Journal Articles Recommendation
01
Coverage and influencing factors of influenza vaccination among community healthcare workers in Shanghai, 2023–2024
This study, published in Human Vaccines & Immunotherapeutics, examined influenza vaccination coverage and associated factors among community healthcare workers (CHWs) in Shanghai during the 2023–2024 influenza season. A cross-sectional survey was conducted across 47 community health service centers in Pudong New Area, Shanghai. Data on vaccination status and reasons for vaccination or non-vaccination were collected via questionnaires, and binary logistic regression was used to identify factors associated with vaccine uptake.
Among 1,781 surveyed CHWs, 335 received the influenza vaccine, corresponding to a coverage rate of 18.81% (95% CI: 17.04–20.72). Vaccination coverage varied significantly by occupation (P < 0.001), with nurses showing the highest uptake (32.08%), followed by public health workers (26.78%), while clinicians had the lowest coverage (11.64%). Multivariable analysis identified age, educational level, occupational category, and household monthly income as significant determinants of vaccination (P < 0.05).
The main reasons for not getting vaccinated included concerns about vaccine side effects, perceived good health and lack of need for vaccination, and doubts regarding vaccine effectiveness or cost-effectiveness, with notable differences across occupational groups.
The study concludes that influenza vaccination coverage among CHWs in Pudong New Area remains suboptimal and uneven across professions. Improving uptake in this critical population will require a combination of targeted health education—addressing misconceptions about vaccine safety and emphasizing influenza-related risks—and structural policy measures, such as full vaccination subsidies.
https://doi.org/10.1080/21645515.2025.2588025
02
Neonatal and infant mortality after maternal influenza and pertussis vaccination: Probabilistically linked cohort study
This study, published in Human Vaccines & Immunotherapeutics, evaluated the association between maternal influenza and pertussis vaccination during pregnancy and all-cause infant mortality, providing real-world evidence on the safety and benefits of antenatal immunization. Using probabilistically linked maternal–infant health data from three regions in Australia (2015–2017), vaccination records were obtained from regional immunization registries, and mortality data were sourced from perinatal and death registration databases. Cox proportional hazards models with vaccination as a time-varying exposure and inverse probability of treatment weighting were applied to estimate adjusted hazard ratios (aHRs).
The cohort included 252,924 mothers and 277,979 live-born infants. Among infants, 3.0% were exposed prenatally to influenza vaccine only, 31.7% to pertussis vaccine only, and 24.1% to both vaccines. A total of 741 infant deaths occurred during follow-up (crude mortality rate: 2.67‰). Compared with infants born to unvaccinated mothers, prenatal exposure to influenza vaccine (aHR 0.66, 95% CI 0.43–0.99) or pertussis vaccine (aHR 0.69, 95% CI 0.54–0.87) was associated with a significantly reduced risk of all-cause infant mortality. The strongest protective effect was observed among infants exposed to both vaccines, with a 42% reduction in mortality risk (aHR 0.58, 95% CI 0.44–0.77).
The mortality reduction was primarily observed in early neonatal deaths (0–7 days), with no significant associations detected for late neonatal (8–28 days) or post-neonatal (29–365 days) mortality. Overall, the findings indicate that influenza and pertussis vaccination during pregnancy is safe and confers substantial protection against early infant death, supporting current recommendations for antenatal immunization.
https://doi.org/10.1080/21645515.2025.2587307
03
Vaccination status in children with congenital heart disease in Wuxi, China: Analysis of retrospective data
This study, published in Human Vaccines & Immunotherapeutics, systematically evaluated disease patterns, vaccination coverage, and adverse events following immunization (AEFI) among children younger than 6 years with congenital heart disease (CHD) in Wuxi, China. Using data from the regional health information platform, 4,267 children with CHD recorded between 2022 and 2023 were included. Information on National Immunization Program (NIP) vaccines and five non-NIP vaccines (EV71, PCV13, Hib, influenza, and rotavirus) was obtained from provincial immunization systems, while AEFI data were sourced from the national surveillance system.
Atrial septal defect, ventricular septal defect, and patent ductus arteriosus were the most common CHD subtypes. For NIP vaccines, completion of first-dose schedules within the first year of life ranged from 81.9% to 90.3%, lower than that of healthy children, with delayed vaccination observed for several vaccines, including MMR, meningococcal, and Japanese encephalitis vaccines. In contrast, overall coverage of non-NIP vaccines was substantially lower (11.3%–37.8%), with declining uptake of EV71, PCV13, Hib, and rotavirus vaccines with increasing age, while influenza vaccination was more common among children aged 4–5 years.
The overall AEFI incidence was 7.86 per 10,000 doses, predominantly mild reactions, and no serious adverse events were reported. Abnormal reaction rates did not differ significantly from those in the general pediatric population.
The study concludes that routine vaccination is safe for most children with CHD, but suboptimal coverage, delayed schedules, and low uptake of non-NIP vaccines may leave this population insufficiently protected. Strengthened monitoring and tailored immunization strategies are needed to optimize vaccine delivery for children with CHD.
https://doi.org/10.1080/21645515.2025.2592428
04
A Hybrid Chatbot to Promote Pneumococcal Vaccination Among Older Adults
A Randomized Clinical Trial
This study, published in JAMA Network Open, evaluated the effectiveness of a hybrid chatbot intervention in increasing pneumococcal vaccination uptake among adults aged 65 years and older. The intervention combined stage-matched, rule-based messaging with real-time question-and-answer support using natural language processing. A partially blinded, parallel-group randomized controlled trial was conducted in Hong Kong, China, between May 2023 and November 2024, enrolling 374 pneumococcal vaccine–naïve older adults via random telephone sampling.
Participants were randomly assigned to either a hybrid chatbot intervention based on the Transtheoretical Model of behavior change or a control intervention consisting of chatbot-delivered standard online video information. Interventions were delivered at baseline and at 1, 2, and 3 months. The primary outcome was verified pneumococcal vaccination status at 12 months.
Intention-to-treat analysis showed significantly higher vaccination uptake in the intervention group compared with the control group (29.4% vs 18.7%; P = 0.01), with a relative risk of 1.57 and an absolute risk difference of 11%. Participants receiving the hybrid chatbot also demonstrated higher behavior change stage scores at 12 months and greater intervention completion rates. The findings indicate that integrating tailored, stage-based messaging with interactive Q&A can effectively enhance pneumococcal vaccination uptake among older adults.
https://doi.org/10.1001/jamanetworkopen.2025.35813
05
Relationship between HPV vaccine hesitancy and attitudes towards early detection of cervical cancer in women of reproductive age
This study, published in Enfermería Clínica, employed a descriptive and correlational research design to examine the relationship between HPV vaccination hesitancy and attitudes toward cervical cancer early screening among women of reproductive age in Turkey. Between May and October 2023, a total of 1,240 women of reproductive age were recruited through online snowball sampling. Data were collected using a questionnaire that included general sociodemographic information, the Cervical Cancer Early Screening Attitude Scale, and a Vaccine Hesitancy and Reasons Form developed based on the WHO “3Cs model” (confidence, complacency, and convenience).
The results showed that the mean age of participants was 20.66 ± 2.38 years. Significant differences in attitudes toward HPV vaccination were observed across women with different educational levels, income levels, and types of residence (P < 0.05), with smoking status showing the strongest association with HPV vaccination attitudes (P = 0.001). Regarding sources of vaccine-related information, recommendations from friends (38.4%) and internet media (31.1%) were the most common. More than half of the respondents (54.7%) reported not knowing where to receive the vaccine, and 25% considered completing the multi-dose vaccination schedule to be challenging. In terms of safety concerns, worries about vaccine safety (51.4%), potential infertility (28.2%), and allergic reactions (19.7%) were the main factors. Beliefs about the necessity of vaccination and its cancer-preventive effects significantly influenced vaccination attitudes and the degree of hesitancy (P < 0.001).
The study concludes that to effectively reduce HPV vaccine hesitancy, it is essential to establish accessible and trustworthy channels for information dissemination, strengthen the professional role of healthcare workers in vaccine advocacy, and deliver targeted health education through digital media platforms commonly used by young people. Finally, structural barriers should be systematically addressed at the policy level, including improving vaccine accessibility, reducing vaccine costs, optimizing the distribution of vaccination sites, and clarifying misconceptions regarding vaccine safety.
https://doi.org/10.1016/j.enfcle.2025.502363
Content Editor: Tianyi Deng
Page Editor: Ruitong Li
