Journal Content Recommandation
01
Health Economic Evaluation of the Pneumococcal Conjugate Vaccine Program for Children in Qinghai and Hainan Provinces, China
This study, conducted by Fang Hai et al. and published in Expert Review of Vaccines, systematically evaluated the health and economic impacts of incorporating the 13-valent pneumococcal conjugate vaccination (PCV13) into the local immunisation programs for children in Qinghai and Hainan Provinces in China. The aim was to provide scientific evidence to optimize vaccine policies in resource-limited regions.
A decision tree Markov model was constructed to simulate the health outcomes and lifetime costs for the 2019 birth cohort under different vaccination strategies. The model parameters integrated data on pneumonia in the two provinces. Data on epidemiology, vaccine efficacy, cost, and utility were obtained from the literature and open databases. The current market vaccination scenario served as the baseline, and nine different vaccination scenarios were considered, including:1) Varying Coverage Levels: 50%, 75%, or complete incorporation into the immunisation program. 2) Different Pricing Strategies: the current market price of US $68.2 per dose, the price ceiling of US $25 per dose as recommended by UNICEF for middle-income countries, and the procurement price of US $14.5 per dose according to the Pan American Health Organization (PAHO). Cost-effectiveness analysis was based on the incremental cost-effectiveness ratio (ICER) as the core indicator, with the per capita GDP of each province used as the cost-effectiveness threshold (in 2019, Qinghai Province’s per capita GDP was US $7,099, and Hainan Province’s was US $8,189).
Under the current market price, incorporating PCV13 into the provincial immunisation program (with a coverage rate of 98.91%) could prevent 7,100 cases of pneumococcal disease and 118 pneumococcal-related deaths in Qinghai Province, while in Hainan Province, it could avert 6,200 cases and 66 deaths. From a societal perspective, the strategy was found to be cost-effective at the current price (with an ICER of US $1,135 per QALY in Qinghai and US $4,597 per QALY in Hainan). Furthermore, if the UNICEF-recommended price were applied, both provinces could achieve cost savings. Sensitivity analyses revealed that vaccine price and disease burden parameters significantly influenced the conclusions, though the overall results remained robust. The study also found that even if vaccination coverage were increased to only 50%, Qinghai and Hainan Provinces could still respectively avoid 3,592 and 3,106 cases of the disease.
This study confirms that incorporating PCV13 into the immunisation programs of Qinghai and Hainan Provinces can significantly reduce the disease burden, improve children’s health, and promote health equity. The findings provide critical evidence for developing vaccine strategies in low- and middle-income regions.
https://doi.org/10.1080/14760584.2024.2443223
02
Administration of Non-National Immunisation Program Vaccines for Children Under Six in a Rural County, Henan Province: Did Costs Matter?
This study, conducted by Long Qian et al. and published in Human Vaccines & Immunotherapeutics, aimed to explore the non-National Immunisation Program (non-NIP) vaccination coverage among children under six years of age in rural regions of Henan Province, China, and to systematically examine the health system, individual, and social determinants influencing immunisation uptake.
A cross-sectional survey was conducted from July to October 2022 in a rural county of Henan Province, enrolling 1,051 caregivers of children under six years of age. In addition to the questionnaire data, four in-depth interviews with frontline healthcare professionals were carried out, complemented by four Focus Group Discussions (FGD) aimed at eliciting detailed insights into local policies, routine practices, and caregivers’ experiences with the administration of non-NIP vaccines. Quantitative data were analyzed using cross-tabulation and multivariate logistic regressions to determine administration rates and identify factors independently associated with vaccine uptake, while qualitative data were examined using a framework approach. The findings from both data streams were integrated during the interpretation phase to provide a comprehensive picture.
The analysis revealed that the overall administration rate for non-NIP vaccines in rural Henan remained low. Specifically, 26.7% of children had not received any non-NIP vaccines, 43.5% had received one to two types, and approximately 30% had received three to five types. Among the various vaccines, the Haemophilus influenzae type b (Hib) vaccine had the highest coverage rate at 59.4%, followed by the varicella vaccine at 55.6% and the enterovirus 71 (EV71) vaccine at 40.0%. In contrast, vaccines with higher costs such as the rotavirus vaccine and the 13-valent pneumococcal conjugate vaccine (PCV13) had the lowest administration rates at 25.0% and 11.6%, respectively. Furthermore, after adjusting for characteristics of the children, caregivers, and households, there were no statistically significant differences in non-NIP vaccine administration between left-behind and non-left-behind children (OR=1.21, 95% CI: 0.84–1.75).
Qualitative findings underscored the high cost of non-NIP vaccines as a primary barrier influencing caregivers’ decisions. The total expenditure for completing the full schedule of five non-NIP vaccines was approximately US $597.37, which accounted for 24.69% of the annual per capita disposable income of local rural residents. Among the non-NIP vaccines, the PCV13 had the highest unit price (US $71.36 per dose), followed by the rotavirus vaccine (US $44.90 per dose). Additionally, poor communication between physicians and caregivers emerged as another significant barrier—an issue attributed to the low retention of healthcare workers, a shortage of qualified professionals, and inadequate financial incentives for physicians.
In conclusion, this study provides new empirical evidence on the current status of non-NIP vaccine administration among children in rural regions, with special attention to the vulnerable subgroup of left-behind children. The results suggest that strategies aimed at reducing the economic burden of vaccines, optimizing the allocation of primary healthcare resources, and enhancing physician–caregiver communication are critical to improving the equitable access to non-NIP vaccines.
https://doi.org/10.1080/21645515.2025.2454744
03
Australia’s Rotavirus Immunisation Program: Impact on Acute Gastroenteritis and Intussusception Hospitalisations Over 13 Years
This study, published in Vaccine, evaluated the long‐term impact of Australia’s rotavirus immunisation program following its incorporation into the National Immunisation Program (NIP) in 2007. The analysis focused on trends in the incidence of hospitalisations coded with ICD‐10 for rotavirus acute gastroenteritis (AGE) (code A08.0), other AGE (codes K52, A01–A09 excluding A08.0), and intussusception (code K56.1). Using 2002–2006 as the pre-vaccine baseline and excluding the transitional policy implementation year (2007), incidence rate ratios (IRRs) were calculated for the periods 2008–2019 and 2020.
In a descriptive before-after study, incidence of hospitalisations with ICD-code of rotavirus AGE (A08.0), other AGE (K52, A01–A09 excluding A08.0) or intussusception (K56.1) between 2002 and 2020 was calculated using population denominators by age and Indigenous status. Analyses were stratified by age groups (<5 years, 5–20 years, 20–65 years, and ≥65 years) and by Indigenous status. Hospitalisation rates and calculated Incidence Rate Ratios (IRRs) were computed based on these strata.
Key findings demonstrated that in children under five years, the mean annual hospitalisation rate for rotavirus infection decreased by 85% in the post-vaccine period when compared to pre-vaccine levels (from 248.3 per 100,000 in 2002–2006 to 37.6 per 100,000 during 2008–2019; IRR 0.15, 95% CI: 0.15–0.16). Among Indigenous children, the reduction reached 61%. Additionally, hospitalisation rates for other forms of AGE fell significantly by 46%. In the 5–20-year age group, both rotavirus AGE and other AGE hospitalisation rates were significantly reduced (IRR 0.52, 95% CI: 0.49–0.56, and IRR 0.86, 95% CI: 0.85–0.87, respectively).Conversely, for individuals aged 20–65 years and those 65 years and older, hospitalisation rates for rotavirus AGE increased by 2.38-fold (IRR 2.38, 95% CI: 2.01–2.83) and 2.24-fold (IRR 2.24, 95% CI: 1.91–2.62), respectively, with a modest rise in hospitalisations for other AGE. These increases are likely attributable to improved detection accuracy through polymerase chain reaction (PCR)-based stool testing. Notably, the average annual hospitalisation rate for intussusception among infants remained similar in the pre- and post-vaccine periods (IRR 0.97; 95% CI: 0.90–1.04).
In summary, over 13 years the rotavirus vaccination program in Australia has led to significant declines in the burden of AGE hospitalisations among individuals younger than 20 years, without any overall change in the risk of intussusception in infants. Although there were statistically significant increases in AGE hospitalisations in adults over 20 years—especially in those aged 65 and above—the magnitude of these increases is relatively small and is most likely related to enhanced PCR-based diagnostic testing. These findings provide high-quality evidence supporting the long-term safety and effectiveness of the rotavirus vaccine, thereby reinforcing its prioritisation in the National Immunisation Program.
https://doi.org/10.1016/j.vaccine.2025.126789
04
The Relationship Between Postpartum Depression and Timely Child Vaccination: A Systematic Review
This study, published in Vaccine, systematically reviews the association between postpartum depression (PPD) and the timeliness of child vaccination. It systematically searched eight databases* from database inception to September 2023. The review covers studies conducted in high-income countries (83%) as well as in low- and middle-income countries (17%), with sample sizes ranging from 134 to 850,000 participants. The study designs were predominantly cohort studies (92%), with cross-sectional studies accounting for the remaining 8%.
Inclusion criteria focused on mothers’ depressive status within 12 months postpartum and the corresponding vaccination records of their children up to 24 months of age. Only studies reporting data from primary investigations conducted on human participants were included, ensuring scientific rigor and comparability. All studies exclusively relied on data from female caregivers; the Edinburgh Postnatal Depression Scale (EPDS) or clinical diagnoses from medical records were primarily used to identify PPD, while the operational definitions of timely vaccination varied in accordance with regional immunisation program standards.
Results indicate that 50% of studies identified a significant negative association between PPD and the timeliness of child vaccination. For example, a retrospective cohort study conducted in Denmark observed a 7% reduced likelihood that children of recently depressed mothers completed the diphtheria, tetanus, pertussis, and polio vaccinations, as well as a 12% reduced likelihood for completion of measles, mumps, and rubella (MMR) vaccinations . However, the vaccine uptake rates of children of depressed and non-depressed differed by ≤3%. Other studies demonstrated that the association between PPD and vaccine uptake tends to diminish after adjusting for socioeconomic factors, suggesting that healthcare accessibility and family support may play critical roles in mediating this relationship. Nevertheless, significant heterogeneity was detected across the studies, partly due to variations in research methodology, vaccine definitions, and control of key confounding variables such as socioeconomic status and healthcare access.
The study underscores the importance of integrating mental health screening into postpartum care, along with personalized vaccination reminders and home-visitation services, to support timely child vaccination among mothers experiencing depression. Future research should adopt standardized measurement tools and extend follow-up periods to elucidate the long-term relationship between maternal mental health and child immunisation, while also considering the impact of healthcare systems and social support networks to inform more effective public health intervention strategies.
* The eight databases included in the systematic search were: MEDLINE ALL, Embase, PsycINFO, CINAHL, LILACS, Web of Science, Sociological Abstracts, and Scopus.
https://doi.org/10.3390/vaccines13030222
Policy Guidelines
01
Recommendations announced for influenza vaccine composition for the 2025–2026 northern hemisphere influenza season by the World Health Organization
On February 28, the World Health Organization (WHO) today announced the recommendations for the viral composition of influenza vaccines for the 2025–2026 influenza season in the northern hemisphere. The recommendations issued are used by the national vaccine regulatory agencies and pharmaceutical companies to develop, produce, and license influenza vaccines for the following influenza season. Trivalent vaccines for use in the 2025–2026 northern hemisphere influenza season contain the following:
Egg-based vaccines：
an A/Victoria/4897/2022 (H1N1)pdm09-like virus
an A/Croatia/10136RV/2023 (H3N2)-like virus
a B/Austria/1359417/2021 (B/Victoria lineage)-like virus.
Cell culture-, recombinant protein- or nucleic acid-based vaccines：
an A/Wisconsin/67/2022 (H1N1)pdm09-like virus
an A/District of Columbia/27/2023 (H3N2)-like virus
a B/Austria/1359417/2021 (B/Victoria lineage)-like virus.
The recommendation for the B/Yamagata lineage component of quadrivalent influenza vaccines remains unchanged from previous recommendations:
a B/Phuket/3073/2013 (B/Yamagata lineage)-like virus.
Content Editor: Ziyi Zhu
Page Editor：Ziqi Liu
