Vaccine: X最新文献

{"title":"A natural oil-based nanoadjuvant enhances the immunogenicity of enterotoxigenic Escherichia coli (ETEC) in an experimental vaccine","authors":"María Eugenia Cecchini ,&nbsp;Sofía Arsaute ,&nbsp;Ivana Dalila Montironi ,&nbsp;Dardo Andrés Roma ,&nbsp;José Raviolo ,&nbsp;Federico Ruiz Moreno ,&nbsp;Belkys Maletto ,&nbsp;Nahuel Matías Camacho ,&nbsp;Fernando Javier Mañas ,&nbsp;Romina Valeria Bellingeri ,&nbsp;Laura Noelia Cariddi","doi":"10.1016/j.jvacx.2025.100724","DOIUrl":"10.1016/j.jvacx.2025.100724","url":null,"abstract":"<div><div>Enterotoxigenic <em>Escherichia coli</em> (ETEC) is the leading cause of post-weaning diarrhea in piglets. The development of novel adjuvanted vaccines that can be administered directly to piglets remains a priority for the swine industry. <em>Minthostachys verticillata</em> essential oil (EO) has shown adjuvant effects, but its poor stability and solubility limit its use, that could be solved by emulsification. This study aimed to evaluate the effect of an EO-based nanoadjuvant to enhance the immunogenicity of ETEC in an experimental vaccine using mice as a preliminary model. A nanoemulsion (NEO) was formulated with EO (20 % v/v), Tween 80 (0.75 % v/v), and Span 60 (0.25 % w/v) using a high-energy method. The interaction between NEO and ETEC was analyzed by a scanning electron microscope. Experimental vaccines were prepared with inactivated ETEC strain combined with NEO (0.5, 0.75, and 1 mg/mL of EO) or EO (1 mg/mL) as adjuvants. Controls included Incomplete Freund's Adjuvant (IFA), Tween 80/Span 60 as a vehicle control, saline, and non-adjuvanted formulations. Balb/c mice were subcutaneously injected with the experimental vaccines, with four doses administered every 14 days. Antigen-specific antibody titers (IgG, IgG1, IgG2a), opsonizing capacity, and CD4⁺/CD69⁺ and CD8⁺/CD69⁺ T cells activation were evaluated. Splenic mononuclear cell proliferation and cytokine production (IFN-γ and IL-10) were also measured. Hepatic enzyme levels and malondialdehyde (MDA) concentrations were assessed to evaluate toxicity. NEO induced anti-ETEC IgG with significant opsonizing potential, increase in the percentage of CD4⁺/CD69⁺ and CD8⁺/CD69⁺ T cells, and production of IFN-γ. It caused no local reactogenicity, did not alter hepatic enzyme levels, and did not increase MDA concentrations. In conclusion, NEO demonstrated adjuvant potential, activating both humoral and cellular immune responses against ETEC without evidence of toxicity.</div></div>","PeriodicalId":43021,"journal":{"name":"Vaccine: X","volume":"27 ","pages":"Article 100724"},"PeriodicalIF":2.2,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145107623","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"COVID-19 Vaccine Hesitancy Scale: Psychometric properties and validation among pregnant and breastfeeding persons and parents","authors":"Heidi Sze Lok Fan ,&nbsp;Edmond Pui Hang Choi ,&nbsp;Elizabeth Keys ,&nbsp;Rishma Chooniedass ,&nbsp;Stephanie Masina ,&nbsp;Alex Halonen ,&nbsp;Kalysse Mantai ,&nbsp;Marie Tarrant","doi":"10.1016/j.jvacx.2025.100720","DOIUrl":"10.1016/j.jvacx.2025.100720","url":null,"abstract":"<div><h3>Introduction</h3><div>The Vaccine Hesitancy Scale (VHS) was developed by the World Health Organization's Strategic Advisory Group of Experts on Immunization (SAGE) to examine parents' vaccine hesitancy toward childhood vaccines. The VHS has been validated and modified to assess vaccine hesitancy toward specific vaccines, including influenza and human papillomavirus vaccines, but not the COVID-19 vaccine. The objective of this study is to validate a modified VHS for the COVID-19 vaccine among pregnant and breastfeeding persons, and parents of children under 12 years of age.</div></div><div><h3>Methods</h3><div>A cross-sectional survey was conducted in British Columbia, Canada from October to December 2021. A total of 1510 participants including pregnant and breastfeeding persons, and parents of children &lt;12 years of age were included in the analysis. Participants completed questionnaires tailored to their respective groups based on self-identification. Confirmatory factor analysis was conducted to assess the original VHS structure. The data were then randomly split into training and validation sets for exploratory and confirmatory factor analyses. Factor structure, internal construct validity, internal consistency, and known-group validity were evaluated.</div></div><div><h3>Results</h3><div>The original VHS model showed a poor fit. Exploratory factor analysis identified a revised one-factor model (VHS-COVID19), which showed satisfactory fit in the validation sample for pregnant participants (comparative fit index [CFI] = 0.999; root mean square error of approximation [RMSEA] = 0.041; standardized root mean squared residual [SRMR] = 0.008; Tucker-Lewis Index [TLI] = 0.997), breastfeeding participants (CFI = 0.995; RMAEA = 0.089; SRMR = 0.006; TLI = 0.990) and parent participants (CFI = 0.995; RMAEA = 0.080; SRMR = 0.004; TLI = 0.992). The revised scale comprised five items for pregnant and breastfeeding participants and six for parent participants<em>.</em> VHS-COVID19 showed high internal construct validity and reliability.</div></div><div><h3>Conclusions</h3><div>The VHS-COVID19 shows adequate psychometric performance for assessing COVID-19 vaccine hesitancy among pregnant, breastfeeding persons, and parents. It is easy to administer and can be used by healthcare providers to rapidly assess vaccine hesitancy of the targeted population in clinical settings.</div></div>","PeriodicalId":43021,"journal":{"name":"Vaccine: X","volume":"27 ","pages":"Article 100720"},"PeriodicalIF":2.2,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145107626","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Potential health impact and cost-effectiveness of human papillomavirus vaccination in Tunisia: A comparative modeling study","authors":"Oumaima Laraj ,&nbsp;Beya Benzina ,&nbsp;Ahlem Gzara ,&nbsp;Amira Kebir ,&nbsp;Kaja Abbas ,&nbsp;Slimane BenMiled","doi":"10.1016/j.jvacx.2025.100712","DOIUrl":"10.1016/j.jvacx.2025.100712","url":null,"abstract":"<div><h3>Background:</h3><div>Cervical cancer is one of the most prevalent cancers affecting women especially in low- and middle income countries and is caused by persistent infection with human papillomavirus (HPV). HPV vaccination can significantly reduce the cervical cancer burden. However, HPV vaccination is not yet included in the Tunisian immunization program. To inform decision-making on HPV vaccine introduction in Tunisia, we conducted a comparative modeling study to project the health impact and cost-effectiveness of four HPV vaccines (Cecolin, Cervarix, Gardasil, 4, and Gardasil-9) targeted to 12-year-old girls in 2025.</div></div><div><h3>Methods:</h3><div>We used two static cohort models (UNIVAC and Papillomavirus Rapid Interface for Modeling and Economics (PRIME)) to estimate the health and economic impact of HPV vaccination from the health system and societal perspectives. Our data inputs to the model include demography and cervical cancer burden as well as unit costs for treatment, vaccines, and vaccine delivery. We estimated health impact in terms of cases, deaths, and disability-adjusted life years (DALYs) averted by HPV vaccination, and economic impact in terms of vaccination costs, treatment costs saved, net cost, and incremental cost-effectiveness ratios (ICERs).</div></div><div><h3>Results:</h3><div>We estimated that Cecolin is the most cost-effective HPV vaccine in Tunisia, particularly when cross-protection is considered. Despite Cervarix offering greater health benefits of 70% versus 62% reductions in cervical cancer cases and deaths at 87% coverage, Cecolin has lower net costs and is more favorable across different willingness-to-pay (WTP) thresholds. At a WTP of USD 1169 per DALY averted (30% of Tunisia’s GDP per capita), Cecolin and Cervarix demonstrate similar probabilities of being cost-effective.</div></div><div><h3>Conclusion:</h3><div>Based on the vaccine impact estimates generated by the UNIVAC and PRIME models, we inferred that the four HPV vaccines (Cecolin, Cervarix Gardasil,4, and Gardasil-9) were cost-effective in the Tunisian context. This evidence is useful to inform HPV vaccine introduction in Tunisia.</div></div>","PeriodicalId":43021,"journal":{"name":"Vaccine: X","volume":"27 ","pages":"Article 100712"},"PeriodicalIF":2.2,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145050302","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Durability of neutralizing antibody and T-cell responses in COVID-19 patients after infection and booster vaccination","authors":"Lin Yao ,&nbsp;Xiao-Lin Jiang ,&nbsp;Jun-Xia Cao ,&nbsp;Qiang Guo ,&nbsp;Meng-Na Wu ,&nbsp;Shu-Zhi Wu ,&nbsp;Li-Jun Duan ,&nbsp;Yuan Shen ,&nbsp;Bing-Dong Zhan ,&nbsp;Jun-Fen Lin ,&nbsp;Ming-Dong Jiang ,&nbsp;Hong-Hong Peng ,&nbsp;Yu-Wei Zhang ,&nbsp;Guo-Jian Yang ,&nbsp;Xue-Dong Song ,&nbsp;Chao Shi ,&nbsp;Ji-Yan Zhang ,&nbsp;Wen-Guo Jiang ,&nbsp;Mai-Juan Ma","doi":"10.1016/j.jvacx.2025.100718","DOIUrl":"10.1016/j.jvacx.2025.100718","url":null,"abstract":"<div><div>Determining the durability of immunity after SARS-CoV-2 infection or vaccination is critical for understanding immune protection upon reinfection and optimizing vaccine design. We measured SARS-CoV-2-specific antibodies and T-cell responses in COVID-19 convalescent patients up to 14 months after infection and COVID-19 convalescents who received two doses of BBIBP-CorV at 6-month intervals. We observed that most convalescents had durable neutralizing antibody and T-cell responses against the SARS-CoV-2 Wuhan strain at least 14 months after infection. Administering a booster dose to convalescent patients significantly increased neutralizing antibodies against the Wuhan strain, but neutralization activity against Omicron BA.1, BA.2, BA.2.12.1, and BA.4/BA.5 was significantly decreased. Six months after the first dose vaccination, the neutralizing antibody levels significantly declined and were not further enhanced by a second dose. Omicron BA.1-specific T-cell responses were detectable in most convalescent patients and were not significantly affected by vaccination. These analyses provide insights into the durability of the immune response after infection and hybrid immunization and may be relevant for future vaccine strategies.</div></div>","PeriodicalId":43021,"journal":{"name":"Vaccine: X","volume":"27 ","pages":"Article 100718"},"PeriodicalIF":2.2,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145107624","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"COVID-19 and influenza vaccination among adults stably engaged in HIV care","authors":"Grazia Alessio ,&nbsp;Drieda Zaçe ,&nbsp;Christopher Jones ,&nbsp;Andrea Di Lorenzo ,&nbsp;Alessandra Imeneo ,&nbsp;Vincenzo Malagnino ,&nbsp;Elisabetta Teti ,&nbsp;Loredana Sarmati ,&nbsp;Alessandra Ruggiero ,&nbsp;Marco Iannetta ,&nbsp;Anna Maria Geretti ,&nbsp;EVAN-CoV-Study Group","doi":"10.1016/j.jvacx.2025.100719","DOIUrl":"10.1016/j.jvacx.2025.100719","url":null,"abstract":"<div><h3>Introduction</h3><div>Vaccination against COVID-19 and influenza is recommended for people living with HIV, but real-world uptake data remain incomplete, especially in populations facing socioeconomic barriers. We assessed uptake and associated factors at an HIV outpatient centre serving a socioeconomically disadvantaged area of Rome. Participants were in stable HIV care and were encouraged to receive vaccination at no cost, at a location of choice. COVID-19 vaccination was initially available both on-site and externally; influenza vaccination was only available externally.</div></div><div><h3>Methods</h3><div>We analysed a random 50 % sample of 750 adults, retrieving data from the vaccination registry and medical records. Full COVID-19 vaccination was defined as primary vaccination plus <span><math><mo>≥</mo></math></span>1 additional dose. Logistic regression identified factors associated with uptake.</div></div><div><h3>Results</h3><div>Between December 2020 and July 2024, 331/375 (88.3 %) participants received primary COVID-19 vaccination (typically two mRNA vaccine doses 3–4 weeks apart) and 286/375 (76.3 %) received ≥1 additional dose, with most vaccinations occurring before September 2023. Odds of full vaccination were lower among participants &lt;50 years and heterosexual men and women (vs. men who have sex with men). Other associated factors included migrant background, injecting drug use, history of advanced immunosuppression, HIV viraemia, and CD4 &lt;500 cells/mm³. Influenza vaccination uptake (2022/2023) was low (99/375, 26.4 %), although almost 4-fold higher among those vaccinated against COVID-19.</div></div><div><h3>Conclusions</h3><div>Disparities in COVID-19 vaccine coverage and suboptimal influenza vaccination uptake persist among adults stably engaged in HIV care. Addressing barriers, particularly in those with additional vulnerabilities, and integrating vaccination into HIV services may improve uptake and reduce preventable illness.</div></div>","PeriodicalId":43021,"journal":{"name":"Vaccine: X","volume":"27 ","pages":"Article 100719"},"PeriodicalIF":2.2,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145050301","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"HPV knowledge, vaccination uptake, and information access among adolescents aged 15–19 in France","authors":"Priscille Dumortier ,&nbsp;Élise Frain ,&nbsp;Nathan Peiffer-Smadja","doi":"10.1016/j.jvacx.2025.100717","DOIUrl":"10.1016/j.jvacx.2025.100717","url":null,"abstract":"<div><h3>Introduction</h3><div>Sexual health information for young people is a global public health issue. HPV is the most common sexually transmitted infection. In France, vaccination was extended to girls and in 2019, but coverage remains low<strong>.</strong> This study assessed knowledge about HPV, vaccination, means of protection, and sources of information among adolescents, and analyzed predictors of vaccination.</div></div><div><h3>Method</h3><div>This was an observational cross-sectional survey among girls and boys aged 15–19 in six secondary schools in France. The study was carried out as part of the mandatory health promotion program for third-year medical students.</div></div><div><h3>Results</h3><div>All 357 questionnaires were completed (100 % response rate). Girls were more likely to be informed about HPV than boys, with 67 % (159/238) of girls reporting prior information compared with 44 % (52/119) of boys (<em>p</em> &lt; 0.001). Vaccination uptake was higher among girls, with 40 % (95/238) vaccinated compared with 21 % (25/119) of boys (<em>p</em> &lt; 0.001). Vaccination was significantly more frequent in schools with a higher social position score (<em>p</em> &lt; 0.01). Overall knowledge about HPV was low without significant differences by gender, age, or school. Only 179/357 (50 %) adolescents knew that both girls and boys are affected by HPV, and only 218/357 (61 %) cited vaccination as protection. Social networks were the preferred means of communication about HPV for young people (270/357, 76 %), followed by advertisements on television or public transport (145/357, 41 %).</div></div><div><h3>Conclusion</h3><div>General practitioners play a central role in informing young people about sexual health and HPV. Promoting information through social networks and public campaigns, seldom used for HPV, was encouraged by high school students.</div></div>","PeriodicalId":43021,"journal":{"name":"Vaccine: X","volume":"26 ","pages":"Article 100717"},"PeriodicalIF":2.2,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145007714","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of measles vaccination on disease severity and economic burden among children in northern Vietnam, 2017–2019","authors":"Hoang Dinh Phi ,&nbsp;Tran Ngoc Ca ,&nbsp;Pham Mai Oanh ,&nbsp;Nguyen Thien Phong ,&nbsp;Ong Thinh ,&nbsp;Pham Thi Hong Nhung","doi":"10.1016/j.jvacx.2025.100714","DOIUrl":"10.1016/j.jvacx.2025.100714","url":null,"abstract":"<div><div>The measles vaccine has a profound impact, significantly reducing incidence and morbidity. However, challenges in achieving high vaccination coverage have resulted in substantial burdens on child health and financial hardship for households. This study evaluates the protective effects of measles vaccination against severity and mortality in Northern Vietnam from 2017 to 2019 and related economics of vaccination.</div><div>We conducted a retrospective analysis of all laboratory-confirmed measles cases admitted to Vietnam National Children Hospital (VNCH), estimating odds ratios between vaccinated and unvaccinated groups while considering disease severity, mortality, and potential confounders. We also analyzed cost - benefit using data from two sources, including VNCH data and National Infectious Disease Surveillance System.</div><div>Among 2064 inpatients, vaccinated children exhibited fewer pneumonia complications and shorter hospitalization duration. Vaccination significantly reduced the risk of severity and mortality with an adjusted OR = 0.46 (0.28–0.72). Treatment costs were significantly lower in the vaccinated group compared to the unvaccinated group. Cost – benefit analysis show that vaccination can save for 4.98 USD to 26.20 USD per measle case with prior vaccination.</div><div>Vaccination significantly reduces severe disease risk, pneumonia complications, and treatment costs. Expanding vaccination coverage (including children, young mothers and women of childbearing age) and targeted financial support in high-risk areas are essential for improving health outcomes and alleviating economic burdens on families<strong>.</strong></div></div>","PeriodicalId":43021,"journal":{"name":"Vaccine: X","volume":"26 ","pages":"Article 100714"},"PeriodicalIF":2.2,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145003900","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Understanding motivation and experience in participating in a paediatric SARS-CoV-2 serosurvey, in Australia","authors":"Archana Koirala ,&nbsp;Shayal A. Prasad ,&nbsp;Philip N. Britton ,&nbsp;Nicholas Wood ,&nbsp;Peter C. Richmond ,&nbsp;Brendan McMullan ,&nbsp;Nigel W. Crawford ,&nbsp;Helen S. Marshall ,&nbsp;Laura Francis ,&nbsp;Michelle Wills ,&nbsp;Emma Leighton ,&nbsp;Kristine Macartney ,&nbsp;Katarzyna Bolsewicz ,&nbsp;On behalf of the PAEDS Serosurvey Group","doi":"10.1016/j.jvacx.2025.100716","DOIUrl":"10.1016/j.jvacx.2025.100716","url":null,"abstract":"<div><h3>Objectives</h3><div>Serosurveys are considered as a valuable tool in estimating population immunity and infection rates but recruitment of children to provide paediatric estimates can be challenging. A novel approach of sampling children undergoing anaesthesia was utilised for a SARS-CoV-2 serosurvey in Australian children and we explore the reasons for participation, feedback on the approach and importance of research into Coronavirus Diseases 2019 (COVID-19).</div></div><div><h3>Design</h3><div>This cross-sectional, nationally representative serosurvey recruited children aged 0–19 years undergoing an anaesthetic procedure from eight paediatric hospitals between 8 June to 31 August 2022. Guardians or participants (18–19 years) were invited, upon receiving their results, to provide an online survey. A qualitative thematic approach was used to analyse the free-text responses.</div></div><div><h3>Results</h3><div>Feedback was provided by 15.7 % (323/2046) participants. Reasons for participating included contributing to research (67/323 responders) and curiosity about SARS-CoV-2 immunity (65/323 responders). The opportunistic sampling method was well-received, convenient, and minimally disruptive. Responders emphasised the importance of research on COVID-19 in children, highlighting the need to understand the long-term impact of the virus and to inform vaccination decisions.</div></div><div><h3>Conclusion</h3><div>There are challenges in conducting ethical, low-burden cross sectional serosurveys in children in a vast country like Australia. This approach not only contributed to the collection of a large paediatric sample size but also supports the use of this method in future serosurveys.</div></div>","PeriodicalId":43021,"journal":{"name":"Vaccine: X","volume":"27 ","pages":"Article 100716"},"PeriodicalIF":2.2,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145027793","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A qualitative study on vaccination program accessibility for the elderly and medical risk groups in the south of the Netherlands","authors":"May Nhu Vu ,&nbsp;Tjalke Arend Westra ,&nbsp;Mickael Hiligsmann","doi":"10.1016/j.jvacx.2025.100713","DOIUrl":"10.1016/j.jvacx.2025.100713","url":null,"abstract":"<div><div>Elderly and medical risk patients face an increased risk of vaccine-preventable infectious diseases. However, their vaccination rates are on a decreasing trend in the Netherlands, contrary to public health recommendations. The current vaccination landscape for Dutch adults is complex, with separate programs and many stakeholders involved such as general practitioners (GP), municipal public health (GGD), and hospital specialists. This contributes to reduced access and vaccination rates. This study sought to gain stakeholder insight on how to improve the accessibility and sustainability of vaccine programs for the elderly and medical risk population in Limburg. Nine semi-structured interviews with vaccination stakeholders such as GPs, GGD, academic experts, specialist doctors and patient organizations were conducted. Four vaccine accessibility themes were identified: barriers to access, Limburg particularities, stakeholder roles and responsibilities, and adjustments to improve access and sustainability. Key barriers were vaccine hesitancy, program rigidity and fragmentation, lack of a data-sharing system, complex reimbursement, lack of stakeholder collaboration and trust, and complacency of different parties. Particularities of Limburg that should be considered are its geographical uniqueness and lower education and socioeconomic conditions. Finally, potential improvements were also identified, mainly: centralising to one vaccination stakeholder through GP and GGD collaboration, improving communication to patients, creating a patient data-sharing system, and maximising vaccination opportunities and convenience. Stakeholders held diverse perspectives on barriers to vaccination access. However, their views converged on centralisation at GGD and collaboration with GPs, a solution that may eliminate their weaknesses and combine their strengths. A focus on how to increase collaboration with GPs, trust, and convenience while centralising vaccination is to be prioritised in future research. Furthermore, an online vaccine registry and patient data-sharing system is desired by all parties. These solutions have the potential to reduce program fragmentation, enhance patient convenience and ultimately increase vaccine uptake among high-risk Dutch adult populations.</div></div>","PeriodicalId":43021,"journal":{"name":"Vaccine: X","volume":"27 ","pages":"Article 100713"},"PeriodicalIF":2.2,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145118944","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The validation of the Slovak vaccination attitudes examination (VAX) scale and pilot study","authors":"Martin Novák ,&nbsp;Jana Zibolenová ,&nbsp;Peter Vyšehradský ,&nbsp;Romana Ulbrichtová ,&nbsp;Eva Malobická ,&nbsp;Eliška Štefanová ,&nbsp;Ján Mikas ,&nbsp;Adriana Mečochová ,&nbsp;Henrieta Hudečková ,&nbsp;Viera Švihrová","doi":"10.1016/j.jvacx.2025.100715","DOIUrl":"10.1016/j.jvacx.2025.100715","url":null,"abstract":"<div><h3>Introduction</h3><div>The resurgence of vaccine-preventable diseases poses a significant global public health challenge, exacerbated by the rise of anti-vaccination attitudes. The aim of this study was to validate the Slovak version of the Vaccination Attitudes Examination (VAX) questionnaire and to examine the attitudes towards vaccination in Slovakia.</div></div><div><h3>Methods</h3><div>The VAX scale questionnaire, translated into Slovak and validated, was used for the survey. The VAX scale uses 12 statements assessing anti-vaccination attitudes. Each statement is scored on a 6-point Likert scale, with higher total score indicates more negative attitudes towards vaccinations. Our questionnaire also included demographic questions (age, gender, residence, education level, profession, and economic activity). For validation, the questionnaire was translated into the Slovak using forward and backward translations. The validation survey was conducted on the sample size of 115 participants. Correlation was calculated using Pearson's correlation coefficient, internal consistency was tested. Confirmatory factor analysis (CFA) was performed to assess validity. Subsequently, a pilot study was conducted in March 2023 with a sample size of 473 participants.</div></div><div><h3>Results</h3><div>The VAX scale demonstrated strong internal consistency (Cronbach's alpha = 0.925) and reliability. The results of the CFA were comparable to findings from other languages versions. The pilot study revealed that parents, non-healthcare professionals, and older individuals exhibited higher anti-vaccination attitudes. In contrast, healthcare professionals had the lowest VAX scores, reflecting more pro-vaccination attitudes.</div></div><div><h3>Conclusion</h3><div>These findings highlight the need for targeted educational and communication strategies to address vaccine hesitancy. By identifying demographic patterns and potential hotspots of vaccine skepticism, public health initiatives can be better tailored to improve vaccination rates. The validated Slovak VAX scale provides a reliable tool for ongoing assessment and intervention efforts.</div></div>","PeriodicalId":43021,"journal":{"name":"Vaccine: X","volume":"26 ","pages":"Article 100715"},"PeriodicalIF":2.2,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144911872","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}