Vaccine最新文献

Introduction: For children who initiate a vaccine series late, the Centers for Disease Control and Prevention (CDC) provides a catch-up schedule to guide providers in achieving full vaccination. Typically, the routine and catch-up schedules recommend the same number of doses for series completion. However, children starting pneumococcal (PCV) or Haemophilus influenzae type b (Hib) vaccination at or after 7 months often require fewer doses than earlier initiators. We aimed to quantify late PCV and Hib series initiators and determine series completion within CDC catch-up guidelines.

Methods: This cross-sectional study analyzed vaccine records from the 2016-2021 National Immunization Survey-Child. We quantified the prevalence of and identified characteristics of children who initiated the PCV or Hib series at or after age 7 months (215 days). We evaluated late initiators' series completion based on age of series initiation and when subsequent doses were received.

Results: Of 99,652 children, 2.5 % (95 % CI: 2.2-2.7 %) and 2.3 % (95 % CI: 2.1-2.5 %) of U.S. children initiated PCV or Hib series late, respectively. The median age of late series initiation was 384 days for PCV and 407 days for Hib. Overall, 34.9 % (95 % CI: 29.9-39.9 %) of late PCV initiators, and 26.3 % (95 % CI: 21.2-31.4 %) of late Hib initiators, received other vaccines from age 6 weeks to <7 months. Late PCV initiation decreased from 2.9 % (95 % CI: 2.4-3.4 %) in 2016 to 1.7 % (95 % CI: 1.3-2.1 %) in 2021. About 77.4 % (95 % CI: 69.0-83.9 %) of late PCV (routine 4-dose series) and 87.5 % (95 % CI: 76.3-93.3 %) of late Hib (routine 4-dose series) initiators completed the series per catch-up guidelines.

Conclusions: A subset of U.S. children initiated the PCV or Hib series at or after 7 months, and most had not received other recommended vaccines between 6 weeks and 7 months-underscoring the need for evidence-based interventions that support early access to primary care.

Introduction: Migration presents complex challenges for global public health. Pathogens do not recognise borders, and despite the success of vaccination in reducing infant and child mortality, significant gaps in coverage between migrants and host populations exist. Immigrant or migrant children are most at risk of severe health outcomes due to under- or non-vaccination. Although multiple factors contribute to low vaccination uptake, research has identified factors linked to parental attitudes towards vaccination. These factors are crucial in influencing children's vaccination against preventable diseases.

Aim: The aim of this review is to synthesise and integrate the evidence on the barriers and facilitators associated with migrant parents' decisions to vaccinate their children.

Methods: This review followed the Joanna Briggs Institute methodology for MMSR using a convergent integrated approach. The population, phenomenon of interest, and context (PICo) was applied to formulate the review question. The following databases were systematically searched; MEDLINE Ovid (1946-2024), EMBASE Ovid (1974-2024), Cinahl EBSCO Host (1937-2024), PsycINFO (Ovid), Web of Science and Scopus.

Results: Twenty studies were included, with four themes emerging. 'Health literacy' highlights how language proficiency and knowledge either help or hinder migrant parents' ability to understand, access, and navigate healthcare systems; 'trust in care' refers to their confidence in health and social care professionals and the system delivering childhood vaccinations; 'access' represents the ease or difficulty they face in reaching and using vaccination services; and 'fear and perception' relate to how trust, perceived susceptibility, and the attitudes of family and social networks influence their vaccination decisions.

Conclusion: Vaccination equity is critical for safeguarding migrant and host populations. Addressing this disparity reduces outbreak risks and ensures global health security. The development of culturally and linguistically appropriate vaccination campaigns is needed to educate migrant parents on vaccination benefits and accessibility.

Background: Respiratory syncytial virus (RSV) is the most common cause of infant hospitalization. Following the introduction of a prefusion F protein vaccine (RSVpreF) for pregnant women and a monoclonal antibody (nirsevimab) for infants aged <8 months in 2023, we aimed to understand public perceptions about RSV immunization to inform targeted health strategies to improve uptake.

Methods: We conducted two nationally representative web-based surveys of pregnant women to understand maternal RSV immunization attitudes and intentions (Wave 1: 9/20/2023-10/3/2023; N = 198; Wave 2: 5/24/2024-6/14/2024; N = 216). We used thematic analysis to identify themes and sub-themes in pooled data across both waves (N = 414).

Results: Motivators for immunization included concerns about the disease's risks, recognized benefits of immunization, and recommendations by healthcare professionals and the Center for Disease Control and Prevention (CDC). Participants reported hesitation to immunize due to insufficient immunization information, low perceived disease risk, lack of trust in vaccine due to product novelty and vaccine-makers, limited availability of RSVpreF vaccine, and concerns about vaccine safety and potential side effects. Individuals who reported hesitancy shared that information needed to encourage immunization should include narratives from parents who chose immunization, research, and evidence underscoring the effectiveness and safety of the immunization, and information about access and availability of the products. Trusted sources of immunization information among all participants included (1) healthcare providers, (2) family/relatives, and (3) research.

Conclusion: Our findings suggest that efforts to promote RSV immunization should focus on engaging healthcare providers to improve pregnant women's knowledge and awareness related to RSV and using vaccine narratives to build confidence in RSV immunization.

Tuberculosis (TB) was a significant public health concern in Japan for over a century. While archaeological evidence suggests its presence as early as 1800 years ago, TB spread rapidly during Japan's modernization in the late 19th century. Initial control measures focused on patient isolation and the establishment of sanatoriums, later supported by the Tuberculosis Prevention Law. After World War II, public health interventions-such as mandatory case reporting, mass BCG vaccination, and the introduction of antimycobacterial agents like streptomycin-contributed to a marked decline in TB incidence and mortality. Treatment outcomes further improved with the development of multidrug chemotherapy. Mass BCG vaccination began in 1949, with universal childhood vaccination implemented in 1974. Japan employs a distinctive intradermal "stamp" method with multiple needles of BCG administration for less complication of a skin ulcer. The current strain, BCG Tokyo-172-1, developed in 1981, is used nationally and distributed globally through WHO-UNICEF programs. Pediatric TB has become rare, with fewer than 100 new cases annually. Most are identified through adults contact investigations; others are diagnosed based on clinical symptoms or screening. In recent years, the proportion of TB cases-including pediatric cases-among individuals born outside Japan, particularly from high-burden countries, has increased. As Japan transitions to a low TB burden setting, the continuation of universal BCG vaccination is under review. Selective vaccination of high-risk infants and enhanced screening among adults may offer more targeted and effective approaches.

Canine distemper virus, CDV, is a worldwide distributed disease of the genus Morbillivirus that can affect dogs of all ages, breeds, and both sexes with varying degrees of morbidity and lethality. The virus consists of six structural proteins, of which the Hemagglutinin is responsible for the efficient fusion to the cell membrane, allowing the virus entrance and replication in susceptible animals. The Hemagglutinin protein is responsible for the virus binding to the SLAM and Nectin-4 proteins present on the host cell membrane to start the infection process. This biochemical mechanism is then used to develop vaccines. However, due to the Hemagglutinin amino acid sequence being highly variable in several countries, animals that are vaccinated develop CDV symptoms. To evaluate this low vaccine efficiency in Brazil, this study explores the genetic and molecular basis to understand the differences in the Hemagglutinin phylogenetic profile compared to the vaccine strains. Specifically, Hemagglutinin, SLAM, and Nectin-4 interaction regions are compared to find amino acid mutations responsible for this behavior. For this purpose, a set of molecular modelling programs and protocols was used. Phylogenetic analysis of 102 Hemagglutinin genes highlighted the distances between several groups from the vaccine and the Brazilian strains. To understand the virus recognition specificities, a set of eighteen new tridimensional structures of this receptor was proposed - eleven Brazilian and seven vaccine strains. Despite the high structural similarities, the conformational comparison shows important differences in amino acids on the Hemagglutinin interaction site with SLAM and Nectin-4. Clearly, this lack of the strains circulating in Brazil and the commercial vaccine may explain the protocol failures due to the absence of specific antibodies in the animals to recognize most local CVD, thus evidencing the need for biotechnological efforts to produce vaccines considering a wider range of strains.

To better inform pneumococcal immunization policies, ongoing surveillance for pneumococcal community-acquired pneumonia (CAP) is crucial. To estimate the serotype-specific CAP burden of pneumococcal disease following the introduction of a new 15-valent pneumococcal conjugate vaccine (PCV), V114, a 15-plex serotype-specific urine antigen detection (SSUAD) assay was developed as a tool for surveillance of Streptococcuspneumoniae serotypes. V114-017 (NCT03547167; EudraCT 2017-004915-38) was a phase 3 randomized controlled trial in which participants (18-49 years) received V114 or 13-valent PCV (PCV13; as an active comparator), followed 6 months later by 23-valent pneumococcal polysaccharide vaccine (PPSV23). Here, we report findings from a prespecified sub-study nested within the phase 3 trial that descriptively assessed the impact of nasopharyngeal/oropharyngeal (NP/OP) carriage and pneumococcal vaccination on serotype detection with the SSUAD assay. In total, 301 individuals (all American Indian/Alaska Native) participated in the sub-study. NP/OP and urine samples were collected at 10 timepoints between baseline (prior to vaccination) and Month 7 (30 days following vaccination with PPSV23). NP/OP carriage was determined using qualitative polymerase chain reaction for pneumococcus detection and serotyping, and urine samples were tested in parallel with SSUAD. At any timepoint, NP/OP carriage was <2.0 % for 10 of the V114 serotypes; carriage was ∼2.6 % for serotype 1 and ranged between 4.0 % and 7.0 % for serotypes 4, 5, 9V, and 33F. At baseline, serotype-specific pneumococcal polysaccharide antigens were detected by SSUAD in only six study participants for serotypes 19A, 19F, and 1. SSUAD positivity for serotypes 4, 5, and 9V increased transiently following vaccination with V114/PCV13 and PPSV23, while SSUAD positivity lasted the longest for serotype 19A following PPSV23 vaccination. In general, SSUAD positivity appeared unrelated to NP/OP carriage. Our findings suggest SSUAD can support pneumococcal disease surveillance and vaccine effectiveness research, excluding individuals with recent pneumococcal vaccination to avoid false-positives.

Despite evidence that maternal vaccines can contribute to reduction of neonatal infections, vaccine hesitancy is a challenge in many low- and middle-income countries like Uganda. We conducted in-depth interviews with pregnant women and focus group discussions with breastfeeding women who were part of a Group B Streptococcus (GBS) clinical trial. We explored the women's concerns about vaccination and their reasons for being hesitant to take vaccines before they joined the trial. Women aged 18-39 were randomly selected from follow-up lists during the study period. Data were analysed thematically. All the women had been hesitant about joining the trial because of fear of possible vaccine side effects. A lack of knowledge on maternal vaccines, rumours and stigma in the community as well the need to follow study procedures were other concerns. Several women were concerned about their male partner view of their trial participation because using a trial vaccine meant taking a decision on behalf of the foetus. Pregnant women's involvement in clinical trials of maternal immunisation requires engagement with their families and community stakeholders, including local leaders and health workers, to ensure people understand what maternal vaccines are and why trials with pregnant women are required.

Background: There is limited data regarding SARS-CoV-2 vaccine uptake in people with HIV (PWH) compared to people without HIV (PWoH).

Methods: Swedish nationwide study of individuals born 1930-2003, assessing SARS-CoV-2 vaccine uptake of 1-5 doses by HIV-status from first SARS-CoV-2 vaccination (2020-12-27) until 2023-02-23. PWH were categorized by prioritization: clinically vulnerable (CD4+ T-cells <50cells/μL, recent opportunistic disease, or CD4+ T-cells <200 in combination with detectable HIV-RNA > 200copies/mL), and not prioritized (non-vulnerable PWH). Relative risks (adjRR) for doses 1-5 were estimated using modified Poisson regression, adjusted for sociodemographics, SARS-CoV-2 infections, and comorbidities.

Results: 7233 non-vulnerable PWH, 435 clinically vulnerable PWH, and 8,168,340 PWoH were included. While unadjusted 3-dose uptake was lower in both PWH groups compared to PWoH, adjusted analysis showed higher uptake in non-vulnerable PWH (adjRR1.17, 95 % CI 1.15-1.19), with similar trends in clinically vulnerable. An interaction between country of birth and HIV-status was identified (p < 0.001). Migrants with HIV had higher 3-dose uptake vs. migrants without HIV, but were less likely vaccinated than Swedish-born with HIV. Among people ≥65 years old, PWH were less likely to receive 3 or more doses compared to PWoH ≥65 years (dose 5: adjRR 0.90, 95 % CI 0.85-0.96).

Conclusions: We found lower vaccination uptake in migrants, irrespective of HIV-status, consistent with previous studies. Most concerningly we identified a lower vaccine uptake among people with HIV who were 65 years or older. This nationwide study highlights the need for targeted vaccination strategies and interventions that address both HIV-status and demographic factors.

Introduction: Vaccine misinformation has been increasingly pervasive since the COVID-19 pandemic. It was a particular challenge among Arabic-speaking communities during vaccine roll-out. This study explored the content, context and mechanisms of vaccine misinformation beliefs and dissemination among the Arabic-speaking community in Victoria, to inform the adaptation of the Cranky Uncle - Vaccine (Arabic) online misinformation inoculation game.

Methods: This qualitative study involved exploratory community focus groups and intervention adaptation workshops. Using convenience sampling, the project's Advisory Group disseminated flyers to Arabic-speaking communities through their networks, in-person and online. Semi-structured discussions used the transcendental (descriptive) phenomenological approach to explore the 'who, 'what', 'where', 'when' of vaccine misinformation dissemination to inform intervention adaptation and utility. Data were combined and inductively thematically analysed.

Results: Four online focus group discussions were held with 16 women (16-70+ years) in total. Sixty-five participants (n = 45 female, 16-70+ years) attended one of two face-to-face workshops. Arabic translators assisted in three focus groups and both workshops. Misinformation about COVID-19 vaccines (but not other vaccines) was easily recalled, and the content aligned with misinformation topics identified elsewhere, e.g. vaccine concerns and conspiracy theories. Regarding context, the information context theme reflected an information gap that encouraged individuals to seek out vaccine information via unofficial sources. The personal context theme was of fear and uncertainty of the vaccine's side effects, and secondarily of mistrust in authorities. In terms of dissemination mechanisms, misinformation was shared through friends and family and was image-based, making it accessible regardless of written or social media literacy. Misinformation was believed when it filled information gaps, was emotive and reinforced fears and beliefs.

Discussion: The findings support the utility of the Cranky Uncle - Vaccine (Arabic) game in inoculating key audiences. The community-centred approach to game adaptation makes it relatable and directly relevant to audiences' vaccine beliefs and concerns.

Background: People infected with human immunodeficiency virus (HIV) are more likely to be infected with hepatitis B virus (HBV), which is a significant public health concern. It is essential to provide protection through the hepatitis B vaccine and to stimulate higher and more sustained levels of anti-HBs antibodies to ensure long-term immunity. We aimed to enhance the duration of immunogenicity by implementing high-dose and multiple-schedule hepatitis B vaccination in adults infected with HIV.

Methods: This open-label, parallel-group, randomised controlled trial (RCT) was conducted between May 2020 and January 2021 at the Second Hospital of Yuncheng. Patients were randomised to receive 3 or 4 doses of 20 μg or 60 μg of hepatitis B vaccine. The follow-up period was extended to 2022 to evaluate the duration of immunogenicity.

Results: The geometric mean concentration (GMC) and response rates of hepatitis B surface antibody (anti-HBs) at month 18 were 200.40 mIU/ml and 66.67 % (58/87) in the IM20 × 3 group, 382.20 mIU/ml and 75.58 % (65/86) in the IM20 × 4 group, 628.50 mIU/ml and 83.13 % (69/83) in the IM60 × 4 group, which were significantly different between the IM20 × 3 and IM60 × 4 groups (P < 0.017). In multivariate analysis, gender and vaccination regimens affected the duration of immunogenicity at month 18. Regarding the multiplicative scale, the interaction effect was significant between the male and the IM60 × 4 group after adjusting for confounders.

Conclusion: In the one-year follow-up (month 18) of adults infected with HIV, four triple doses regimen of hepatitis B vaccine improved the duration of immunogenicity in male patients.