Vaccine最新文献

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.

Background: This prospective study aimed to evaluate the dynamics and seroprevalence of anti-SARS-CoV-2 antibodies in a cohort of vaccinated and unvaccinated health workers (HWs) in Bamako, Mali. The study also measured antibody responses as a function of SARS-CoV-2 infections, socio-demography, vaccination status and associated comorbidities.

Method: 685 vaccinated and 413 unvaccinated HWs (total = 1098) were monitored over a 15-month periods with follow-up visits every 3 months for the first 6 months and a final visit after 15 months. Anti-spike and anti-nucleoprotein antibodies were assessed using ELISA. Non-parametric tests and logistic regression analyses were performed to compare antibody levels and to investigate associated factors.

Results: Overall, anti-SARS-CoV-2 antibodies tended to increase over the first 3 months in both vaccinated and unvaccinated groups. Spike (>98 %) and nucleoprotein (>91 %) antibodies remained high and relatively stable after 3 months and correlated inversely with the rate attack of symptomatic and asymptomatic COVID-19. Males demonstrated lower antibody responses, particularly for nucleoprotein (p < 0.05) compared to females. HWs with comorbidities demonstrated higher antibody responses. Participants with active SARS-CoV-2 infections exhibited decreased antibody levels. Vaccinated participants exhibited a trend toward higher spike antibodies. Virus-inactivated type vaccination increased nucleoprotein antibodies. Furthermore, there was no increase of antibody levels after receiving, two or more vaccine doses, independently of whether the same or a different type of used vaccines. Nucleoprotein antibodies varied significantly at inclusion among participants across blood groups.

Conclusion: This study identified a progressive increase in anti-spike and anti-nucleoprotein antibodies in both vaccinated and unvaccinated HWs, correlating with reduced COVID-19 infection rates. These findings highlight the significance of both natural and vaccine-induced immunity and the need to assess antibody levels and long-term protection beyond the 15-month study period.

Background: National Immunization Technical Advisory Groups (NITAGs) are crucial for enhancing vaccine use in immunization programs, particularly through off-label recommendations. This study sought to assess the adoption and trends of off-label vaccine recommendations made by NITAGs across low-, middle-, and high-income countries since the COVID-19 pandemic.

Methods: An online survey was distributed to NITAG representatives in World Health Organization (WHO) member states, asking questions related to off-label use of vaccines including policies, procedures, legislation, and regulations for NITAGs in participants' countries. Respondents across all six WHO regions were invited to participate.

Results: Respondents from 76 countries participated in the survey (55 %) were NITAG representatives, and 45 % were immunization program managers or from the NITAG secretariat). Most respondents 52 (68 %) reported their NITAG makes off-label recommendations, 18 (24 %) indicated their NITAG does not make off-label recommendations, and 6 (8 %) were unsure of their NITAG's role. There was a noticeable shift relating to off-label vaccine recommendations observed pre, during, and post-pandemic period. Prior to 2022, 25 (48 %) respondents indicated their country recommended off-label vaccines, 11 (21 %) specified off-label recommendations were limited to emergencies as temporary or conditional expansions, and 6 (12 %) were unsure. After 2022, 30 (58 %) respondents indicated their country recommended off-label vaccines, 4 (8 %) specified off-label recommendations were limited to emergencies as temporary or conditional expansions, 18 (35 %) selected no, and 0 (0%) were unsure. While most countries make off-label recommendations, few (15 %) have policies and procedures to support implementation.

Conclusions: Although WHO broadly provides guidance on the mandate and core functions of NITAGs, globally, they have differing mandates and operational capacities related to off-label vaccine use. These findings suggest the need for increased awareness of off-label vaccine recommendations and strengthened dialogue around implementation of off-label recommendations.

Background: Chengdu, China, is facing an increasing burden of cervical cancer. Although human papillomavirus (HPV) vaccines have been introduced in China since 2016, vaccination coverage remains suboptimal, and data on regional disparities are limited. In 2021, Chengdu implemented a subsidized HPV vaccination program targeting girls aged 13-14 years. This study aims to evaluate HPV vaccination coverage among females aged 9-45 years in Chengdu from 2017 to 2023, stratified by age group, geographic area, and vaccine type, and to examine changes in vaccination coverage among girls aged 13-14 years following the city's enrollment in the pilot subsidy program.

Methods: HPV vaccination data were sourced from the Sichuan Provincial Immunization Information System. Descriptive analyses assessed annual and cumulative vaccination coverage from 2017 to 2023 among females aged 9-45 years in Chengdu. An interrupted time series (ITS) analysis using a segmented regression model (SRM) was conducted to quantify changes in vaccination rates following program implementation among girls aged 13-14 years.

Results: From 2017 to 2023, first- and full-dose HPV vaccination coverage among females aged 9-45 years in Chengdu showed significant upward trends across age groups, geographic areas, and vaccine types. By 2023, cumulative first-dose coverage reached 34.17 %, with full-dose coverage at 24.40 %. Notably, vaccination rates for girls aged 13-14 years exhibited markedly higher first- and full-dose coverage compared to pre-program levels (β = 1.899, p-value = 0.002; β = 4.859, p-value <0.001, respectively).

Conclusions: Following the HPV vaccination program in Chengdu, the vaccination rate for girls aged 13-14 years significantly increased. However, the overall vaccination rate for women aged 9-45 years remains relatively low, particularly among certain subpopulations. To enhance overall vaccination rates, strategic priorities should include targeted interventions for subpopulations with suboptimal coverage, expansion of pilot programs, and stronger political commitment to integrating the HPV vaccine into the National Immunization Program.