Effect of a pay-it-forward strategy on reducing HPV vaccine delay and increasing uptake among 15–18-year-old girls in China: A randomized controlled trial

This study from Fudan University School of Public Health and the Shanghai CDC, published in Human Vaccines & Immunotherapeutics, leveraged the city’s immunization registry to conduct a retrospective cohort analysis of children born between September 1, 2018 and August 30, 2023. Children were classified by the COVID-19 phase at their expected vaccination dates (pre/post-epidemic, baseline, epidemic). Three pertussis-containing vaccines were included, namely, DTP, DTP-Hib, and DTP-IPV-Hib. Kaplan–Meier estimators and multivariable Cox models showed marked declines in timeliness when vaccination windows coincided with epidemic phases—for example, at 2 months the probability of timely vaccination was 0.89 (95% CI 0.86–0.92) during baseline vs 0.53 (95% CI:0.51–0.55) during epidemic periods; hazard ratios for timely vaccination at 3 and 5 months decreased by 12% (HR=0.88, 95% CI:0.86–0.90) and 9% (HR=0.91, 95% CI:0.87–0.94) in baseline vs pre/post, and by 49% (HR=0.51, 95% CI:0.49–0.53) and 57% (HR=0.43, 95% CI:0.40–0.46) during epidemic periods. Findings underscore the need for targeted catch-up and service-continuity measures to mitigate disruptions to routine childhood immunization.

This study from the Beijing Center for Disease Prevention and Control and the Beijing Research Center for Respiratory Infectious Diseases was published in Vaccine. In 2022, 2,333 healthy children under five from four sites in Hainan Province yielded 737 pneumococcal isolates. Grouped by individual PCV13 vaccination status and regional coverage, analyses showed significantly lower carriage of vaccine-type serotypes among vaccinated children (e.g., 6B: 7.0% vs 2.7%, P<0.01; 6A: 4.2% vs 1.2%, P<0.05; 23F: 2.2% vs 0.3%, P<0.05). Overall Spn non-susceptibility was high to erythromycin (92.3%), azithromycin (87.5%), clindamycin (81.2%), tetracycline (91.2%), penicillin (38.9%), and cefuroxime (64.7%), with 82.9% of isolates being multidrug-resistant (notably 92.4% among vaccine-type strains). Isolates from high-coverage areas exhibited lower resistance and MDR than those from low-coverage areas, indicating that expanding PCV13 coverage could reduce vaccine-type carriage and the community resistance burden.

This research, led by Prof. Jing Li from Sichuan University, in collaboration with Prof. Dan Wu from Nanjing Medical University, was published in PLOS ONE. Based on a randomized controlled trial conducted in Chengdu, China, the study investigated key factors influencing caregivers’ actions to vaccinate adolescent girls against HPV. The results highlighted the significant role of a novel “pay-it-forward” intervention in doubling HPV vaccine uptake. Other factors, including caregivers’ knowledge, intention to delay vaccination, occupational status, and prior vaccine refusal, were also strongly associated with vaccination behavior. Recommendations to promote universal and equitable access to HPV vaccine through targeted health education, financial support and community engagement.