Vaccine最新文献

Background: Measles remains a leading vaccine-preventable killer in low- and middle-income countries (LMICs). Using the WHO/UNICEF Estimates of National Immunization Coverage (WUENIC) 2024 revisions, this article assesses measles-containing vaccine first-dose (MCV1) and second-dose (MCV2) coverage trends, inequities, and priority groups for targeted action.

Methods: Data from 2019 to 2024 for 137 LMICs were analysed using descriptive statistics; Welch's t-tests and Wilcoxon rank-sum tests to compare fragile versus non-fragile states; Gini coefficients for inequality; k-means clustering (k = 4) on coverage, MCV1-to-MCV2 dropout, change, unvaccinated counts, and fragility; and bounded linear models to project MCV1 to 2030.

Results: In 2024, mean MCV1 coverage was 79.2% (95% CI: 76.8-81.6)-below the 95% threshold-with fragile LMICs at 68.5% versus 87.4% in non-fragile LMICs (difference - 18.1 percentage points; p < 0.001). MCV2 gaps were larger (-26.9 percentage points; p < 0.001). DTP1-based zero-dose prevalence was 20.8%, with 15.6 million children unvaccinated for MCV1 and 22.4 million for MCV2; West and Central Africa accounted for 7.2 million MCV1-unvaccinated (46.2%). Inequality rose (Gini 0.22 → 0.25, 2019-2024). Projections indicate MCV1 of 84.2% by 2030, with fragile LMICs off-track. Clustering identified four profiles: (1) very low coverage, high dropout, high fragility (22 countries); (2) high coverage, low dropout (44); (3) low coverage, severe dropout (31); and (4) low coverage, moderate dropout (40), each implying distinct priorities (conflict-adapted SIAs; sustaining gains; follow-up campaigns; expanding first-dose access).

Conclusions: Persistent and widening measles immunization gaps-especially in fragile settings-threaten IA2030's 90% coverage targets. Pairing the 2024 WUENIC revision with fragility-sensitive clustering and bounded projections provides a practical framework to prioritize equity-focused funding and operational strategies where need is greatest.

Salmonella vaccines constitute the largest group of antibacterial immunological veterinary medicinal products (IVMPs) introduced to the EU market by the Polish Official Medicines Control Laboratory (OMCL). This is especially relevant, as Poland is the EU's leading producer of poultry meat. The General European OMCL Network is coordinated by the European Directorate for the Quality of Medicines & HealthCare (EDQM). Despite strict control of IVMPs, genomic aspect has not yet been controlled in veterinary pharmacy. The aim of the project was to assess the usefulness of High-throughput sequencing (HTS) for the genetic control of vaccines. The research was conducted on the most commonly marketed serovar in Poland - Salmonella enterica subspecies enterica serovar Enteritidis (SE). Live attenuated Salmonella vaccines for chickens were tested - three batches of different vaccines (coded B-01, B-05, B-07). Several publicly available genomic tools were applied for comprehensive characterization of vaccines. Generated sequences confirmed that the main genetic component of each vaccine was S. enteritidis without significant contaminants and with stability across batches. Comparative analysis showed that B-05 and B-07 IVMPs were genetically almost identical, while B-01 was quite distant. No major antibiotic resistance genes or point mutations were detected. HTS confirmed presence of multiple virulence markers in all tested batches. Further data indicated presence of multireplicon plasmid IncF in B-05 and B-07, harbouring two virulence cassettes - pef (plasmid-encoded fimbriae) and spv (type III secretion system). The presented work is an interdisciplinary project linking quality control of IVMPs with advanced genomics. This study provides the first comprehensive genomic characterization of Salmonella enterica vaccine strains on the European market, confirming their safety, genetic stability, compliance with manufacturer declarations, and highlighting HTS as a valuable tool for vaccine quality assessment. As a supplement to phenotypic methods, HTS implementation requires coordination with manufacturers and EDQM before routine use in OMCLs.

Understanding how parents make decisions about child vaccination is important to guide interventions to increase child vaccination rates. However, few studies have examined parent vaccine decision making within households and no studies have examined this question from the perspective of fathers. In a sample of 943 fathers, from the Fathers & Families cohort and living in two-parent (father-mother) households, this study examines parents' decision making and agreement about their child receiving, or not receiving, the COVID-19 vaccine, and links with children's vaccination status. The association between fathers' and mothers' agreement about whether or not to vaccinate child against COVID-19 and child COVID-19 vaccination status was examined using multivariate logistic regression, adjusting for parent characteristics. The vast majority of fathers (89.0%) reported that they and their child's mother jointly decided on vaccinating their child and typically agreed on whether or not to vaccinate their child against COVID-19. Multivariate logistic analysis showed that children whose parents agreed on whether or not to vaccinate them were 14.8 times (B = 2.70, 95% CI: 7.1-31.2) more likely to have received the COVID-19 vaccine than those whose parents disagreed or had not discussed vaccination. The findings highlight a new avenue for outreach efforts aimed at promoting child vaccination rates through understanding fathers' specific concerns about child vaccines and communication with fathers and mothers about child vaccination.

Background: Hospital discharge codes can be used to identify possible Adverse Events of Special Interest (AESI) following COVID-19 vaccinations.

Aim: We sought to estimate the positive predictive value (PPV) and level of certainty of ICD-10-AM and SNOMED coding for meeting Brighton Collaboration case definitions of AESIs in Aotearoa, New Zealand.

Methods: Our expert panel identified 24 ICD-10-AM codes and 2 SNOMED codes expected to identify 9 AESIs. We sought codes likely to be specific rather than sensitive. Medical record reviews were conducted by an experienced coder, adjudicated by medical specialists, for the level of certainty that each case met the target case definition. Admissions coded to an explicit alternative diagnosis were classified as Not a Case.

Results: Our data covered over 3 million people. Reviews were conducted on 761 medical records, randomly selected from admissions principally in calendar years 2016 to 2019. We report the PPV of each code with respect to its level of certainty of meeting the case definition. Only Guillain-Barré had a single code specific to a single AESI. Several neurological conditions had overlapping codes, conditions and case definitions. PPVs for individual codes to meet case definitions ranged from 11% to 100%. Level of certainty of each code and PPV are specified.

Conclusion: PPVs of codes for each AESI need to be assessed on a case-by-case basis. Many codes are arguably insufficiently 'accurate' to identify a target AESI. We did not assess PPVs for combinations of codes. Our method did not allow us to estimate the number of cases missed by the coding.

ACAM2000® [Smallpox and Mpox (Vaccinia) Vaccine, Live] is an attenuated vaccinia vaccine indicated in the US for active immunization for the prevention of smallpox and mpox disease in individuals determined to be at high risk for smallpox or mpox infection. The current study assessed the ability of a screening algorithm to identify a population of previously vaccinated individuals for whom revaccination with ACAM2000 vaccine could be used to assess safety (NCT02443623). Vaccination in this study stimulated anti-vaccinia antibodies in plasma donors for the preparation of vaccinia immune globulin intravenous (VIGIV). This was an open label, single-arm, multi-center study. The protocol criteria were designed to screen out individuals with risk factors associated with increased risk of adverse events, specifically myocarditis/pericarditis, including an algorithm to be followed in the event of symptom development. Post-vaccination safety data was collected including solicitation for symptoms of myocarditis/pericarditis. There were 4088 participants screened, of which 3032 were vaccinated, 850 failed the screening criteria and 206 were enrolled but not vaccinated. The median age was 51, ranged from 18 to 65, and was comprised of 75% males. Out of the 3032 vaccinated participants, 1420 (47%) reported 2478 adverse events (AEs), of which 1468 AEs in 1190 (39.2%) participants were considered related. Twenty-one participants (0.7%) reported severe events, serious adverse events were uncommon (0.8%), two were considered related to vaccination and there was one unrelated death. Inadvertent autoinoculation was reported in six participants but did not require medical intervention. The most frequently reported vaccination related AEs were cutaneous reactions and constitutional symptoms. Out of 3032 vaccinated participants, 65 had potential symptoms of myocarditis/pericarditis (myopericarditis) which were resolved, and there were no diagnoses of myopericarditis. Administration of ACAM2000 vaccine was well tolerated in this population of previously vaccinated participants.

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.