Human Vaccines & Immunotherapeutics最新文献

{"title":"Vaccination status of children with special health-care needs visiting a vaccination consultation clinic of a pediatric hospital in Wuxi, China, from 2020 to 2023: A cross-sectional study.","authors":"Lingling Wang, Xiaojuan Zhang, Xuwen Wang, Hongxia Xiang, Yuan Shen, Shixin Xiu","doi":"10.1080/21645515.2026.2613562","DOIUrl":"10.1080/21645515.2026.2613562","url":null,"abstract":"<p><p>There has been a considerable controversy about vaccination practices of children with special health-care needs (CSHCNs) in China. We aim to describe current vaccination recommendations, immunization status, and vaccination safety of CSHCNs in Wuxi. We conducted a cross-sectional study of CSHCNs aged <18 y visiting the vaccination consultation clinic (VCC) at Wuxi Children's Hospital in 2020-2023. Demographic information was collected from Electronic Medical Records, vaccination data was obtained from Vaccination Integrated Service Management Information System of Jiangsu Province, China. Safety monitoring data was acquired from China National Adverse Events Following Immunization Information System (CNAEFIS). Descriptive data were presented as percentages, and Poisson test was used to compare the cumulative incidence of AEFIs between groups. Four thousand one hundred and twenty-two participants were included and the majority (73.0%) were under 12 months. The top three diseases consulted were those relating to the certain conditions originating in the perinatal period, developmental anomalies, and diseases of the blood or blood-forming organs. Only 6.1% had previously received all age-eligible vaccine doses before seeking evaluation. According to the vaccination guidance issued by the VCC, 59.9% were recommended to continue vaccine normally, partial vaccination was recommended for 37.2%, and 4.1% were advised to delay. A total of 3927 CSHCNs received 62,744 vaccine doses after consultation. None had serious adverse events and the cumulative incidence of AEFIs was higher than the general population of children. Specialist consultation is helpful to improve the vaccine uptake. Further research on strategies to improve the vaccination coverage of CSHCNs is warranted.</p>","PeriodicalId":49067,"journal":{"name":"Human Vaccines & Immunotherapeutics","volume":"22 1","pages":"2613562"},"PeriodicalIF":4.2,"publicationDate":"2026-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12826754/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146020388","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative safety assessment of measles-containing vaccination schedules in Jiangsu Province, China: A population-based pharmacovigilance study (2014-2024).","authors":"Yuanyuan Zhu, Jing Yu, Ran Hu, Zhiguo Wang, Xiang Sun","doi":"10.1080/21645515.2026.2686496","DOIUrl":"https://doi.org/10.1080/21645515.2026.2686496","url":null,"abstract":"<p><p>China's immunization policy was updated in 2020, replacing the sequence of MR (at 8-12 months) and MMR (at 18-24 months) with a comprehensive two-dose MMR schedule.This study aims to evaluate the safety of this policy shift by comparing the incidence of Adverse Events Following Immunization (AEFI) before and after the adjustment.Methods: A retrospective analysis was conducted using AEFI surveillance data from Jiangsu Province. The study compared two cohorts: the \"pre-adjustment\" group (MR at 8 months, MMR at 18 months) and the \"post-adjustment\" group (MMR at both 8 and 18 months). Incidence rates of non-serious reactions (fever, fatigue, local redness, and swelling) and serious reactions (allergic rash, febrile seizures, etc.) were analyzed using Chi-square tests and rate ratios (RR). Results: The transition to a two-dose MMR schedule was associated with an increase in reported mild AEFIs. Specifically, at the 8-month dose, the incidence of fever, fatigue, local redness, and swelling was significantly higher in the MMR8 group compared to the MR8 group (<i>P</i> < .001). The incidence of allergic rash also showed a 31% increase in the MMR8 group (45.39 per 100,000) compared to the MR8 group (34.71 per 100,000), though it remained below global safety thresholds. Crucially, there were no statistically significant differences in the incidence of serious AEFIs, such as thrombocytopenic purpura (<i>P</i> = .670) or febrile seizures (<i>P</i> = .915), between the two strategies. Furthermore, serious reactions as a whole category showed no statistically significant difference between MR8 and MMR8 (<i>P</i> = .710). The implementation of a two-dose MMR immunization schedule in Jiangsu Province is safe. While the shift was associated with an increase in mild, self-limiting reactions, it did not lead to an increase in serious adverse events. These findings support the continued use of the two-dose MMR strategy to provide broader protection against measles, mumps, and rubella without compromising vaccine safety.</p>","PeriodicalId":49067,"journal":{"name":"Human Vaccines & Immunotherapeutics","volume":"22 1","pages":"2686496"},"PeriodicalIF":4.2,"publicationDate":"2026-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148266664","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Immunotherapy impact of macrophage glycosylation on cholangiocarcinoma and its prognostic and immune microenvironment significance.","authors":"Yufen Xu, Xiaofang Xu, Yan Xu, Jianwen Duan","doi":"10.1080/21645515.2026.2635867","DOIUrl":"10.1080/21645515.2026.2635867","url":null,"abstract":"<p><p>Cholangiocarcinoma (CCA) has a complex tumor microenvironment that critically influences tumor progression and therapeutic resistance. Glycosylation abnormalities have been linked to cancer growth and progression. This work was designed to develop a prognostic model based on glycosylation-related genes (GRGs) for predicting CCA outcomes and immunotherapy responses. Glycosylation patterns in macrophage subsets of CCA were analyzed via scRNA-seq. Key genes were identified by integrating module genes from WGCNA and DEGs. A risk model for CCA was established utilizing LASSO Cox regression. In vitro tests were conducted to validate the function of PGK1. The immune checkpoint blockade group exhibited elevated M1 signature scores and higher glycosylation levels. A risk model incorporating five genes (ANXA3, PGK1, PLAUR, CREB5, SPP1) for CCA was established. The high macrophage glycosylation-related risk score group had a considerable infiltration of M0 macrophages. In vitro experiments confirmed that PGK1 advanced glycation end products accumulation, drove M2 polarization of macrophages, and increased CCA cell proliferation and migration. This work proposes a glycosylation-based risk model for predicting CCA prognosis and directing therapeutic strategies. PGK1 is highlighted as a potential therapeutic target in CCA.</p>","PeriodicalId":49067,"journal":{"name":"Human Vaccines & Immunotherapeutics","volume":"22 1","pages":"2635867"},"PeriodicalIF":4.2,"publicationDate":"2026-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12973474/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147379363","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Epidemiological and virological characteristics of influenza in Zhejiang Province, China: A 15-year surveillance study.","authors":"Jialie Jin, Zhao Yu, Ying Zhu, Yanli Cao, Hangjie Zhang, Xiaoxiao Wang, Jimin Sun","doi":"10.1080/21645515.2026.2675787","DOIUrl":"10.1080/21645515.2026.2675787","url":null,"abstract":"<p><p>Understanding the complex epidemiological and virological characteristics of influenza is critical for optimizing seasonal influenza control and prevention programs; to this end, we analyzed the influenza and influenza-like illness (ILI) cases reported in Zhejiang Province from 2010 to 2025. Annual average percentage (AAP) approach was used to estimate the influenza seasonal epidemic onset and duration. Generalized additive model (GAM) was used to explore the nonlinear relationship between age and the positive rate of influenza. Spearman correlation analysis was performed to assess the association between weekly ILI% and influenza positivity rate. A total of 5,853,160 influenza cases and 8,732,124 ILI cases were reported. The ILI% ranged from 2.49 to 6.84% (mean: 4.37%), with the lowest level in 2010-2011 and the highest in 2023-2024. The median duration of seasonal influenza epidemics was 4.59 months (IQR: 2.84-5.88). Children aged 5~14 y had the highest influenza positivity rate (41.73%). Influenza virus subtypes/lineages varied significantly by seasons and age groups. A/H3N2 was the predominant pathogen during the summer seasons and the positivity rate of A/H3N2 was much higher than that of other subtypes/lineages among individuals aged ≤60 y. ILI% was positively correlated with influenza positivity during 2010-2025 except in the 2020-2021 surveillance year. This study revealed significant variations in seasonal epidemic period and age-specific distributions across influenza subtypes/lineages, as well as a marked disruption of influenza activity due to the COVID-19 pandemic.</p>","PeriodicalId":49067,"journal":{"name":"Human Vaccines & Immunotherapeutics","volume":"22 1","pages":"2675787"},"PeriodicalIF":4.2,"publicationDate":"2026-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13196651/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147976626","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Antigen anisotropy: The overlooked geometric determinant of vaccine immunogenicity and fidelity.","authors":"Daniel Santiago","doi":"10.1080/21645515.2026.2638640","DOIUrl":"10.1080/21645515.2026.2638640","url":null,"abstract":"<p><p>Antigen anisotropy, the directional dependence of protein conformation, epitope exposure, and conformational dynamics, is an under-appreciated determinant of vaccine immunogenicity. Preserving this geometric fidelity may influence outcomes such as neutralization breadth, affinity maturation, and B/T-cell response quality. Native antigens engage B-cell receptors, T-cell receptors, and MHC through oriented interactions that rely on spatial and dynamic constraints for effective immune recognition. This framework is increasingly relevant amid widespread use of nucleoside-modified mRNA vaccines, as recent studies suggest platform-specific deviations in antigen geometry and processing. Platform interventions including chemical inactivation (e.g., formaldehyde and β-propiolactone), formulation and storage conditions, and mRNA design choices (e.g., N¹-methylpseudouridine incorporation, codon optimization) can introduce perturbations that influence folding, glycan shielding, epitope presentation, and hydrodynamic behavior. These effects can generate antigen ensembles that diverge from native forms, and may plausibly contribute to differences in response breadth and quality. Prioritizing anisotropy preservation offers a complementary design principle for next generation vaccines, one that seeks to more closely recapitulate the geometric and dynamic features of natural infection and may improve the predictability and durability of protective immunity.</p>","PeriodicalId":49067,"journal":{"name":"Human Vaccines & Immunotherapeutics","volume":"22 1","pages":"2638640"},"PeriodicalIF":4.2,"publicationDate":"2026-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12969738/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147357152","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The real-world economic impact of herpes zoster disease in patients with selected underlying conditions in Spain.","authors":"Helena Moza Moríñigo, Andrea García, Eleftherios Zarkadoulas, María Del Rosario Cambronero Mártinez, Javier Varas, Alba Martín, María García, Alfonsina Trento, Ignacio Hernández, Laura Amanda Vallejo-Aparicio","doi":"10.1080/21645515.2026.2620909","DOIUrl":"10.1080/21645515.2026.2620909","url":null,"abstract":"<p><p>People with underlying diseases are at-increased-risk of suffering from herpes zoster (HZ). However, the economic impact of HZ on these populations is not well described. This study aimed to quantify the clinical and economic impact of HZ in patients with comorbidities (diabetes, chronic obstructive pulmonary disease, heart disease, kidney disease, asthma) and immune disorders (inflammatory bowel disease, rheumatoid arthritis, systemic lupus erythematosus, multiple sclerosis, psoriasis, COVID-19 and psoriatic arthritis) in Spain. This is an observational, retrospective case-control study using the BIG-PAC electronic records from 01 Jan 2014 to 31 Aug 2021. Healthcare resource use and costs over 12 months following HZ diagnosis were compared between patients and controls, matched by propensity scores. The total annual economic burden was estimated using HZ-related costs per patient and HZ crude incidence over the study period, together with the estimated prevalence of each comorbidity in the Spanish population aged ≥18 y. Mean incremental costs per HZ episode were €1,108 in patients with comorbidities and €1,203 in patients with immune disorders. Indirect costs accounted for 4.7% and 22.9% of incremental costs in people with comorbidities and immune disorders, respectively. Mean annual crude HZ incidence rates were 613.6 cases per 100,000 people with comorbidities and 659.0 cases per 100,000 people with autoimmune disorders. Total annual costs due to HZ in these populations were estimated at €121 million. HZ may cause a significant economic burden in Spain from a societal perspective in patients with underlying conditions, highlighting the importance of improving vaccination programs.</p>","PeriodicalId":49067,"journal":{"name":"Human Vaccines & Immunotherapeutics","volume":"22 1","pages":"2620909"},"PeriodicalIF":4.2,"publicationDate":"2026-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12893685/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146144207","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring the impact of reimbursement ratios on willingness to vaccinate: A mixed-effects modeling approach using panel data.","authors":"Linbo Xie, Jie Xing, Mengsha Yan, Peiyao Li, Junfang Xu, Xin Fang, Ziting Guo, Min Yuan, Jiming Zhu","doi":"10.1080/21645515.2025.2609339","DOIUrl":"10.1080/21645515.2025.2609339","url":null,"abstract":"<p><p>Vaccination remains one of the most cost-effective methods for disease prevention. However, utilization of self-paid vaccines, including EV71, varicella, influenza, and DTaP-IPV-Hib in this study, remains insufficient among children under six in China. To investigate the determinants of willingness to vaccinate (WTV) for self-paid vaccines and assess cost-WTV heterogeneity, we conducted structured-questionnaire surveys with 2212 randomly selected households in Hangzhou, each with at least one child under six. Multiple regression analysis was used to identify the key determinants of WTV, and a mixed-effect model was employed to analyze the correlation between vaccine cost and WTV, further segmenting the data with unsupervised clustering techniques. Our findings highlighted impact of vaccination cost as a pivotal factor influencing the WTV for self-paid vaccines. We categorized the population into four groups based on their sensitivity to vaccine cost. Families with one child, children aged 1-3 y, highly-educated parents, and higher socioeconomic status consistently exhibited high WTV. Our analysis offers targeted strategies to enhance vaccine uptake and improve immunization coverage.</p>","PeriodicalId":49067,"journal":{"name":"Human Vaccines & Immunotherapeutics","volume":"22 1","pages":"2609339"},"PeriodicalIF":4.2,"publicationDate":"2026-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12959184/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147349625","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effectiveness of COVID-19 vaccines and the added benefit of booster doses in Hessen, Germany, during the COVID-19 pandemic: Results from a vaccinated-only study.","authors":"Ivo M Foppa, Malin Trabold, Michael Frowein","doi":"10.1080/21645515.2025.2611641","DOIUrl":"10.1080/21645515.2025.2611641","url":null,"abstract":"<p><p>Estimates of the added benefit from COVID-19 vaccine booster doses can inform seasonal vaccine recommendations. We set out to estimate COVID-19 vaccine effectiveness (VE), avoiding common sources of bias. We chose a modified screening method, using only vaccinated cases of symptomatic COVID-19 recorded in the mandatory infectious disease reporting system, with data from a vaccination registry. Effect estimates were obtained by Bayesian logistic regression, comparing outcomes within dose strata between immunized (15-21d after vaccination) and not yet immunized (up to 7d). VE estimates were calculated recursively and relative VE estimates were obtained to quantify the added benefit of booster doses. We found VE for clinical illness to be around 90% during the predominance of the SARS-CoV-2 Alpha variant. During the Delta period, VE was distinctly lower, but did not decrease much further. The first booster dose added substantial protection during the Delta period, but that benefit became marginal during the Omicron period in the 18+. The effect of second booster doses, which became widespread only during the Omicron period, was modest. Using a novel, vaccinated-only study design we found that two doses of a COVID-19 vaccine offered substantial protection from symptomatic COVID-19, even during the Omicron period. One booster dose was highly effective during the Delta period, but the effect became modest during the Omicron period, when second booster doses offered, but a marginal benefit.</p>","PeriodicalId":49067,"journal":{"name":"Human Vaccines & Immunotherapeutics","volume":"22 1","pages":"2611641"},"PeriodicalIF":4.2,"publicationDate":"2026-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12959224/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147318644","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Structural asymmetry in knowledge of active and passive tetanus immunization among frontline healthcare workers: Implications for adult booster policy in China.","authors":"Quanjun Fang, Jilai Mao, Longcai Yu, Xiaoying Gong, Canjie Zheng, Guoping Cao, Zhiying Yin","doi":"10.1080/21645515.2026.2694172","DOIUrl":"10.1080/21645515.2026.2694172","url":null,"abstract":"<p><p>Despite sustained high childhood tetanus vaccination coverage in China, adult booster immunization has not been institutionalized, leaving a substantial immunity gap. Frontline healthcare providers play a critical role in post-exposure prophylaxis decisions; however, their knowledge regarding tetanus immunization remains inadequately characterized We conducted a cross-sectional survey among 343 healthcare professionals working in 22 emergency departments and 39 dog bite clinics in Quzhou, China. A validated questionnaire assessed knowledge of tetanus disease, active immunization schedules, and passive immunization use. Knowledge scores were categorized into quartiles and analyzed using ordered logistic regression. Recognition of key clinical manifestations ranged from 94.75% (325/343) to 97.67% (335/343). In contrast, knowledge regarding active immunization was markedly limited: only 12.24% (42/343) correctly identified the five-dose childhood schedule and 35.57% (122/343) recognized the recommended 10y adult booster interval. Awareness that tetanus may occur without a clear trauma history was 33.24% (114/343). Among respondents with prior clinical experience managing tetanus, knowledge of wound management was high (94.87%, 74/78), whereas understanding of long-term immunization strategies remained low (14.10%, 11/78-39.74%, 31/78), indicating a procedural-preventive knowledge imbalance. Institution type, vaccine availability at the institution, occupational role, educational level, and prior training were independently associated with higher knowledge scores (all <i>P</i> < .05). Frontline providers demonstrated adequate clinical recognition but insufficient understanding of active immunization and adult booster strategies. This imbalance may contribute to inappropriate reliance on passive immunization in trauma settings. Strengthening guideline-based training and improving institutional vaccine accessibility are essential to optimize tetanus prophylaxis practices and support adult immunization policy development.</p>","PeriodicalId":49067,"journal":{"name":"Human Vaccines & Immunotherapeutics","volume":"22 1","pages":"2694172"},"PeriodicalIF":4.2,"publicationDate":"2026-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13313201/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148320221","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The syndemic nexus: How vaccine hesitancy and COVID-19 interact to influence vaccine uptake among university students.","authors":"Bara' Abdallah AlShurman, Shannon E Majowicz, Kelly Grindrod, Joslin Goh, Zahid Ahmad Butt","doi":"10.1080/21645515.2026.2621473","DOIUrl":"10.1080/21645515.2026.2621473","url":null,"abstract":"<p><p>This study examined whether COVID-19 Vaccine Hesitancy (VH) and COVID-19-related factors interact to influence COVID-19 booster doses uptake among university students in Canada, from a syndemic perspective. A cross-sectional survey was conducted among 4453 students at the University of Waterloo in 2024. VH was measured toward both COVID-19 primary and booster doses. Change in VH scores were computed to capture shifts in hesitancy over time. Logistic regression models assessed the main effects of VH and COVID-19-related factors on booster uptake. Interactions were tested using additive and multiplicative scales. Increased VH was associated with a 23% decrease in booster uptake. Younger ages, not being hospitalized due to COVID-19, not receiving the influenza vaccine, noncompliance with COVID-19 guidelines, and belief in conspiracy theories predicted lower booster uptake. Significant interactions were found between change in VH scores and COVID-19 diagnosis and hospitalization history, guideline adherence, and conspiracy beliefs. For students who did not receive booster doses, the change in VH was greater among those who reported following public health guidance than those who did not. Similarly, for students who did not receive booster doses, the change in VH was greater among those who reported not believing in conspiracy theories compared to those who did. The findings support a syndemic model, indicating that VH and COVID-19-related experiences jointly influence booster uptake. Targeted interventions such as rebuilding trust, addressing misinformation, and reducing stigma may improve booster uptake even if not all barriers are addressed. Further research is needed to examine these interactions.</p>","PeriodicalId":49067,"journal":{"name":"Human Vaccines & Immunotherapeutics","volume":"22 1","pages":"2621473"},"PeriodicalIF":4.2,"publicationDate":"2026-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12885408/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146120748","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}