Acta Paediatrica最新文献

{"title":"The History of Measles and Vaccine Development","authors":"Heikki Peltola","doi":"10.1111/apa.70370","DOIUrl":"10.1111/apa.70370","url":null,"abstract":"<div>\u0000 \u0000 <p>Measles is one of the oldest human diseases, but the fact that it was separate from smallpox, scarlatina and rubella was only disclosed a century ago. It is extremely contagious, as the infection may spread for up to 4 days before the first symptoms appear. One patient may infect 12–18 secondary cases, who then spread the infection further. Before the vaccine era, measles caused 2–3 million deaths a year, with remote populations facing chaotic consequences from epidemics. Safe and inexpensive live-virus vaccines, often combined with mumps and rubella components, have been available for 50 years. The global death toll first dropped below 100 000 per year in 2021, but setbacks have been seen in many countries, including Europe. High mortality is mainly due to immune amnesia, as previously acquired memory is partly disturbed because of the elimination of T and B cells. Impaired protection from pathogens other than measles recovers slowly in subsequent years. Measles is almost exclusively a human infection, which is potentially eradicable with vaccinations. It warrants two doses, especially when contacts with natural measles are minimal or lacking. The World Health Organization is running a measles and rubella elimination program, but current vaccination levels will make that difficult.</p>\u0000 </div>","PeriodicalId":55562,"journal":{"name":"Acta Paediatrica","volume":"115 11","pages":"2361-2369"},"PeriodicalIF":1.8,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145544075","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":"Vaccination Against Meningococcal Disease in Children—A European Perspective","authors":"Lisbeth M. Næss,&nbsp;Sara V. Watle","doi":"10.1111/apa.70224","DOIUrl":"10.1111/apa.70224","url":null,"abstract":"<div>\u0000 \u0000 <p>Invasive meningococcal disease (IMD) is a severe disease caused by the bacterium <i>Neisseria meningitidis</i>. The highest incidence is seen in children. The epidemiology of IMD is unpredictable and varies over time by country, age and serogroup, and IMD surveillance is pivotal for vaccine recommendations. The incidence of IMD has declined in recent years, partly due to vaccination, but some countries like France are experiencing the highest case numbers in years. Efficient meningococcal vaccines with good safety profiles are available. Including meningococcal vaccines in national immunisation programmes should be considered in all European countries, and surveillance of <i>N. meningitidis</i> strains should be continued.</p>\u0000 </div>","PeriodicalId":55562,"journal":{"name":"Acta Paediatrica","volume":"115 11","pages":"2441-2449"},"PeriodicalIF":1.8,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144796192","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":"Respiratory Syncytial Virus Vaccination Is Associated With Increased Odds of Preterm Birth","authors":"Ilari Kuitunen,&nbsp;Marjut Haapanen","doi":"10.1111/apa.17595","DOIUrl":"10.1111/apa.17595","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>To analyse whether respiratory syncytial virus (RSV) vaccination during pregnancy increases the odds of preterm birth.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A rapid review and meta-analysis was performed. The main outcome was the risk of preterm (gestational week less than 37) birth. A fixed-effects model was used to analyse pooled odds ratios (OR) with 95% confidence intervals (CI). Evidence certainty was assessed according to GRADE.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We included six randomised controlled trials with 17 656 births and two observational studies with 3446 births. The odds for preterm birth were increased in the randomised studies (OR 1.17, CI 1.02–1.34). No evidence of a difference was seen in the observational studies (OR 0.93, CI 0.69–1.25). Combined, these showed increased odds for preterm birth (OR 1.13, CI 1.00–1.27). Evidence certainty was rated to be moderate. When restricted to market-approved vaccine, the odds seemed to be increased in RCTs (OR 1.21, CI 0.98–1.49).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Based on the available evidence, RSV vaccination seems to be associated with increased odds for preterm birth. RSV vaccination needs continuous population-level observational safety data monitoring on the perinatal outcomes during the early phases of vaccine rollouts to detect possible safety signals and further confirm the magnitude of the effect on preterm birth.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55562,"journal":{"name":"Acta Paediatrica","volume":"115 11","pages":"2473-2477"},"PeriodicalIF":1.8,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/apa.17595","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143016662","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":"Metaphorical Language in Paediatric Vaccine Communication: Framing Risk and Building Trust Among Children and Adolescents","authors":"Fabiana Nuccetelli,&nbsp;Valeria Gabellone,&nbsp;Pier Luigi Lopalco","doi":"10.1111/apa.70534","DOIUrl":"10.1111/apa.70534","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>To examine the effectiveness of metaphorical language in framing risk and building trust among parents, children and adolescents in paediatric vaccine communication.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A narrative synthesis was conducted using empirical studies, institutional reports from the Istituto Superiore di Sanità, European Centre for Disease Prevention and Control, and National Institute for Health Research, alongside an original survey involving 2681 Italian adolescents, providing preliminary results. The survey compared three message framings: war metaphors, protective/caring metaphors and neutral factual statements.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Protective metaphors emphasising safety, care and collective responsibility achieved the highest Vaccine Confidence Index scores (mean 9.1), significantly outperforming both war metaphors and neutral messages (<i>p</i> &lt; 0.01). While war metaphors may initially mobilise urgency, they risk inducing anxiety, resistance and reduced perceived personal agency, particularly among younger audiences.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Integrating age-appropriate protective and caring metaphors into paediatric vaccine communication enhances trust and vaccine acceptance. Future campaigns should prioritise language that fosters safety, community and personal responsibility while avoiding metaphors likely to trigger fear or alienation.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55562,"journal":{"name":"Acta Paediatrica","volume":"115 11","pages":"2487-2490"},"PeriodicalIF":1.8,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/apa.70534","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147640742","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":"Rationale for Recommending Varicella Vaccination Into the Swedish National Immunisation Programme","authors":"Annika Ersson,&nbsp;Kari Johansen,&nbsp;Sören Andersson","doi":"10.1111/apa.70497","DOIUrl":"10.1111/apa.70497","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>Under Swedish law, a vaccination may be included in the National Immunisation Programme (NIP) if it effectively prevents transmission in the population, is cost-effective and aligns with ethical and humanitarian principles. The Public Health Agency of Sweden (PHAS) evaluated these criteria for introducing varicella vaccination.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The evaluation included a literature review, disease modelling to assess dose timing, a health economic analysis and an ethical review addressing vaccine acceptance and equitable access.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Varicella vaccines are safe and highly effective, providing near-complete protection against severe disease requiring hospitalisation when two doses are given. Modelling indicates that virus circulation could be eliminated within 2–3 years with high coverage and catch-up vaccination, also protecting unvaccinated and immunocompromised individuals of all ages through population immunity. Two doses are recommended at 18 months and 7–8 years, both co-administered with MMR. This schedule ensures durable immunity and high acceptance. Health economic analyses show the programme would be cost saving.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Following PHAS's evaluation, the Swedish government has decided to include varicella vaccination in the NIP from 2027, with catch-up vaccination for susceptible individuals up to 18 years, implemented primarily through the child and school health services to ensure equitable access.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55562,"journal":{"name":"Acta Paediatrica","volume":"115 11","pages":"2460-2465"},"PeriodicalIF":1.8,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/apa.70497","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147522810","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":"Gastrointestinal Adverse Events Following Rotavirus Vaccination in Children: A Systematic Review","authors":"Francesca Musto,&nbsp;Antonio Corsello,&nbsp;Sara Curto,&nbsp;Giuseppe Logrieco,&nbsp;Antonio Mellos,&nbsp;Salvatore Guercio Nuzio,&nbsp;Anna Claudia Romeo,&nbsp;Giuseppe Stella,&nbsp;Matteo Bramuzzo","doi":"10.1111/apa.70709","DOIUrl":"10.1111/apa.70709","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>To review current evidence regarding the occurrence, clinical presentation, and management of gastrointestinal adverse events following administration of RV1 and RV5 rotavirus vaccines in the paediatric population.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A systematic literature search was performed between April and August 2025. The review included randomised controlled trials, meta-analyses, and relevant case reports published from 2007 onwards. Primary outcomes focused on gastrointestinal manifestations: Prolongeddiarrhoea, intussusception, and immune-mediated diseases. Secondary outcomes included clinical management of GI post-vaccination events.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Out of 197 identified studies, 86 met the inclusion criteria. Mild gastrointestinal symptoms, such as transient diarrhoea and vomiting, were common but typically self-limited. No increased risk of prolonged diarrhoea was identified in healthy infants, although rare cases were reported in children with severe immunodeficiencies. Data showed no increased risk of intussusception or immune-mediated conditions like celiac disease or inflammatory bowel disease. Specific high-risk groups, including infants with a history of intussusception, severe combined immunodeficiency, or metabolic disorders, were associated with a higher incidence of adverse events.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>RV1 and RV5 vaccines maintain an excellent safety profile. In high-income settings, prolonged post-vaccination diarrhoea should be considered a clinical marker for underlying immunodeficiency rather than a risk factor for future immune-mediated intestinal disorders.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55562,"journal":{"name":"Acta Paediatrica","volume":"115 11","pages":"2389-2397"},"PeriodicalIF":1.8,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148655095","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":"Trained Immunity in Childhood Vaccination","authors":"ChenRongRong Cai,&nbsp;Lubnaa Hossenbaccus,&nbsp;Eva Kaufmann","doi":"10.1111/apa.70751","DOIUrl":"10.1111/apa.70751","url":null,"abstract":"<p>Conventionally, vaccine design has focused on identifying antigens that induce durable T and B cell memory and provide long term protection against subsequent encounters with the same pathogen. Unconventionally, a growing number of epidemiological, preclinical, and clinical studies demonstrate that live vaccines, including Bacillus Calmette Guérin (BCG), measles-containing vaccines, and oral polio vaccine, induce protection through trained immunity, a form of metabolically and epigenetically mediated memory in innate immune cells and their progenitors. This concept is particularly relevant during early life, when adaptive immune responses are constrained and innate immunity represents the principal line of host defence. In this review, we discuss the unique characteristics of neonatal and infant immunity, summarize current evidence for trained immunity induced by childhood vaccines, and describe the bidirectional interplay between innate and adaptive immune memory. We further highlight the potential of trained immunity to broaden protection against severe infections, improve vaccine efficacy, and provide therapeutic opportunities for non-infectious paediatric diseases, including cancer and allergic disorders. Harnessing trained immunity represents a conceptual shift in paediatric vaccinology and may guide the development of next generation vaccines that provide broader and more resilient protection during the period of greatest immunological vulnerability.</p>","PeriodicalId":55562,"journal":{"name":"Acta Paediatrica","volume":"115 11","pages":"2402-2413"},"PeriodicalIF":1.8,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/apa.70751","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149018888","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":"Application of mRNA Vaccines in Children's Vaccination: Technical Advantages, Clinical Practice and Future Challenges","authors":"Yu-ling Song,&nbsp;Yang-dong Gao,&nbsp;Xiao-yan Geng,&nbsp;Yan-bing Liu","doi":"10.1111/apa.70412","DOIUrl":"10.1111/apa.70412","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>To summarise the current paediatric applications of Message RNA (mRNA) vaccines and to identify the key efficacy, safety, and future challenges that must be solved before routine childhood use can be expanded beyond Corona Virus Disease 2019 (COVID-19).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>PubMed and ClinicalTrials.gov were searched (up to May 2025) for clinical studies of mRNA vaccines administered to children aged 0–17 years. Search terms combined “mRNA vaccine” with “child”, “infant”, “adolescent”, “paediatric”, “safety”, “immunogenicity”, and “trial”.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>COVID-19 and RSV mRNA vaccines have effectively reduced the incidence rate among certain age groups of children, while serious adverse events or deaths were rarely observed. Most trials about mRNA vaccines are mainly conducted among adults. More studies are needed to explore the long-term safety and efficacy of mRNA vaccines in children.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>mRNA vaccines offer rapid, precise, and child-tailored protection, but robust longitudinal data and public-science frameworks are urgently needed before their promise can be fully translated into routine paediatric prevention strategies.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55562,"journal":{"name":"Acta Paediatrica","volume":"115 11","pages":"2427-2432"},"PeriodicalIF":1.8,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145702918","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":"Exploring the Development of Vaccine Platforms, With a Particular Focus on the COVID-19 Pandemic","authors":"Matti Sällberg","doi":"10.1111/apa.70762","DOIUrl":"10.1111/apa.70762","url":null,"abstract":"<p>Vaccines have been a cornerstone of human health for more than 200 years and one of the most important tools to reduce childhood deaths caused by pathogens. The concept of vaccines is basically to take something safe, make it immunogenic and induce an immune response in the host that will protect it against something dangerous. Live attenuated vaccines were the only option two centuries ago. These are excellent, and possibly the best vaccine platform, but they have limitations as they cannot always be given to everyone safely, for example due to deficient immunity or pregnancy. That is why newer platforms, such as killed or inactivated vaccines, were developed. These provide better all-round safety, but are often less immunogenic and require additional doses. Subcomponent vaccines were then developed in the 1980s. These only used parts of the virus, further improving safety and introducing the possibility of producing vaccines using gene technology. Adding genetic vaccines to the toolbox revolutionized the way that we handled the COVID-19 pandemic. The host became the producer of the vaccine, which better mimicked the immune responses induced by the live attenuated vaccines. All these platforms will be discussed in this mini-review.</p>","PeriodicalId":55562,"journal":{"name":"Acta Paediatrica","volume":"115 11","pages":"2421-2426"},"PeriodicalIF":1.8,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/apa.70762","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149042233","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":"Ethical Considerations Regarding the Vaccination of Children—The Power Dynamics Between Doctors and Parents","authors":"Mikael Sandlund,&nbsp;Ingemar Engström,&nbsp;Anders Castor","doi":"10.1111/apa.70367","DOIUrl":"10.1111/apa.70367","url":null,"abstract":"<p>While childhood vaccination programmes provide outstanding contributions to improving health, they can also pose challenges through the interactions between parents and healthcare. This paper focuses on the ethical dimensions of interactions between healthcare professionals and parents. Since the knowledge that professionals possess creates an asymmetrical relationship with parents, it can be helpful to analyse the situation from a power perspective. An example of ethical problem-solving using a simple model for discussing ethically difficult situations is demonstrated.</p>","PeriodicalId":55562,"journal":{"name":"Acta Paediatrica","volume":"115 11","pages":"2414-2420"},"PeriodicalIF":1.8,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/apa.70367","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145472509","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}