Research Content Recommendation
01
Antibody persistence in Chinese toddlers at 1 year and 2 years after two different 4-dose schedules of a novel 13-valent pneumococcal conjugate vaccine (PCV13-TT)
This study, published in Vaccine, investigated the antibody persistence of the 13-valent pneumococcal conjugate vaccine (PCV13-TT), which has been widely used in China since its licensure in 2019. Pre-licensure Phase III clinical trials demonstrated that PCV13-TT, administered in either a 3 + 1 immunization schedule beginning at 2 months (PCV13-2M) or 3 months of age (PCV13-3M), elicited robust immune responses against all 13 vaccine-included serotypes.
As an extension of the pivotal PCV13–002 trial, this open-label, multicenter study was conducted to assess the long-term immunogenicity of PCV13-TT following completion of the 4-dose series. The study was carried out at Centers for Disease Control and Prevention in Shanxi and Henan provinces. A total of 786 healthy toddlers previously enrolled in PCV13–002 at 2 or 3 months of age (as early as 6 weeks) were recalled for participation if they met the following eligibility criteria: (1) received all 3 primary doses and 1 booster dose of either PCV13-TT or the comparator vaccine (PCV7) according to protocol; (2) had valid IgG serological results at one month post-primary and one month post-booster. Blood samples were collected at 1 and 2 years post-booster, and serotype-specific antibody levels were measured using enzyme-linked immunosorbent assay (ELISA) and opsonophagocytic activity (OPA) assays.
The results showed comparable immune response profiles between the two PCV13-TT schedules (PCV13-2M and PCV13-3M). At two years post-booster, the geometric mean concentrations (GMCs) of IgG antibodies for all 13 serotypes remained above the World Health Organization (WHO) protective threshold of 0.35 μg/mL (range: 0.39–4.68 μg/mL). For shared serotypes such as 6B, 14, 19F, and 23F, the IgG seropositivity rates (IgG concentration ≥ 0.35 μg/mL) consistently reached 100%. Although the IgG seropositivity rates for serotypes 4 and 18C were slightly lower in the PCV13-3M group (both 78.2%) than those in the PCV7 group (83.3% and 86.0%, respectively) two years after booster vaccination, they still significantly exceeded the protective threshold.
Additionally, OPA geometric mean titers (GMTs) and OPA seropositivity rates (defined as titers ≥8) remained high at both 1 and 2 years post-booster. For serotypes unique to PCV13 (e.g., 1, 5, 6A, 7F, 19A), both IgG GMCs and OPA GMTs were significantly higher in the PCV13-TT groups compared to the PCV7 group (P < 0.05). For example, the IgG seropositivity rate for serotype 7F was 97.7% in the PCV13-3M group at 2 years, significantly higher than 81.9% in the PCV7 group (P < 0.001); for serotype 5, the rates were 99.1% versus 95.5%, respectively (P = 0.0196). However, for shared serotype 18C, the IgG GMCs were relatively lower in the PCV13-TT group, which may be related to the immunogenicity differences associated with the tetanus toxoid (TT) carrier protein.
This study is the first to systematically confirm that the domestically produced PCV13-TT induces long-term protective immunity against all 13 serotypes in both 2-month and 3-month initiation schedules. It also shows superior antibody persistence against the additional serotypes not covered by PCV7. Although antibody levels declined over time, the GMCs for all serotypes remained well above the clinical protection threshold two years after the booster dose, providing critical evidence to support the scientific application of PCV13-TT in China’s national immunization strategy.
*This study was supported by Yuxi Walvax Biotechnology Co., Ltd. https://doi.org/10.1016/j.vaccine.2025.126815
02
Implementation of mid-adult HPV vaccination guidelines into clinical practice
This study, published in Vaccine, aimed to assess the clinical implementation of the 2019 U.S. guideline recommending Shared Clinical Decision-Making (SCDM) for human papillomavirus (HPV) vaccination among mid-adults aged 27 to 45 years, with a particular focus on provider practices and influencing factors. Using a quota sampling approach, the researchers surveyed 600 healthcare providers in the United States who deliver care to mid-adult populations. The study evaluated providers’ HPV vaccination behaviors and the extent to which they adhered to the SCDM recommendation, utilizing descriptive statistics and bivariate analyses.
The results indicated that approximately 47% of healthcare providers reported often or always engaging in SCDM regarding HPV vaccination, while 50% reported offering the HPV vaccine in clinical practice. There were statistically significant differences in guideline implementation across provider specialties (p < 0.01). Specifically, obstetricians and gynecologists (OB/GYNs) reported the highest rate of consistently offering the HPV vaccine (26%), compared to family medicine providers (10%) and internal medicine providers (12.5%). Key barriers to the implementation of SCDM included limited time for consultation (67%) and perceived inadequate insurance coverage for patients (65%).
Although the SCDM recommendation has been formally approved, its clinical uptake varies considerably depending on provider specialty and patient characteristics. The study highlights time constraints and insurance-related concerns as primary obstacles to widespread adoption. The authors suggest that future efforts should involve tailored interventions for different clinical disciplines—such as OB/GYN, family medicine, and internal medicine—to promote consistent application of the SCDM model and enhance equitable access to HPV vaccination for mid-adult populations.
* Shared Clinical Decision-Making (SCDM) refers to a patient-centered approach in which healthcare providers and patients collaboratively make healthcare decisions, integrating the best available clinical evidence with patient values and preferences. Through information exchange and bidirectional dialogue, patients are empowered to make informed decisions regarding their care.
https://doi.org/10.1016/j.vaccine.2025.126867
03
Evaluation of the Reliability and Validity of the Health Literacy Scale for HPV Vaccination Among Parents of Girls Aged 9–14
This article, published in Human Vaccines & Immunotherapeutics, aims to develop and evaluate the reliability and validity of a Health Literacy Scale for HPV Vaccination tailored for parents of girls aged 9–14 years. The study was conducted in a school located in a district of Shanghai, China, from March to April 2024, using a convenience sampling method to recruit a total of 830 parents of girls in grades 3 to 8. Item analysis was performed using the critical ratio method, correlation coefficient method, and Cronbach’s alpha coefficient. Reliability was assessed using Cronbach’s alpha, Spearman-Brown split-half reliability coefficients, and test-retest correlation coefficients, while content validity and confirmatory factor analysis (CFA) were applied to assess the scale’s validity.
Following item analysis, one item—“Whether a doctor’s recommendation affects vaccination”—was removed. The finalized scale consists of 34 items, categorized into three dimensions: Medical Services (11 items), Disease Prevention (15 items), and Health Promotion (8 items). The overall Cronbach’s alpha coefficient was 0.913; the coefficients for the three dimensions were 0.848, 0.839, and 0.747, respectively. The split-half reliability coefficients for the total scale and subdimensions were 0.751, 0.743, 0.875, and 0.762; the corresponding test-retest reliability coefficients were 0.794, 0.890, 0.785, and 0.837.
Content validity assessment indicated strong content coverage, while the results of CFA demonstrated a good model fit for the final version of the scale, with the following indices: RMSEA = 0.041, GFI = 0.937, and AGFI = 0.914.
In conclusion, the findings indicate that this scale demonstrates robust psychometric properties and may serve as a valid and reliable instrument for assessing HPV vaccine health literacy among parents of girls aged 9–14.
https://doi.org/10.1080/21645515.2025.2465022
04
The impact of HPV vaccine disinformation and misinformation in disadvantaged educational settings in Ireland: A multi-year analysis of a school immunisation system
This study, published in Vaccine, aims to assess the long-term impact of HPV vaccine misinformation disseminated between 2015 and 2017 on vaccination uptake rates in socioeconomically disadvantaged schools in Ireland, specifically those included in the Delivering Equality of Opportunity in Schools (DEIS) programme. Since the national implementation of Ireland’s school-based HPV vaccination programme in 2010, DEIS schools have consistently shown lower uptake rates compared to non-DEIS schools.
Using a register-based cohort design, the study integrates HPV vaccination records from the national Schools Immunisation System (SIS) with DEIS status data from the Department of Education. Data from six academic years (2013–2019) were analysed, segmented into three distinct periods: (1) Pre-misinformation period (2013–2015), (2) Misinformation period (2015–2017), and (3) Recovery period (2017–2019), to investigate the long-term impact of vaccine misinformation on vaccination coverage in DEIS schools.
Findings indicate that overall HPV vaccine uptake declined from 84.8% before the misinformation period to 55.2% during it, with partial recovery to 72.9% in the subsequent years. The uptake gap between DEIS and non-DEIS schools widened progressively across the three periods: 4.5% (95% CI: 1.80–7.17) pre-misinformation, 8.0% (95% CI: 5.35–10.68) during misinformation, and 12.4% (95% CI: 9.80–14.91) in the recovery phase. Despite an overall improvement in uptake, DEIS schools experienced significantly lower recovery rates compared to non-DEIS schools (64.5% vs. 76.5%, p < 0.001).
The study demonstrates that HPV vaccine misinformation had a disproportionately adverse impact on vaccine uptake in socioeconomically disadvantaged schools, leading to a lagged recovery in these settings. The findings underscore the need for targeted interventions to address this disparity, particularly focusing on improving vaccine accessibility and parental trust in disadvantaged communities.
*Delivering Equality of Opportunity in Schools (DEIS) is an Irish governmental initiative designed to enhance the quality of education in socioeconomically disadvantaged areas. Schools designated under the DEIS scheme are typically located in areas of socioeconomic deprivation and serve student populations from low-income families.
https://doi.org/10.1016/j.vaccine.2025.126868
05
Acceptance and preference between respiratory syncytial virus vaccination during pregnancy and infant monoclonal antibody among pregnant and postpartum persons in Canada
This study, published in Vaccine, aimed to examine self-reported acceptance and preferences among pregnant and postpartum individuals in Canada regarding two immunization strategies for respiratory syncytial virus (RSV): maternal vaccination during pregnancy (administered at 20–36 weeks of gestation) and postnatal administration of monoclonal antibodies (mAb) to infants. The study was based on data from the national prospective COVERED cohort and employed a web-based cross-sectional survey conducted between September 2023 and March 2024.
Eligible participants were Canadian residents aged ≥19 years who became pregnant in 2023. Individuals with multiple gestations or immunosuppression were excluded. Data were collected using a standardized questionnaire (Cronbach’s α = 0.82), which captured demographic characteristics, vaccination history, and stated willingness to accept either RSV immunization strategy (maternal vaccination, infant mAb, or neither). A stepwise logistic regression model (entry criterion p < 0.10) was used to identify independent predictors of maternal RSV vaccine acceptance.
A total of 723 respondents completed the survey, among whom 50.3% (n = 364) were currently pregnant. Of all participants, 79.0% (n = 568) expressed willingness to accept at least one RSV immunization strategy. Acceptance of maternal RSV vaccination (77.3%, n = 559) was significantly higher than that of the infant monoclonal antibody strategy (54.8%, n = 396; χ² = 64.32, p < 0.001). In terms of preference, 79.0% (n = 567) preferred maternal vaccination, only 4.4% (n = 32) favored infant mAb, and 14.0% (n = 98) reported no clear preference. Regarding the prioritization of vaccines during pregnancy, Tdap (tetanus, diphtheria, and pertussis) was ranked highest (51.0%), followed by RSV (17.0%), COVID-19 (14.0%), hepatitis B (11.0%), and influenza (7.0%).
Multivariable analysis identified three independent predictors of maternal RSV vaccine acceptance: a history of Tdap vaccination during pregnancy (adjusted odds ratio [aOR] = 4.21, 95% CI: 2.98–5.94), receipt of COVID-19 vaccination during pregnancy (aOR = 2.15, 95% CI: 1.25–3.70), and ranking the RSV vaccine as high priority (aOR = 3.02, 95% CI: 1.38–6.63), with all associations reaching statistical significance (p < 0.01).
In conclusion, the study demonstrates that Canadian pregnant and postpartum individuals show a marked preference for maternal RSV vaccination over infant mAb administration. This preference is strongly associated with prior vaccine uptake behaviors. Policymakers are encouraged to take maternal preferences into account, prioritizing implementation of maternal RSV vaccination programs during mid-to-late pregnancy, while reserving the infant mAb as a complementary strategy for individuals unable to complete antenatal immunization.
https://doi.org/10.1016/j.vaccine.2025.126818
06
Early evidence of RSV vaccination impact on hospitalisation rates of older people in Scotland
Published in The Lancet Infectious Diseases, this study explores changes in hospitalisation rates due to respiratory syncytial virus (RSV) among adults aged 75 years and older in Scotland following the implementation of an RSV vaccination programme.
Scotland (one of four UK nations) initiated a nationwide RSV immunisation programme on August 12, 2024, prioritising the administration of the Pfizer ABRYSVOvaccine to adults aged 75–79 years and those turning 75 before July 2025. The programme also extended to pregnant individuals at 28 weeks’ gestation to protect neonates against RSV infection. By September 9, 2024, a total of 154,348 eligible older adults (52.4%) had received the vaccine, with coverage increasing to 68.6% (201,891 individuals) by November 27.
Leveraging this high uptake, the study conducted a preliminary assessment of the vaccine’s effect on RSV-related hospitalisations. A regression discontinuity design (RDD) was employed, using Poisson generalised linear regression models to evaluate the association between vaccination and RSV hospitalisation incidence.
The analysis focused on individuals aged 74–79 years during the pre-implementation (October 1 to December 8, 2023) and post-implementation (October 1 to December 8, 2024) periods, and compared them with unvaccinated age groups (70–73 and 80–84 years). RSV-related hospitalisation was defined as an emergency admission with a positive RSV test result within 14 days prior to or 2 days after admission.
According to the findings, in November 2024, the RSV incidence rate in individuals aged 75 years and older reached 8 per 100,000. In the context of relatively low influenza and COVID-19 circulation during this period, RSV emerged as the primary cause of respiratory hospitalisations, accounting for 62% of cases, while influenza and COVID-19 accounted for 20% and 18%, respectively. Prior to vaccine rollout in 2023, RSV hospitalisation rates in the 74–79 age group did not significantly differ from those in adjacent unvaccinated age groups (70–73 and 80–84).
Model projections estimated that, in the absence of vaccination, RSV-related hospitalization rates during the 2023–2024 winter would increase by 6% with each additional year of age. Compared to this estimate, following vaccination, the target population (aged 74–79) experienced a 62.1% reduction in RSV hospitalization rates (95% CI: 35.0–79.8), demonstrating substantial vaccine effectiveness.
As one of the first real-world studies of RSV vaccination among older adults in the UK and Europe, this research provides compelling evidence of the vaccine’s impact on reducing RSV-related hospitalisations in elderly populations. These findings offer critical scientific support for future immunisation policy development and optimisation.
https://doi.org/10.1016/S1473-3099(25)00064-7
Content Editor: Ruitong Li
Page Editor: Ruitong Li
