Vaccine最新文献

Background: Paediatric COVID-19 vaccination programmes were initiated in response to the coronavirus pandemic declared by the World Health Organisation (WHO) in 2020. Ten COVID-19 vaccines received WHO Emergency Use Listing, however, only five were approved for use in children. ChAdOx1 nCoV-19 (AZD1222) was approved in adults in a two-dose regimen. We previously reported interim findings of a phase 2 study of ChAdOx1 nCoV-19 in children with immunogenicity, comparable with adults. Final results after 12 month follow-up are reported.

Methods: Single-blind, randomised controlled trial across four UK centres, recruiting 261 children and adolescents (aged 6-17 years). Participants received either two doses of ChAdOx1 nCoV-19 or Bexsero vaccine (controls). The primary outcome was safety (adverse events for 28 days following vaccination and serious adverse events throughout), and secondary outcome was immunogenicity (measured by SARS-CoV-2 anti-spike enzyme-linked immunosorbent assay (ELISA) and enzyme-linked immunosorbent spot (ELISpot)).

Findings: Five serious adverse events and four adverse events of special interest were reported. None were related to study vaccinations, and there were no deaths. Geometric mean titres (GMTs) from an anti-spike (Wuhan) ELISA in participants aged 6-11 years were 1 EU/ml (95% CI 1-2) at baseline versus 796 EU (95% CI 161-3948, n =4) at D364. In participants aged 12-17 years, GMTs were 1 EU/ml (95% CI 1-2, n=3) at baseline versus 1432 EU/ml (95% CI 2337-6083; n=6) at D364 (2 dose regimen at 112-day interval), compared to 3 EU/ml (95% CI 0-62) at baseline versus 392 EU/ml (95% CI 24, 6493; n=3) at D364 (2 dose regimen at a 28-day interval).

Interpretation: A two-dose regimen of ChAdOx1 nCoV-19 was immunogenic and safe in the trial population. No vaccine-related serious adverse events were reported. Immune responses persisted to 12 months in participants who did not experience breakthrough infection, This trial was registered with ISRCTN, trial number 15638344.

Funding: The study was funded by the Department of Health and Social Care, through the National Institute for Health Research, and AstraZeneca.

Background: Past studies have shown that people are less inclined to get vaccinated when healthcare providers are hesitant about the immunisation. Nurses have been documented as the most hesitant healthcare group towards COVID-19 vaccination in both Western and Chinese communities. This study investigates the perceptions of COVID-19 vaccines among nurses in a Chinese society and the reasons contributing to their high hesitancy.

Methods: A qualitative descriptive approach was used, involving in-depth semi-structured interviews from September to December 2022 with 35 nurses in Hong Kong who did not receive COVID-19 vaccinations. A thematic analysis of the data was implemented in accordance with the critical medical anthropology framework.

Results: Two themes were identified: barriers to receiving COVID-19 vaccinations and the moral struggles of participants in not getting vaccinated. Participants demonstrated a lack of confidence and individual safety concerns, related to the negative information shared among their healthcare colleagues and non-healthcare workers through social media platforms. Participants revealed resistance towards the vaccination policies of the government and their workplaces, and they distrusted the commercial and profit-oriented nature of the vaccines against COVID-19.

Conclusion: At the individual level, participants' lack of confidence and worries about vaccine safety emerged from the intertwined relationship of the negative information shared among their healthcare colleagues and non-healthcare workers through social media platforms at both the individual and micro-social levels. In addition, resistance was seen at the intermediate-social level, involving distrust of the profit-oriented nature of the capitalist operation, as well as cultural confidence in the efficacy of traditional Chinese medicine against COVID-19 infection at the macro-social level. This study suggests that addressing the agents that can affect nurses' socialisation process at different social levels according to the critical medical anthropology framework is crucial for motivating nurses' vaccine acceptance.

Introduction: Nipah virus (NiV) is a deadly zoonotic disease with pandemic potential, prioritized by the World Health Organization for research and vaccine development. Since Bangladesh has faced annual NiV outbreaks and repeated spillovers since 2001, it is likely to be the site of a Phase II vaccine trial. This study explored people's knowledge about NiV and their willingness to participate in a NiV vaccine trial in Bangladesh.

Methods: We conducted a mixed methods study, collecting qualitative and quantitative data from Mirpur township, Dhaka, and NiV-affected Faridpur District. From December 2021 to November 2022, the team interviewed adult male and female respondents responsible for household treatment and vaccination decisions.

Results: The team conducted 66 in-depth interviews and 978 survey interviews. Many in-depth interviewees were aware of NiV and, when asked if they would participate in a NiV vaccine trial, responded with one of three options: willing, unwilling, or would decide later. They were concerned about vaccine safety and side effects when making a decision about participation. In the survey, more respondents from Mirpur township, Dhaka, had heard about a disease transmitted from bats to people (57 %, 272/478 vs. 52 %, 262/500) and were willing to participate in a vaccine trial (45 %, 217/478 vs. 22 %, 111/500) than those from Faridpur. A high number expressed willingness to take an investigational NiV vaccine during an outbreak (Dhaka 75 %, 205/272 vs. Faridpur 81 %, 398/491 Faridpur). We did not find any association between knowledge about NiV and willingness to participate in a NiV vaccine trial.

Conclusion: Many respondents expressed willingness to participate in a NiV vaccine trial, especially during an outbreak, suggesting that such a trial may be feasible in Bangladesh. Given concerns about safety and side effects, clear communication on these issues may support informed participation.

Vaccines are effective in preventing infection by pathogens. The inactivated Edwardsiella piscicida vaccine to elicit immune response after vaccination of flounder (Paralichthys olivaceus) has been shown in previous studies. The molecular mechanism of this protection is yet to be clarified. Transcriptome sequencing was employed to investigate head kidney of flounder on day 7 post-immunization with an inactivated vaccine, as well as on days 1 and 7 following E. piscicida infection, 5 weeks after immunization. Cellular immune responses and histopathology were also studied. The analysis revealed that each library generated an average of 50 million raw reads, with over 99.5 % of them passing quality control, and Q30 values exceeding 92.5 % in every instance. The numbers of differentially expressed genes (DEGs) detected were 1257 on day 7 after immunization, and 832 and 1545 on days 1 and 7 after challenge, respectively. These DEGs were mapped to the GO and KEGG databases, revealing their involvement in immune functions such as antigen presentation, cytokine interactions, and cell differentiation. To explore immune-related DEGs linked to vaccine protection, 34 genes were primarily involved in the Toll-like and NOD-like receptor signaling pathways on day 1 post-challenge. Analysis of protein interactions identified ten hub genes (IL6, IL1B, NFKBIA, VCAM1, etc.) involved in immune activation and the initiation of innate responses. 66 DEGs were notably involved in T cell receptor signaling and Th cell differentiation on day 7 post-challenge. Fifteen hub genes (SRC, IL10, JUN, CD28, etc.) were closely associated with cellular immune response and differentiation. On day 7 post-challenge, the vaccine group exhibited a notable increase in CD4⁺ cells. Flounder had low E. piscicida loads in the head kidney after challenge. Responses of multiple signaling pathways and differentiation of T cells provide protection after pathogen infection. The study enhances the understanding of the vaccine's immune protection mechanism.

Introduction: Local organizational collaborations and "community-ready information" are central elements of enacting "meaningful community engagement." Academic partnerships with health departments and community organizations can practice co-design, even during emergencies such as the global COVID-19 pandemic. Co-design is a method to include multiple perspectives, build trust, and share resources and power with community organizations and members.

Materials and methods: The University of Maryland Prevention Research Center and Horowitz Center for Health Literacy activated established relationships with a national network of organizations serving LGBTQ+ populations and a state network of local health improvement coalitions to support COVID-19 vaccination messaging and behavioral nudges in plain language and primary languages. This paper describes the co-design process and customized COVID-19 vaccination products for the partners.

Results: The process helped to build partner communication capacity and rapidly develop customized COVID-19 vaccination products for partner networks. We sustained relationships with both partner networks and actively worked together on developing messages and materials during the project's 12 months. Partner organizations reported high satisfaction with the co-design process and a wide range of communication materials with many unique nudges.

Discussion and conclusions: Our project contributes to the public health co-design literature in 2 ways. Our project had robust evaluation throughout, which responds to the call for more evaluation of co-design effectiveness. We also show the combined usefulness of communication expertise and co-design, even under emergency conditions. Co-designing communication products can be time-consuming, but we were able to iterate, collect and apply feedback, and respond to partner requests on short notice. The communication expertise of the academic team allowed the communication material and nudge development to be high-quality and well-tailored for the intended audiences. Our project suggests that a well-executed co-design project should be paired with a robust, ongoing dissemination and staffing infrastructure to ensure products reach into communities.

Background: Although SARS-CoV-2 vaccination was a critical component to mitigate impact of the pandemic, it also brought specific challenges related to adverse drug reactions (ADRs) when large cohorts of healthcare workers were vaccinated.

Methods and findings: This study reports solicited ADRs and IgG anti-SARS-CoV-2 levels from 3805 healthcare workers in Sweden following primary immunization during 2021. Differences in systemic reactions at a level where study participants needed sick-leave or rescheduling of work shifts differed substantially between vaccine regimens, ranging from 12 % (Comirnaty) to 48 % (heterologous vaccination with Vaxzevria/Spikevax). Multivariable linear regression showed that the anti-S IgG response was dependent on vaccine label and that higher age and increased time from vaccination significantly correlated with lower antibody titers. Multivariable logistic regression models describing the risk for each ADR category in relation to vaccine label, age, sex, anti-S IgG levels post vaccination and time from vaccination showed vaccine label-dependent statistically significant differences in adjusted odds ratios for wide range of ADR categories, as high as OR 10 (95 % CI 7.6-13.5) for fever and chills when comparing Vaxzevria to Comirnaty. Among the mRNA vaccines, use of Spikevax (compared to Comirnaty) correlated with a statistically significant 1.3 to 3.5-fold increase in adjusted ORs for several ADR categories.

Conclusions: Based on a large cohort of health workers, our study confirms that adverse reactions after COVID-19 vaccination can lead to a substantial amount of missed work shifts, potentially causing organizational-level disturbances in staffing. There are significant differences in ADR frequencies related to vaccine type, age and sex, at overall levels not observed for other commonly used vaccines for adults.