Journal Article Recommendation
01
Preferences for and drivers of adult vaccination clinic site selection: A cross-sectional study in 30 provinces in China
This article, authored by Feng Luzhao et al. and published in Human Vaccines & Immunotherapeutics, focuses on vaccines available to adults not included in the National Immunization Program. By analyzing the decision-making process for adult vaccination, the study provides evidence for developing more efficient and patient-centered vaccination strategies, addressing vaccine hesitancy, improving accessibility to vaccination sites, and increasing vaccination rates.
The research was conducted from November 1 to December 10, 2023, via the “Yuemiao” platform, using a combination of convenience sampling and purposive sampling methods. A total of 2,014 adult participants were recruited. Data on sociodemographic characteristics, sources of information about vaccination sites, satisfaction with vaccination services, and the influence of site selection on vaccination decisions were collected through an online survey. Univariate and multivariate logistic regression analyses were performed to identify factors influencing beliefs about influenza vaccination.
The findings reveal that gender, age, income level, and vaccination history are significant factors affecting adults’ choice of vaccination sites. Participants generally preferred sites that are convenient, efficient in service provision, transparent in pricing, and having comfortable environment. Adults aged 35–44, those with a monthly income above 10,000 RMB, and those who had previously received vaccines other than COVID-19 vaccines were more likely to choose community health service centers as their vaccination sites. A consistent pattern was observed in the selection of sites for influenza, herpes zoster, and pneumococcal vaccines, with the majority preferring community health service centers for vaccination services.
Satisfaction analysis revealed that individuals who had received influenza vaccines were more satisfied with appointment systems, waiting times, and service durations compared to those who had not been vaccinated. Multivariate analysis of vaccine decision-making indicated that factors such as perceived importance of influenza vaccination (OR: 0.53, 95% CI: 0.29, 0.99), disregard for service costs (OR: 0.63, 95% CI: 0.46, 0.86), convenience, and following doctors’ recommendations significantly increased the likelihood of influenza vaccination. Greater familiarity with community health service centers, as compared to hospitals, and preferences for secondary or tertiary hospitals were also associated with higher vaccination willingness. Awareness of information channels for vaccination sites positively influenced vaccination rates, while familiarity with service hours had a positive but non-significant effect on vaccination willingness.
The study recommends that public health strategies prioritize enhancing the convenience, service quality, and transparency of vaccination sites. Optimizing vaccination service systems is crucial to increasing adult vaccination rates.
https://doi.org/10.1080/21645515.2024.2442104
02
Socioeconomic disparities in childhood vaccine hesitancy among parents in China: The mediating role of social support and health literacy
This article, authored by Jiang Minghuan et al. and published in Human Vaccines & Immunotherapeutics, focuses on socioeconomic status (SES) disparities in vaccine hesitancy among parents in China and the potential mediating effects of perceived social support and health literacy. The study used a questionnaire survey targeting parents of children under six years old across six provinces in China (Guangdong, Jiangsu, Henan, Jiangxi, Sichuan, and Shaanxi). SES was assessed through educational attainment, annual household income, and subjective SES (measured on a 1–10 rating scale). Linear regression analysis was employed to examine the association between SES and vaccine hesitancy, while 5,000 bootstrap resampling tests were used to assess mediation effects.
A total of 1,638 parents participated in the study. Compared to parents with an annual household income exceeding 200,000 RMB, those earning between 100,000 and 150,000 RMB exhibited significantly higher levels of vaccine hesitancy. Educational attainment showed no significant association with vaccine hesitancy. However, subjective SES demonstrated a U-shaped relationship with vaccine hesitancy, indicating that parents at both extremes of SES were more likely to exhibit hesitancy. Perceived social support and health literacy played both independent and sequential mediating roles in the relationship between subjective SES (indirect effect: -0.240) and vaccine hesitancy, as well as in the effects of household income (indirect effect for income ≤100,000 RMB: 1.250; for income between 100,000 and 150,000 RMB: 0.759).
The findings indicate that vaccine hesitancy among Chinese parents is significantly influenced by SES disparities, with perceived social support and health literacy serving as critical mediators in this relationship. These results provide valuable scientific evidence for designing targeted interventions to reduce SES-related disparities in vaccine hesitancy and highlight the priority of enhancing social support and health literacy in public health strategies.
https://doi.org/10.1080/21645515.2024.2444008
03
Influenza vaccine effectiveness against medically-attended influenza infection in 2023/24 season in Hangzhou, China
This article, authored by Zhao Gang, Wang Zhe, et al., was published in Human Vaccines & Immunotherapeutics. The COVID-19 pandemic has profoundly impacted the global transmission patterns of influenza viruses, particularly the disappearance of the B/Yamagata influenza virus lineage. This phenomenon has sparked extensive discussion on the relevance of quadrivalent influenza vaccines (IIV4) that include this lineage. Evaluating the effectiveness of influenza vaccines is crucial for optimizing future vaccination strategies.
The study employed a case-control design and was conducted from October 1, 2023, to March 31, 2024, across five tertiary hospitals in Hangzhou, Zhejiang Province, China. The participants were patients aged six months and older who sought medical care for influenza-like illness (ILI). Using a multivariable logistic regression model adjusted for gender, age, influenza testing methods, and testing timing, the study evaluated the vaccine effectiveness (VE) against ILI cases.
Of the 157,291 medically-attended ILI participants enrolled 56,704 (36%) tested positive for influenza. Adjusted overall VE against any medically-attended influenza infection was 48% (95% Confidence interval (CI: 46%–51%). The overall VE of the trivalent inactivated influenza vaccine (IIV3) was 59% (95% CI: 50%–66%), followed by the trivalent live attenuated vaccine (LAIV3) (VE = 53%, 95% CI: 42%–62%) and quadrivalent inactivated influenza vaccine (IIV4) (VE = 47%, 95% CI: 45%–50%). Notably, in preventing infections caused by type B influenza viruses, IIV3 demonstrated significantly superior protection compared to IIV4 (IIV3: VE = 87%, 95% CI: 81%–92%; IIV4: VE = 53%, 95% CI: 50%–57%).
The findings indicate that during the 2023/2024 influenza season in Hangzhou, influenza vaccines provided moderate protection, with IIV3 showing exceptional effectiveness in preventing type B influenza infections. These results further support the World Health Organization’s 2023 recommendation to remove the B/Yamagata antigen from quadrivalent influenza vaccines, offering scientific evidence to guide the optimization of global influenza vaccination policies.
https://doi.org/10.1080/21645515.2024.2435156
04
Rotavirus vaccine effectiveness and coverage among children younger than 5 years old in Shanghai, China: A test-negative case control study
This article, authored by Wu Huanyu, Wang Weibing, et al., was published in Vaccine. Although China approved the Lanzhou lamb rotavirus vaccine (LLR) in 2000 and introduced the pentavalent rotavirus live attenuated vaccine (RotaTeq) in 2018, post-marketing effectiveness studies for these vaccines remain relatively limited. This study aimed to evaluate the vaccine effectiveness (VE) of LLR and RotaTeq and their vaccination coverage among children under five years old.
The study used a test-negative case-control study based on prospective surveillance was conducted among diarrhea patients aged 5 years and younger at five hospitals in Shanghai, China. Cases and controls were defined based on the results of real-time fluorescent quantitative reverse transcription polymerase chain reaction (rRT-PCR) of fecal samples for rotavirus. Both matched and unmatched case-control study designs were employed using logistic regression models, with adjustments for age at onset age and the rotavirus epidemic season.
In the LLR-specific analysis (247 cases, 2191 controls), the VE of partial LLR vaccination (2 doses) was 49.09 % (95 % CI: 1.69 %-73.64 %) in multivariate analyses. In the RotaTeq-specific analysis (42 cases and 523 controls), the VE of complete RotaTeq vaccination was 87.13 % (95 % CI: 45.87 % – 96.94 %), 89.46 % (95 % CI: 55.03 % – 97.53 %), and 85.69 % (95 % CI: 33.43 % – 96.93 %) respectively in univariate, multivariate, and matched analyses, respectively. The vaccination coverage for any dose among 2893 patients with rotavirus-negative diarrhea born between 2011 and 2022 was 49.78 %. Following the licensure of RotaTeq in 2018, this coverage increased from 45.02 % to 61.77 %.
RotaTeq demonstrates a robust protective effectiveness, while LLR provides a certain level of protection against mild to moderate rotavirus diarrhea in children in Shanghai. For privately purchased (non-NIP) vaccines, we estimate that the coverage for rotavirus vaccines among children in Shanghai is high. Complete rotavirus vaccination is recommended for age-eligible children. Further post-marketing research on rotavirus vaccines is necessary to inform decision-making regarding the introduction of rotavirus vaccination in China.
*The test-negative design (TND) is a novel research design developed from case-control studies, primarily used to evaluate vaccine effectiveness. Patients presenting with similar symptoms and tested for the target disease are included, with test-positive patients forming the case group and test-negative patients forming the control group. By comparing vaccination rates between the two groups and calculating vaccine effectiveness (VE) using odds ratios (OR), TND minimizes selection bias and confounding factors.
https://doi.org/10.1016/j.vaccine.2025.126731
05
Determinants of Rotavirus Vaccine Acceptance in an Area of Southern Italy with Low Vaccination Coverage: A Case-Control Study by the Health Belief Model Questionnaire
This article, published in Vaccines, examines the impact of rotavirus as a leading cause of gastroenteritis in children under five years old globally. Although the introduction of vaccines has significantly reduced related child mortality rates, vaccination coverage in Italy remains below target levels and displays notable regional disparities. Vaccination rates in Sicily have fluctuated significantly, primarily due to parental concerns about vaccine safety and a lack of awareness.
The study collected data from 226 parents in southern Italy, using a structured questionnaire to assess their sociodemographic characteristics, vaccine-related knowledge, and attitudes based on the Health Belief Model (HBM). Results revealed that 49% of children had been vaccinated, with 79.3% of parents aware of the vaccine. Among those informed, 68.6% obtained information from healthcare professionals, with pediatricians being the preferred source. Additionally, 74% of parents expressed a willingness to recommend the vaccine.
HBM analysis indicated that parents’ perceived benefits of vaccination were the most significant factor influencing their willingness to vaccinate (OR = 13.65; 95% CI: 6.88–27.09; p < 0.001). The perceived benefits scored significantly higher than other factors such as perceived barriers, severity, and susceptibility, demonstrating that parental confidence in the vaccine’s effectiveness and safety directly impacts vaccination decisions.
The study suggests that targeted interventions and educational campaigns are essential to improve vaccination coverage and address regional and socioeconomic barriers. Ensuring the consistent delivery of scientific information by healthcare providers is crucial for increasing vaccine uptake.
*The Health Belief Model (HBM) is a behavioral psychology theory designed to explain and predict individuals’ health behavior decisions. It analyzes how personal perceptions of health issues—such as disease severity, susceptibility, benefits, and barriers to action—along with external cues, influence key factors driving health behavior.
https://doi.org/10.3390/vaccines13010063
06
Australian preferences for influenza vaccine attributes and cost: A discrete choice experiment
This article, published in Human Vaccines & Immunotherapeutics, explores how Australian residents value different attributes of influenza vaccines, despite having access to multiple options and limited awareness of their features. Using a discrete choice experiment (DCE), the study systematically assessed the relative importance of vaccine attributes to inform strategies for optimizing vaccine promotion.
The study targeted adults (N=1203) who were not eligible for free influenza vaccination, had been vaccinated in the past five years, and planned to vaccinate again. Participants completed an online survey where they selected their preferred vaccine from configurations describing eight attributes. Half of the scenarios assumed the flu season would be as severe as the previous year, while the other half assumed it would be more severe. Data were analyzed using a mixed multinomial logit (MMNL) model.
The effect of the constant for a new vaccine was lower compared to the standard vaccine, this means that participants were on average more likely to choose the standard vaccine holding everything else equal. All eight attributes significantly predicted influenza vaccine choice for both same severity and more severe influenza seasons (all p < .05). For both influenza season severity models, participants have a higher preference for a vaccine with higher level of protection against the flu, modern vaccine technology and manufactured by an Australian company. The three most critical attributes were vaccine effectiveness, precise matching, and cost.
Regarding willingness to pay, participants were willing to pay higher amounts for precise matching and increased effectiveness. Specifically, for each 1% increase in effectiveness, participants were willing to pay AUD 1.61 (when the flu season severity was the same as the previous year) or AUD 2.18 (when the flu season was more severe than the previous year). For precise strain matching, they were willing to pay AUD 25.37 (same severity) or AUD 32.37 (more severe). The willingness to pay for healthcare professional recommendations was AUD 4.06 (same severity) or AUD 15.97 (more severe).
The study highlights that precise matching, effectiveness, cost, and professional recommendations are key factors influencing vaccine preferences, underscoring the value of shared decision-making. These findings provide critical insights for designing patient-centered, targeted strategies to promote influenza vaccination, ultimately improving vaccination rates and public health outcomes.
https://doi.org/10.1080/21645515.2024.2440164
Content Editor: Xiaotong Yang
Page Editor: Ziqi Liu