Vaccine[JOURNAL]
Sun
200 papers
Intranasal influenza vaccination using an outer membrane vesicle platform.
Magnusson AC, Lim S, Niemi C … +4 more , Wolf N, van den Berg van Saparoea B, Martina B, Lundgren M
Vaccine · 2026 Jun · PMID 42361782 · Publisher ↗
Influenza A vaccines have been used successfully for a long time to prevent disease, but most vaccines are produced using egg-based technologies that cause long production lead times and challenges to match circulating i...
Influenza A vaccines have been used successfully for a long time to prevent disease, but most vaccines are produced using egg-based technologies that cause long production lead times and challenges to match circulating influenza strains. Furthermore, these vaccines are often given as intramuscular injections, which induce systemic immune responses but limited mucosal immunity. Mucosal vaccination strategies have been developed to prevent various air-borne respiratory infections, including influenza. An influenza A vaccine candidate was developed based on Outer Membrane Vesicles (OMVs) derived from genetically engineered bacteria. A plug-and-play-like technology allows for high-density covalent decoration of these OMVs with recombinant antigens to generate highly immunogenic mucosal vaccines. In the present study, the OMV-platform was used for the development of an intranasal influenza A vaccine candidate. Influenza A/Puerto Rico/8/1934 (H1N1) (PR8) hemagglutinin (HA) was produced in HEK-293-F suspension cells and coupled to OMVs. The vaccine substance was purified and formulated in a buffer suitable for mucosal administration, PBS + 15% glycerol. Mice were vaccinated intranasally three times at two-week intervals, and the immune response, as well as protection against influenza virus challenge, was measured. Antigen-specific IgG could be measured after two vaccinations, and a strong induction of IgA was observed in both nasal lavage fluid and lung tissue. Furthermore, influenza virus was non-detectable in nasal lavage or lung tissue three days after viral infection in vaccinated animals. Clinical signs of influenza disease were also prevented by the vaccination, indicating a vaccine-induced protective response. CONCLUSION: The intranasal OMV influenza vaccine candidate induces a strong mucosal and protective immune response.
Updates on the research on nanocarriers in fish vaccine oral, immersion and injection delivery: A major review.
Wang WJ, Zhu Q, Zhi YX … +3 more , Huang MM, Fei H, Yang S
Vaccine · 2026 Jun · PMID 42349135 · Publisher ↗
Fish farming is facing severe challenges from frequent disease outbreaks with the intensification and high-density development of aquaculture. Vaccination, as a green and efficient disease prevention and control strategy...
Fish farming is facing severe challenges from frequent disease outbreaks with the intensification and high-density development of aquaculture. Vaccination, as a green and efficient disease prevention and control strategy, relies heavily on delivery efficiency for its effectiveness. Currently, fish vaccines are primarily administered through injection, immersion, and oral vaccination. However, challenges such as antigen inactivation in water, degradation in the digestive tract after oral and immersion vaccination, and low mucosal adhesion and penetration efficiency have significantly limited the application of immersion and oral vaccines. Nanocarriers have emerged as a critical research direction for fish vaccine delivery due to their unique physicochemical properties, such as excellent biocompatibility, antigen protection capabilities, and mucosal adhesion. This review systematically summarizes the research progress on nanocarriers for fish vaccine delivery across different vaccination methods including oral, immersion, and injection, with a focus on analyzing the preparation methods, characteristics, and delivery efficacy of various nanocarriers for different vaccine types. The review further explores the current challenges and limitations in the field and provides insights into the future development directions of nano-delivery systems, promoting the green and sustainable development of aquaculture.
Public health impact and cost-effectiveness of adjuvanted RSVPreF3 vaccination among US adults aged 18-49 years at increased risk for severe RSV disease.
Singer D, La EM, Dubois de Gennes C … +4 more , Graham J, Grace M, Biundo E, Verelst F
Vaccine · 2026 Jun · PMID 42349134 · Publisher ↗
BACKGROUND: Adults with certain medical conditions (e.g., chronic pulmonary or cardiovascular disease, weakened immune systems) are at increased risk for severe respiratory syncytial virus (RSV) disease, which can have s...
BACKGROUND: Adults with certain medical conditions (e.g., chronic pulmonary or cardiovascular disease, weakened immune systems) are at increased risk for severe respiratory syncytial virus (RSV) disease, which can have substantial clinical and economic burden. This study evaluated the public health impact and cost-effectiveness of adjuvanted RSVPreF3 vaccination among United States (US) adults aged 18-49 years at increased risk for severe RSV disease. METHODS: A static, multicohort Markov model simulated adjuvanted RSVPreF3 vaccination versus no vaccination over 5 years, assuming the same uptake as influenza vaccines. The base-case population included adults aged 18-49 years with ≥1 of the following risk factors for severe RSV disease: asthma, coronary artery disease, heart failure, chronic kidney disease, diabetes, and/or severe obesity. Model inputs were informed by existing literature. The base-case analysis estimated incremental RSV cases, RSV-related healthcare resource use and deaths, discounted quality-adjusted life years (QALYs) lost, and incremental cost-effectiveness ratios (ICERs) from a societal perspective (direct and indirect costs). Sensitivity analyses assessed varying model inputs and parameter uncertainty, while scenario analyses estimated ICERs from a healthcare sector perspective (direct costs only) and among condition-specific subgroups. RESULTS: Overall, 7,957,333 of the total 24,260,162 increased-risk adults aged 18-49 years received adjuvanted RSVPreF3 vaccination, which was estimated to avoid 869,819 RSV cases over 5 years, including 303,924 RSV-related outpatient visits, 444 RSV-related deaths, and 20,540 QALY losses versus no vaccination. The corresponding ICER was $61,717 per QALY gained from the societal perspective. Scenario analyses estimated that adjuvanted RSVPreF3 vaccination was cost-saving or cost-effective among all condition-specific subgroups based on a hypothetical willingness-to-pay threshold of $150,000 per QALY gained. Results were robust across sensitivity analyses. CONCLUSIONS: Model findings suggest considerable potential public health benefits and cost-effectiveness of adjuvanted RSVPreF3 vaccination among US adults aged 18-49 years at increased risk for severe RSV disease.
Effectiveness of inactivated and live-attenuated influenza vaccines in children during the 2025-2026 influenza season with genetically distinct influenza A and B viruses.
Shinjoh M, Furuichi M, Sugimoto R … +25 more , Kawakami C, Abe K, Kusano C, Otsubo G, Tsumura Y, Tezuka M, Narabayashi A, Kamei A, Maeda N, Shibata A, Nishida M, Yoshida M, Tsunematsu K, Yamada G, Itaki R, Chiga M, Yamaguchi Y, Fukushima H, Yaginuma M, Tokita A, Iwatsuki-Horimoto K, Narumi S, Kawaoka Y, Sugaya N, Keio Pediatric Influenza Research Group
Vaccine · 2026 Jun · PMID 42349133 · Publisher ↗
As part of ongoing surveillance since the 2013/14 season, we evaluated influenza vaccine performance among children in Japan during the 2025/26 season, when subclade K A(H3N2) predominated. A test-negative design was app...
As part of ongoing surveillance since the 2013/14 season, we evaluated influenza vaccine performance among children in Japan during the 2025/26 season, when subclade K A(H3N2) predominated. A test-negative design was applied to hospitalized febrile children who underwent outpatient influenza testing at 16 hospitals. Among 1033 participants, vaccine uptake among test-negative controls was 38% (274/723) for inactivated influenza vaccine (IIV) and 5% (35/723) for live-attenuated influenza vaccine (LAIV). Adjusted VE against influenza A was estimated at 43% (95% CI: 15-62) for IIV (N = 922) and 81% (95% CI: 15-96) for LAIV (N = 640), although the number of LAIV recipients was relatively small. No significant protection was observed against influenza B. These findings indicate that both vaccines remained effective against influenza A, despite circulation of genetically distinct influenza A viruses. Continued surveillance is warranted to further clarify comparative effectiveness between vaccine types as LAIV uptake increases.
Safety and immunogenicity of a genetically inactivated stand-alone acellular pertussis vaccine as a booster to Australian adults: a randomized, controlled, non-inferiority trial.
Ong MM, van den Biggelaar AHJ, Goh L … +8 more , Hutton H, Fortuna L, Yuwaree V, Kerdsomboon C, Mansouri S, Thai PH, Richmond PC, Wadia U
Vaccine · 2026 Jun · PMID 42349132 · Publisher ↗
INTRODUCTION: Waning immunity after acellular pertussis (aP) vaccines shown in pertussis outbreaks highlights the need for more effective aP vaccines. We evaluated the immunogenicity and safety of a stand-alone 2-compone...
INTRODUCTION: Waning immunity after acellular pertussis (aP) vaccines shown in pertussis outbreaks highlights the need for more effective aP vaccines. We evaluated the immunogenicity and safety of a stand-alone 2-component aP vaccine (aP) containing genetically inactivated pertussis toxin (PT) and filamentous hemagglutinin (FHA) compared with a licensed 3-component Tdap vaccine (Tdap) containing chemically inactivated PT, FHA, and pertactin (PRN) in adults. METHODS: This randomized controlled trial enrolled 102 healthy Australian adults aged 18-30 years. Participants were randomized 2:1 (aP: Tdap) with stratification for priming in infancy with whole-cell (wP) or aP vaccines. Immunogenicity was assessed measuring serum PT-IgG, FHA-IgG and PT-neutralizing antibodies (PTNA) at baseline, Day-28 and 1-year post-vaccination. Seroconversion was defined as ≥4-fold rise in antibody titers from baseline. Safety was monitored throughout. RESULTS: Day 28 seroconversion rates for PT-IgG were 98.5% (95% CI 91.7-100.0) for aP and 82.4% (65.5-93.2) for Tdap (Δ, absolute difference = 16.1%) and for FHA-IgG 87.7% (77.2-94.5) for aP and 61.8% (43.6-77.8) for Tdap (Δ25.9%), meeting the pre-defined seroconversion non-inferiority margin of > - 10%. Geometric mean concentrations/titers of PT-IgG and PTNA were significantly higherin the aP group compared to Tdap at 28 days (PT-IgG 132.70 IU/mL vs. 57.42 IU/mL, p = 0.0001; PTNA 146.97 IU/mL vs. 69.32 IU/mL, p = 0.0010) and 1-year post-vaccination (PT-IgG 27.61 IU/mL vs. 12.51 IU/mL, p = 0.0099; PTNA 31.02 IU/mL vs. 15.70 IU/mL, p = 0.0100). Exploratory analysis showed aP elicited higher PT-IgG and PTNA titers in both wP- and aP-primed adults at both timepoints. Safety profiles were comparable between vaccines, with most adverse events being mild to moderate. Four serious adverse events were reported throughout the study, none of which were vaccine-related. CONCLUSION: These findings suggest that aP vaccine is safe and more immunogenic in adults compared with Tdap vaccine, supporting its use as a pertussis booster.
Personal vs professional HPV vaccination and screening among female healthcare workers in China.
Yang H, Gao X, Zhang R … +5 more , Pei C, Shi K, Li X, Zhu L, Dong Q
Vaccine · 2026 Jun · PMID 42349131 · Publisher ↗
BACKGROUND: Female healthcare workers (FHCWs) play a key role in promoting HPV vaccination and cervical cancer screening, yet their own preventive behaviors may not align with their professional recommendations. This stu...
BACKGROUND: Female healthcare workers (FHCWs) play a key role in promoting HPV vaccination and cervical cancer screening, yet their own preventive behaviors may not align with their professional recommendations. This study aimed to assess the dissociation between personal uptake and professional promotion of HPV vaccination and cervical cancer screening among FHCWs in China. METHODS: A cross-sectional survey was conducted among 7149 FHCWs in gynecology and obstetrics across 31 provinces in China in 2024. A unified Bayesian network simultaneously modeled four outcomes: own HPV vaccination, own cervical cancer screening within 3 years, and recommendation of vaccination and screening to patients. Bootstrap resampling (1000 replicates) and conditional independence tests assessed the stability and significance of each predictor. RESULTS: Among 7149 FHCWs, 45.3% were vaccinated, 80.8% had been screened within 3 years, 75.2% recommended vaccination to patients, and 83.1% recommended screening to patients. For personal behavior, age was the sole direct parent (100% bootstrap; p < 10). For recommendation behavior, profession was directly associated with vaccination recommendation (100% bootstrap; p < 10) and screening recommendation (86.0% bootstrap; p < 10); physicians recommended vaccination to 87.2% of patients versus 67.6% for nurses (p < 10), despite similar personal vaccination rates (43.8% vs 46.2%; p = 0.052). HPV knowledge was associated with vaccination recommendation (86.9% bootstrap; p < 10) but not personal vaccination (36.1% bootstrap). Cervical cancer risk factor knowledge was associated with screening recommendation (83.4% bootstrap; p < 10). CONCLUSION: Knowledge and profession were associated with what FHCWs recommend to patients but were not associated with their own vaccination or screening. Increasing FHCW vaccination requires structural interventions. Increasing patient uptake requires improving knowledge and recommendation practices among FHCWs, particularly nurses.
Factors associated with COVID-19 vaccine acceptance among refugee women at Dzaleka refugee camp in Malawi.
Gondwe KW, Hearst MO, Mbutuka HR … +9 more , Khwepeya M, Abusbaitan H, Hoffman SJ, Nyondo-Mipando AL, Dressel AE, Eyadat A, Jaman PB, Lopez AA, Mkandawire-Valhmu L
Vaccine · 2026 Jun · PMID 42335759 · Publisher ↗
BACKGROUND: In 2020, the COVID-19 pandemic had a significant impact on healthcare systems worldwide, with varying effects depending on location and socioeconomic status. Two of the challenges faced were the limited avail...
BACKGROUND: In 2020, the COVID-19 pandemic had a significant impact on healthcare systems worldwide, with varying effects depending on location and socioeconomic status. Two of the challenges faced were the limited availability of COVID-19 vaccines and the slow uptake of those vaccines. Women refugees are uniquely vulnerable during migration, experiencing gender-based violence, which is associated with poor health outcomes related to gender inequality. However, there is limited literature on COVID-19 vaccination decision-making among refugee women in refugee camps, particularly in African countries such as Malawi. The purpose of this analysis was to examine COVID-19 vaccination acceptance and to explore factors associated with COVID-19 vaccination status among refugee women of childbearing age. METHODS: This was a descriptive-correlational study conducted at Dzaleka Refugee Camp in Malawi. We recruited 296 women of childbearing age. A survey was used to collect data on participant characteristics, COVID-19 vaccination status, and the reasons for their immunization status. We used descriptive statistics to analyze participants' characteristics and vaccine status. We used regression analysis to examine the characteristics of participants associated with their COVID-19 vaccination status. RESULTS: Results showed that 76% of the women had received at least one COVID-19 vaccine, with more than half fully vaccinated. Vaccine hesitancy was associated with having fewer children and less education. Open-ended questions revealed that women feared of infertility, death, unknown adverse effects, and partner influence were among the factors that deterred them from receiving the COVID-19 vaccine. CONCLUSION: Refugee women in Malawi had high COVID-19 vaccine uptake. Malawi's high immunization rates are the result of successful, informative immunization campaigns and supportive healthcare workers, who have positively influenced COVID-19 vaccine uptake among refugee women of childbearing age. Despite having high COVID-19 vaccination rates, barriers to vaccine uptake persist due to a lack of accurate information and concerns about the safety of the new vaccine. Healthcare workers must continue to engage communities in information dissemination campaigns to foster trust and ensure that accurate information is shared.
Burden of infection and hospitalization from respiratory syncytial virus-associated acute lower respiratory tract infections in Chinese children: Modeling of national, regional, and provincial estimates.
Liu Z, Wang X, Hu Y … +7 more , Duan X, Xu S, Ge Q, Zhu W, Zhao J, Yao Y, Wang W
Vaccine · 2026 Jun · PMID 42335758 · Publisher ↗
BACKGROUND: Respiratory syncytial virus (RSV) is a major cause of acute lower respiratory tract infections (ALRIs) in children. To guide policymaking on controlling RSV-associated ALRIs (RSV-ALRIs) in China, we estimated...
BACKGROUND: Respiratory syncytial virus (RSV) is a major cause of acute lower respiratory tract infections (ALRIs) in children. To guide policymaking on controlling RSV-associated ALRIs (RSV-ALRIs) in China, we estimated the national, regional, and provincial burdens of RSV-ALRIs and associated hospitalizations for children under 5 years old. METHODS: We systematically identified publications about RSV-ALRIs in China with epidemiological data before 2020. We compared seasonality data from this period with data during the COVID-19 epidemic. We built a dataset to assess RSV-ALRI burden by age and region, using a generalized linear mixed-effects model and a conceptual proportionality framework to assess hospitalization rates. A risk factor-based model were used to estimate regional and provincial RSV-ALRI incidence. FINDINGS: Children aged 0 to 12 months had the highest risk of RSV-ALRI and associated hospitalization. Provincial variations existed, with some southern provinces exhibiting higher incidence and some western provinces higher hospitalization rates. The COVID-19 epidemic shifted RSV hospitalization peaks to early autumn (Guangdong, Shanghai), whereas Hubei and Shandong demonstrated delayed peak onset compared with the pre-pandemic period. INTERPRETATION: Our study of the burden RSV-ALRIs in China identified obvious heterogeneity by age and region. These findings highlight the need for targeted RSV vaccination strategies and resource allocation prioritizing high-risk groups and areas. FUNDING: This work was supported by the Shanghai Municipal Science and Technology Major Project (Grant No. ZD2021CY001), the National Natural Science Foundation of China (Grant No. 82073612), and Shanghai New Three-year Action Plan for Public Health (GWVI-1, GWVI-11.1-03 and GWVI-11.1-01).
Purified gamma-irradiated influenza A vaccine demonstrates high immunogenicity and protection against a drifted H1N1 strain.
Couto Moniz M, Luo S, Krokhin A … +5 more , Egorov A, Davies JB, Saint D, Comerford I, Alsharifi M
Vaccine · 2026 Jun · PMID 42330776 · Publisher ↗
Although vaccination is recognised as the optimal method to reduce the health burden associated with influenza virus infections, current vaccines regularly demonstrate low efficacy despite annual reformulation. To addres...
Although vaccination is recognised as the optimal method to reduce the health burden associated with influenza virus infections, current vaccines regularly demonstrate low efficacy despite annual reformulation. To address the critical need for a more effective vaccine, our group has developed a gamma-irradiated influenza A virus (IAV) vaccine (γ-flu) and illustrated broad-spectrum immunity against drifted and heterosubtypic IAV infections following intranasal vaccination. For clinical development, highly purified vaccine preparations based on clinically relevant IAV isolates are required. Here, we report the structural integrity of a highly purified γ-flu preparation based on A/Brisbane/02/2018-like H1N1pdm09, which was included in recent World Health Organisation (WHO) recommendation for seasonal vaccine formulation. To illustrate immunogenicity and protective efficacy, mice were vaccinated twice via intramuscular injections using low doses of purified γ-flu and challenged with a lethal dose of drifted IAV strain. Analysis of immune serum from vaccinated animals showed significant neutralising antibody responses against both homotypic and closely related drifted IAV strains compared to sera from control unvaccinated mice. This high immunogenicity was also associated with significant protection against a lethal challenge with drifted IAV strain. Overall, this study illustrates the structural integrity and immunogenicity of a highly purified γ-flu vaccine preparation suitable for clinical development.
Vaccine coverage and quarantine during a school-based measles outbreak, South Carolina, USA, 2025-2026.
Chen S, Hupert N, Bento AI
Vaccine · 2026 Jun · PMID 42330775 · Publisher ↗
Abstract loading — click title to view on PubMed.
Comparison of immunogenicity of mRNA and protein subunit SARS-CoV-2 vaccines in dialysis patients: a multicenter study.
Morio R, Takazono T, Morimoto S … +11 more , Ashizawa N, Hirayama T, Yoshida M, Takeda K, Hirano K, Ide S, Iwanaga N, Hosogaya N, Funakoshi S, Yanagihara K, Mukae H
Vaccine · 2026 Jun · PMID 42322683 · Publisher ↗
Patients on maintenance hemodialysis (HD) have impaired immune function and are at high risk of severe COVID-19; however, comparative data on immunogenicity and vaccine choice behavior between mRNA and protein subunit SA...
Patients on maintenance hemodialysis (HD) have impaired immune function and are at high risk of severe COVID-19; however, comparative data on immunogenicity and vaccine choice behavior between mRNA and protein subunit SARS-CoV-2 vaccines remain limited. In this observational study, 227 participants (202 patients on HD and 25 non-dialysis individuals) received either an mRNA vaccine (BNT162b2) or a protein subunit vaccine (NVX-CoV2373) in 2024 vaccination season. Anti-SARS-CoV-2 spike antibody levels were assessed at weeks 0, 4, and 24, with week 4 defined as the primary outcome and week 24 as a secondary time point for longer-term persistence; the association between previous adverse events and vaccine choice was evaluated. At week 4, BNT162b2 induced significantly higher antibody levels than NVX-CoV2373 in patients on HD. BNT162b2 also induced significantly higher antibody levels than NVX-CoV2373 in non-dialysis individuals. Antibody levels declined by week 24 in both vaccine groups, although differences in antibody levels were observed up to week 24. Previous adverse events did not deter selection of BNT162b2 (OR 8.08, 95% CI 0.98-66.5), although this association may reflect participant perceptions or other unmeasured factors. Non-dialysis subgroup with limited number of patients also showed higher antibody levels in the BNT162b2 group. These findings suggest that BNT162b2 is associated with higher anti-spike antibody levels at predefined post-vaccination time points in patients on HD. However, these findings should be interpreted cautiously because clinical outcomes and formal antibody decay modeling were not evaluated.
Evaluation of immunogenicity and efficacy of a Plasmodium vivax nanoparticle vaccine in mice.
Ntumngia FB, Kolli SK, Howard GP … +12 more , Subramani PA, Barnes SJ, Ogbondah MM, Mahdavi P, Lu J, Nicholas J, De SL, Barnes BB, Dinglasan RR, Janse CJ, Mao HQ, Adams JH
Vaccine · 2026 Jun · PMID 42322682 · Publisher ↗
BACKGROUND: Plasmodium vivax malaria is an increasing global health threat and the second leading cause of malaria globally. An efficacious vaccine aimed at preventing disease and transmission would greatly facilitate ma...
BACKGROUND: Plasmodium vivax malaria is an increasing global health threat and the second leading cause of malaria globally. An efficacious vaccine aimed at preventing disease and transmission would greatly facilitate malaria elimination. The P. vivax circumsporozoite protein (PvCSP) is considered a leading pre-erythrocytic stage vaccine target. While P. falciparum malaria vaccines currently in clinical use have CSP as the critical component, their limited efficacy and the need for multiple doses continue to pose challenges for malaria vaccines. This study evaluated a novel customized size-tuned nanoparticle production and conjugation protocol co-displaying PvCSP with a TLR agonist as a vaccine platform to induce sporozoite-neutralizing antibodies to prevent sporozoite infection of hepatocytes. METHODS: The immunogenicity and efficacy of a P. vivax CSP nanoparticle vaccine (NPV) were evaluated in BALB/c mice. Vaccine-induced antibody titers were assessed by standard ELISA, and their ability to inhibit sporozoite infection of hepatocytes was tested using transgenic P. berghei sporozoites expressing P. vivax CSP. RESULTS: The CSP-NPV elicited high-titer anti-CSP antibodies that significantly inhibited hepatocyte infection by transgenic P. berghei sporozoites expressing P. vivax CSP in vitro and partially protected mice following in vivo sporozoite challenge. CONCLUSIONS: These data validate NPVs as a suitable CSP vaccine delivery platform to prevent sporozoite infection. Its versatility makes it suitable for testing other PE vaccine antigens and adjuvants for the potential development of a multivalent vivax malaria vaccine.
Applying a human-centered design approach to increase immunization coverage and reduce the number of zero-dose children in Tshopo Province, Democratic Republic of the Congo: A costing analysis.
Sanogo M, Tendo-Bugondo C, Abedi M … +4 more , Kasongo DK, Rusangiza RK, Brenzel L, Debellut F
Vaccine · 2026 Jun · PMID 42322681 · Publisher ↗
The Democratic Republic of the Congo (DRC) is among the countries with the highest number of zero-dose and under-immunized children in the world. Tshopo Province, located in the North-Central area of the country, is part...
The Democratic Republic of the Congo (DRC) is among the countries with the highest number of zero-dose and under-immunized children in the world. Tshopo Province, located in the North-Central area of the country, is particularly impacted, with alarmingly low immunization rates and a proportion of zero-dose children higher than 60%. Innovative and targeted interventions are required to reach children missed by the immunization program. In collaboration with the DRC Ministry of Health, PATH implemented a human-centered design (HCD) project to co-create and test solutions that could help the community address the issue in four targeted health areas of Tshopo Province. As part of the project, we conducted a study to assess the incremental financial, opportunity, and economic costs of implementing the HCD approach and derived prototype interventions. The aim was to inform decision-makers and technical and financial partners about the economic viability of the HCD approach and its potential for scale-up, and to provide a basis for comparison with other strategies to improve immunization coverage. Using a microcosting, ingredients-based approach, we documented and valued all resources used during the project and reported cost per pre-defined activities and cost categories. Among the interventions implemented, the involvement of private health facilities in immunization activities resulted in a financial and economic cost per zero-dose child vaccinated with Penta 1 of US$16 and US$31 respectively; community engagement activities resulted in a financial and economic cost per zero-dose child identified of US$10 and US$17, respectively. The overall implementation costs of the interventions are expected to decrease after the initial design, testing, and refinement phrases are completed. Given these results, HCD-developed approaches may provide a feasible mechanism for identifying locally adapted strategies to improve childhood immunization coverage.
Influenza, pneumococcal, and herpes zoster vaccination in Italy: Knowledge, uptake, and determinants across the adult life course.
Levati E, Calvani R, Cacciatore S … +7 more , Tosato M, Galluzzo V, Ciciarello F, Salini S, Russo A, Marzetti E, Landi F
Vaccine · 2026 Jun · PMID 42322680 · Publisher ↗
BACKGROUND: Vaccinations are fundamental to maintaining healthy aging, contributing to the prevention, reduction of complications, functional decline, and mortality associated with different infectious diseases. Vaccinat...
BACKGROUND: Vaccinations are fundamental to maintaining healthy aging, contributing to the prevention, reduction of complications, functional decline, and mortality associated with different infectious diseases. Vaccination coverage rates for influenza, herpes zoster, and pneumococcal infection exhibit significant heterogeneity and frequently show suboptimal levels. The aim of this study is to evaluate awareness and self-reported vaccination coverage for influenza, herpes zoster, and pneumococcal vaccines among an adult Italian population. Furthermore, the study aims to delineate specific patterns within this population. METHODS: We analyzed data from the Look-Up 8+ project, which included adults aged 18 or more from various Italian regions. Participants completed a comprehensive lifestyle assessment and a structured interview regarding their influenza, pneumococcal, and herpes zoster vaccination habits. This included their level of awareness, whether they had received the vaccinations, and if not, the reasons behind their decision. Logistic regression models were used to examine the correlation between vaccination uptake and potential determinants. RESULTS: Among 4575 participants (mean age 54.9 ± 16.0 years; 55% women), awareness of influenza vaccination was consistently high (>90%), whereas awareness of pneumococcal and herpes zoster vaccination was substantially lower and more heterogeneous. Influenza vaccination uptake increased with age (80% in women aged ≥80 years). Pneumococcal vaccination prevalence remained low in younger adults and increased after 70 years of age. Herpes zoster vaccination uptake was low overall. In multivariable analyses, increasing age was independently associated with uptake of influenza (OR 1.04; 95% CI 1.03-1.04), pneumococcal (OR 1.02; 95% CI 1.01-1.03), and herpes zoster vaccination. Smoking status, regular physical activity, and diabetes were positively associated with influenza and pneumococcal vaccination, while female sex and physical activity were associated with herpes zoster vaccination. Across all vaccines, the most frequently reported reason for non-vaccination was the perceived lack of necessity (45-59%), followed by lack of confidence in vaccines (13-18%) and fear of side effects (10%). CONCLUSIONS: Despite recommendations, awareness of and coverage for pneumococcal and herpes zoster vaccination remain low. More effective vaccination policies incorporating tailored educational strategies are needed.
Half a century of pneumococcal vaccination in sickle cell disease: Are we winning the battle or losing immunity?
Jamwal S, Omene B, Giri A … +8 more , Rojas K, Mohanty S, Calhoun C, Krishnamurti L, Montgomery RR, Shaw AC, Andemariam B, Yildirim I
Vaccine · 2026 Jun · PMID 42322679 · Publisher ↗
Despite marked reductions in the rate of invasive pneumococcal disease (IPD) due to widespread use of penicillin prophylaxis and vaccination, individuals with sickle cell disease (SCD) remain at disproportionately high r...
Despite marked reductions in the rate of invasive pneumococcal disease (IPD) due to widespread use of penicillin prophylaxis and vaccination, individuals with sickle cell disease (SCD) remain at disproportionately high risk of pneumococcal infections. Pneumococcal conjugate vaccines (PCVs) have demonstrated improved immunogenicity over time by inducing T cell-dependent memory responses and have contributed significantly to reducing vaccine-type IPD in this population. However, persistent disease burden from non-vaccine serotypes and suboptimal antibody durability underscores the need for broader serotype coverage and a tailored immunization schedule. Until recently, the 23-valent pneumococcal polysaccharide vaccine (PPSV23) was recommended for individuals with SCD to expand serotype protection. However, numerous studies indicate that PPSV23 has limited effectiveness in immunocompromised populations, including SCD, and may induce hyporesponsiveness when administered repeatedly or when inappropriately sequenced with PCVs. The approval of higher-valency conjugate vaccines (e.g., PCV20 and PCV21) offers promise for expanding serotype coverage while minimizing reliance on PPSV23. Nonetheless, real-world data on immunogenicity, durability, and clinical efficacy in SCD remain sparse. This review examines the intricate immunological interactions between PCVs and PPSV23 in the context of SCD, with a focus on vaccine-induced hyporesponsiveness, serotype replacement, and the evolving epidemiology of pneumococcal disease. It highlights the need for optimized evidence-based vaccination strategies and longitudinal monitoring among patients with SCD. A precision vaccination approach tailored to the unique immunological deficits of individuals with SCD will be essential to ensure sustained and comprehensive protection against pneumococcal disease.
Clinical outcomes among SARS-CoV-2 omicron-infected adults according to prior infection and vaccination history in Iran: A retrospective registry-based study.
Torkaman-Asadi F, Bakhtiari S, Safarzadeh M … +4 more , Riahi-Rad Z, Riahi-Rad Z, Doosti Irani A, Ansari N
Vaccine · 2026 Jun · PMID 42322678 · Publisher ↗
BACKGROUND: Omicron subvariants of SARS-CoV-2 have challenged immunity derived from prior infection and vaccination. Evidence from Middle Eastern populations using heterogeneous vaccine platforms remains limited. We eval...
BACKGROUND: Omicron subvariants of SARS-CoV-2 have challenged immunity derived from prior infection and vaccination. Evidence from Middle Eastern populations using heterogeneous vaccine platforms remains limited. We evaluated associations between pre-existing immunity profiles and clinical outcomes among laboratory-confirmed Omicron-infected adults in Iran. METHODS: We conducted a retrospective registry-based study in Hamedan Province, Iran, including 4674 adults with laboratory-confirmed COVID-19 between March 2022 and March 2023. Participants were classified into four pre-existing immunity groups: no documented immunity (V - Inf-), vaccination only (V + Inf-), prior infection only (V - Inf+), and hybrid immunity (V + Inf+). The primary outcomes were hospitalization and mortality among infected individuals. Multivariable logistic regression models adjusted for age, sex, comorbidities, and calendar period corresponding to predominant Omicron subvariant circulation. RESULTS: Among infected individuals, hybrid immunity (V + Inf+) was associated with lower observed hospitalization and mortality than vaccination only (V + Inf-). Vaccination only was associated with the highest observed hospitalization and mortality proportions. Prior infection only (V - Inf+) was also associated with more favorable outcomes than vaccination only. Associations were attenuated after adjustment for age and clinical covariates but remained directionally consistent. CONCLUSIONS: Among adults with laboratory-confirmed Omicron infection, pre-existing hybrid immunity was associated with more favorable clinical outcomes than vaccination only. Because analyses were conditioned on infection, the findings should be interpreted as differences in outcomes among cases rather than protection against acquiring infection.
Outcomes in adult liver transplant patients receiving recombinant herpes zoster vaccine.
Henkes NC, Heien HC, Inselman JW … +2 more , Farraye FA, Keaveny AP
Vaccine · 2026 Jun · PMID 42322677 · Publisher ↗
INTRODUCTION AND OBJECTIVES: Immunosuppressed patients are at an increased risk of complications from herpes zoster (HZ). Recombinant HZ vaccine (RZV) is highly efficacious in preventing HZ in the general population. We...
INTRODUCTION AND OBJECTIVES: Immunosuppressed patients are at an increased risk of complications from herpes zoster (HZ). Recombinant HZ vaccine (RZV) is highly efficacious in preventing HZ in the general population. We sought to evaluate the real-world effectiveness of RZV in liver transplant (LT) recipients compared to those not immunized. METHODS: We identified patients with ≥2 LT diagnosis episodes using Optum Labs Data Warehouse from 1/1/2018 to 12/31/2024. The index date was defined as the earliest date of diagnosis code for transplant or the first date of RZV after identifying an LT patient. We divided the cohort into those with and without RZV and dropped patients who had HZ during the baseline. All patients were required to have continuous enrollment for at least 365 days pre-index and 90 days post. Competing risk analysis was performed where the primary outcome of interest was HZ, and mortality was the competing risk factor. RESULTS: We identified 3214 LT recipients of which 938 patients received RZV after the LT episode. The competing risk model found the RZV group was significantly less likely to develop HZ versus the non-RZV group (subdistribution hazard 0.54, p < 0.026). CONCLUSIONS: LT recipients not vaccinated had higher rates of HZ in the first three years compared with those who received RZV. Among LT patients, RZV helps improve patient care by effectively and simply reducing HZ while also reducing the risk of developing complications that may be associated with HZ.
Immunogenicity and protective efficacy of an inactivated cluster 2.1 duck Tembusu virus vaccine in ducks: Evidence of cross-genotype immune responses.
Rungprasert K, Areeraksakul P, Tunterak W … +9 more , Prakairungnamthip D, Wannaratana S, Yurayart N, Charoenvisal N, Limpavithayakul K, Jansen CA, Nedumpun T, Banlunara W, Thontiravong A
Vaccine · 2026 Jun · PMID 42320385 · Publisher ↗
Duck Tembusu virus (DTMUV) is an emerging flavivirus causing neurological disease and severe egg drop syndrome in ducks, resulting in significant economic losses across Asia. Most current DTMUV vaccine candidates are der...
Duck Tembusu virus (DTMUV) is an emerging flavivirus causing neurological disease and severe egg drop syndrome in ducks, resulting in significant economic losses across Asia. Most current DTMUV vaccine candidates are derived from cluster 2.2 Chinese strains, while vaccines targeting other circulating clusters, particularly those prevalent in Thailand, remain unavailable. Given the marked antigenic differences among DTMUV clusters, which may limit cross-protection, the development of region-specific vaccines is urgently needed. Here, we evaluated the immunogenicity and protective efficacy of a newly developed inactivated cluster 2.1 DTMUV vaccine using one- and two-dose regimens in ducks and assessed its ability to induce cross-genotype immune responses by measuring cross-neutralizing antibody responses and T-cell cross-reactivity against heterologous cluster 1 and/or cluster 3 viruses. Our results demonstrated that both vaccination regimens provided complete clinical protection against morbidity and mortality following lethal homologous cluster 2.1 DTMUV challenge. However, the two-dose regimen elicited stronger and more rapid anamnestic adaptive immune responses, conferred superior protection against pathological lesions, and more effectively reduced viral loads in target tissues and viral shedding compared with the one-dose regimen. Furthermore, the vaccine, particularly under the two-dose regimen, induced cross-reactive humoral and cellular immune responses to clusters 1 and/or 3; however, its ability to confer heterologous protection remains unknown and warrants further investigation through in vivo challenge studies. Taken together, these results highlight the inactivated cluster 2.1 DTMUV vaccine as a promising and effective candidate for homologous protection against cluster 2.1 DTMUV in ducks.
Bivalent foot-and-mouth disease virus mRNA vaccine induces well-balanced humoral and cellular immune responses.
Wang L, Li Z, Zhu H … +3 more , Jia X, Su Z, Zhang S
Vaccine · 2026 Jun · PMID 42320384 · Publisher ↗
Foot-and-mouth disease (FMD) poses a significant threat to global livestock industries due to its high viral contagiousness. Despite inactivated viral vaccines remaining effective, their production requires stringent bio...
Foot-and-mouth disease (FMD) poses a significant threat to global livestock industries due to its high viral contagiousness. Despite inactivated viral vaccines remaining effective, their production requires stringent biocontainment and faces limitations in stability and cross-serotype immunogenicity. Here, we developed a novel bivalent mRNA@LNP vaccine targeting FMDV serotypes A and O. The design incorporated optimized immunodominant epitopes from the VP1 protein, combined with a conserved T-cell epitope from 3A non-structural protein. We validated antigen expression in vitro and evaluated the immunogenicity of mRNA@LNP in mice. It elicited faster early immune activation and stronger humoral and cellular immune responses than the inactivated virus vaccine. Throughout the entire immunization period, the antibody levels induced by 5 μg mRNA@LNP were consistently equivalent to those of the 5 μg inactivated vaccine. Furthermore, the immune efficacy of the 10 μg mRNA dose following the booster vaccination was consistent to that of the ISA 206-adjuvanted inactivated vaccine. Liquid-blocking ELISA indicated that immunization of the mRNA@LNP induced strong blocking antibody titers against both serotype A(titer>256 at 5 μg) and serotype O(titer>128 at 10 μg). Antibody isotyping (high IgG2a/IgG1 ratio) and cytokine profiling (high IFN-γ) revealed a pronounced Th1-skewed immune response, consistent with enhanced GC B cell activation and CTL activation. In contrast, the ISA-206 adjuvanted vaccine induced a weaker cellular immune response and a more Th2-biased profile, highlighting the capacity of the mRNA vaccine to achieve not only comparable humoral immunogenicity to inactivated vaccines but also a more balanced and robust cellular immunity. These findings support mRNA vaccines as a promising, virus-free platform for multivalent FMD vaccines, offering potential solutions to current limitations and providing broader protection against FMDV outbreaks.
Burden of incomplete immunization and its determinants among children under five years in India: a systematic review and meta-analysis (2015-2025).
Gupta B, Shafi B, Gupta A … +4 more , Gupta K, Singla P, Singh T, Grover K
Vaccine · 2026 Jun · PMID 42320383 · Publisher ↗
BACKGROUND: Despite substantial improvements in childhood vaccination coverage under India's Universal Immunization Programme (UIP) and initiatives such as Mission Indradhanush, incomplete immunization remains a signific...
BACKGROUND: Despite substantial improvements in childhood vaccination coverage under India's Universal Immunization Programme (UIP) and initiatives such as Mission Indradhanush, incomplete immunization remains a significant public health challenge. This systematic review and meta-analysis aimed to estimate the pooled prevalence of incomplete immunization among children under five years in India and identify its major determinants. METHODS: A systematic search of PubMed/MEDLINE, Scopus, Web of Science, Embase, Cochrane Library, Google Scholar, IndMed, and grey literature was conducted for studies published between January 2015 and December 2025. Observational studies reporting prevalence and/or determinants of incomplete immunization among children aged 0-59 months in India were included. Random-effects meta-analysis with Hartung-Knapp-Sidik-Jonkman adjustment was performed. Heterogeneity was assessed using the I statistic, while publication bias was evaluated using contour-enhanced funnel plots, Egger's regression test, and Begg's rank correlation test. RESULTS: Forty-five cross-sectional studies involving more than 428,000 participants were included. The pooled prevalence of incomplete immunization was 26% (95% CI: 21%-32%), with substantial heterogeneity (I = 99.9%). Higher prevalence was observed in northern and multistate studies compared with southern and northeastern regions. Significant determinants of incomplete immunization included absence of an immunization card (OR 9.46, 95% CI: 3.28-27.28), non-institutional delivery (OR 3.59, 95% CI: 1.96-6.56), maternal illiteracy (OR 3.25, 95% CI: 2.22-4.78), low socioeconomic status (OR 2.03, 95% CI: 1.51-2.71), higher birth order (OR 1.88, 95% CI: 1.17-3.03), and female gender (OR 1.34, 95% CI: 1.06-1.69). Sensitivity analyses confirmed robustness of findings. CONCLUSIONS: Approximately one in four children in India remains incompletely immunized. Persistent socioeconomic, maternal, and healthcare access barriers contribute substantially to inequities in vaccination coverage. Strengthening institutional delivery, maternal education, immunization tracking systems, and targeted outreach for vulnerable populations is essential to achieve Immunization Agenda 2030 targets in India.
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