Human Vaccines & Immunotherapeutics最新文献

The global rise in preterm infants presents specific challenges for hepatitis B prevention. Although hepatitis B vaccination is recommended, detailed understanding of immunogenicity patterns and influencing factors requires further investigation. We analyzed 699 preterm infants completing the hepatitis B vaccination series to assess immunogenicity via geometric mean concentration (GMC) and seroprotection rate (SPR). The regimen was highly immunogenic, with an overall SPR of 99.43% (GMC: 986.36 mIU/mL) and 95.28% of infants achieving high-level protection (anti-HBs ≥100 mIU/mL). Though SPR was consistently high across subgroups, notable GMC variations emerged: infants with gestational age <28 weeks markedly higher GMC (3,735.59 mIU/mL) than more mature subgroups. Statistically significant GMC differences were noted between immunization protocols, with uniform schedules yielding higher values (1,281.26 mIU/mL) than mixed approaches (691.91 mIU/mL; P < .001). Preterm infants of HBsAg-positive mothers maintained a high SPR (96.55%) despite a lower GMC (572.18 mIU/mL). This study confirms that hepatitis B vaccination induces a robust immune response at 1 to 2 months post-vaccination in preterm infants. Observed variations in antibody response magnitude related to vaccine expression system may inform optimization of initial vaccination strategies for preterm populations.

Intradermal (ID) vaccine administration is a promising alternative to intramuscular injection yet remains underused, as the classically employed Mantoux technique is difficult to perform consistently. Hollow microneedles (HMNs) offer a more user-friendly approach for liquid vaccine delivery but face issues such as inconsistent skin piercing and inefficient liquid injection. To address these issues, in the preclinical phase, skin models are used that mimic the mechanical, structural, and immunological properties of human skin as well as the interaction between skin and needle. However, current models often fail to capture the entire biological complexity. This review discusses recent findings, challenges, and engineering solutions for reliable HMN skin piercing and liquid injection, alongside emerging trends in skin model technologies for vaccine delivery. Unique to this review paper is the final perspective, which highlights how advances in skin model technologies can be leveraged to accelerate and de-risk HMN development, streamlining the preclinical phase.

The Parent Attitudes about Childhood Vaccines (PACV) survey is a 15-item parent-report measure of vaccine hesitancy. The initial description of the PACV's development was published in the pages of this journal 15 y ago in 2011 as the first survey of its kind. Subsequent evaluations in 2011 and 2013 of the PACV's psychometric performance in a United States population established its construct validity, predictive validity, test-retest reliability, and its internal consistency reliability. Overall, the PACV has now been featured in 141 studies published in one of three bibliographic databases (PubMed, Embase, and/or Web of Science), with 16-20 publications each year for the last 5 y. The PACV has been translated into 20 languages and has been used in 59 countries across 6 continents in studies involving over 100,000 participants. It has been most frequently used as descriptive tool, but it also has been the subject of psychometric evaluations and critical reviews as well as used as an outcomes measure, surveillance tool, screening tool, and as an intervention itself. The PACV has become a widely used valid and reliable method for measuring vaccine hesitancy.

This study aimed to assess knowledge, attitudes, and practices toward herpes zoster (HZ) disease and vaccination and identify factors influencing HZ vaccination perceptions and behavior in adults ≥50 y of age (YOA) among the public and physicians in Hong Kong (HK), Singapore (SG), Republic of Korea (KR), and Taiwan (TW). A two-phase cross-sectional study was conducted in January-September 2022, including concept elicitation interviews (first phase, previously published) and a quantitative online survey (second phase, current article). The second phase involved a larger sample from the same target populations with different individuals. Participants in the second phase included: 1,970 adults ≥50 YOA, 203 adults aged 30-49 YOA with parents ≥50 YOA, and 220 physicians. Substantial knowledge gaps existed among the public about the causes, long-term impact, and risk factors for HZ. Awareness of HZ vaccine availability varied across locales (highest in KR [76%]; lowest in TW [35%]), and higher among individuals with a history of HZ (73%) than HZ-naïve individuals ≥50 YOA (49%). Key drivers of HZ vaccination included preventing disease/recurrence (44%) and long-term complications (41%), and physician recommendations (36%). Two-in-five individuals ≥50 YOA were recommended HZ vaccination. Most physicians agreed that recommending HZ vaccines to patients ≥50 YOA was important but reported initiating HZ vaccination conversations with 27.8% of their patients ≥50 YOA. Knowledge gaps surrounding HZ and HZ vaccination remain. Initiatives are needed to improve public awareness regarding the importance of HZ prevention. Physicians also play an important role in having proactive discussions about HZ prevention with their patients.

The 20-valent pneumococcal conjugate vaccine (PCV20) was developed to expand protection against vaccine-preventable disease caused by Streptococcus pneumoniae beyond the 13-valent pneumococcal conjugate vaccine (PCV13). This review summarizes the adult clinical development program of PCV20. Across studies, the safety profile of PCV20 was acceptable and similar to that of PCV13 and the 23-valent pneumococcal polysaccharide vaccine (PPSV23). Pivotal noninferiority comparisons of serotype-specific opsonophagocytic activity responses (PCV20 to PCV13 for the 13 matched serotypes; PCV20 to PPSV23 for the 7 additional serotypes) were conducted in pneumococcal vaccine‒naive ≥60-y-old adults to infer efficacy. Immunobridging of PCV20 responses to adults 60-64 y of age supports PCV20 use in adults 18 through 59 y of age, including those at increased risk of pneumococcal disease. Additionally, PCV20 elicited functional responses to all 20 vaccine serotypes in adults ≥65 y old who were previously vaccinated with PCV13 and/or PPSV23.

Vaccine confidence plays a critical role in public health. Understanding demographic differences in trust and sources of vaccine information is essential for designing equitable communication strategies. We analyzed nationally representative summary data from Cycle 2 of the Canadian COVID-19 Vaccine Coverage Survey (CVCS), collected April-May2021 during the initial phase of the national vaccine rollout. The survey included adults aged 18 and older (n = 10,678). This study examines trust in vaccine safety, efficacy, and information sources across demographic factors such as age, gender, and visible minority status. Trust in vaccine safety and effectiveness was high overall (95% and 97%, respectively), peaking among older adults (96% and 98%) and lower among younger males (as low as 85% for perceived COVID-19 vaccine protection). In general, public health agencies were the most trusted sources of information (84%), followed by physicians and health scientists (70%); trust in vaccine manufacturers remained low (31%). Visible minority respondents were more likely to trust public health regulations (87% vs 83%) but also more likely to prefer natural immunity (20% vs. 14%) than non-visible minorities population. These findings provide a unique population-level snapshot of vaccine trust during the critical early phase of Canada's COVID-19 vaccine rollout. By identifying demographic differences in vaccine perceptions and information sources, our study offers an essential benchmark to inform future public health communication strategies and preparedness efforts.

Aging reshapes immunity through immunosenescence and inflammaging, increasing susceptibility to infection, exacerbating chronic conditions, and blunting vaccine responses. This review frames "immunofitness" as a practical goal of healthy aging and examines how adult vaccination builds immune resilience. Vaccination strengthens adaptive memory, leverages adjuvants to optimize antigen presentation, and can reprogramme innate cells (trained immunity), yielding heterologous benefits beyond target pathogens. We integrate evidence in older adults for influenza, respiratory syncytial virus, pneumococcal, COVID-19, and recombinant zoster vaccines, including reductions in respiratory events, cardiovascular outcomes, hospitalization, and mortality. We highlight emerging platforms and precision vaccinology to tailor schedules by immune age, comorbidity, and frailty. Integrating routine, age-appropriate vaccination with lifestyle measures is a feasible, high-impact strategy to promote immunofitness.

This study aimed to evaluate the cost-effectiveness of introducing 23-valent pneumococcal polysaccharide vaccine (PPV23) for elders into provincial immunization program in Zhejiang, China. From a societal perspective, a decision tree-Markov model was constructed to stimulate the economic and health consequences of Streptococcus pneumonae infection diseases in both 60-y-old and 70-y-old cohort, with one dose PPV23 vaccination and a coverage of 90% versus no vaccination. The model accounted for invasive pneumococcal disease (IPD) and non-bacteremic pneumococcal pneumonia (NBP). Model parameters were obtained from up-to-date published literature and statistical data. The costs associated with vaccination and medical treatment, quality-adjusted life years (QALYs), the number of Spn infection cases averted, and the incremental cost-effectiveness ratio (ICER) were calculated. Both effects and costs were discounted by 3% annually. The sensitivity analysis was implemented to evaluate the robustness of the model. Compared to the no-vaccination, the PPV23 vaccination program could reduce the number of IPD case, NBP case, death by 9.56%, 3.93% and 6.72% in the 60-y-old cohort. The corresponding figures for the 70-y-old cohort were 20.96%, 30.22%, and 15.70%. The ICER was estimated at US$ 635.31/QALY and US$ 69.36/QALY for the 60-y-old and 70-y-old cohort, respectively, and these results were robust in sensitivity analyses. Introducing a vaccination program of PPV23 targeting both 60 y old and 70 y old was economical based on the parameters, having the potential to substantially reduce morbidity and mortality related to Spn and the related disease burden.

After infection with the varicella-zoster virus (VZV), the virus becomes latent in the sensory ganglia. Immune senescence may lead to its reactivation, resulting in herpes zoster (HZ). The limited immunogenicity of current vaccines in elderly populations remains a significant challenge for prevention and control. This study investigated the immune-enhancing effects of the novel compound adjuvant BC02 on a recombinant VZV glycoprotein E (gE) subunit vaccine in a serum-positive elderly mouse model. A seropositive state was simulated through pre-immunization with the Oka strain of VZV, and the impacts of vaccines with various adjuvant formulations on humoral and cellular immunity in aged mice were systematically compared. Results demonstrated that the number of gE-specific IFN-γ- and IL-2-secreting cells induced by the BC02-adjuvanted vaccine (gE+BC02-1) increased 11.8- and 5.7-fold compared to the single-adjuvant group, significantly enhancing the multifunctionality of CD4+ T cells. The neutralizing antibody titer reached 1:122, comparable to that of the commercial vaccine Shingrix®, while the ratio of memory T/B cells was markedly higher than in the control group. Cross-age group experiments revealed that BC02 could overcome the limitations imposed by immune senescence in elderly models, inducing a balanced Th1/Th2 response and long-term immune memory comparable to that observed in younger groups (antibody titers maintained for ≥8 months). This study confirmed that the BC02 adjuvant synergistically activates innate and adaptive immunity, significantly enhancing the immune efficacy of the gE vaccine in serum-positive elderly individuals, thereby providing an potential strategy for optimizing herpes zoster vaccines for the elderly population.

Considering the complex nature of vaccine hesitancy and the vast amount of misinformation surrounding vaccination, training healthcare professionals (HCPs) in vaccine communication is important to ensure high vaccine uptake. Recently, a new vaccine communication approach, known as the Empathetic Refutational Interview (ERI), was developed to help HCPs in conversations with patients who have vaccine concerns. In the present study, we developed and validated the ERI Skills Inventory (ERISI) for assessing learning outcomes of training in ERI. The ERISI measures are (1) ERI-related knowledge, (2) ERI-related skills, and (3) confidence in using the ERI. A sample of 103 HCPs who took part in ERI training responded to the ERISI, as well as questions about their self-efficacy in vaccine consultations and preparedness to refute arguments against vaccination, before and after the training. At two follow-ups, they also reported their understanding and use of the ERI. Results showed that the ERISI is sensitive to positive changes in ERI knowledge and confidence as a result of training. Participants also showed increased use post-training of ERI skills to demonstrate empathy toward patients. However, no change was observed for ERI skills that refute misconceptions and inform patients using factual information, which participants tended to already use at pretest. ERI knowledge correlated positively with ERI skills at posttest. ERI confidence demonstrated both concurrent and predictive validity. The ERISI questionnaire is a valuable tool for assessing ERI training outcomes that can guide training development to ensure learning and future skill application.