The COVID-19 pandemic revealed global disparities in accessing medical countermeasures, as high-income countries prioritised their own interests while disregarding low- and middle-income countries. Despite global efforts to ensure an equitable pandemic response, these initiatives largely failed to achieve their objectives for LMICs due to systemic inequalities. This review critically examines these disparities, identifying that excessive stockpiling by HICs, fragmented international coordination, inadequate research and manufacturing capacity, restricted access to emergency research funding, intellectual property constraints, unequal participation in clinical trials, and inadequate regulatory harmonisation collectively hinder LMICs ability to respond effectively. By analysing diverse case scenarios and global response strategies, all plausible key shortcomings that contributed to the failure of coordinated pandemic preparedness were highlighted. Based on these insights, actionable strategies are proposed to address these gaps in LMICs so as to ensure affordability, accessibility, and equitable distribution of vaccines, diagnostics, and biotherapeutics in future public health emergencies, strengthening global biosecurity.

Recently, immunotherapy has been a key therapeutic strategy for cancer. Deubiquitinating enzymes (DUBs), which are protein-modifying enzymes, have a crucial role in the pathogenesis of cancer, autoimmune diseases, and inflammation. DUBs influence the tumor immune microenvironment by regulating immune cell functions and key signaling pathways. Thus, the potential applications of DUBs in immunotherapy have piqued the interest of the scientific community. This study performed bibliometric analysis to comprehensively examine the research hotspots and trends in this field, providing theoretical foundations and guidance for future research. Studies associated with DUBs and immunotherapy conducted over a decade (2014 to 2024) were searched and extracted from Web of Science Collection database. The analysis was performed using CiteSpace, VOSviewer, and the Bibliometrix package in R software. Visualizations were generated for countries, institutions, authors, journals, references, and keyword co-occurrences. In total, 321 articles related to DUBs and immunotherapy were retrieved. The number of publications increased markedly since 2020. China had the highest number of publications, while the United States exerted the most influence in this field. Zhang Jinfang was the most influential author in this field. Zhejiang University was the institution with the highest number of publications. Nature was the most cited journal (807 total citations). Keyword analysis revealed that the primary research hotspots were expression, immunotherapy, ubiquitination, degradation, and cancer. This bibliometric analysis revealed the research trends and emerging frontiers in DUBs and immunotherapy, offering novel strategies for the application of DUBs in immunotherapy.

Immunity has vital research value and promising applications in triple-negative breast cancer (TNBC). Nevertheless, few bibliometric analyses have systematically investigated this area. This study aimed to comprehensively review the collaboration and impact of countries, institutions, authors, and journals on the role of immunity in TNBC from a bibliometric perspective, evaluate the keyword co-occurrence of the knowledge structure, and identify hot trends and emerging topics. Articles and reviews related to immunity in TNBC were retrieved from the Web of Science core collection using subject search. A bibliometric study was conducted primarily using CiteSpace and VOSviewer. A total of 3,104 articles and reviews were included from January 1, 2014, through December 31, 2024. The number of articles on immunization in TNBC is rising. These publications are mainly from 415 institutions in 82 countries, led by China and the USA. Among these publications, published the most papers, while was co-cited the most. The most productive journals focused on molecular biology, biological immunology, and clinical medicine. Furthermore, co-citation analysis revealed that tumor microenvironment, biomarkers, and immune checkpoint inhibitors are current and developing research areas. The keywords and are also likely to be new trends and focal points for future research. This study adopted bibliometric and visualization methods to provide a comprehensive review of the research on immunization in TNBC. This article will help researchers better understand the dynamic evolution of the role of immunity in TNBC and identify areas for future research.

Africa's participation in vaccine trials has historically been limited, but the COVID-19 pandemic highlighted the need for greater involvement. This study explores vaccine clinical development in Africa, emphasizing its importance for global health security. Using a scoping review and bibliometric analysis, we examined 662 vaccine trials conducted before, during, and after the pandemic. The analysis revealed a significant increase in vaccine trials after 2018 and particularly following the end of the COVID-19 pandemic in May 2023. Most trials focused on viral infections and were single-country studies. Pharmaceutical company sponsors funded most of the earlier trials, with increased government and academic involvement post-2020. Despite progress, challenges remain in the geographic distribution of trials, the number of government-supported studies, and the diversity of conditions studied. Addressing these gaps is crucial to bolstering Africa's role in global vaccine development.

Invasive meningococcal disease (IMD) imposes a heavy burden of mortality and life-long sequelae on infected individuals and has devastating impacts on their family members. International data show that meningococcal vaccination programs have reduced IMD incidence and changed the serogroup distribution of the disease. Furthermore, newer data show that although the public health measures in response to the coronavirus disease 2019 (COVID-19) pandemic temporarily reduced the incidence of IMD, there has been a resurgence in the years since. In the Asia-Pacific (APAC) region, many countries do not include meningococcal vaccines in their routine vaccination programs, and approaches to IMD surveillance are inconsistent. This review summarizes recent data and consensus statements from a group of experts from selected APAC countries on the burden of IMD in the region, evidence for vaccination, and how barriers to IMD vaccination may be addressed.

Despite the implementation of a single-dose universal varicella vaccination program in Peru since 2018, vaccination coverage rates (VCRs) remain low, with a VCR of 66% as of 2022. We employed a dynamic transmission model (DTM) to evaluate the impact of increasing varicella VCRs in Peru. We parameterized a previously published DTM with publicly available demographic, healthcare resource use, cost, and epidemiological data inputs specific to Peru (or suitable regional proxy), including Peruvian varicella VCRs up to 2022. We modeled six single-dose UVV strategies over 10 years (2023-2032) that increased VCRs to 80-90% over 1-, 2- or 5-year periods, compared with the reference strategy assuming the continuation of the current VCR of 65.6%. Clinical and economic outcomes were reported; economic outcomes were reported in 2023 USD with 5% annual discounting. Parameter uncertainty was evaluated through probabilistic and deterministic sensitivity analyses. All six strategies with increased VCR resulted in 13%-25% fewer varicella cases, and 13%-24% fewer outpatient and inpatient cases, over 10 years, compared to continuing the current varicella VCR, with shorter VCR ramp-up periods resulting in more clinical outcomes averted. However, this led to a 12%-21% ($0.05-0.08 per person per year) increase in costs from the payer perspective. The PSA indicated that model results were robust to parameter uncertainty. Increasing varicella VCR led to improved clinical outcomes, with small increase in costs. Improving VCR at faster rates leads to better clinical outcomes relative to the reference strategy at a small per-capita cost increase.

The success of COVID-19 vaccination is linked to trust, hesitancy, and confidence. Racial discrimination impacts vaccine hesitancy and trust, particularly in racialized groups. This study investigates factors influencing COVID-19 vaccine confidence among Canadian parents from different racial groups, addressing a gap in existing research. Data were collected in 2023 (October to November) included 2,528 parents of children aged 0-12. Findings showed significant mean differences between racial groups, (7, 2520) = 9.92,  < .001, with Arabs presented lower means of confidence ( = 30.26,  = 9.39) compared to Asian ( = 35.71,  = 8.14), Black ( = 33.23,  = 9.50), and Indigenous parents ( = 35.07,  = 9.45). Multiple linear regression among White participants showed that conspiracy beliefs were negatively associated with COVID-19 vaccine confidence ( = -.60,  < .001), whereas health literacy was positively associated with COVID-19 vaccine confidence ( = .09,  < .001). Results among racialized groups showed that conspiracy beliefs ( = -.23,  < .001) and racial discrimination ( = -.05,  = .049) were negatively associated with COVID-19 vaccine confidence, while health literacy was positively associated with COVID-19 vaccine confidence ( = .31,  < .001). This study highlights the complex factors influencing COVID-19 vaccine confidence among Canadian parents from racialized groups, suggesting that racial discrimination and conspiracy beliefs significantly reduce vaccine confidence, while health literacy plays a crucial role in increasing confidence. These results underscore the importance of addressing misinformation and systemic barriers to trust in vaccination efforts.

Respiratory syncytial virus (RSV) is a leading cause of acute respiratory infection and can lead to severe disease in older adults or those with comorbidities. This analysis aims to evaluate the demographic and clinical burden of RSV hospitalizations among older adults in Italy and inform potential preventative strategies. Adults aged ≥50 years with ≥1 hospitalization discharge diagnosis for RSV from 2010 to 2021 were included. Demographic characteristics before the first RSV hospitalization and clinical outcomes during this hospitalization and the 12 months following are described. Of the 243 patients, mean (SD) age was 73.7 (13.1) years, 40.7% were male, and the most common comorbidities were chronic obstructive pulmonary disease (37.9%), diabetes (21.8%), and heart failure (15.2%). Mean length of index hospitalization was 17.0 days, during which 9.1% of patients died. At index or during the 12-month follow-up, 5.8% had an intensive care unit admission, 61.3% were prescribed antibiotics, 8.2% had a stroke, and 3.3% had an acute myocardial infarction. During the 12-month follow-up, approximately, half of patients experienced worsening of preexisting comorbidities, with notable rates of re-hospitalization and mortality (44.4% and 29.6%). This study shows a high clinical burden of RSV among older adults in Italy, emphasizing a need for improved RSV surveillance, and may guide policymakers and healthcare providers in making informed recommendations for, and implementation of, RSV vaccination in Italy.

The licensed prophylactic human papillomavirus (HPV) vaccines, based on L1 virus-like particles (VLPs), effectively prevent infection and HPV-associated cancers caused by the vaccine types but offer limited protection against non-vaccine types. L2 N-terminal peptides, such as the RG1 epitope peptide, contain conserved cross-neutralizing epitopes, and their immunogenicity could be enhanced via display on the surface of L1VLPs. To our knowledge, there have been no reports on the construction and immunogenicity research of chimeric L1-L2 proteins based on HPV58 L1VLP, the third most prevalent high-risk type in Asia. Here, we inserted the RG1 epitope peptides at two sites of the highly expressed HPV58 L1 - the h4 coil region or the DE loop (with linkers) - to construct seven chimeras. These chimeras were expressed in insect cells, self-assembled into chimeric VLPs (cVLPs), and their immunogenicity was assessed in a mouse model. Notably, three cVLPs with h4 coil insertions elicited comparable levels of L1-specific antibody response in mice to the L1VLP control and induced cross-neutralizing antibody responses against fourteen pseudoviruses. Conversely, four cVLPs with DE loop insertions induced significantly lower L1-specific antibody titers compared with the L1VLP control ( < .001). This might be attributed to the disruption or obstruction of neutralizing epitope(s) targeted by HPV58-specific conformation-dependent monoclonal antibodies, caused by the sequence insertions. Our findings suggest that the h4 coil region of HPV58 L1VLP might be a potential location for RG1 epitope display, guiding the presentation of heterologous epitopes to develop chimeric HPV58 L1VLP-based vaccines.

Pneumococcal conjugate vaccines (PCVs) reduce infection and carriage. After switching from PCV13 to PCV10 in 2015-2016, Belgium switched back to PCV13 in 2019. Building on our systematic monitoring of childhood nasopharyngeal carriage since 2016, here, we analyze the serotypes of and other pathogens in children attending daycare centers (DCCs) from 2018 to 2021. From the period of 2018-2019 to 2020-2021, we included a total of 2,741 nasopharyngeal swabs collected from children aged 6 to 30 months. We identified , , and and conducted serotyping and antimicrobial susceptibility assessments of strains using culture methods and real-time PCR. carriage was frequent and quite stable over the three study years. and were more frequently carried than . Frequency of all PCV13-serotypes together among carriers decreased significantly from 19.4% in 2018-2019 to 9.9% in 2020-2021 ( < .001), largely due to the decreased serotype 19A carriage. Resistance of pneumococcal strains to penicillin increased significantly over the three study years. Two years after the second switch to PCV13 in 2019, pneumococcal serotype 19A carriage decreased again significantly in Belgian children attending daycare centers.

Children with primary immunodeficiency disorder (PID) are at higher risk of developing vaccine-associated paralytic poliomyelitis (VAPP) or vaccine-derived polioviruses (VDPV) infection when inadvertently expose to poliovirus vaccine, oral (OPV). A pilot study was initiated to describe the epidemiology of immunodeficiency-associated VDPV (iVDPV) and to estimate the risk of iVDPV shedding among individuals with PID. Children under 18 years of age newly diagnosed with PID were recruited for investigation and tested for poliovirus excretion. Children with poliovirus-positive stool samples had regular follow-up testing for poliovirus excretion and determination of clinical prognosis. A patient with severe combined immunodeficiency (SCID) with compound heterozygous mutations in the gene was found to be excreting Sabin-like type 3 (SL3) poliovirus. Excretion stopped six weeks after hematopoietic stem-cell transplantation (HSCT). Graft versus host disease (GVHD) and poor graft function (PGF) occurred after HSCT, resulting in failure of hematopoiesis and immune system reconstitution. Given deficient innate and adaptive immunity, immune-mediated destruction of gastrointestinal (GI) tract caused by GVHD and inflammatory diarrheal illness of the girl may have contributed to her clearance of SL3 poliovirus. Intermittent surveillance of immune system parameters for iVDPV excreters receiving HSCT should be included in the PID surveillance program for further understanding poliovirus clearance mechanisms.

Emulsion-based antigen delivery systems have emerged as a novel approach to enhance the effectiveness of subunit vaccines. This study presents the development of a newly formulated oil-in-water (o/w) nanoemulsion adjuvant (NEA) composed of squalene oil and α-tocopheryl polyethylene glycol 1000 succinate (TPGS), which serves dual roles as an emulsifier and an immunostimulator. In comparison to AS03, an FDA-approved emulsion adjuvant that includes α-tocopherol, squalene, and polysorbate 80, NEA is devoid of α-tocopherol and exhibits comparable physicochemical properties, including particle size, polydispersity index, morphology, pH, zeta potential, and viscosity. Stability assessments conducted using Turbiscan Lab indicated that NEA undergoes an uplift process without experiencing flocculation, agglomeration or delamination. Model subunit antigens of recombinant glycoprotein E (gE) targeting the varicella-zoster virus (VZV) and highly purified hemagglutinin (HA) protein against trivalent seasonal influenza viruses (TIV) were employed to assess the adjuvanticity of NEA. It was revealed that the specific anti-gE IgG titers induced by the gE/NEA were markedly higher than those generated by gE alone, with titers of 13,000 3,000 for the primary vaccination, and 5 × 10 5 × 10 for the booster vaccination. Additionally, the TIV/NEA group exhibited a significantly improved immunogenic response relative to TIV alone across all three HA antigens at six-week after immunization, as evidenced by anti-HA titers of 256 32. Furthermore, the NEA demonstrated no significant difference in efficacy compared to AS03 in both the VZV and TIV vaccines. Consequently, NEA presents a promising alternative to AS03 for the development of effective subunit vaccines.

HPV-FASTER is an innovative public health intervention combining HPV vaccination and HPV-based screening in adult women at the same visit. FASTER-Tlalpan adapted the combined HPV-FASTER strategy in Tlalpan, Mexico City for women aged 25-45 years. To understand the barriers and facilitators to participation in a combined strategy, we conducted semi-structured interviews with 14 FASTER-Tlalpan participants. We used the constant comparative method for the analysis, as well as the socioecological model to organize the findings. At the intrapersonal level, barriers included the belief that only younger women are at risk for HPV, embarrassment about the pelvic exam, and lack of time, while facilitators were having information regarding the benefit of the combined strategy, perception of time saved by having both procedures at once, feeling reassured about their health, self-esteem regarding their health, and perceived severity of cervical cancer. Interpersonal-level barriers were experiences of stigma and prejudice, and lack of support from partners, while facilitators were family encouragement and peer-to-peer communications. Institutional-level barriers were lack of infrastructure and inconvenient hours at the health center, perceived high time burden, and low quality of care from providers, while facilitators included high-quality care by health center personnel, including partners in the combined strategy, and phone reminders. Community-level facilitators included willingness to participate. Public policy facilitators included mass information campaigns and free procedures. Our findings point to significant barriers which need to be addressed, along with facilitators which can be leveraged to scale up the combined strategy in similar settings.

Cancer vaccines represent a promising approach within immunotherapies. These vaccines are tailored to target tumor-specific antigens, thereby offering a precision approach to cancer treatment. The key principles in developing therapeutic cancer vaccines include identifying appropriate vaccine targets and selecting effective vaccine delivery platforms. These delivery platforms are diverse and have evolved to enhance the immune response. This review explores live cancer vaccines and the biological entities involved. Live cancer vaccines leverage the use of various biological entities to stimulate an immune response. These biological entities including bacterial, yeast-based and viral vectors, have unique properties that can be harnessed to target and destroy cancer cells while eliciting a robust immune response. Clinical trials of cancer vaccines are investigating standalone and combination treatment strategies in the prophylactic, adjuvant, and palliative settings. This review offers insights into the current oncologic vaccine landscape and potential future development.

In recent years, immune checkpoint inhibitors (ICIs) have emerged as a novel immunotherapeutic approach, offering renewed hope for enhancing cervical cancer patient prognosis. This study represents the inaugural bibliometric analysis of ICIs in the context of cervical cancer, covering the period from 2014 to 2024. A total of 422 articles were identified through the Web of Science Core Collection database, amassing 10,977 citations, with a consistent annual increase in the number of publications. The leading contributors in terms of countries, institutions, journals, and authors included China, the University of Texas System, , and Bradley J. Monk, respectively. The journal with the highest frequency of citation and co-citation was . The researchers with the highest number of citations and co-citations were Sarina A Piha-Paul and Krishnansu S Tewari respectively. The keyword cluster analysis identified four main research directions. Furthermore, literature co-citation analysis and burst citation analysis revealed three research hotspots and four potential emerging topics within this domain, respectively. This study provides valuable reference and enlightenment for researchers in this field. As research progresses, ICIs are anticipated to offer significant hope and breakthroughs in the treatment of cervical cancer.

Rotavirus is a major cause of severe diarrhea and mortality in children under five years of age, leading to approximately 128,500 deaths annually. Vaccination is the most effective strategy for preventing rotavirus infection. While two widely used vaccines, Rotarix and RotaTeq, have shown good efficacy in high-income countries, their effectiveness is lower in low- and middle-income countries due to factors such as malnutrition and poor sanitation. These challenges include complex vaccination schedules and high production costs. Researchers are working on novel vaccines, including inactivated virus and viral protein-based options, as well as virus-like particles and recombinant proteins. Improving vaccine stability and applicability is crucial for resource-limited settings, and global vaccination strategies are expected to significantly reduce infection burdens, improve child health, and contribute to the achievement of global health goals..

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccine hesitancy is associated with community aggregation, inducing low vaccine coverage and potentially more frequent community-level outbreak. Addressing vaccine hesitancy in community settings should be a priority for healthcare providers. A cross-sectional online questionnaire survey was conducted during June and July 2022. Ten sites were set up in eastern, central, and western China, from where residents were recruited in a community setting. In total, 7,241 residents from 71 communities were included. Of the residents, 7.0% had refusal administration, 30.4% had delayed administration, and community clustering accounted for 2.4-3.7% and 8.5-9.6% of the variation, respectively. The reasons for primary-dose refusal were diseases, pregnancy, or lactation, whereas the main reasons for booster-dose refusal were diseases during the vaccination period, no time to vaccinate, and felt unnecessary to vaccinate. Younger age (under 40), female, residing in urban settings and having self-reported diseases were sociodemographic indicators of risk for refusal. In the health belief model of refusing to vaccinate, perceived barriers had a positive impact on refusal (β = 0.08), while perceived benefits had a negative impact (β = -0.09). In conclusion, this study underscores the population heterogeneity and community clustering of SARS-CoV-2 vaccine hesitancy. Targeted interventions for these high-risk groups are crucial to enhance vaccination coverage and prevent outbreaks. Public health strategies should address vaccine hesitancy at different stages and doses, while considering both individual beliefs and community dynamics.

In the United States, while meningococcal vaccines are available and recommended for adolescents and young adults, coverage remains low and disparities persist. We evaluated meningococcal serogroups A, C, W, Y (MenACWY) and B (MenB) vaccine uptake, completion, and compliance using a cross-sectional analysis of National Immunization Survey-Teen (NIS-Teen) data (2015-2021) and a cohort analysis of commercial claims data (2010-2021). Regression models were used to identify factors associated with vaccine uptake. Included in the NIS-Teen MenACWY and MenB analyses were 138,952 and 177,077 patients, respectively. Included in the claims MenACWY and MenB analyses were 953,905 and 818,424 patients, respectively. In 2021, MenACWY uptake was 86.4% (95% confidence interval [CI]: 83.6-88.8%) among ≤13-year-olds (NIS-Teen) and 63.2% (62.8-63.5%) among 11-12-year-olds (claims). MenB was 33.7% (30.5-37.1%) among ≤17-year-olds (NIS-Teen), 41.6% (41.2-42.0%) among 16-18-year-olds (claims), and 15.0% (14.7-15.4%) among 19-23-year-olds (claims). The states with the lowest and highest MenB uptake by ≤17-year-olds in 2021 (NIS-Teen) were Minnesota (10.1% [3.9-23.6%]) and North Dakota (69.9% [52.1-83.2%]). Factors associated with MenACWY uptake included living in a state with a vaccine mandate, Black or Hispanic race (versus White), and well-child visit attendance. Factors associated with MenB uptake included having Medicaid (versus private insurance) and Hispanic race (versus White). The findings suggest that meningococcal vaccination coverage disparities persist across vaccines, age, geography, and race and ethnicity. Higher MenACWY (versus MenB) coverage suggests the benefit of routine recommendations. Annual well-child visits and simplified vaccination schedules could reduce vaccination access barriers.

Infection with varicella-zoster virus (VZV) causes chickenpox and shingles, both manifesting as a blistering skin rash. The skin is central to VZV, as the site of viral replication, transmission from cell-free virus in blisters and as the gateway to sensory nerves for establishing latency. The existing chickenpox vaccine is based on the live attenuated vOka strain and is impaired for replication in skin. While the genetics of the vOka vaccine have been extensively studied, critical gaps exist in understanding the molecular and cellular mechanisms of vOka attenuation, particularly in human skin models. This review aims to explore the molecular biology of vOka vaccine, focusing on its genetic diversity, interaction with host skin pathways, and the impact of vOka mutations in key VZV genes on attenuation mechanisms in human skin models. Insights from this review may guide the development of next-generation varicella vaccines and enhance the understanding of VZV pathogenesis.

Immunization is a crucial public health intervention, and in Ethiopia, a nation characterized by diversity, immunization coverage shows considerable variations. This study aims to assess immunization coverage across various vaccines in Ethiopia and understand the prevalence and factors affecting immunization rates. This study utilized secondary data from the 2019 Ethiopian Mini Demographic and Health Survey (EMDHS), a community-based cross-sectional study. A Poisson regression model was used to evaluate the children's immunization coverage: the number of vaccinations a child received across 18 different vaccines. The overall immunization coverage in Ethiopia was found to be 40%, with significant regional disparities. Coverage was highest in Addis Ababa and Harari and lowest in Afar and Somali regions. BCG had the highest coverage (34.42%), while measles-2 vaccination had the lowest (3.7%). The Poisson regression analysis identified several significant predictors of immunization uptake. Children from wealthier households, those born in public health facilities, and those whose mothers attended antenatal care (ANC) visits had higher immunization counts ( < .001). Conversely, children from rural areas, female children, and those born into larger families had lower immunization rates ( < .01). Maternal education, pregnancy counseling, and family planning utilization were positively associated with vaccine uptake. Despite improvements in immunization coverage, Ethiopia's rates remain below the African regional average. Socioeconomic disparities, healthcare access, and maternal education significantly influence vaccination rates. Strengthening community-based outreach, expanding ANC services, improving healthcare infrastructure, and addressing gender-related disparities can enhance immunization coverage.

The safety, immunogenicity, and efficacy of the original formulation of the investigational mRNA-1010 vaccine for seasonal influenza were investigated in two randomized, active-controlled, phase 3 trials in adults (NCT05415462 and NCT05566639), and the results were used to evaluate hemagglutination inhibition (HAI) titers as correlates of risk and protection against influenza-like illness. mRNA-1010 (50-µg) demonstrated an acceptable reactogenicity and safety profile among the >14,000 adult participants vaccinated in both trials. The efficacy profile of mRNA-1010 was generally reflective of immunogenicity findings, with higher immune responses against influenza A strains and lower responses against influenza B strains relative to an active comparator (licensed inactivated influenza vaccine). An analysis of HAI titers as a correlate of protection against influenza infection provided support for its use as a surrogate endpoint for mRNA-1010, similar to licensed influenza vaccines. These findings support further optimization and development of mRNA-1010 against seasonal influenza.