Journal Article Recommandation
01
Effectiveness of quadrivalent human papillomavirus vaccination against high-grade cervical lesions by age and doses: a population-based cohort study
This article, published in The Lancet Regional Health Europe, evaluates the protective efficacy of the quadrivalent human papillomavirus (HPV) vaccine against high-grade cervical lesions at different vaccination ages and doses. The study included 2,200,495 females aged 10–35 residing in Sweden between 2006 and 2022, of whom 26.6% (584,676 individuals) received at least one dose of the quadrivalent HPV vaccine. Poisson regression models were used to calculate incidence rate ratios (IRR) to assess the relationship between vaccination age, dosage, and the risk of high-grade cervical lesions.
The results showed that among girls who started vaccination before the age of 15, the risk of developing high-grade cervical lesions was reduced by 58% (IRR = 0.42, 95% CI 0.33–0.52) with one dose, 46% (IRR = 0.54, 95% CI 0.47–0.63) with two doses, and 50% (IRR = 0.50, 95% CI 0.47–0.53) with three doses, compared to unvaccinated individuals. For girls who began vaccination between the ages of 15 and 17, the risk reductions were 40% (IRR = 0.60, 95% CI 0.52–0.70) for one dose, 45% (IRR = 0.55, 95% CI 0.49–0.62) for two doses, and 46% (IRR = 0.54, 95% CI 0.52–0.56) for three doses. However, women who initiated vaccination after the age of 20 required more doses to achieve a significant reduction in risk.
The study indicates Receiving one or two doses of HPV vaccines prior to age 17, especially for those initiating before age 15, has comparable effectiveness against high-grade cervical lesions with those who received three doses.
https://www.thelancet.com/journals/lanepe/article/PIIS2666-7762(24)00347-8/fulltext
02
Closer adult child–parent relations the stronger the vaccine hesitancy: A cross-sectional study of adult Children’s attitudes toward pneumococcal vaccination of elderly parents and its determinants in Guangzhou, China
This article, published in Human Vaccines & Immunotherapeutics, explores adult children’s attitudes toward pneumococcal vaccination for their elderly parents and identifies the factors influencing their decisions, providing insights for improving vaccine coverage. A cross-sectional survey conducted in Guangzhou in October 2022 analyzed the sociodemographic characteristics of 1,597 adult children and their parents, health beliefs about vaccination, and the influence of parent-child relationship types on vaccine hesitancy.
Using latent class analysis (LCA), the study identified three types of parent-child relationships: detached, intimate but distant, and tight-knit. Binary logistic regression models were then employed to analyze the association between these relationship types and vaccine hesitancy.
The results showed that 59.8% of adult children expressed hesitancy toward vaccinating their parents against pneumococcal disease. Compared to those with detached relationships, adult children in intimate but distant relationships (OR = 3.04) and tight-knit relationships (OR = 3.01) were more likely to exhibit vaccine hesitancy. Additionally, respondents with higher education levels (OR = 2.63) and greater perceived barriers to vaccination (OR = 1.18) demonstrated higher hesitancy. Conversely, those with higher income levels (OR = 0.35) or parents facing difficulties in daily living activities (OR = 0.44) were more likely to support vaccination.
The study highlights that close parent-child relationships may heighten children’s sense of responsibility and sensitivity to vaccine risks, thereby increasing vaccine hesitancy. As a result, health education efforts should extend beyond elderly individuals to include their adult children, focusing on reducing perceived barriers and promoting vaccine knowledge to enhance vaccination rates among older adults.
https://doi.org/10.1080/21645515.2024.2440959
03
Rotavirus vaccine coverage, completion, and compliance: A systematic literature review
This article, published in Human Vaccines & Immunotherapeutics, examines the global coverage, completion rates, and adherence to two internationally licensed oral rotavirus vaccines (RVVs) included in national immunization programs across more than 100 countries. These RVVs are administered in either two (Rotarix™; 2D-RV) or three (RotaTeq®; 3D-RV) doses. The study aims to assess these metrics and analyze key factors influencing vaccine coverage.
Through a systematic review of literature published between 2006 and 2021 on PubMed and Embase, 74 studies from 31 countries were included. The results showed that full coverage of 3D-RV were 59% and 87% for 2D-RV. The coverage rate varied significantly at the country’s economic level, vaccine type, and year of implementation. However, due to market preferences and limited data, a comprehensive comparison of coverage rates between 2D-RV and 3D-RV could not be conducted. Nevertheless, studies from Italy, Mexico, and the United States demonstrated that 2D-RV had higher completion rates and adherence compared to 3D-RV.
Among the 23 studies reporting factors associated with vaccine coverage, 21 focused on the period after RVV implementation within national immunization programs. Influencing factors varied by a country’s income classification. In low-income countries, the most frequently reported factors associated with coverage, completion, or adherence included mother’s education level, access to perinatal care, and the distance or travel time to vaccination centers.
This study reveals significant differences in rotavirus vaccination coverage globally, highlighting the impact of factors such as economic level, vaccine type, and vaccination strategy on vaccination coverage and adherence. The findings provide a valuable reference for optimizing national vaccination programs and highlight the importance of increasing vaccination completion and adherence to improve the effectiveness of public health interventions.
https://doi.org/10.1080/21645515.2024.2442780
04
What will it take? Perspectives from five low- and middle-income countries on opportunities and challenges of introducing new maternal vaccines
This article, published in Vaccine, focuses on the practice of maternal immunization (MI) in high-income countries in recent years to protect the early health of newborns and explores the necessary conditions, opportunities, and challenges for implementing MI programs in low- and middle-income countries.
To inform cost of MI delivery studies, the study gathered perspectives from key stakeholders in five countries (Bangladesh, Ghana, Kenya, Mozambique, and Nepal) regarding health system requirements, opportunities, and challenges to introducing new maternal vaccines into routine health programs.
The results show that existing maternal vaccination programs (e.g., tetanus vaccination) provide a reliable foundation for introducing new maternal vaccines. At the service provision level, maternal health programs are closely integrated with immunization programs, but coordination and planning at the national policy level still need strengthening. National-level coordination and unified planning are key to the successful implementation of new vaccination interventions. Moreover, while many healthcare workers have received similar training and possess skills applicable to new vaccine administration (such as vaccine storage, vaccination procedures, and record management), establishing clear operational guidelines to define specific responsibilities is seen as crucial for ensuring accountability and effective management. At the same time, participants generally identified human resource shortages, insufficient funding sustainability, and a lack of public awareness regarding the disease burden and new maternal vaccine programs as the main challenges.
Through the workshop format, this study provided a platform for in-depth communication among stakeholders in various countries, discussing the necessary conditions for introducing new maternal vaccines and fostering understanding and consensus on the need for MI implementation plans. Despite differing national contexts, participants were generally optimistic about their health systems’ ability to integrate new maternal vaccines.
https://doi.org/10.1016/j.vaccine.2024.126654
05
Barriers to influenza vaccination during pregnancy in France: A national population-based study
This article, published in Vaccine, explores the reasons for the low influenza vaccination rate among pregnant women in France and the factors hindering vaccination. Although France has recommended influenza vaccination for all pregnant women since 2012, by 2021, the vaccination coverage remained only around 30%. The study aims to assess the recommendation and actual vaccination rates for pregnant women and analyze the main barriers to vaccination to reveal the key obstacles to inadequate vaccination.
This study used data from the French National Perinatal Survey (Enquête Nationale Périnatale [ENP]). ENPs are conducted at regular intervals (each 5–6 years) in France to collect information about health status, perinatal care, maternal behavior, and risk factors over a one-week period.
The results show that among the 10,838 pregnant women included in the study, 40.7% (95% CI, 39.8–41.6) reported not being recommended for the influenza vaccine. Characteristics of pregnant women who were not recommended for vaccination included: younger age (under 25 years, adjusted prevalence ratio [PRa] 1.23, 95% CI, 1.14–1.33), multiparity (PRa 1.37, 95% CI, 1.27–1.49), foreign birth (PRa 1.20, 95% CI, 1.12–1.29), and lower education levels (PRa 1.46, 95% CI, 1.34–1.58). Additionally, among the 6,427 pregnant women who were recommended vaccination, 53.9% (n=3463) did not receive the vaccine. Non-vaccinated women were also more likely to be younger (PRa 1.23, 95% CI, 1.14–1.33), multiparous (PRa 1.18, 95% CI, 1.07–1.30), and have lower education levels (PRa 1.70, 95% CI, 1.56–1.85).
The study findings indicate that the low influenza vaccination rate during pregnancy in France is primarily due to ineffective vaccination recommendations by healthcare services, particularly among younger women and those with lower education levels. Future public health strategies should focus on improving the equity and accessibility of healthcare services, enhancing vaccine promotion and services for vulnerable groups, thereby increasing vaccination rates and overall health among pregnant women.
PRa (Adjusted Prevalence Ratio): The prevalence ratio adjusted for confounding factors (such as age, gender, education level, etc.) in multivariate analysis, aimed at reflecting the independent association of exposure factors with the outcome.
https://doi.org/10.1016/j.vaccine.2024.126671
06
Estimating the cost-effectiveness of maternal respiratory syncytial virus (RSV) vaccination in Australia: A dynamic and economic modelling analysis
This article, published in Vaccine, explores the economic impact and potential effects of respiratory syncytial virus (RSV) vaccination on the health of pregnant women and their infants. With Australia recently approving the use of the RSV vaccine for pregnant women, evaluating its economic feasibility and health benefits is timely. The study employs a comprehensive dynamic and economic evaluation model to quantify the specific impact of RSV disease and the cost-effectiveness of an annual RSV vaccination program for pregnant women. The incremental cost-effectiveness ratio (ICER) is calculated by determining the cost per quality-adjusted life year (QALY) gained to assess the economic reasonableness of the program.
From a healthcare system perspective, the study shows that when the vaccine price is below approximately 120 AUD ($AU), and the willingness-to-pay (WTP) threshold is set at 50,000 AUD/QALY, the vaccination program for pregnant women is considered cost-effective. In terms of cost savings, about 82% is attributed to preventing hospitalizations of infants under 6 months old due to RSV infection. However, this age group only contributes about 25% of the QALY benefits, with the remaining QALY benefits primarily derived from herd immunity effects, such as reducing mortality risks in the elderly population and alleviating mild disease burdens in adolescents and adults. If the cost savings and QALY benefits for the population aged 6 months and older are excluded, the vaccine price would need to be reduced to 63 AUD to meet the assumed WTP threshold.
The study suggests that Australia’s RSV vaccination program for pregnant women could be economically feasible by reducing hospitalizations and associated costs for infants under 6 months old. Furthermore, it emphasizes that when assessing the cost-effectiveness of the RSV vaccine for pregnant women, the herd immunity effects on populations outside the target group should be thoroughly considered.
https://doi.org/10.1016/j.vaccine.2024.126651
Policy Updates
01
State Council Issues “Opinions on Deepening Drug and Medical Device Regulatory Reform to Promote High-Quality Development of the Pharmaceutical Industry” and Explores Segmented Production Model for High-valent/Combined Vaccines
On January 3, 2025, the General Office of the State Council issued the “Opinions on Deepening Drug and Medical Device Regulatory Reform to Promote High-Quality Development of the Pharmaceutical Industry.” The policy guidelines state that in order to meet the specific requirements of the production processes and facilities for multi-valent/combined vaccines, antibody-drug conjugates, and other biologics, China will conduct pilot programs for segmented production of biologics in certain regions. The pilot programs will be initiated by provincial drug regulatory departments, and upon approval by the National Medical Products Administration (NMPA), they will be implemented.
The opinion specifies that the pilot programs will prioritize the segmented production of key biologics, including multivalent/combined vaccines, and explore a new model of cross-border segmented production where qualified overseas drug marketing authorization holders can conduct segmented production through self-built capacity or contract manufacturing under a unified drug quality management system. This initiative will effectively enhance China’s biologic research and manufacturing capabilities, strengthen international exchanges and cooperation, and provide important support for ensuring global accessibility to vaccines.
Source: State Council of the People’s Republic of China
https://mp.weixin.qq.com/s/rSEivwan0KyCAl08dot_RA
02
Gardasil® Expands Its Indications for Male Vaccination
On January 8, 2025, Merck’s Gardasil® (Quadrivalent Human Papillomavirus Vaccine [Yeast]) received approval from the National Medical Products Administration (NMPA) for multiple indications, making it the first and currently only HPV vaccine approved for use in males in China. The new indications cover the prevention of anal cancer caused by HPV types 16 and 18, genital warts (condyloma acuminata) caused by HPV types 6 and 11, and precancerous or atypical lesions caused by HPV types 6, 11, 16, and 18, including Grade 1, 2, and 3 anal intraepithelial neoplasia (AIN). This approval fills the gap in HPV vaccination for males, enhancing China’s disease prevention and control efforts and contributing to gender-equal vaccination.
Source: MSD China
https://mp.weixin.qq.com/s/g4bMqwMAjZU9Alur5wJB0A
Content Editor: Xiaotong Yang
Page Editor: Ziqi Liu
