Vaccines最新文献

{"title":"Influenza Vaccination Coverage and Influencing Factors in Type 2 Diabetes in Mainland China: A Systematic Review and Meta-Analysis.","authors":"Cheng Yang, Shijun Liu, Jue Xu, Wen Fu, Xin Qiu, Caixia Jiang","doi":"10.3390/vaccines12111259","DOIUrl":"10.3390/vaccines12111259","url":null,"abstract":"<p><strong>Background: </strong>Influenza has many harmful effects on people with type 2 diabetes mellitus (T2DM), such as hyperglycemia and increasing incidence of cardiovascular and cerebrovascular diseases. Epidemiological evidence shows that influenza vaccinations can effectively prevent deterioration in T2DM patients. At present, there is a lack of nationwide studies on the vaccination status of influenza vaccines for patients with certain chronic diseases. This study aimed to evaluate the influenza vaccination status of T2DM patients in mainland China and the factors affecting their influenza vaccination.</p><p><strong>Methods: </strong>Data were sourced from PubMed, Embase, Web of Science, the China Biology Medicine Disc (CBMdisc), the China National Knowledge Infrastructure (CNKI), and the Wanfang Database. The keywords used in the literature search included \"diabetes\", \"diabetes mellitus\", \"DM\", \"diabetic\", \"T2DM\", \"influenza vaccine\", \"flu vaccine\", \"China\", and \"Chinese\". A total of 249 articles were retrieved through the searches; 7 articles met the inclusion criteria. The fixed-effects model was used when heterogeneity was low and a random-effects model was used when the heterogeneity was high.</p><p><strong>Results: </strong>The influenza vaccination coverage rate was 1.46% in diabetic patients and 9.99% in elderly diabetic patients. The influenza vaccination rate of type 2 diabetes patients with a high education level is higher than that of patients with a low education level. (OR: 1.462 [1.123, 1.903]). Meanwhile, gender (OR: 1.076, 95%CI: 0.893-1.295), marriage (OR: 1.283; 95%CI: 0.931-1.766), and occupation (OR: 1.049; 95% CI: 4.422-2.606) have no significant impact on influenza vaccination in patients with type 2 diabetes.</p><p><strong>Conclusions: </strong>This study found that the coverage of influenza vaccination in patients with T2DM in Chinese mainland was low, and there were few relevant research articles. In China's mainland areas, education background is an important factor affecting the influenza vaccination of T2DM patients. China should continue to improve the influenza vaccination rate of patients with type 2 diabetes.</p>","PeriodicalId":23634,"journal":{"name":"Vaccines","volume":"12 11","pages":""},"PeriodicalIF":5.2,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11598730/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142732944","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Measles-Rubella Microarray Patches Phase III Clinical Trial Framework: Proposal and Considerations.","authors":"Darin Zehrung, Bruce L Innis, Auliya A Suwantika, Mahmoud Ameri, Robin Biellik, James C Birchall, Alejandro Cravioto, Courtney Jarrahian, Lee Fairlie, James L Goodson, Sonali Kochhar, Katrina Kretsinger, Christopher Morgan, Mercy Mvundura, Niraj Rathi, Edward Clarke, Jessica Joyce Mistilis, Marie-Chantal Uwamwezi, Birgitte Giersing, Mateusz Hasso-Agopsowicz","doi":"10.3390/vaccines12111258","DOIUrl":"10.3390/vaccines12111258","url":null,"abstract":"<p><p><b>Background</b>: The Measles-Rubella Microarray Patch (MR-MAP) is an important technology that is expected to reduce coverage and equity gaps for measles-containing vaccines (MCVs), reach zero-dose children, and contribute to elimination of measles and rubella. MR-MAPs are anticipated to be easier to deploy programmatically and could be delivered by lesser-trained health workers, thereby increasing immunization coverage. The most advanced MR-MAP has reached clinical proof-of-concept through a Phase I/II trial in the target population of infants and young children. The World Health Organization (WHO) and partners have developed the Phase III clinical trial framework for MR-MAPs presented in this article. <b>Objectives and Methods</b>: The purpose of such framework is to inform the considerations, design and approach for the pivotal clinical trial design, while considering the anticipated data requirements to inform regulatory approval, WHO prequalification, and policy decision. <b>Results</b>: The proposed Phase III trial would compare the immunogenicity and safety of an MR-MAP with MR vaccine delivered subcutaneously in 9- to 10-month-old infants. An analysis of non-inferiority (NI) of immunogenicity would occur six weeks after the first dose. Should regulatory agencies or policy makers require, a proportion of infants could receive a second dose of either the same or alternate MR vaccine presentation six months after the first dose, with those children returning six weeks after the second dose for a descriptive assessment of immunogenicity, and then followed up six months after the second dose for evaluation of safety and immunogenicity. It is anticipated that this proposed pivotal Phase III trial framework would generate the required clinical data for regulatory licensure and WHO prequalification (PQ) of MR-MAPs. However, the trial design would need to be reviewed and confirmed by a national regulatory authority (NRA) that will assess the product for regulatory licensure and the WHO PQ team. Additional research will likely be required to generate data on concomitant vaccine delivery, the safety and immunogenicity of MR-MAPs in other age groups such as children 1-5 years and infants younger than 9 months of age, and the impact of MR-MAPs on coverage and equity. Such studies could be conducted during or after clinical MR-MAP development.</p>","PeriodicalId":23634,"journal":{"name":"Vaccines","volume":"12 11","pages":""},"PeriodicalIF":5.2,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11598609/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142732958","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"SARS-CoV-2-Neutralizing Antibodies.","authors":"Yawen Liu, Jianhui Nie","doi":"10.3390/vaccines12111256","DOIUrl":"10.3390/vaccines12111256","url":null,"abstract":"<p><p>The COVID-19 pandemic, triggered by the SARS-CoV-2 virus, has profoundly and permanently affected many aspects of the world [...].</p>","PeriodicalId":23634,"journal":{"name":"Vaccines","volume":"12 11","pages":""},"PeriodicalIF":5.2,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11598284/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142732641","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety and Immunogenicity of Intranasal Razi Cov Pars as a COVID-19 Booster Vaccine in Adults: Promising Results from a Groundbreaking Clinical Trial.","authors":"Mohammad Hossein Fallah Mehrabadi, Monireh Hajimoradi, Ali Es-Haghi, Saeed Kalantari, Mojtaba Noofeli, Ali Rezaei Mokarram, Seyed Hossein Razzaz, Maryam Taghdiri, Ladan Mokhberalsafa, Fariba Sadeghi, Vahideh Mohseni, Safdar Masoumi, Rezvan Golmoradi-Zadeh, Mohammad Hasan Rabiee, Masoud Solaymani-Dodaran, Seyed Reza Banihashemi","doi":"10.3390/vaccines12111255","DOIUrl":"10.3390/vaccines12111255","url":null,"abstract":"<p><p>Protective antibodies in the upper respiratory tract prevent the spread of COVID-19 in the community. Intranasal vaccines could raise the specific secretory IgA and IgG levels. This is a single-center, randomized, double-blind, placebo-controlled clinical trial to evaluate the safety and immunogenicity of Razi Cov Pars (RCP) intranasal recombinant protein subunit COVID-19 vaccine as a booster in adults. We compared specific IgG and IgA levels in the intranasal RCP group (<i>n</i> = 97) versus placebo (<i>n</i> = 96) in serum, saliva, and nasal mucosal secretions on days 0 and 14 and reported their Geometric Mean Ratios (GMR) and 95% confidence intervals (CI). We showed significant increases in IgA and IgG anti-RBD in the nasal mucosa in the RCP group, but their increase was not detectable in the serum and saliva. Anti-spike IgA in the nasal mucosa also increased in the RCP group compared to the placebo. This increase against the COVID-19 variant Omicron was also similar to that of the Wuhan. We detected no serious adverse reactions or anaphylaxis and all adverse events resolved completely during the follow-up period and were similar in both groups. Intranasal RCP is safe, stimulates the respiratory mucosal immunity, and could be a booster on various COVID-19 vaccines and be effective against new virus variants.</p>","PeriodicalId":23634,"journal":{"name":"Vaccines","volume":"12 11","pages":""},"PeriodicalIF":5.2,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11598910/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142732635","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"EMSIG: Uncovering Factors Influencing COVID-19 Vaccination Across Different Subgroups Characterized by Embedding-Based Spatial Information Gain.","authors":"Zongliang Yue, Nicholas P McCormick, Oluchukwu M Ezeala, Spencer H Durham, Salisa C Westrick","doi":"10.3390/vaccines12111253","DOIUrl":"10.3390/vaccines12111253","url":null,"abstract":"<p><p><b>Background/Objectives:</b> COVID-19 and its variants continue to pose significant threats to public health, with considerable uncertainty surrounding their impact. As of September 2024, the total number of deaths reached 8.8 million worldwide. Vaccination remains the most effective strategy for preventing COVID-19. However, vaccination rates in the Deep South, U.S., are notably lower than the national average due to various factors. <b>Methods:</b> To address this challenge, we developed the Embedding-based Spatial Information Gain (EMSIG) method, an innovative tool using machine learning techniques for subgroup modeling. EMSIG helps identify subgroups where participants share similar perceptions but exhibit high variance in COVID-19 vaccine doses. It introduces spatial information gain (SIG) to screen regions of interest (ROI) subgroups and reveals their specific concerns. <b>Results:</b> We analyzed survey data from 1020 participants in Alabama. EMSIG identified 16 factors encompassing COVID-19 hesitancy and trust in medical doctors, pharmacists, and public health authorities and revealed four distinct ROI subgroups. The five factors, including COVID-19 perceived detriment, fear, skepticism, side effects related to COVID-19, and communication with pharmacists, were commonly shared across at least three subgroups. A subgroup primarily composed of Democrats with a high flu-shot rate expressed concerns about pharmacist communication, government fairness, and responsibility. Another subgroup, characterized by older, white Republicans with a relatively low flu-shot rate, expressed concerns about doctor trust and the intelligence of public health authorities. <b>Conclusions</b>: EMSIG enhances our understanding of specific concerns across different demographics, characterizes these demographics, and informs targeted interventions to increase vaccination uptake and ensure equitable prevention strategies.</p>","PeriodicalId":23634,"journal":{"name":"Vaccines","volume":"12 11","pages":""},"PeriodicalIF":5.2,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11599077/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142732955","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hepatitis B Virus-Related Cirrhosis and Hepatocellular Carcinoma Hospital Discharge Rates from 2005 to 2021 in Spain: Impact of Universal Vaccination.","authors":"Angela Domínguez, Ana Avellón, Victoria Hernando, Núria Soldevila, Eva Borràs, Ana Martínez, Conchita Izquierdo, Núria Torner, Carles Pericas, Cristina Rius, Pere Godoy","doi":"10.3390/vaccines12111254","DOIUrl":"10.3390/vaccines12111254","url":null,"abstract":"<p><p><b>Background:</b> The main consequences of chronic hepatitis B virus (HBV) infections are cirrhosis and hepatocellular carcinoma (HCC), both associated with frequent hospitalization. The aim of this study was to analyze the impact of universal HBV vaccination in Spain on chronic HBV-related hospital discharges from 2005 to 2021. <b>Methods:</b> Using data from the Minimum Basic Data Set of the Spanish National Health System, we calculated the hospital discharge rate ratio (HDRR) and 95% confidence interval (CI) values for chronic HBV-related discharges between 2005 and 2021. For comparative purposes, we calculated the HDRR and 95% confidence interval (CI) values for the early (2005-2013) and later (2014-2021) periods and the vaccinated compared with unvaccinated cohorts for the 20-39 age group. <b>Results:</b> The hospital discharge rate per 1,000,000 people was 3.08 in 2005 and 4.50 in 2021 for HCC, and 4.81 in 2005 and 1.92 in 2021 for cirrhosis. Comparing the early and later periods, values were higher for HCC (HDRR 1.13; 95% CI: 1.06-1.20) and lower for cirrhosis (HDRR 0.56; 95% CI: 0.51-0.60). The rate for the 20-39 age group was lower for the vaccinated compared with the unvaccinated cohorts overall (HDRR 0.53; 95% CI: 0.45-0.62), for HCC (HDRR 0.66; 95% CI: 0.53-0.82), and for cirrhosis (HDRR 0.41; 95% CI: 0.33-0.53). <b>Conclusions:</b> This study describes the important impact, after 25 years, of universal HBV vaccination in Spain: cirrhosis hospital discharge rate was reduced, and the vaccinated cohorts, compared with the unvaccinated cohorts in the 20-39 age group, had a lower hospital discharge rate of both HCC and cirrhosis.</p>","PeriodicalId":23634,"journal":{"name":"Vaccines","volume":"12 11","pages":""},"PeriodicalIF":5.2,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11598889/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142732341","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exposure to Pollutants and Vaccines' Effectiveness: A Systematic Review.","authors":"Carmela Protano, Federica Valeriani, Katia Vitale, Jole Del Prete, Fabrizio Liguori, Giorgio Liguori, Francesca Gallè","doi":"10.3390/vaccines12111252","DOIUrl":"10.3390/vaccines12111252","url":null,"abstract":"<p><p><b>Background:</b> Many human activities release harmful substances, contaminating the air, water, and soil. Since exposure to environmental pollutants is currently unavoidable, it is important to verify how these compounds may influence individual immune responses to vaccines. <b>Methods:</b> This review was conducted in accordance with the PRISMA statement. The protocol was registered on the PROSPERO platform with the following ID: CRD42024582592. We evaluated all observational, semi-experimental, and experimental studies written in both Italian and English that reported possible effects of exposure to environmental pollutants on the production of vaccine-induced antibodies. <b>Results:</b> Forty-two studies were included. The effects of pollutants were examined mainly in terms of antibody production in relation to mumps, measles and rubella, diphtheria and tetanus, hepatitis A and B, Haemophilus influenzae type B, influenza, tuberculosis, pertussis, Japanese encephalitis, poliomyelitis, and COVID-19 vaccines. Perfluorinated compounds were the most studied pollutants. <b>Conclusions:</b> Correlations between exposure to pollutants and reductions in antibody production were found in quite all the selected studies, suggesting that pollution control policies could contribute to increase the efficacy of vaccination campaigns. However, the heterogeneity of the examined studies did not allow us to perform a meta-analysis, and the literature on each type of vaccine or pollutant is still too limited to generate robust evidence. In order to confirm the findings of the present systematic review, and in the perspective of establishing possible exposure limit values for each type of pollutant, further research in this field is required.</p>","PeriodicalId":23634,"journal":{"name":"Vaccines","volume":"12 11","pages":""},"PeriodicalIF":5.2,"publicationDate":"2024-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11599004/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142732967","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Systematic Review on Influenza Burden in Emerging Markets in 2018-2023-An Evidence Update to Guide Influenza Vaccination Recommendations.","authors":"Moe H Kyaw, Sophie Bozhi Chen, Shishi Wu, Chee Yoong Foo, Verna Welch, Constantina Boikos, Oladayo Jagun","doi":"10.3390/vaccines12111251","DOIUrl":"10.3390/vaccines12111251","url":null,"abstract":"<p><p><b>Background:</b> Influenza is a contagious respiratory illness responsible for seasonal epidemics and with potential to cause pandemics. The decline in influenza-related studies published since 2018 resulted in data gaps, particularly in emerging markets. <b>Methods:</b> This systematic review searched for studies in six databases and gray literature sources to define the clinical burden of influenza and influenza-like illness (ILIs) and their associated sequelae among humans across emerging markets. Eligible studies were published in English, Spanish, or Chinese between January 2018 and September 2023 and conducted in Asia, the Middle East, Africa, and Latin America. <b>Results:</b> In total, 256 articles were included, mostly on lab-confirmed influenza infections (n = 218). Incidences of lab-confirmed influenza cases in Asia (range 540-1279 cases/100,000 persons) and Sub-Saharan Africa (range 34,100-47,800 cases/100,000 persons) were higher compared to Latin America (range 0.7-112 cases/100,000 persons) and the Middle East and North Africa (range 0.1-10 cases/100,000 persons). Proportions of lab-confirmed influenza cases and influenza-associated outcomes (i.e., hospitalization, ICU admission and death) varied widely across regions. Temporal variation in influenza trend was observed before and during the COVID-19 pandemic. <b>Conclusions:</b> In conclusion, influenza causes significant disease burden in emerging markets. Robust large real-world studies using a similar methodology are needed to have more accurate estimates and compare studies within age groups and regions. Continuous monitoring of influenza epidemiology is important to inform vaccine programs in emerging markets with heavy influenza disease burden.</p>","PeriodicalId":23634,"journal":{"name":"Vaccines","volume":"12 11","pages":""},"PeriodicalIF":5.2,"publicationDate":"2024-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11599016/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142732862","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enhanced Humoral and Cellular Immune Responses Elicited by Adenoviral Delivery of SARS-CoV-2 Receptor-Binding Motif Fused to Human Fc.","authors":"Yea-Jin Lee, Maheswaran Easwaran, Yong-Sam Jung, Yingjuan Qian, Hyun-Jin Shin","doi":"10.3390/vaccines12111247","DOIUrl":"10.3390/vaccines12111247","url":null,"abstract":"<p><p><b>Background/Objectives</b>: The receptor binding motif (RBM) of the SARS-CoV-2 spike protein is critical for viral entry into host cells. Development of a vaccine targeting this region is a promising strategy for COVID-19 prevention. To enhance the immunogenicity of SARS-CoV-2 vaccines, we developed an adenoviral vector expressing the RBM from the SARS-CoV-2 spike protein that fused to the human Fc (hFc) domain. <b>Methods</b>: The recombinant RBM_hFc fusion protein was successfully cloned into the pacAd5CMV-N-pA (pAd5) vector and expressed in HEK293 cells as a ~40 kDa protein. A recombinant adenovirus encoding RBM_hFc was subsequently generated and confirmed by cytopathic effect assay. <b>Results</b>: Western blot analysis verified the expression of RBM_hFc in the adenovirus (AdV). ELISA assays, validated for IgG detection, demonstrated a twofold increase in IgG antibody levels (M-1.090 at 450 nm; SD-±0.326; and 95% CI-0.250 [0.839 to 1.340]) in sera from BALB/c mice immunized with Ad/RBM_hFc, compared to the negative control group. Result suggests a robust humoral immune response induced by the Ad/RBM_hFc vaccine. Moreover, ELISpot assays demonstrated a tenfold increase in IFN-γ -producing cells (M-440 spot-forming cells; SD-±124.976; and 95% CI-75.522 [364.478 to 515.522]) in mice immunized with AdV/RBM_hFc compared to the negative control group. Result proved that AdV/RBM_hFc-stimulated a robust cellular immune response in animal model. <b>Conclusions</b>: Our findings indicate that the RBM_hFc fusion protein enhances both humoral and cellular immune responses. These results suggest the potential of adenoviral vectors carrying RBM_hFc as vaccine candidates. However, comprehensive evaluation of the protective efficacy of these adenoviral vectors will necessitate rigorous experimental studies.</p>","PeriodicalId":23634,"journal":{"name":"Vaccines","volume":"12 11","pages":""},"PeriodicalIF":5.2,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11598816/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142733040","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Potential Impact of a Single-Dose HPV Vaccination Schedule on Cervical Cancer Outcomes in Kenya: A Mathematical Modelling and Health Economic Analysis.","authors":"Grace Umutesi, Christine L Hathaway, Jesse Heitner, Rachel Jackson, Christine W Miano, Wesley Mugambi, Lydiah Khalayi, Valerian Mwenda, Lynda Oluoch, Mary Nyangasi, Rose Jalang'o, Nelly R Mugo, Ruanne V Barnabas","doi":"10.3390/vaccines12111248","DOIUrl":"10.3390/vaccines12111248","url":null,"abstract":"<p><p><b>Background</b>: Human Papillomavirus (HPV) is the primary cause of cervical cancer. Single-dose HPV vaccination can effectively prevent high-risk HPV infection that causes cervical cancer and accelerate progress toward achieving cervical cancer elimination goals. We modelled the potential impact of adopting single-dose HPV vaccination strategies on health and economic outcomes in Kenya, where a two-dose schedule is the current standard. <b>Methods</b>: Using a validated compartmental transmission model of HPV and HIV in Kenya, we evaluated the costs from the payer's perspective to vaccinate girls by age 10 with either one or two doses and increasing coverage levels (0%, 70%, 77%, 90%). Additionally, we modelled single-dose strategies supplemented with either catch-up vaccination of adolescent girls and young women or vaccination for all by age 10, funded with the first five-years of cost savings of switching from a two- to one-dose schedule. Costs and outcomes were discounted at 3% annually, and incremental cost-effectiveness ratios (ICERs) were calculated per disability-adjusted-life-year (DALY) averted. <b>Results</b>: All one-dose and the two-dose 90% coverage strategies were on the efficiency frontier, dominating the remaining two-dose strategies. The two-dose 90% coverage strategy had a substantially higher ICER (US$6508.80/DALY averted) than the one-dose 90% coverage (US$197.44/DALY averted). Transitioning from a two- to one-dose schedule could result in US$21.4 Million saved over the first five years, which could potentially fund 2.75 million supplemental HPV vaccinations. With this re-investment, all two-dose HPV vaccination scenarios would be dominated. The greatest DALYs were averted with the single-dose HPV vaccination schedule at 90% coverage supplemented with catch-up for 11-24-year-old girls, which had an ICER of US$78.73/DALYs averted. <b>Conclusions</b>: Considering the logistical and cost burdens of a two-dose schedule, a one-dose schedule for girls by age 10 would generate savings that could be leveraged for catch-up vaccination for older girls and accelerate cervical cancer elimination in Kenya.</p>","PeriodicalId":23634,"journal":{"name":"Vaccines","volume":"12 11","pages":""},"PeriodicalIF":5.2,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11598770/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142732984","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}