Journal Content Recommendation
01
The effect of pertussis vaccination in pregnancy on the immunogenicity of acellular or whole-cell pertussis vaccination in Gambian infants (GaPS): a single-centre, randomised, controlled, double-blind, phase 4 trial
This study, published in The Lancet Infectious Diseases, reports findings from the GaPS trial (NCT03606096), a single-centre, randomised, controlled, double-blind, phase 4 trial conducted in The Gambia. The trial investigated the impact of maternal immunisation with a tetanus-diphtheria-acellular pertussis-inactivated poliovirus vaccine (Tdap-IPV) during pregnancy on the immunogenicity of infant pertussis vaccinations. A total of 343 healthy, HIV-negative pregnant women were randomly assigned (1:1) to receive either Tdap-IPV or tetanus toxoid (TT) between 28 and 34 weeks of gestation. Their infants were then randomly assigned to receive three doses of either diphtheria-tetanus-acellular pertussis (DTaP) or diphtheria-tetanus-whole-cell pertussis (DTwP) vaccines at 8, 12, and 16 weeks of age. The primary outcome was the geometric mean concentration (GMC) of anti-pertussis toxin IgG antibodies at 20 weeks and 9 months of age.
The findings revealed that maternal Tdap-IPV vaccination led to a blunting of the infant’s pertussis-specific immune responses, especially in those who received the DTwP vaccine. At 20 weeks, DTwP-vaccinated infants born to Tdap-IPV-immunised mothers had significantly lower anti-pertussis toxin IgG levels compared to DTaP-vaccinated infants in the same maternal group (adjusted geometric mean ratio [GMR] = 0.28; 98.75% CI: 0.16–0.50), and this difference persisted at 9 months (GMR = 0.31; 98.75% CI: 0.17–0.55). Conversely, among infants born to TT-immunised mothers, those who received DTwP showed higher IgG levels at 9 months than those who received DTaP (GMR = 2.02; 95% CI: 1.15–3.55). In addition to reduced IgG levels, DTwP-vaccinated infants born to Tdap-IPV-vaccinated mothers also exhibited reduced neutralising activity (PTNA), bactericidal activity (SBA), total antibody binding, and memory B-cell responses. These effects were less pronounced in the DTaP group. However, the absolute immune responses in the DTwP group remained comparable to, and in many cases exceeded, those observed in the DTaP group. No differences in vaccine reactogenicity were observed between maternal vaccine groups, with the majority of adverse events graded as mild. No serious adverse events were attributed to vaccination.
The study concludes that maternal Tdap-IPV vaccination is safe and well tolerated in a sub-Saharan African setting and enhances early-life pertussis-specific antibody responses. Despite the observed blunting effects, DTwP-vaccinated infants retained functional immune responses, supporting the use of maternal pertussis immunisation in low- and middle-income countries to strengthen neonatal protection against pertussis.
https://doi.org/10.1016/S1473-3099(25)00072-6
02
Joint Scientific Statement on Vaccine Safety by the WHO Global Advisory Committee on Vaccine Safety (GACVS) and the Advisory Committee on the Safety of Medicinal Products (ACSoMP)
From November 12 to 14, 2024, the World Health Organization (WHO) Global Advisory Committee on Vaccine Safety (GACVS), in collaboration with the Advisory Committee on the Safety of Medicinal Products (ACSoMP), released its latest systematic assessment report on the safety of vaccines and medicines.
The report reviewed the safety data of the respiratory syncytial virus (RSV) maternal vaccine Abrysvo® and proposed strategic recommendations for global monitoring and risk management. The findings indicated a slight but statistically significant increase in preterm birth risk among vaccinated groups in some regions (e.g., South Africa). However, no such association was observed in high-income countries. According to the benefit–risk modeling analysis, assuming a 98% vaccination coverage rate among pregnant women at 27–36 weeks of gestation, the protective benefits to infants outweigh the potential risks. Real-world data from the United States also showed a similar rate of preterm birth among RSV-vaccinated pregnant women (4.0%) compared to unvaccinated individuals (4.5%), with no concerning safety signals detected. To further support global rollout, Pfizer has launched four post-marketing, non-interventional safety studies, covering both pregnant women and high-risk adults. The company will also assess the potential impact of maternal immunization on low birth weight and preterm birth outcomes across four African countries.
The report also underscored the regional disparities and data gaps in safety evidence related to maternal vaccination, especially in low- and middle-income countries (LMICs), highlighting the urgent need to strengthen surveillance. The committee recommends that countries establish baseline data for adverse pregnancy outcomes, implement targeted surveillance of high-risk pregnant women (such as those with hypertensive disorders or immunocompromising conditions), and enhance the capacity to identify and analyze adverse events following immunization (AEFI)—especially in the context of co-administration of vaccines—in order to improve national maternal vaccine safety surveillance systems.
https://iris.who.int/bitstream/handle/10665/380714/WER10010-eng-fre.pdf
03
Perceived feasibility of a multicomponent prenatal intervention on childhood vaccinations: Findings from a national cross-sectional survey of prenatal care providers, April–June 2022
This article, published in the International Journal of Gynecology & Obstetrics, aimed to assess the feasibility of promoting childhood vaccine confidence through prenatal care services. It systematically evaluated prenatal care providers’ attitudes toward the implementation of a multicomponent intervention and identified potential barriers. A national cross-sectional survey was conducted among members of prenatal care professional organizations in the United States from April to June 2022.
The study proposed a three-component intervention: (1) a standardized prenatal provider recommendation for childhood vaccination in accordance with clinical guidelines; (2) an interactive educational website integrating evidence-based content on vaccine safety, schedules, and navigation of available resources; (3) access to a vaccine navigator via phone during pregnancy to address individualized concerns. Intervention feasibility was quantified using an adapted Feasibility of Intervention Measure (FIM), and key determinants of implementation were identified using multivariable logistic regression.
Among the 495 respondents included in the analysis, 65.1% agreed that it is important to discuss vaccinations during prenatal care, yet only 46.7% felt confident in their ability to influence patients’ vaccination decisions. In terms of perceived feasibility, the educational website component received the highest agreement (71.4%–75.2%), followed by provider recommendation (54.0%–59.7%) and the vaccine navigator (53.9%–56.7%). The top three perceived barriers to implementation were insufficient staffing (48.0%), limited time during visits (47.8%), and inadequate training on childhood vaccines (45.4%). Conversely, 57.7% of providers identified the availability of high-quality patient education materials as a key facilitator.
The study concluded that the proposed multicomponent intervention was perceived as feasible within prenatal care settings. To support successful implementation, it is critical to provide supportive strategies that alleviate time and staffing burdens and enhance providers’ communication skills and confidence in addressing childhood vaccination. These findings support further efforts to integrate childhood vaccination promotion into routine prenatal care as part of a broader strategy to address vaccine hesitancy and improve immunization coverage.
https://doi.org/10.1002/ijgo.15970
04
Insights from national stakeholders and health workers on learning and performance interventions in immunisation programs: a multi-country situational analysis
This article, published in the Journal of Global Health, systematically analyzed the influencing factors of learning performance improvement among health workers in immunisation programs across seven Gavi-supported countries (Pakistan, Kenya, South Sudan, Burkina Faso, Ghana, Tanzania, and Zambia). Using a mixed-methods approach, the study conducted field investigations from April to May 2022, including in-depth interviews with 38 policy-makers and surveys with 215 frontline personnel.
The findings revealed that traditional in-service training remains dominant, while the application of digital learning technologies has rapidly increased, though the evidence on its effectiveness remains limited. Career advancement emerged as the strongest motivational factor; however, there is a disconnect between training and professional development pathways. Key barriers included workforce shortages, limited training opportunities, and weak digital infrastructure. Quality improvement teams and collective problem-solving mechanisms were identified as effective learning strategies to enhance practical competencies, whereas newer approaches such as e-learning require further evidence to validate their impact.
The study recommends that policymakers prioritize evidence-based, integrated intervention strategies that combine multiple learning modalities to improve service delivery performance. Furthermore, it is critical to strengthen the evaluation of both existing and emerging learning interventions to promote evidence-based practices. Ensuring that resource allocation aligns with intervention effectiveness will be essential for optimizing learning systems for health workers globally.
https://doi.org/10.7189/jogh.15.04109
05
Using an Electronic Immunization Registry (Aplikasi Sehat IndonesiaKu) in Indonesia: Cross-Sectional Study
This study, published in the Interactive Journal of Medical Research, systematically evaluated the implementation of Indonesia’s first national electronic immunization registry—Aplikasi Sehat IndonesiaKu (ASIK). Using a cross-sectional survey design, the study leveraged real-time data collection and structured analysis to comprehensively examine ASIK’s deployment across 10,382 primary health care centers.
The findings demonstrated rapid and extensive adoption of the ASIK system in a short period: among the 34 provinces in Indonesia, 93.5% of primary health centers, 93.5% of subdistricts, and 97.5% of districts reported immunization data through ASIK, with more than 21 million data entries recorded. System monitoring data showed that national coverage rates for the measles–rubella vaccine, oral poliovirus vaccine (OPV), inactivated poliovirus vaccine (IPV), and the DTP–HepB–Hib combination vaccine were 50.1%, 36.2%, 30.7%, and 40.2%, respectively. Survey results indicated that 80.3% of users reported being proficient in using the ASIK system; 61.7% agreed that the system interface and user experience were generally positive though still needed improvement; 54% stated that the variable settings generally met operational needs but required further refinement; and 59.1% reported having experienced occasional system outages.
The study concluded that ASIK, as Indonesia’s first nationwide electronic immunization registry, significantly improved the timeliness and accuracy of immunization data. However, challenges remain, including the dual-recording burden for health workers, the digital divide across regions, and the lack of full system integration. The study highlighted that continued technological optimization, enhanced intersectoral collaboration (e.g., data integration with the Ministry of Home Affairs), and the establishment of a unified digital reporting workflow are key to ensuring the successful implementation and sustainability of electronic immunization registries in resource-limited settings.
06
The impact of influenza vaccination on the risk of influenza-associated hospitalizations and complications among over two million older adults: a study using a target trial emulation framework
This study, published in BMC Medicine, evaluated the clinical effectiveness of influenza vaccination in adults aged 65 years and older during the 2018–2019 influenza season in Taiwan, China, using a target trial emulation framework based on the Health Insurance Research Database (NHIRD). The study aimed to assess the impact of influenza vaccination on influenza-associated hospitalizations, complications, and healthcare expenditures.
Through propensity score matching, the study included 1,214,392 matched pairs of vaccinated and unvaccinated older individuals. The findings showed that influenza vaccination was associated with a 14% reduction in the risk of influenza-related hospitalization (95% CI: 10%–18%), with consistent protective effects across various age groups, frailty levels, and high-risk populations. However, vaccine effectiveness declined over time: the protective effect was 25% (95% CI: 19%–30%) between October 2018 and March 2019, 23% (95% CI: 18%–28%) between October 2018 and May 2019, and 14% (95% CI: 10%–18%) across the full follow-up period until September 2019. Moreover, influenza vaccination significantly reduced the risk of a range of influenza-related complications, including a 30% reduction in influenza-associated mortality, a 12%–26% reduction in respiratory complications, a 39%–47% reduction in cardiovascular events such as acute myocardial infarction and stroke, and a 23% reduction in the incidence of acute kidney injury. The study estimated that influenza vaccination could save approximately USD 3 million in hospitalization costs related to influenza.
These real-world findings highlight the substantial clinical and economic benefits of influenza vaccination in the elderly population, particularly in reducing the burden of severe influenza outcomes. However, the effectiveness of the vaccine was lower among adults aged 75 years and older and those with frailty, and its protective effect waned over the course of the influenza season. These results underscore the importance of maintaining high vaccination coverage in older adults and suggest the potential value of using high-dose or adjuvanted influenza vaccines in this population to provide longer-lasting protection.
*Target Trial Emulation Framework: A causal inference approach used in observational research that seeks to replicate the design and analytic rigor of a hypothetical randomized controlled trial (RCT). By specifying eligibility criteria, treatment strategies, assignment procedures, follow-up, and outcome definitions a priori, this method aims to minimize bias and enhance the validity of causal interpretations in real-world settings.
https://doi.org/10.1186/s12916-025-03955-w
Content Editor: Ziqi Liu
Page Editor: Ziqi Liu
