Human Vaccines & Immunotherapeutics最新文献

Some individuals with cancer may receive immunomodulatory treatment such as immune checkpoint inhibitors (ICIs). ICIs are now part of standard of care for many cancers and have improved survival for cancer patients. However, they are also associated with immune-related adverse events (irAEs), which can affect any organ or system, and can range from mild to severe. It has been hypothesized that vaccination of these individuals could increase the risk of irAEs or other vaccine-associated adverse events. This narrative review of 28 primary research articles presents findings from existing literature on vaccine safety for individuals receiving ICIs, and makes recommendations for future research on this topic. The existing evidence suggests that influenza and COVID-19 vaccines are safe for individuals receiving ICIs and do not pose additional risks of irAEs beyond baseline risks associated with ICI therapy.

Rotavirus gastroenteritis (RVGE) is a major public health concern, particularly amongst children below five-years-old. In China, the disease burden remains high owing to the absence of a comprehensive detection system. This study analyses RVGE incidence, population distribution, and pathogenic genotypes reported in studies published between 2014 and 2023, providing evidence to support vaccine and drug development. A systematic review of studies on RVGE published between 2014 and 2023 was conducted. Articles were screened using a standardized algorithm. A random-effects model was employed to analyze rotavirus positive rates and genotype variation trends. Among 320 studies, the highest rotavirus positive rates in children (≤5 y) were in Jilin (48.59%), Shanxi (40.89%), and Xinjiang (37.65%), while the highest number of infections were in Yunnan (89,128), Jiangsu (82,869), and Guangxi (36,524). Among adults (≥15 y), Shaanxi (27.73%), Inner Mongolia (22.95%), and Heilongjiang (17.82%) had the highest rotavirus positive rates, whereas Shanghai (3,170), Beijing (2,019), and Fujian (1,044) recorded the most infections. The rotavirus positive rates were 26.46% and 32.85% for children visiting the outpatient/emergency department and the inpatient department, respectively. Before 2018, the dominant G genotypes were G9 (children: 42.89%; adults: 56.13%) and G3 (children: 20.17%; adults: 14.71%), whereas the dominant P genotype was P[8] (children: 76.30%; adults: 80.78%). After 2018, G9 (children: 66.73%; adults: 67.43%) and P[8] (children: 88.62%; adults: 88.57%) became predominant in both groups, with an increase in G8 (before: 0.89%; after: 5.08%) among children. RVGE remains a significant burden in China, with evolving distributions. Continuous surveillance is essential to guide vaccine strain selection and development.

Guardians' satisfaction is an important quality indicator of vaccination services. However, there is insufficient contemporary, post-pandemic research on parent/guardian satisfaction with immunization services in China. In this study, we explore satisfaction of guardians of young children with vaccination services, and factors associated with satisfaction. During December 2022 to March 2023, we conducted a cross-sectional, questionnaire-based satisfaction survey of guardians of 0-6-y-old children attending any of 180 vaccination clinics in 10 provinces selected through a multi-stage stratified random sampling method. The primary outcome was guardian satisfaction with eight aspects of routine immunization services. Among 3,099 guardians, 84.6% were very satisfied or satisfied with all eight aspects of immunization services. Individual item satisfaction ranged from 85.8% (clinic queuing time) to 97.9% (staff service attitude). Multivariate logistic regression showed that medical-worker guardians were 2.13 times more likely to be satisfied than non-medical worker guardians (OR: 2.13; 95% CI: 1.32-3.44); satisfaction was positively associated travel time to clinic ≤10 min (OR: 1.78; 95% CI: 1.45-2.19); making an appointment (OR: 2.58; 95% CI: 2.10-3.16); having confidence in vaccine effectiveness (OR: 2.10; 95% CI: 1.33-3.29) and waiting times ≤10 min (OR: 1.29; 95% CI: 1.05-1.59). Guardians with an annual family income >100,000 yuan had a lower satisfaction level (OR: 0.61; 95% CI: 0.49-0.76). Guardians' satisfaction with vaccination services was high overall, but can be improved. Satisfaction is influenced by guardians' occupation, income, service accessibility, and knowledge. Optimizing appointment systems, shortening waiting times, and enhancing education about vaccination may improve the quality of immunization services and guardians' satisfaction.

Pneumococcal vaccination effectively reduces the incidence of pneumococcal pneumonia and the associated mortality rates in older adults. Understanding trends in coverage and the influencing factors is essential for optimizing future vaccination programs. Two cross-sectional surveys were conducted in October 2022 and September 2024 among residents aged 60 and above in Pudong New Area, Shanghai. Data on demographic characteristics, pneumococcal vaccination status, and reasons for either receiving or not receiving the vaccine were also collected. A generalized linear mixed model (GLMM) investigated temporal trends in vaccination rates, adjusting for sociodemographic factors. Interactions with the survey year were evaluated to identify associated with time-varying effects on vaccination. The pneumococcal vaccination rate was 34.8% (95% confidence interval [CI]: 32.9-36.6) in 2024, a significant increase of 10.6% points from 24.1% (95% CI: 22.4-25.8) in 2022. (P < .01). Living alone and residence in a care facility were consistently associated with lower vaccination uptake. The proportion of people worried about adverse vaccine reactions increased compared to that in 2022. Although the pneumococcal vaccination coverage in Pudong New Area, Shanghai, has improved in recent years, it remains substantially lower than the rates observed in other developed countries and regions. Targeted monitoring and intervention programs need to be prioritized for vulnerable groups such as those living alone and in older adult care facilities.

Meningococcal infections range from asymptomatic carriage to fulminant sepsis with tissue necrosis. As the disease progresses rapidly, vaccination remains the most effective preventive strategy. Parental acceptance of vaccination is closely linked to awareness, knowledge, attitudes, and behaviors. This study explores these factors and offers targeted recommendations to enhance vaccine uptake. This cross-sectional, descriptive, and comparative study was conducted via a questionnaire administered to parents of pediatric patients seen or hospitalized at the University of Health Sciences Haydarpaşa Numune Training and Research Hospital. The survey assessed socio-demographic characteristics, awareness and knowledge of meningococcal infections and vaccines, and vaccination-related attitudes and behaviors. A total of 306 parents participated voluntarily. Of the 306 participating parents, 257 (84%) were mothers and 49 (16%) were fathers.Only 71 parents (23.3%) were aware of meningococcal infections and vaccines, and just 29 (9.5%) had their child vaccinated. Among those aware of the vaccine, the main reasons for non-vaccination were lack of recommendation from their family physician (57.1%), insufficient knowledge about side effects (54.8%), and exclusion from the national immunization program (52.4%). The low rate of vaccine acceptance among parents is primarily attributed to their limited awareness of meningococcal diseases and vaccines. Therefore, public health authorities - particularly the Ministry of Health - should implement organized vaccination awareness campaigns through media and social networks to enhance public knowledge and increase awareness levels.

For successful clinical translation of therapeutic human papillomavirus (HPV) vaccines, optimizing antigen selection is key to enhancing efficacy. Traditional E6/E7 targets are limited by heterogeneous tumor expression. This review advocates expanding the antigen repertoire to include tumor-specific neoantigens in next-generation vaccines. We systematically evaluate established HPV therapeutic antigens and vaccine platforms, and comprehensively explore the frontier of novel antigens, advanced screening technologies, and recent vaccine innovations. Central is a bioinformatics-guided antigen selection framework spanning multi-omics analysis, immunogenicity prediction, and vaccine design. Key selection parameters - including antigen clonality, expression level, major histocompatibility complex (MHC) binding affinity and stability, and immunogenic potential - are critically assessed alongside state-of-the-art computational tools. By proposing standardized selection criteria and optimization strategies, this review aims to provide a roadmap for developing more potent and broadly effective therapeutic vaccines, ultimately bridging the gap between the molecular etiology of HPV-associated cancers and successful therapeutic discovery.

Human papillomavirus (HPV) 16 and HPV 18 are the two most common HPV types leading to cervical cancer; however, HPV 35 accounts for about 2% of invasive cervical cancers worldwide and a higher percentage in women of African ancestry. Further investigation into potential cross-protection against HPV 35 by current vaccines is needed to determine whether the addition of HPV 35 antigens to the next generation of vaccines is warranted. In this study, we developed and qualified serology assays to measure antibodies against HPV 35, including enzyme-linked immunosorbent assays (ELISA) and pseudovirion (PsV)-based neutralization assays (PBNA). HPV 35 virus-like particles (VLP) and HPV 35 PsV both containing L1 (late-expressed major capsid protein) and L2 (late-expressed minor capsid protein) were successfully produced and qualified for use in these methodologies. ELISA qualification established a cutoff of 9.8 ELISA Units/mL (EU/mL) and excellent reproducibility, with an intraclass correlation coefficient (ICC) of 0.995. The PBNA qualification indicated a cutoff of 10 was suitable for assessing neutralization and that the assay was highly specific and exhibited good reproducibility with an ICC of 0.931. Qualified HPV 35 binding and neutralization assays will allow us to understand if current vaccines induce neutralizing antibody responses against HPV 35, as well as assess next-generation vaccines for HPV 35 immunogenicity, with the goal of improving protection against HPV 35 associated cancers in vulnerable populations.

Immunization is a critical and cost-effective public health intervention, yet Somalia continues to face low coverage and high child mortality. This study assessed maternal satisfaction with childhood immunization services and its associated factors in Mogadishu, Somalia. A community-based cross-sectional study was conducted from September to November 2024 among 400 mothers or caregivers whose children received immunization. Data were collected using a structured interviewer-administered questionnaire covering socio-demographics, access, process-related experiences, and satisfaction, and analyzed using SPSS version 24. Logistic regression was employed to identify factors associated with maternal satisfaction. Overall, 49.3% of mothers were satisfied with the immunization services. In the multivariable logistic regression, several factors were significantly associated with maternal satisfaction. Mothers residing outside Mogadishu had higher odds of satisfaction compared to those residing within the city (AOR = 5.677; 95% CI: 2.057-15.707). Male children were associated with higher odds of maternal satisfaction compared to females (AOR = 1.690; 95% CI: 1.057-2.701). Children of second or third birth order had lower odds of maternal satisfaction than first-borns (AOR = 0.383; 95% CI: 0.209-0.700). Mothers with primary education (AOR = 0.293; 95% CI: 0.171-0.503) and high school education (AOR = 0.217; 95% CI: 0.078-0.602) had lower odds of satisfaction compared to those with no formal education. Finally, mothers who were self-employed had higher odds of satisfaction compared to housewives (AOR = 5.678; 95% CI: 2.310-13.954). The findings underscore the need to strengthen caregiver education, address service disparities, and enhance communication for improved immunization outcomes.

Despite universal newborn hepatitis B vaccination recommendations, birth dose coverage remains suboptimal with persistent racial disparities. While individual-level factors are well-studied, institutional practices' role in vaccination outcomes remains poorly understood. We conducted a retrospective cohort study of 87,246 singleton births across eight Washington, DC hospitals from 2017-2023, using multilevel mixed-effects logistic regression to examine institutional disparities in vaccine refusal. Overall refusal rate was 6.7%, declining from 12.1% in 2017 to 3.5% in 2023. Hospital-specific rates varied dramatically, from near-zero to over 50%. Multilevel analysis revealed 31.1% of refusal variance was attributable to between-hospital and between-year differences, with stable hospital characteristics accounting for 71% of this contextual variance (22.1% of total) and temporal trends accounting for 29% (9.0% of total). Analysis of hospital-specific temporal trajectories revealed marked heterogeneity in response speed to the 2018 ACIP policy change: safety-net hospitals achieved target refusal rates within one year, while institutions with higher baseline refusal required 2-4 y. In contrast to national adult vaccination patterns where White individuals have higher coverage, White infants had lower refusal odds than Black infants after covariate adjustment, suggesting institutional practices may be associated with context-specific disparities that differ from broader population patterns. Sensitivity analyses confirmed robustness of findings. Substantial institutional variation in vaccination practices is associated with disparities beyond what would be expected from patient demographics alone, highlighting the need for system-level interventions targeting organizational factors to achieve equitable vaccination coverage.

Prophylactic HPV vaccines are effective against cervical cancer and its precursors, but data on their impact on fertility and pregnancy are limited. This registry-based study examined the association between HPV vaccination and childbirth rates. Study population comprised 6200 HPV- and 1667 hepatitis B-virus (HBV) vaccinated women born in 1992-1993 and an age- and community-aligned cohort of 19,473 unvaccinated women born in 1990-1991. Nearly half of the HPV-vaccinated women participated in a cervical screening trial between ages 22 and 28. Childbirth numbers and rates per 10,000 person-years with 95% confidence interval (CI) were compared across the groups. The mean age at first childbirth ranged between 22.9 and 23.4 years among the vaccinated and unvaccinated women. At the age of 28, the cumulative proportion of all childbirths among HPV-vaccinated and screened cohorts was 2277 (36.7%), among HBV-vaccinated 781 (46.9%) and among unvaccinated reference cohorts 8997 (46.2%). Childbirth rates per 10,000 person years were 306 (95% CI 294-319), 390 (95% CI 364-419) and 385 (95% CI 377-393), respectively. HPV-vaccinated and screened women had lower childbirth rates compared to unvaccinated women at young age, possibly due to sexual counseling that HPV-vaccinated participants got in an overlapping cervical screening trial conducted between ages 22 and 28. This may have postponed their family planning to later ages.