Journal Articles Recommendation
01
Adverse reaction surveillance analysis of domestic human papillomavirus vaccines with different production processes
This article was published in the Chinese Journal of Preventive Medicine. By comparing vaccination uptake and the occurrence of adverse events after administration of two domestically produced bivalent human papillomavirus (HPV) vaccines among individuals aged 9–30 years, the study analyzed the effects of different production processes and immunization schedules on vaccination compliance and adverse event rates. The study was conducted by the Immunization Program Department of the Liuzhou Center for Disease Control and Prevention between November 2023 and June 2024, using a single-center, randomized, open-label, parallel-group design. Eligible participants aged 9–30 years were socially recruited and randomly assigned to receive one of the two domestic HPV vaccines—WalrinVax or Cecolin. According to the vaccine instructions, participants were stratified by age into a two-dose group (9–14 years) and a three-dose group (15–30 years). Full-course vaccination rates, timely full-course vaccination rates, and the occurrence of adverse events within 0–30 days after vaccination were recorded.
The results showed that a total of 400 participants were enrolled. Both the full-course vaccination rate and the timely full-course vaccination rate in the two-dose group were significantly higher than those in the three-dose group (exact probability test, P<0.01; χ²=7.06, P<0.01). A total of 985 vaccine doses were administered, with an overall adverse event rate of 18.78% (185/985). Among these, the incidence of local reactions was 8.02% (79/985), and systemic reactions accounted for 10.76% (106/985). The most common adverse events were injection-site pain (4.97%) and fever (4.47%). No grade 4 adverse events or adverse events of special interest were observed. During the 0–6 month follow-up period after vaccination, the overall adverse event rates for the two domestic HPV vaccines produced using different expression systems (Pichia pastoris expression system vs. Escherichia coli expression system) were 13.96% (55/394) and 17.46% (69/395), respectively, with no statistically significant difference between the two groups. Age-stratified analysis showed that the adverse event rate in the 9–14-year group (9.77% [39/399]) was significantly lower than that in the 15–30-year group (24.91% [146/586]), and the difference was statistically significant (χ²=35.67, P<0.01).
The study demonstrates that both domestic bivalent HPV vaccines have good safety profiles in individuals aged 9–30 years, with mostly mild adverse reactions. Compared with the three-dose (0–2–6) schedule used in those aged 15–30 years, the two-dose (0–6) schedule for those aged 9–14 years significantly reduces the incidence of adverse events and effectively improves vaccination compliance. These findings provide practical evidence to support the optimization of HPV vaccination strategies across different age groups.
DOI：10.3760/cma.j.cn112150-20250425-00355
02
Implementation of school-based vaccination in French middle schools: Efficient or not?
This article was published in Vaccine. It evaluated the effectiveness of a school-based vaccination program implemented in public middle schools (students aged 11–13 years) in the Normandy region of France during the 2019–2023 academic years in increasing coverage of recommended vaccines. Since 2019, the regional health authority authorized vaccination centers to deliver vaccines on school premises. The program covered recommended vaccines, including DTaP-IPV, hepatitis B (HBV), measles–mumps–rubella (MMR), meningococcal serogroup C, and human papillomavirus (HPV) vaccines. Parental consent was required prior to implementation; students whose parents consented to at least one vaccine underwent medical assessment and vaccination. The study compared coverage of all mandatory and recommended vaccines (full vaccination coverage, VC) before and after program implementation.
Across 199 schools, 18,476 students were included. Parental consent for at least one vaccine was obtained for 33.6% (n=6,217) of students. Among 5,450 students assessed for vaccination, 81.9% (n=4,464) were vaccinated. Following program implementation, VC increased significantly from 10.7% (n=585) to 65.7% (n=3,585). Coverage of all vaccines improved markedly: meningococcal C from 64.8% to 87.5%, HBV from 67.6% to 85.6%, and HPV showing the largest increase, from 14.6% (675/4,614) to 79.9% (3,685/4,614). Multivariable analysis indicated that the post–COVID-19 period (2021–2022 academic year) was significantly associated with having at least one vaccine not administered on time (OR 1.4, 95% CI: 1.2–1.9). Regarding vaccine refusal, parental refusal was highest for HBV (36.1%) and meningococcal C vaccines (26.9%), while HPV refusal declined significantly over time (from 26.5% to 18.1%).
The study demonstrates that school-based vaccination programs effectively increase coverage of all recommended vaccines and should not be limited to HPV vaccination alone. Further improvements require strengthened health education, better access to information, and enhanced multisectoral collaboration to increase acceptance and support among students, parents, and schools.
https://doi.org/10.1016/j.vaccine.2025.127007
03
Analysis of Influenza Vaccination Coverage in Liaoning Province, 2014–2024
This article was published in the Chinese Journal of Biologicals and aimed to analyze influenza vaccination coverage in Liaoning Province from 2014 to 2024, providing evidence for the development of population-based influenza prevention and control strategies. Using data from the China Immunization Planning Information Management System and the Liaoning Provincial Immunization Information Platform, the study examined trends in influenza vaccination uptake over the past decade, including vaccine types, regional distribution, and seasonal patterns.
The results showed a sustained increase in per capita influenza vaccine doses administered in Liaoning Province from 2014 to 2024, reaching 348.96 doses per 10,000 population in 2023, a year-on-year increase of 119.40%. The proportion of influenza vaccines among non–National Immunization Program (non-NIP) vaccines rose from 6.91% in 2018 to 32.19% in 2023. Since 2019, influenza vaccines of different technological platforms have been included in reporting, with quadrivalent split influenza vaccines accounting for 67.40% of all influenza vaccine doses, increasing to 82.83% in 2024. Regionally, Dalian reported the highest cumulative number of doses administered (1,679,818), followed by Shenyang (1,284,318). In terms of vaccination coverage, Dalian ranked first (2.55%), followed by Benxi (2.17%) and Shenyang (1.56%). Influenza vaccination was highly seasonal, with 96.14% of doses administered between August and December each year.
The study indicates a rapid increase in per capita influenza vaccination in Liaoning Province, reflecting growing public health awareness and the positive impact of public health interventions. However, overall coverage remains low, with marked regional disparities.
https://doi.org/10.13200/j.cnki.cjb.004607
04
The rural adolescent vaccine enterprise (RAVE): a cluster-randomized trial testing a multicomponent intervention to improve HPV vaccination in rural primary care settings
This study was published in BMC Primary Care. Aiming to evaluate the effectiveness of a multicomponent intervention implemented in rural primary care clinics to improve HPV vaccination coverage among adolescents aged 11–17 years in rural Oregon, USA, and to examine its impact on the development of clinic-level quality improvement (QI) systems. The study used a stepped-wedge cluster randomized trial design and was conducted over five years through the Oregon Rural Practice-based Research Network.
Participating clinics received an 18-month tailored intervention, during which they selected and implemented evidence-based HPV vaccination promotion strategies based on their local needs. These strategies included vaccination reminders, initiating HPV vaccination at age 9, clinician and staff education, workflow optimization, and data system improvements. The primary outcome was clinic-level HPV vaccine initiation and series completion rates. Changes in vaccination rates over time were analyzed using mixed-effects Poisson regression models. Clinic QI capacity was assessed before and after the intervention using the Quality Improvement Capacity Assessment (QICA) tool.
Among the 45 enrolled clinics, 36 (80%) completed the intervention. Most clinics prioritized improving HPV series completion, with 72% focusing specifically on completion of the HPV vaccine series and employing multiple strategies simultaneously. During the study period, overall HPV vaccine initiation rates increased by an average of 0.5% per quarter, and series completion rates increased by 1.4% per quarter; both trends were statistically significant. However, the analysis did not demonstrate an additional effect attributable specifically to the intervention itself (e.g., incidence rate ratio for initiation = 1.000; 95% CI: 0.985–1.015). In contrast, clinics showed a significant improvement in QI capacity, with a mean increase in QICA score of 1.19 points (95% CI: 0.80–1.59, p < 0.01), most notably in care coordination.
The study suggests that although the tailored multicomponent intervention did not produce a measurable independent effect on HPV vaccination uptake, vaccination rates continued to improve over time and clinic engagement in improvement activities remained high. Given the disruptions caused by the COVID-19 pandemic and heterogeneity in intervention implementation, future efforts should focus on resource-limited rural primary care settings by integrating high-intensity external support with multilevel community engagement and extending post-intervention follow-up to better assess long-term effectiveness and sustainability.
https://doi.org/10.1186/s12875-025-03076-6
05
From Misinformation to Action: A Multifaceted Approach to Combating Vaccine Hesitancy
Published in The Journal of Pediatrics, this article examines vaccine hesitancy and response strategies, analyzes the drivers of declining public trust in childhood vaccines, and proposes practical approaches to improve vaccination coverage.
The study attributes reduced trust partly to limited public understanding of vaccine development and safety oversight, cultural emphasis on individual autonomy and resistance to mandates, and fragmented electronic health records that hinder vaccination tracking and timely reminders.
The authors emphasize rebuilding confidence through targeted communication and public engagement. Personalized health education and bidirectional communication with parents, alongside transparent and empathetic policy messaging, can enhance trust and uptake. Streamlining vaccination workflows, promoting combination vaccines, and improving logistics and access help address structural barriers and advance immunization equity.
Establishing modern surveillance systems and data-driven decision-making is essential to sustain high coverage. Monitoring vaccination status, identifying immunity gaps, and implementing targeted interventions can counter misinformation and psychological barriers. Rebuilding public trust requires integrating scientific evidence, empathetic communication, and systemic reforms to ensure sustainable protection of child health and herd immunity.
https://doi.org/10.1016/j.jpeds.2025.114895
06
Minimum Data Set and Metadata for Active Vaccine Safety Surveillance: Systematic Review
Published in JMIR Public Health Surveillance, this study systematically identifies the core variables most frequently used in active vaccine safety surveillance (AVSS) research, with the aim of defining a minimum data set (MDS) required for active vaccine safety monitoring and informing implementation, particularly in low- and middle-income countries.
The authors reviewed 123 AVSS-related studies published between January 1, 2018, and September 7, 2022. Guided by World Health Organization (WHO) and Council for International Organizations of Medical Sciences (CIOMS) recommendations, they developed an MDS framework across four domains—vaccines, health outcomes, demographics, and covariates—retaining variables reported in at least 5% of studies.
Of the included studies, 102 (82.9%) were cohort studies, and 98 (79.7%) were conducted in high-income countries, covering populations across the life course. The resulting MDS comprised 68 variables: 13 vaccine-related, 12 outcome-related, 11 demographic, and 32 covariate variables. Key variables included a unique anonymized individual identifier; vaccine name and vaccination date; diagnosis and diagnosis date; age and sex; and medical and medication history. Frequency analysis showed that “diagnosis” was the most commonly reported variable in both the outcome (96.8%) and covariate (82.9%) domains, “geographic information” was most frequent in the demographic domain (89.4%), and “vaccine name” was most commonly reported in the vaccine domain (88.6%).
The study concludes that the proposed MDS provides clear and practical guidance on the essential data required for active vaccine safety surveillance. Establishing a globally standardized MDS, together with comprehensive metadata, is critical to strengthening the global vaccine safety ecosystem.
https://publichealth.jmir.org/2025/1/e63161
Content Editor: Tianyi Deng
Page Editor: Ruitong Li
