Human Vaccines & Immunotherapeutics最新文献

Gender-neutral vaccination (GNV) of human papillomavirus (HPV) may help reduce the transmission and incidence of HPV-related diseases. However, approximately 40 countries have implemented HPV GNV schedules. We systematically evaluated HPV GNV cost-effectiveness models from January 2008 to May 2024 using MEDLINE, Embase, and Cochrane to identify key drivers of cost-effectiveness results. Fifty-three publications were included, primarily from high-income countries. Vaccine coverage, price, protection duration, and discount rates impacted cost-effectiveness, with lower prices and protection against HPV-related diseases resulting in cost-effective results. Results in models that included adults (≥18 years) were mixed and dependent on price, inclusion of non-cervical HPV-related diseases, and age groups considered. We conclude that HPV GNV can be a cost-effective strategy for preventing HPV-related diseases. However, its cost-effectiveness is highly dependent on vaccine coverage, price, and inclusion of non-cervical HPV-related diseases in models. Further economic evaluations of HPV GNV in low- and middle-income countries are recommended.

Respiratory infections significantly impact adult health in Southeast Asia, yet vaccine coverage remains low. This systematic review evaluated the economic evaluations of vaccines targeting respiratory infections in the region. A comprehensive search was conducted across several databases, including MEDLINE/PubMed, EMBASE, NHSEED, CINAHL, EconLit, Web of Science, Scopus, and Cochrane Library, up to April 24, 2024. Nineteen eligible studies were identified, focusing primarily on influenza (8 studies) and COVID-19 vaccines (7 studies), with fewer studies on pneumococcal (2 studies), varicella (1 study), and pertussis (1 study) vaccines. Overall, influenza, COVID-19 (boosters), and pneumococcal vaccines were found to be cost-effective or highly cost-effective compared to no-vaccine or no-booster scenarios. The only study on maternal pertussis vaccination found it not to be cost-effective. The most common parameters considered in sensitivity analyses were vaccine efficacy and discount rates. This review highlights the economic evaluations of influenza, COVID-19, and pneumococcal vaccines in Southeast Asia, providing essential evidence to guide vaccine policy. Future studies should address limitations in model selection, incorporate herd immunity, ensure the model validation (i.e. validity of cost and benefit measurements), and explore the cost-effectiveness of other vaccines across the region.

COVID-19 during pregnancy can be associated with adverse pregnancy and infant outcomes. We assessed the safety, reactogenicity, and immunogenicity of maternal vaccination with Ad26.COV2.S COVID-19 vaccine and monitored serum and breast milk antibody levels in mothers and infants until 6 months post-delivery. This open-label Phase 2 study enrolled previously COVID-19 vaccinated or COVID-19-vaccine-naive healthy pregnant women in trimester two or three (NCT04765384). All women received a single dose of Ad26.COV2.S. Mothers and infants were followed-up for safety until 1-year post-partum and for immunogenicity, including antibodies in breast milk, until 6 months post-partum. Recruitment was stopped at 51 participants due to rapidity of roll-out of COVID-19 vaccines recommended during pregnancy. Ad26.COV2.S was well-tolerated regardless of previous COVID-19 vaccination history. All pregnancies resulted in a live infant, four were preterm. One serious adverse event of placental insufficiency Day-36 post-vaccination was considered vaccine-related by the investigator. One infant died due to complications associated with an unrelated ventricular septal defect. Ad26.COV2.S induced robust immune responses in women with different COVID-19 vaccination histories. Spike-binding antibody (SAbs) and virus neutralizing antibody (NAbs) titers at delivery tended to be higher in mothers vaccinated during trimester three. Maternal serum and cord blood were strongly correlated. 100% of infants had detectable SAbs at aged 6 months, and 70.6% had detectable NAbs, including 68.2% born to initially vaccine-naïve mothers. Maternal vaccination with an adenovirus-vector vaccine was well-tolerated and immunogenic in mothers and infants. These data could support the adoption of heterologous booster regimens during pregnancy and future adenovirus-vector vaccine development.

Herpes zoster imposes a substantial disease burden in China. Despite vaccination being critical for burden mitigation, willingness-to-pay (WTP) for herpes zoster vaccines among urban residents remains understudied, with a lack of national-level evidence on its determinants. A national-wide survey was conducted among 2,864 urban residents aged ≥25 years across nine provinces and nine cities in China. Using the contingent valuation method (CVM), three elicitation approaches - payment scales, bidding, and open-ended questions - were employed to assess respondents' willingness-to-pay (WTP) for herpes zoster vaccination. Univariate statistical analyses were then performed to explore the associations between socioeconomic characteristics and WTP. Median WTP varied by methods (payment cards: CNY 300, bidding: CNY 500, open-ended: CNY 300). Across these methods, 36.09%, 29.06%, and 23.64% of participants, respectively, were unwilling to pay (including those rejecting free vaccination). For higher thresholds, 2.36% and 9.96% reported WTP ≥ 2,000 CNY via the payment scale and bidding methods, while 2.09% indicated WTP ≥ 2,000 CNY through the open-ended method. Age was negatively associated with WTP, and respondents from moderately developed regions had the highest WTP. Education and annual household income showed positive associations with WTP. Additionally, unemployment, chronic disease, divorced or widowed residents, and below-average self-reported health correlated with lower WTP. While respondents with public or commercial insurance had highest WTP. In conclusion, individual WTP for herpes zoster vaccine is substantially influenced by socioeconomic characteristics, which are inherently linked to income. This highlights the need for income-sensitive policies, including affordable pricing and targeted health education for vulnerable groups.

Regional disparities exist in China's varicella vaccination policies, with Beijing's voluntary two-dose program requiring self-payment having been implemented for more than a decade. In this study, we investigated parental acceptance and vaccination patterns among 2,189 children aged 4-12 years in Beijing's Chaoyang District, where policy integration is under consideration. The results revealed high baseline vaccination willingness (81.8%), potentially increasing to 86.3% with inclusion of an immunization program. Key determinants extended beyond demographic factors and disease knowledge to include parental satisfaction with immunization services and utilization of parenting apps. Current coverage rates were 74.5% for the first dose (VarV1) versus 53.2% for the second dose (VarV2), indicating significant second-dose attrition. Primary barriers to vaccination included limited awareness of the option to vaccinate, safety concerns, and perceptions that a single dose offers sufficient protection. Notably, 58.8% of children received VarV1 later than the recommended schedule, partly due to vaccination scheduling. School-based verification requirements emerged as a critical driver of compliance. Our study provides actionable insights for immunization policy optimization. We advocate targeted communication strategies via new media platforms, such as parenting apps, to address knowledge gaps, emphasize two-dose protocols, and boost vaccine confidence. This approach fosters a cycle of tool usage, knowledge acquisition, and timely vaccination, leveraging the demonstrated synergy between app usage and vaccine knowledge in enhancing adherence.

Dengue virus (DENV) is an important arthropod-borne virus that poses a global health threat, with half of the world's population at risk of infection. Currently, there is a lack of safe and effective vaccines for its prevention. Antibody-dependent enhancement (ADE) occurs when cross-reactive antibodies fail to neutralize heterologous DENV serotypes effectively, facilitating viral entry into Fc receptor-bearing cells and leading to more severe disease. It is reported that multifunctional T cells are closely related to the protective effects of the vaccine. We selected 25 peptide candidates based on predictions from the IEDB database and relevant literature. These peptides were validated to stimulate the production of multifunctional T cells. The DNA sequences of the corresponding peptides were cloned into the pVAX1 vector, and monovalent DNA vaccines for DENV 1-4 were constructed. We analyzed cellular immunity, symptom scores, body weight changes, and survival rates after DENV challenge with the identical immunizing strain.Our studies confirmed that DNA vaccines can protect mice against DENV challenge. Compared with control groups, mice immunized with our DNA vaccines demonstrated better immune protection after being challenged with the corresponding strain of DENV. Our studies provide a basis for the development of new DENV tetravalent vaccines.

Chimeric antigen receptor (CAR)-T cell immunotherapy represents an evolutionary advance in the treatment of cancer, yet it faces challenges such as manufacturing complexity, high cost, and time-consuming process. In recent years, the strategy of in vivo CAR-T cell therapy is emerging as a promising approach to improve anti-tumor effectiveness and safety. Briefly, T cells are genetically modified to express CAR protein directly in the body by delivery of vectors. With the continuous optimization of gene delivery systems, gene editing technologies and CAR structures, advancements in in vivo CAR-T therapies have notably enhanced safety, effectiveness, and application in clinical settings. Here, we review the key platforms of in vivo gene delivery and the progress of in vivo CAR-T cell therapy for cancers. We discuss the challenges of in vivo CAR-T cell therapy, such as safety issues of gene delivery, the persistence and function of CAR-T cell, and the immunosuppressive microenvironment in solid tumors.

This study examines how Italian national newspapers portrayed COVID-19 vaccines during 2020-2021. A corpus of 5,621 articles from seven newspapers, collected via the Italian National Institute of Health's daily press review, was analyzed with SketchEngine using corpus-assisted discourse methods. Quantitative analysis showed a rise in vaccine-related coverage at the end of 2020 and throughout 2021. Core terms such as vaccino (vaccine) and vaccinazione (vaccination) were frequent, while occasional use of synonyms like serum and antidote risked creating confusion. Qualitative analysis revealed instances of "false balance," where anti-vaccine views were presented alongside pro-vaccine perspectives as if equally supported by evidence. These findings suggest that even authoritative outlets reproduced reporting practices that may undermine public understanding of vaccines. Greater awareness of such practices, and closer collaboration between health professionals and communication experts, could help improve the quality of health information in the media.

Dengue is a common arboviral infection that poses a serious health concern worldwide, including Latin America. Our study assessed the safety and immunogenicity of CYD-TDV, a recombinant, live-attenuated, tetravalent dengue vaccine, among HIV-infected adults in Brazil, with previous exposure to dengue infection, and maintained on antiretroviral therapy. This observer-blind, placebo controlled, phase II study (NCT02741128) enrolled participants aged 18-50 years, randomized 2:1 to receive CYD-TDV or placebo subcutaneously at 0, 6, and 12 months. Serological assessments were performed using plaque reduction neutralization assays at baseline and 28 days following each vaccination. Overall, 133 participants were randomized (CYD-TDV, n = 89; placebo, n = 44). At day 28, post-initial vaccination, participants receiving CYD-TDV reported 3.11- to 6.37-fold increase in neutralizing antibody geometric mean titers compared with those at baseline across dengue virus serotypes 1-4 but were sustained after 3 doses. No notable immune responses were observed to any of the serotypes in the placebo group. The safety profiles were comparable across both study groups. In the CYD-TDV and placebo groups, pain was the most commonly reported injection site reaction post-first injection in 18.4% and 29.5% participants, respectively. There were no reports of Grade 3 solicited injection site reactions post-CYD-TDV administration. No safety signals were detected after CYD-TDV administration, including immediate unsolicited AEs/ARs, SAEs/AESIs, or HIV-related conditions. None of the participants discontinued the study due to an AE, and no deaths were reported. CYD-TDV demonstrated adequate safety and robust immunogenicity against all dengue serotypes in HIV-positive adults receiving prior antiretroviral treatment.