, Spain introduced systematic vaccination with the recombinant zoster vaccine (RZV). We conducted a retrospective, descriptive study using hospital discharge data from the Spanish Minimum Basic DataSet (MBDS) for the years 2022-2023. Hospitalization rates (HR), mortality rates (MR), case fatality rates (CFR), length of stay, comorbidities, and costs were analyzed nationally and for the region of Madrid. A total of 16,277 HZ-related hospitalizations were recorded in Spain, with 80% occurring in individuals aged ≥65 y. The HR was 16.85 per 100,000 inhabitants, and the CFR was 7.44%. In Madrid, 3263 hospitalizations were recorded, with a higher HR (23.73 per 100,000) and CFR (6.41%) compared to the national average. Complicated HZ cases accounted for over 64% of hospitalizations nationally and 69% in Madrid. Total hospitalization costs were €98.1 million in Spain and €21.4 million in Madrid. This is the first study to assess HZ hospitalization burden in Spain and Madrid following the introduction of RZV. The findings highlight the substantial toll of HZ on older and immunocompromised populations. Future studies with longer follow-up are needed to assess vaccine impact.

Human papillomavirus (HPV) is a major global health concern due to its link to cervical and other cancers. Although HPV vaccination is highly effective, acceptance and willingness to pay (WTP) differ widely across populations. This review summarizes global evidence from 2015-2025. A systematic search of PubMed, Scopus, CENTRAL, Web of Science, and Google Scholar was conducted in 2025 following PRISMA guidelines. Studies reporting data on knowledge, acceptance, attitudes, and WTP across any population were included. Quality assessment used ISPOR checklists, and data were synthesized in Excel 2019. Thirty-five studies met inclusion criteria, with China and Nigeria contributing most. WTP ranged from 52.68% in lower-middle-income countries to 65.38% in low-income countries. Mean WTP was highest in upper-middle-income settings. Knowledge, positive attitudes, socioeconomic status, and trust increased WTP, while cost remained the primary barrier. Improving affordability, awareness, and policy support is essential to enhance global HPV.

Kazakhstan planned to reintroduce the human papillomavirus (HPV) vaccine into the national vaccination calendar in 2024 for girls aged 12-14. A 2013 pilot attempt failed due to low acceptance. To inform implementation, we evaluated HPV vaccine knowledge and recommendation practices among primary healthcare workers (HCWs). In April-May 2023, we conducted a cross-sectional survey using convenience sampling among HCWs responsible for vaccination at 5 private and 29 of the largest public polyclinics in Almaty. Participants self-completed anonymous questionnaires. Knowledge scores >70% were considered adequate. We used logistic regression to assess factors associated with intention to recommend HPV vaccines, reporting adjusted odds ratios (OR) and 95% confidence intervals (CI). Among 832 participants, 68% were nurses, and 18% had >20 y experience. One-third (33%) had adequate HPV knowledge, 22% knew HPV has no cure, and 71% understood it is not airborne. One-fifth (20%) could dispel common HPV vaccine myths, 39% dispelled common childhood immunization myths, 61% correctly identified childhood vaccine contraindications, and 58% believed in childhood vaccines' safety and effectiveness. Overall, 28% would recommend the HPV vaccine to patients or their friends' children. Doctors were more likely to recommend than nurses (OR = 1.52, 95% CI = 1.06-2.18). Higher recommendation odds were also associated with ability to dispel childhood vaccines myths (OR = 1.47, 95% CI = 1.03-2.07), adequate HPV knowledge (OR = 1.63, 95% CI = 1.14-2.32), belief in vaccine safety (OR = 1.65, 95% CI = 1.12-2.47), and support for vaccinating HCWs (OR = 3.07, 95% CI = 2.11-4.54). HPV-related knowledge and recommendation intent among HCWs were low. Targeted training and communication may improve HPV vaccine uptake in Kazakhstan.

Immune escape mechanisms critically restrict the efficacy of immunotherapy in lung cancer (LC), with only 20%-30% of patients responding to checkpoint inhibitors. To systematically map global trends and identify emerging hotspots, this study analyzed 2813 publications related to immune escape in LC immunotherapy from 1995 to 2025 (data retrieved August 9, 2025; analysis of annual trends uses complete year data through 2024) sourced from the Web of Science Core Collection database. Bibliometric visualization was performed using VOSviewer (version 1.6.19), CiteSpace (version 6.2.R3), and the biblioshiny R package. The dataset encompassed 75 countries, 3421 institutions, and 18,023 researchers across 693 journals. Publication trends delineated three distinct phases: an initial phase (1995-2010), an acceleration phase (2011-2018), and a maturation phase (2019-2024). China dominates in publication volume (1,382 papers) and total citations (45,657), whereas the University of Texas MD Anderson Cancer Center emerged as the most influential institution (n = 87). The Frontiers in Immunology recorded the highest number of publications (n = 155), while Cancer Research received the most co-citations (6,149). Li Zhang ranks as the most prolific author with 19 publications and 1251 citations, while R.S. Herbst holds the highest number of co-citations (n = 628). Current research clusters focus primarily on "therapeutic strategies and treatment integration," "tumor microenvironment characterization and immune cell dynamics," and "translational biomarkers and precision immunotherapy." Future research emphasizes "spatial microenvironment architecture," "computational predictive modeling," "alternative cell death pathways," "precision biomarker development," "hypoxia-immune interactions," and "stemness-EMT immune interfaces." Overall, the field's exponential growth and geographic disparities provide a structural foundation for developing strategies to overcome immune escape mechanisms by integrating spatial microenvironment characterization with advanced computational modeling.

The problem of waning immunity is a major global concern of vaccine programs, with immunity against diseases such as COVID-19 (reduction in efficacy by ~25% in six months), pertussis (waning in 4-12 y), and influenza (annual updates needed) expected to decrease with time. While boosters reduce serious results in high-risk categories, these effects are short-term (4-6 months) and encourage global imbalances, where low-income areas lag in primary vaccination (<2%). Computational models have shown that primary vaccination in underserved regions prevents ~60% of hospitalizations worldwide, surpassing booster-focused measures (~47%). To maintain protection, variant-responsive boosters, rapid booster-design pipelines, universal vaccine platforms (including pan-coronavirus vaccines), and equity-based solutions (decentralized production) need to be integrated. Aligning with frameworks like the Immunization Agenda 2030 of the World Health Organization, plans should balance the expansion of high-risk groups while broadening primary access, providing infrastructure investment, and real-time surveillance to address evolving pathogens and systemic disparities.

Immune checkpoint inhibitors (ICIs) may cause immune-related adverse events (irAEs), ranging from mild to life-threatening. High-risk irAEs can lead to treatment discontinuation and higher mortality, though ICI-treated patients' death rate is under 5%. Currently, no reliable biomarkers predict irAEs' occurrence or severity. This study investigates the link between accessible biomarkers and high-risk irAEs in gastric cancer patients on ICIs, as well as to develop and assess a predictive model for such events. Data were collected from patients with gastric cancer who received ICIs therapy between May 2020 and March 2025. The incidence and risk factors associated with irAEs were analyzed using the chi-square test or the Mann-Whitney U test. Univariate and multivariate logistic regression analyses were conducted to develop a predictive model. This model was validated through 10-fold cross-validation and assessed using the area under the receiver operating characteristic curve (AUC), sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV), calibration curves, and decision curve analysis. A total of 184 gastric cancer patients receiving ICIs therapy were enrolled in this study. The incidence of irAEs of any grade was 21.2%, while the incidence of grade ≥3 irAEs was 12.5%. Multivariate logistic regression analysis identified NLR-1 (p < .001), NLR2-1 (p < .001), PLR-1 (p = .001), tumor thickness (p = .018), CV (p = .001), and intratumoral necrosis (p = .028) as independent predictors of grade ≥3 irAEs. The AUC of the developed model was 0.878, with a sensitivity of 78.26%, specificity of 80.12%, PPV of approximately 80.95%, and NPV of approximately 75.52%. The corrected C-index, derived from bootstrap resampling, was 0.849, and both calibration curves and decision curve analysis confirmed good calibration and clinical utility. These predictors may aid risk stratification and optimized patient management.