Vaccine最新文献

In an effort to improve pandemic preparedness and health security, many low- and middle-income countries (LMICs) have launched initiatives to expand regional vaccine manufacturing. A number of elements relating to vaccine markets, production, value chains, and ecosystems significantly impact the ability to generate economically viable and sustainable vaccine manufacturing in LMICs. This paper provides an overview of vaccine manufacturing characteristics and global vaccine markets dynamics. Establishing vaccine manufacturing is a complex undertaking due to a variety of factors including intense competition, associated uncertainty regarding the ability to capture market share and substantial capital investment requirements. Substantive government commitment and investment are essential to ensure new local entrants compete successfully. In the medium to long run, the role of government should shift from supporting individual firms to strengthening local science ecosystems as this bolsters economic sustainability in three ways. First, investment in science promotes technological advances which can reduce production costs, e.g., through process innovations for vaccine manufacturing. Second, strong science ecosystems help to address the skills gap faced by manufacturers. And third, strong science ecosystems enable research and development of new vaccines that address local unmet needs and open new markets. Furthermore, developing a regional approach to vaccine manufacturing and procurement, with associated regulatory harmonization, is crucial to achieving economically viable and distributed vaccine manufacturing. Importantly, investment in research and development and fostering of regional collaborations drives innovation, feeding into new product discovery and consequently a strong pipeline of new vaccine products, driving economically sustainable regional vaccine manufacturing. This offers the potential to prevent endemic infectious diseases with significant socioeconomic and health burden or to develop therapeutic vaccines, generating regular interpandemic demand for regional vaccine manufacturers, consequently sustaining capacity retention and associated pandemic preparedness.

Background: Following approval of the first Maternal RSV vaccine (MV) and long-acting monoclonal RSV antibody (la-mAbs) in Europe, several countries have begun integrating the products into their infant RSV immunization programs.

Methods: Based on a survey supplemented by policy documents, this paper provides a descriptive, policy-focused cross-sectional overview of RSV immunization strategies across 32 European countries.

Results: As of September 2025, 22 countries offered programmatic RSV prophylaxis for infants. Of these, 5 use only MV, 10 use only la-mAbs and 7 countries offer both. Considerable variation was observed in programmatic approaches with respect to (gestational) age of administration, delivery pathways, eligibility criteria for mothers and infants, and reimbursement mechanisms.

Conclusions: The RSV immunization policy landscape in Europe is diverse and dynamic, presenting both challenges and opportunities for shared learning and policy development.

Objectives: To investigate indirect vaccine effectiveness (indirVE) of vaccination of children and adolescents with seasonal influenza vaccines against influenza-related outcomes occurring in other population groups.

Methods: We performed a systematic review of studies (randomized and non-randomized) on indirVE of vaccination of participants aged 6 months-17 years with tri- or quadrivalent seasonal influenza vaccines against influenza (lab-confirmed; non-lab-confirmed) occurring in contacts of vaccinated persons or members of the wider community (last search: 17th March 2024). GRADE certainty of evidence (CoE) was evaluated (PROSPERO: CRD42024546400).

Results: We identified 28 studies (5 randomized; 23 non-randomized). In community-based studies, indirect protection against laboratory-confirmed influenza (LCI) ranged from -38 % [95 % CI: -574 to 72] to 61 % [95 % CI: 8-83] (very low CoE). In household-based settings, indirVE against LCI varied between -151.2 % [95 % CI: -1194.6 to 51.3] and 39.4 % [95 % CI: 7.4 to 60.3] (very low CoE). In school-based settings, highly variable indirect effects were observed on LCI, hospitalization, emergency department visits and school/work absenteeism (very low CoE).

Conclusions: There is no clear evidence of indirect effects from influenza vaccination in children. While plausible, effect size is uncertain and varies by study design, population, and vaccine type. Stronger indirect effects appeared only when direct VE was high.

Malaria remains a leading cause of morbidity and mortality and is responsible for over 0.5 million annual deaths globally. During the first two decades of this century, scale-up of a range of tools was associated with significant reductions in malaria mortality in the primary risk group, young African children. However, in recent years progress has stalled and even reversed in some high-burden countries, highlighting the urgent need for new interventions. Since 2021, two malaria vaccines have received World Health Organization (WHO) recommendations and Gavi, the Vaccine Alliance financing and are now in high demand across sub-Saharan Africa. Despite their promise, including a 13 % decline in all-cause mortality and a 22 % drop in severe malaria hospitalizations following pilot introduction, there remains keen interest in developing improved vaccines in alignment with WHO's preferred product characteristics (PPCs), revised in 2022 (see https://www.who.int/publications/i/item/9789240057463). Further, monoclonal antibody (mAb) prophylaxis has emerged as a promising new intervention, which led to WHO's developing a new guidance document to inform PPCs for malaria mAbs (see https://www.who.int/publications/i/item/9789240070981). The priority focus for these aspirational tools is on prevention of disease and death in young African children; however, there is increasing focus on tools that could be deployed across entire populations to break the cycle of parasite transmission and accelerate elimination. Further, accelerated impact of next-generation vaccines is emerging thanks to the pioneering introduction of current vaccines into established national immunization programs and strong coordination with national malaria programs. This vaccine value profile (VVP) for malaria-developed by a working group of subject matter experts from academia, nonprofit and multilateral organizations, and public-private partnerships-provides a high-level, holistic assessment of current, existing information and data that are publicly available to inform the potential public health, economic, and societal value of vaccines and prophylactic mAbs in the development pipeline.

Introduction: This study examined associations between information sources and COVID-19 vaccination behavior among pregnant and postpartum women in Brazil, Ghana, Kenya, and Pakistan.

Methods: This mixed methods study involved concurrent in-depth interviews and cross-sectional surveys.

Results: A total of 1797 women participated in the study. Overall, participants were more likely to be vaccinated if they believed that they knew enough about safety to make a decision (aOR: 1.51; CI: 1.04-2.20) and trusted the information they received from healthcare providers (aoR: 1.74; CI: 1.19-2.54). Odds of vaccination were higher among those who trusted information provided by scientists (aoR:1.86; CI: 1.31-2.63) and among those who believed that leaders in their community recommended the COVID-19 vaccine (aOR: 1.4; CI: 1.01-1.92). Higher odds of vaccination were observed among participants in Pakistan who had the information they needed to make a decision (aOR: 2.58; CI: 1.35-4.94), knew enough about safety to make a decision (aOR: 3.82; CI: 1.85-7.89), trusted the information they received from healthcare providers (aOR: 3.20; CI: 1.39-7.34), and believed that community leaders recommended the COVID-19 vaccine (aOR: 2.53; CI: 1.22-5.25). Participants in Brazil who trusted information provided by scientists (aOR: 4.70; CI: 1.23-18.05); participants in Kenya who trusted information from the media (aOR: 1.94; CI: 1.10-3.44); and participants in Ghana who trusted recommendations from their government (aOR: 2.66; CI: 1.42-5.0) had higher odds of vaccination. Interviewed women noted that they felt overwhelmed with the amount of information and misinformation related to COVID-19 and the vaccine specifically.

Discussion: Trusted COVID-19 vaccine information sources reported by pregnant and postpartum women vary by country, suggesting the need to identify sources across different target populations to improve vaccine acceptability and uptake with the goal of realizing the population level benefits of vaccination.

Background: Among pregnant and postpartum women, decision-making for receiving the COVID-19 vaccine is influenced by vaccine safety concerns, misconceptions, shifting vaccine policies, and exclusion in the initial vaccine rollout. This caused confusion and vaccine hesitancy among many groups including pregnant and postpartum women.

Objective: The objective of this study was to understand the multilevel factors that influence vaccine decision-making among pregnant and postpartum women in Pakistan, which is crucial for improving vaccine demand among the vulnerable group-pregnant and postpartum women.

Methods: This study is part of a multi-country mixed method study conducted in Brazil, Ghana, Kenya, and Pakistan. In Pakistan, fifty in-depth interviews were conducted with pregnant and postpartum women from two hospitals in Karachi. A grounded theory analysis approach was used, and a socio-ecological framework encompassing four levels of influence was applied to synthesize the study findings.

Results: At the individual level, influences included concerns about vaccine safety, particularly regarding the health of the women and their babies due to potential side effects. Strong religious beliefs and trust in God also deterred some women from receiving the COVID-19 vaccine, as they relied on their faith practices. However, women with confidence in the vaccine had a positive attitude toward vaccination. At the interpersonal level, factors influencing vaccine decisions included the strong influence of observing others and recommendations from family and healthcare providers. Community-level factors included misconceptions about the vaccine's purpose and effects, and religious leaders' recommendations either supporting or discouraging vaccination. Policy-level factors involved mandatory vaccination for accessing public spaces, employment, and healthcare services. Coercive vaccination policies led some women to obtain vaccine cards without getting vaccinated.

Conclusions: Efforts to promote vaccination among pregnant and postpartum women in Pakistan should engage family members, healthcare providers, and religious leaders, and implement evidence-based vaccine mandates to increase demand and to support uptake of maternal COVID-19 vaccination.