Guideline Updates
01
The Chinese Center for Disease Control and Prevention (CDC) released the Technical Guidelines for Influenza Vaccination in China (2025–2026)
On November 3, the Chinese Center for Disease Control and Prevention (China CDC) released the Technical Guidelines for Influenza Vaccination in China (2025–2026). The guidelines recommend that all individuals aged ≥6 months without contraindications receive influenza vaccination, with priority given to key and high-risk populations, including:
- Healthcare workers (e.g., clinical care providers, public health professionals, and health inspection personnel);
- Adults aged ≥60 years;
- Individuals with one or more chronic conditions;
- Residents and staff of congregate settings such as nursing homes, long-term care facilities, and welfare institutions;
- Pregnant women;
- Children aged 6–59 months;
- Household members and caregivers of infants aged <6 months; and
- Populations in key settings such as childcare institutions, primary and secondary schools, and custodial facilities.
For children aged 6 months to 8 years, those without prior influenza vaccination history should receive two doses of inactivated influenza vaccine at first vaccination (same vaccine formulation, with an interval of ≥4 weeks), whereas those with prior vaccination history require only one dose. For this age group, live attenuated influenza vaccine requires one dose regardless of prior vaccination history. Individuals aged ≥9 years require only one dose per season, irrespective of vaccine type or prior vaccination history. Protective antibody levels are generally achieved 2–4 weeks after vaccination. Given regional variations in the timing and duration of influenza activity in China, vaccination should ideally be completed before the local influenza season, with September to October typically representing the optimal vaccination window. Individuals who miss this period may still be vaccinated throughout the influenza season. Within the same influenza season, persons who have completed the recommended vaccination schedule do not need revaccination.
https://mp.weixin.qq.com/s/m53ShkH7UmnxjiWnITxXlg
Journal Articles Recommendation
01
Optimizing immunization through concurrent vaccination: a safety and cost analysis of PCV13 and rotavirus vaccines co-administration in Shanghai
This study, published by Wang Weibing et al. in Vaccine, aimed to evaluate the safety and socioeconomic impact of co-administration of the 13-valent pneumococcal conjugate vaccine (PCV13) and rotavirus vaccine among infants in Shanghai. The study employed a prospective active safety monitoring approach combined with a societal-perspective economic evaluation. For safety assessment, infants aged 2–6 months were recruited from outpatient clinics across different districts of Shanghai using cluster sampling and, based on parental preference, were assigned to PCV13 alone, rotavirus vaccine alone, or concomitant administration groups. Adverse events occurring on the day of vaccination and within 7 days post-vaccination were recorded. The economic evaluation utilized cost-minimization analysis (CMA) and budget impact analysis (BIA), incorporating direct medical costs, direct non-medical costs, and indirect costs, with sensitivity analyses conducted to verify the robustness of results.
The study reported that, in 2023, a total of 166,776 doses of PCV13 and 244,999 doses of rotavirus vaccine were administered to children under two years in Shanghai. A total of 91,576 infants were included in the active safety monitoring. The incidence of systemic adverse events was 4.82% in the PCV13 alone group, 4.35% in the rotavirus alone group, and 4.11% in the concomitant administration group, with no statistically significant differences among groups. Local injection-site reactions were rare, and no serious safety signals were observed. Economic analysis indicated that partial-dose concomitant administration was cost-saving: compared with separate vaccination, co-administration of 1, 2, and 3 doses reduced total costs by 2.29%, 2.20%, and 1.07%, respectively, with a maximum per-child cost reduction of approximately 10.06%. Cost savings were primarily driven by reductions in direct non-medical costs (44.2%) and indirect costs (49.4%), mainly due to decreased transportation and caregiving expenses.
The study concluded that, compared with separate administration of PCV13 and rotavirus vaccines, co-administration is safe and can optimize the use of immunization service resources, reduce the number of clinic visits, and lower family costs. This strategy is particularly relevant for enhancing the efficiency and sustainability of immunization programs in densely populated urban settings.
https://doi.org/10.1016/j.vaccine.2025.127880
02
HPV vaccination efficacy in primary and tertiary prevention of vulvar and vaginal HPV-related high grade dysplasia and cancers: A systematic review
This study, published in Human Vaccines & Immunotherapeutics, aimed to systematically evaluate the efficacy of quadrivalent (qHPV) and nine-valent (9vHPV) human papillomavirus vaccines in primary and tertiary prevention of high-grade vulvar and vaginal intraepithelial neoplasia (VIN/VaIN) and related cancers. Following PRISMA guidelines, randomized controlled trials and observational studies were systematically searched, resulting in the inclusion of 11 studies: 7 focusing on primary prevention and 4 on tertiary prevention. The primary outcomes included the incidence of HPV-related high-grade lesions and cancers, as well as post-treatment recurrence rates.
The results indicated that, in HPV-naïve populations, the quadrivalent HPV vaccine demonstrated substantial efficacy for primary prevention of HPV16/18-associated VIN/VaIN and related cancers, with protocol-defined analyses showing 100% efficacy and intention-to-treat analyses showing 71% efficacy. The nine-valent vaccine further extended protection to five additional high-risk types (HPV 31/33/45/52/58), with overall protective efficacy exceeding 94%. Real-world studies confirmed a significant reduction in vulvar and vaginal cancer incidence post-vaccination, particularly among younger women; for instance, in the United States, vaginal cancer incidence decreased by 65% among women aged 25–34 following vaccination.
Regarding tertiary prevention, some studies suggested that vaccination might help reduce the risk of recurrence of HPV-related lesions after treatment, but meta-analyses did not detect significant overall effects, indicating that larger studies are needed for confirmation. All studies reported good vaccine safety profiles, with common adverse events being mild local reactions and serious adverse events being rare.
In summary, HPV vaccination is highly effective in preventing high-grade vulvar and vaginal lesions and associated cancers, particularly when administered prior to HPV exposure, with protective efficacy maintained for at least ten years post-vaccination. While vaccination shows potential in reducing post-treatment recurrence, current evidence supporting tertiary prevention remains limited.
https://doi.org/10.1080/21645515.2025.2567704
03
Adult Vaccine Coadministration Is Safe, Effective, and Acceptable: Results of a Survey of the Literature
This study, published in Influenza and Other Respiratory Viruses, conducted a systematic review of the literature to evaluate the reactogenicity of co-administration of adult vaccines and its impact on vaccine effectiveness. The research team systematically searched the Medline database for randomized controlled trials and observational studies examining co-administration of influenza vaccines with COVID-19 vaccines, respiratory syncytial virus (RSV) vaccines, herpes zoster vaccines, pneumococcal vaccines, and tetanus-diphtheria-acellular pertussis (Tdap) vaccines. Additionally, reference lists of the included studies were screened to capture supplementary relevant evidence.
The results indicated that all evaluated vaccine combinations exhibited good safety profiles. The vast majority of adverse events were mild to moderate, transient, and primarily involved injection site pain, fatigue, or headache. Some studies reported a slight increase in reactogenicity with co-administration, but serious adverse events or safety signals were rare. Regarding immunogenicity, nearly all studies confirmed that co-administration did not significantly affect the immune response of any vaccine and no significant interference with immunogenicity was observed. Specifically, co-administration of influenza and RSV vaccines maintained robust immunogenicity across all age groups, while co-administration of influenza vaccine with herpes zoster or pneumococcal vaccines, as well as COVID-19 and Tdap vaccines in pregnant women, showed no safety concerns or immune interference.
The study concludes that co-administration of adult vaccines is a safe, effective, and feasible public health strategy, with benefits outweighing potential risks. This approach not only enhances convenience for vaccine recipients and reduces missed opportunities but also supports the efficient use of healthcare resources.
https://doi.org/10.1111/irv.70090
04
Updated Evidence for Covid-19, RSV, and Influenza Vaccines for 2025–2026
This study, published in The New England Journal of Medicine, aimed to evaluate the effectiveness, immunogenicity, and safety of the COVID-19 vaccines, respiratory syncytial virus (RSV) vaccines, and monoclonal antibody nirsevimab, as well as influenza vaccines in the United States, providing evidence to inform immunization strategies for the 2025–2026 season.
A total of 511 eligible studies were included through systematic review. The results showed that the mRNA COVID-19 vaccines targeting the XBB.1.5 variant demonstrated pooled vaccine effectiveness (VE) against hospitalization of 46% (95% CI: 34%–55%, cohort studies) and 50% (95% CI: 43%–57%, case-control studies) in adults, with effectiveness of 37% (95% CI: 29%–44%) among immunocompromised adults.
For RSV vaccines administered to pregnant women (for infant protection), nirsevimab use in infants, and RSV vaccination in adults aged 60 years and older, VE against hospitalization was at least 68%. Influenza vaccines showed pooled VE against hospitalization of 48% (95% CI: 39%–55%) in adults aged 18–64 years, and 67% (95% CI: 58%–75%) in children.
In terms of safety, the review aligned with previous assessments and did not identify any serious safety signals. Reported incidence of myocarditis related to COVID-19 vaccines in male adolescents ranged from 1.3 to 3.1 cases per 100,000 doses, with extended dosing intervals reducing the risk. In older adults, RSVpreF vaccines were associated with a small excess risk of Guillain-Barré syndrome, estimated at 18.2 cases per million doses. Administration of RSV vaccine at 32–36 weeks of gestation was not associated with significant risk of preterm birth.
The study concludes that COVID-19, RSV, and influenza vaccines demonstrate good effectiveness and safety for the 2025–2026 season.
https://doi.org/10.1056/NEJMsa2514268
05
Blended finance to the rescue? Subsidies, vaccine bonds and matching funds in global health
This study, published in Global Public Health, employed a mixed-methods approach to systematically evaluate the real-world impact of blended finance in global health, with a focus on three types of instruments: vaccine bonds, advanced market commitments (AMC), and matching funds. The analysis centered on their operational mechanisms, costs, and actual benefits for low- and middle-income countries (LMICs) and public funders.
The study first conducted a systematic analysis of financial data, then reviewed annual reports and evaluation literature from the Coalition for Epidemic Preparedness Innovations (CEPI), Gavi, the Vaccine Alliance, and the International Finance Facility for Immunisation (IFFIm). In addition, in-depth interviews were conducted with 16 global health finance experts involved in or studying these mechanisms to verify challenges and controversies.
The findings indicate that IFFIm converts future donor pledges into capital market guarantees by issuing vaccine bonds, thereby monetizing funds in advance and providing predictable cash flow for vaccine procurement. This mechanism significantly supported Gavi’s early vaccine procurement and market risk-sharing. However, it exhibits three structural shortcomings: high financing costs, limited transparency, and reduced policy flexibility.
AMC, as a “pull” subsidy, aims to incentivize vaccine research, development, and supply through guaranteed future procurement. Its effectiveness is highly debated. For instance, the pneumococcal conjugate vaccine (PCV) AMC did not accelerate the development of new products—the first vaccine was launched five years later than expected—and approximately 83% of subsidy funds flowed to a few multinational companies, including Pfizer and GlaxoSmithKline. Evidence that AMC reduced vaccine prices remains limited; PCV remains one of the most expensive vaccines in Gavi’s procurement portfolio. The cost-effectiveness of AMC is difficult to assess accurately due to pharmaceutical companies’ refusal to disclose production costs.
Matching funds attempt to leverage private donations through a 1:1 co-funding mechanism to amplify public resources, but their actual effectiveness has been limited.
Overall, the study highlights that these three blended finance tools in practice are characterized by high costs and uncertain effectiveness. The high costs primarily benefit large corporations, private investors, and intermediaries, while the real benefits for LMICs and public donors remain unclear.
*Blended finance refers to a financing model in which public and philanthropic sectors use financial instruments to “mobilize,” “attract,” or “crowd in” private investment that would not otherwise be available for development purposes.
https://doi.org/10.1080/17441692.2025.2468338
Content Editor: Tianyi Deng
Page Editor: Ruitong Li
