01
Decline in Type 1 Diabetes in Young Children After Rotavirus Vaccination: Data From 8 Countries
This study, published in AJPM Focus, aimed to evaluate whether the introduction of rotavirus vaccines into national immunization programs (NIP) is associated with changes in the incidence of type 1 diabetes mellitus (T1DM) among children under five years of age, using ecological data from multiple countries. Rotavirus—one of the leading causes of gastroenteritis in infants and young children—can induce pancreatic β-cell apoptosis and trigger hyperglycemic responses, and has therefore been considered a potential contributor to T1DM onset.
The researchers compiled national T1DM incidence data before and after the introduction of rotavirus vaccines from eight countries: Australia, Austria, Finland, Ireland, Israel, Mexico, Wales (of Great Britain), and the Dominican Republic. Interrupted time series analysis (ITSA) was applied to compare incidence trends and assess changes following nationwide vaccine implementation.
Except for the Dominican Republic, where the annual number of T1DM cases was too small to analyze, all seven evaluable countries showed a downward trend in T1DM incidence after introducing routine rotavirus vaccination. In Finland and Israel, both of which use pentavalent rotavirus vaccines, incidence declined by approximately 21% and 21.7%, respectively. Mexico also demonstrated a marked decline after switching from a monovalent to a pentavalent vaccine. In contrast, countries using monovalent vaccines showed relatively modest reductions.
The study suggests that incorporating rotavirus vaccines into national immunization programs may contribute to a reduced risk of T1DM among young children. These findings provide real-world evidence supporting the potential non-specific health benefits of rotavirus vaccination beyond the prevention of gastroenteritis.
https://doi.org/10.1016/j.focus.2025.100409
02
Parental perceptions and willingness to pay for childhood vaccination experiences in China: a multi-city comprehensive evaluation study
This article, published in Vaccine, aimed to evaluate Chinese parents’ overall perceptions, attitudes, and willingness to pay (WTP) toward improving children’s vaccination experiences, with particular attention to preferences for combination vaccines such as the DTaP-IPV-Hib formulation. The study was conducted between January and December 2021 across five cities—Beijing, Hangzhou, Zhengzhou, Chongqing, and Lanzhou—using a multi-city cross-sectional survey.
Face-to-face interviews were carried out in 60 community health service centers with 1,845 parents of children aged 1–18 months, assessing four vaccine attributes (number of injections, number of diseases prevented per dose, on-time coverage rate, and cost) as well as parents’ WTP for reducing pain, preventing adverse reactions, and improving convenience.
The average age of participating parents was 30.95 ± 4.34 years; 79% were mothers and 66.4% held a bachelor’s degree. The findings indicate substantial parental concern about multiple aspects of the vaccination experience: more than two-thirds (67.84%) expressed strong worries about potential adverse reactions, 74.40% reported that their child cried heavily during vaccination, and 65.02% felt that traveling to vaccination sites was time-consuming or inconvenient. Results from the discrete choice experiment (DCE) showed consistent parental preferences for vaccine options with fewer injections, broader disease prevention per dose, higher on-time coverage, and lower cost (all P < 0.001). Regarding specific benefits, parents demonstrated the highest WTP for avoiding severe adverse reactions—with 54.53% willing to pay 200 RMB for each avoided reaction—substantially exceeding their WTP for convenience-related improvements. Educational attainment, income, and age were key determinants of WTP.
The study highlights that Chinese parents prioritize vaccine safety over convenience, express high levels of concern about adverse reactions, and strongly prefer combination vaccines that reduce injection frequency. These findings provide evidence for advancing combination-vaccine development, optimizing government procurement strategies, and strengthening communication around vaccine safety.
https://doi.org/10.1016/j.vaccine.2025.127826
03
Maternal influenza vaccination intention and associated factors among pregnant women in Guizhou Province, China
This article, published in Human Vaccines & Immunotherapeutics, examined influenza vaccination willingness among pregnant women in Guizhou Province, China, and the factors influencing their decisions. A cross-sectional survey was conducted in several hospitals across the province between January and February 2022, enrolling a total of 564 pregnant women.
Guided by the Health Belief Model (HBM), the study assessed cognitive, social, and structural determinants of vaccination willingness. Group differences were analyzed using the Mann–Whitney U test, and modified Poisson regression models were applied to estimate prevalence ratios (PRs).
The findings showed that only 11.9% (67/564) of participants had received an influenza vaccine prior to pregnancy, and 36.7% (207/564) expressed willingness to be vaccinated during pregnancy. The HBM-based analysis identified several key predictors: (1) perceived barriers, predominantly concerns about fetal and maternal safety and opposition from family members; (2) cues to action and perceived benefits; and (3) perceived susceptibility to and severity of influenza. Specifically, higher levels of perceived barriers were associated with lower vaccination willingness (PR = –0.34, 95% CI: –0.51 to –0.17, P_trend < 0.001), whereas cues to action and perceived benefits were positively associated with willingness (PR = 0.34, 95% CI: 0.13–0.55, P_trend = 0.002). Sensitivity analyses further indicated that multiparous women had higher willingness than primiparous women (PR = 1.39, 95% CI: 1.04–1.86, P = 0.027).
The study demonstrates that influenza vaccination coverage among pregnant women in Guizhou Province remains low, and vaccination willingness is shaped by multidimensional health belief factors. Safety concerns and family opposition emerged as the most influential barriers, while multiparity—identified as a novel factor—warrants further exploration. The authors recommend implementing integrated interventions, such as prenatal counseling, mobile health education, financial incentives, peer-support networks, and vaccination reminders, to address cognitive, social, and structural barriers and enhance facilitators of vaccination uptake.
https://doi.org/10.1080/21645515.2025.2575651
04
Pentavalent rotavirus vaccine effectiveness among children in Shenzhen, China: A population-based test-negative design with directed acyclic graphs bias adjustment
This article, published in Infectious Medicine, aimed to evaluate the seasonal protective effectiveness of the pentavalent rotavirus vaccine (RV5) against rotavirus gastroenteritis (RVGE) among children under five years of age. The study utilized laboratory data from diarrhea cases in children aged 2–59 months recorded between January 2020 and March 2024 in Shenzhen Longhua District, drawing from the National Notifiable Disease Reporting System (NDRS) and the regional immunization information system. A test-negative case–control design was applied, and confounders were identified and adjusted for using directed acyclic graphs (DAGs). Vaccine effectiveness (VE) was estimated using unconditional logistic regression.
The results showed that RVGE incidence increased and then declined between January 2020 and March 2023, with no seasonal resurgence observed in the first quarter of 2023. Among the 928 cases included during peak seasons (674 RV-positive and 254 RV-negative), the overall VE of RV5 was 79.6% (95% CI: 68.9%–86.6%). Dose-specific analyses demonstrated a clear dose–response relationship: VE was 26.7% (95% CI: −162.1% to 79.5%) after one dose, 76.6% (95% CI: 46.2%–89.8%) after two doses, and 82.7% (95% CI: 72.2%–89.2%) after three doses. Age-stratified analyses further indicated that the three-dose schedule conferred strong protection among children under 36 months: VE was 79.5% (95% CI: 56.8%–90.3%) in children aged 2–11 months, 83.8% (95% CI: 66.4%–92.2%) in those 12–23 months, and 79.6% (95% CI: 68.9%–86.6%) in those 24–35 months. In contrast, effectiveness was substantially lower in children aged 36–59 months (31.2%, 95% CI: −251.8% to 86.5%).
The findings indicate that the full three-dose RV5 schedule provides strong protection against RVGE among children younger than 36 months during seasonal transmission periods. The study underscores the vaccine’s public health value and provides supportive evidence for considering its inclusion in China’s national immunization program.
https://doi.org/10.1016/j.imj.2025.100201
05
Level and determinants of pentavalent vaccine dropout during infancy: A hierarchical analysis of community-level longitudinal study
This article, published in PLOS ONE, aimed to systematically assess the magnitude of dropouts during the infant pentavalent vaccination schedule in Ethiopia and to identify multilevel determinants contributing to missed doses. Using data from the Performance Monitoring for Action (PMA) Ethiopia panel survey, the study conducted a multilevel longitudinal community-based analysis across three major regions—Amhara, Oromia, and the former Southern Nations, Nationalities, and Peoples’ Region (SNNP). A multistage cluster sampling strategy with urban–rural stratification was applied to obtain a representative sample of households and women of reproductive age.
A total of 1,295 infants were included in the final analysis. Overall, 37.48% of infants who received the first dose of the pentavalent vaccine failed to complete the third dose. Multilevel regression analyses identified several key factors associated with higher dropout risk: infants born at home had 1.84 times higher odds of dropping out compared with those born in health facilities (AOR=1.84, 95% CI: 1.24–2.72); infants whose mothers perceived insufficient community support for postnatal care had 1.77 times higher odds of dropout (AOR=1.77, 95% CI: 1.04–2.99); and infants whose mothers experienced difficulty accessing postnatal care during the COVID-19 pandemic had an especially elevated dropout risk (AOR=5.06, 95% CI: 1.32–19.48). Substantial geographic disparities were observed: infants living in the former SNNP region had 3.78 times higher odds of dropout (AOR=3.78, 95% CI: 1.75–8.16), and those residing in high-poverty communities faced 2.75 times higher odds (AOR=2.75, 95% CI: 1.17–6.43).
The study highlights that the pentavalent vaccine dropout rate in Ethiopia—from dose 1 to dose 3—is considerably higher than levels reported in many other settings. Key contributors include living in high-poverty communities, home births, inadequate perceived community postnatal support, and reduced access to postnatal care during the COVID-19 pandemic. Strengthening community-based postnatal services, improving facility-based delivery coverage, and building resilience in maternal–child health services during public health emergencies may be critical to reducing dose completion gaps.
https://doi.org/10.1371/journal.pone.0326684
Content Editor: Tianyi Deng
Page Editor: Ruitong Li
