Introduction: As new vaccines become available, countries must assess the relevance to introduce them into their vaccination schedules. Malawi has recently introduced several new vaccines and plans to introduce more. ...Introduction: As new vaccines become available, countries must assess the relevance to introduce them into their vaccination schedules. Malawi has recently introduced several new vaccines and plans to introduce more. This study was conducted to identify key factors that need to be considered when deciding to introduce a new vaccine and current challenges faced by low and middle income countries using Malawi as an example. Methodology: The study employed a desk review approach, examining published literature from various sources such as PubMed, Medline, and Google Scholar. Policy documents from organizations like the World Health Organization, GAVI the Alliance, and the Ministry of Health for Malawi were also included. A total of 99 articles and documents on new vaccine introduction, challenges of immunization, policy documents in immunization and health systems strengthening were included. The review focused on addressing five key areas critical to new vaccine introduction namely: the need for a vaccine, availability of the vaccine, safety and effectiveness of the vaccine, demand for the vaccine, and the prudent use of public or private funds. Results: Malawi considered the burden of cervical cancer and the significance of malaria in the country when introducing the HPV and malaria vaccines. The country opted for vaccines that can be handled by the cold chain capacity and available human resources. Despite that malaria vaccine and Typhoid Conjugate Vaccine trials were done in country, there are limited vaccine safety and efficacy trials conducted in Malawi, leading to a reliance on WHO-prequalified vaccines. Demand for newly introduced vaccines varied, with high demand for Oral Cholera Vaccine during a cholera outbreak, while demand for COVID-19 vaccines decreased over time. Although cost-effectiveness studies were limited in the country, 2 studies indicated that Typhoid Conjugate Vaccine and malaria vaccine would be cost effective. All these have been implemented despite having challenges like lack of accurate surveillance data, inadequate cold chain capacity, limited safety and efficacy vaccine clinical trials, political influence, and limited funding. Conclusion: Despite several challenges Malawi set a good example of the careful considerations required before introducing a new vaccine. The process involves data review, priority setting, precise planning, and consultation with stakeholders. Low-income countries should invest in vaccine safety, efficacy, and cost-effectiveness trials.展开更多
Objective:To explore the changes in the epidemiological characteristics of varicella before and after implementing the two-dose varicella vaccine(VarV)immunization program in the Banan District of Chongqing and to pro...Objective:To explore the changes in the epidemiological characteristics of varicella before and after implementing the two-dose varicella vaccine(VarV)immunization program in the Banan District of Chongqing and to provide a reference for future epidemic prevention and control.Methods:The data of reported varicella cases in Banan District from 2014 to 2023 were collected and analyzed using the China Disease Prevention and Control Information System.Descriptive epidemiological methods were employed to assess the changes in the reported incidence of varicella before(2014-2018)and after(2019-2023)the implementation of the two-dose VarV immunization program.Results:The average annual reported incidence rate of varicella in Banan District from 2014 to 2023 was 81.53 per 100,000.From 2014 to 2018,the reported incidence rate showed an upward trend year by year(trend x2=223.96,P<0.05).However,the reported incidence rate decreased from 2019 to 2023(trend x?=189.51,P<0.05).Before and after the adjustment of the immunization program,the reported incidence rate for the 5-9 years old group was 774.62 per 100,000 and 476.98 per 100,000,respectively,with a statistically significant difference(x2=161.26,P<0.05).The onset of varicella showed a bimodal distribution,with peak incidence periods in May-June and October-December.From 2014 to 2023,a total of 155,181 doses of VarV were administered in Banan District.The estimated annual vaccination rate for the first varicella vaccine(VarV1)from 2019 to 2023 was 86.28%,and for the second dose(VarV2)was 59.18%.The primary vaccination targets were the 5-9-year-old group,accounting for 64.21%.Conclusion:After implementing the two-dose VarV immunization program in Banan District,the vaccination rate increased yearly,and the reported incidence of varicella showed a downward trend.The incidence rate of varicella in children aged 5-9 years reduced significantly,but the overall downward trend for the entire population was not as pronounced.Therefore,it is necessary to increase the vaccination rate of VarV2.展开更多
Immune checkpoint inhibitors are increasingly drawing much attention in the therapeutic development for cancer treatment. However, many cancer patients do not respond to treatments with immune checkpoint inhibitors, p...Immune checkpoint inhibitors are increasingly drawing much attention in the therapeutic development for cancer treatment. However, many cancer patients do not respond to treatments with immune checkpoint inhibitors, partly because of the lack of tumor-infiltrating effector T cells. Cancer vaccines may prime patients for treatments with immune checkpoint inhibitors by inducing effector T-ceU infiltration into the tumors and immune checkpoint signals. The combination of cancer vaccine and an immune checkpoint inhibitor may function synergistically to induce more effective antitumor immune responses, and clinical trials to test the combination are currently ongoing.展开更多
Human papillomavirus(HPV)vaccination administered before viral exposure(i.e.,prior to sexual debut)effectively prevents infection with vaccine-type HPV strains and associated diseases,including cervical cancer.To adva...Human papillomavirus(HPV)vaccination administered before viral exposure(i.e.,prior to sexual debut)effectively prevents infection with vaccine-type HPV strains and associated diseases,including cervical cancer.To advance HPV vaccination efforts and cervical cancer prevention,China has incorporated the bivalent HPV vaccine(types 16/18)into its National Immunization Program(NIP)as a program vaccine.This Policy Note presents comprehensive technical and implementation guidelines for HPV vaccine deployment,encompassing guidance development methodology,target population definition,routine vaccination schedules,catch-up vaccination protocols,implementation strategies,vaccine coverage and adverse event monitoring plans,and anticipated implementation challenges with proposed mitigation measures.The Vaccine Technical Working Groups of the China CDC developed relevant technical recommendations and guidelines,which were officially issued in November 2025.展开更多
Background Migrant and left-behind families are vulnerable in health services utilization,but little is known about their disparities in immunization of non-National Immunization Program(NIP)vaccines.This study aims t...Background Migrant and left-behind families are vulnerable in health services utilization,but little is known about their disparities in immunization of non-National Immunization Program(NIP)vaccines.This study aims to evaluate the immunization coverage,knowledge,satisfaction,and associated factors of non-NIP vaccines among local and migrant families in the urban areas and non-left-behind and left-behind families in the rural areas of China.Methods A cross-sectional survey was conducted in urban areas of Zhejiang and rural areas of Henan in China.A total of 1648 caregivers of children aged 1-6 years were interviewed face-to-face by a pre-designed online questionnaire,and their families were grouped into four types:local urban,migrant,non-left-behind,and left-behind.Non-NIP vaccines includedHemophilus influenza b(Hib)vaccine,varicella vaccine,rotavirus vaccine,enterovirus 71 vaccine(EV71)and 13-valent pneumonia vaccine(PCV13).Log-binomial regression models were used to calculate prevalence ratios(PRs)and 95%confidence intervals(CIs)for the difference on immunization coverage of children,and knowledge and satisfaction of caregivers among families.The network models were conducted to explore the interplay of immunization coverage,knowledge,and satisfaction.Logistic regression models with odds ratios(ORs)and 95%CIs were used to estimate the associated factors of non-NIP vaccination.Results The immunization coverage of all non-NIP vaccines and knowledge of all items of local urban families was the highest,followed by migrant,non-left-behind and left-behind families.Compared with local urban children,thePRs(95%CIs)for getting all vaccinated were 0.65(0.52-0.81),0.29(0.22-0.37)and 0.14(0.09-0.21)among migrant children,non-left-behind children and left-behind children,respectively.The coverage-knowledge-satisfaction network model showed the core node was the satisfaction of vaccination schedule.Non-NIP vaccination was associated with characteristics of both children and caregivers,including age of children(>2 years-OR:1.69,95%CI:1.07-2.68 for local urban children;2.67,1.39-5.13 for migrant children;3.09,1.23-7.76 for non-left-behind children);and below caregivers’characteristics:family role(parents:0.37,0.14-0.99 for non-left-behind children),age(≤35 years:7.27,1.39-37.94 for non-left-behind children),sex(female:0.49,0.30-0.81 for local urban children;0.31,0.15-0.62 for non-left-behind children),physical health(more than average:1.58,1.07-2.35 for local urban children)and non-NIP vaccines knowledge(good:0.45,0.30-0.68 for local urban children;7.54,2.64-21.50 for left-behind children).Conclusions There were immunization disparities in non-NIP vaccines among migrant and left-behind families compared with their local counterparts.Non-NIP vaccination promotion strategies,including education on caregivers,and optimization of the immunization information system,should be delivered particularly among left-behind and migrant families.展开更多
Background Non-National Immunization Program (NIP) vaccines have played an important role in controlling vaccine-preventable diseases (VPDs) in China. However, these vaccines are paid out of pocket and there is room t...Background Non-National Immunization Program (NIP) vaccines have played an important role in controlling vaccine-preventable diseases (VPDs) in China. However, these vaccines are paid out of pocket and there is room to increase their coverage. We focused on four selected non-NIP vaccines in this study, namely Haemophilus influenzae type b (Hib) vaccine, human papillomavirus (HPV) vaccine, pneumococcal conjugate vaccine (PCV), and rotavirus vaccine. We aimed to conduct a scoping review of their vaccination rates and the major barriers faced by health systems, providers, and caregivers to increase coverage.Methods We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR). We searched five English databases (PubMed, Web of Science, EMBASE, Scopus, and WHO IRIS) and four Chinese databases using the search strategy developed by the study team. Two independent reviewers screened, selected studies, and examined their quality. We summarized the non-NIP vaccine coverage data by vaccine and applied the 5A framework (Access, Affordability, Acceptance, Awareness, Activation) to chart and analyze barriers to increasing coverage.Results A total of 28 articles were included in the analysis (nine pertaining to vaccine coverage, and another 19 reporting challenges of increasing uptake). Among the four selected vaccines, coverage for the Hib vaccine was the highest (54.9-55.9% for 1 dose or more from two meta-analyses) in 2016, while the coverage of the other three vaccines was lower than 30%. Eight of the nine included articles mentioned the regional disparity of coverage, which was lower in under-developing regions. For example, the three-dose Hib vaccination rate in eastern provinces was 38.1%, whereas the rate in central and western provinces was 34.3% and 26.2%, respectively in 2017. Within the 5A framework, acceptance, awareness, and affordability stood out as the most prominent themes. Among the 12 identified sub-themes, high prices, low vaccine awareness, concerns about vaccine safety and efficacy were the most cited barriers to increasing the uptake.Conclusions There is an urgent need to increase coverage of non-NIP vaccines and reduce disparities in access to these vaccines across regions. Concerted efforts from the government, the public, and society are required to tackle the barriers and challenges identified in this study, both on the demand and supply side, to ensure everybody has equal access to life-saving vaccines in China. Particularly, the government should take a prudent approach to gradually incorporate non-NIP vaccines into the NIP step by step, and make a prioritizing strategy based on key factors such as disease burden, financial resources, and market readiness, with special attention to high-risk populations and underdeveloped regions.展开更多
Background Immunization is a crucial preventive measure to safeguard children under five years old against a range of diseases.In China,the coverage rate of non-National Immunization Program(non-NIP)vaccines can be im...Background Immunization is a crucial preventive measure to safeguard children under five years old against a range of diseases.In China,the coverage rate of non-National Immunization Program(non-NIP)vaccines can be improved by leveraging the recommendation from public health workers.Hence,understanding the influencing factors of recommendation behaviors assume paramount importance.This study aims to investigate influencing factors of public health workers’recommendation behaviors towards non-NIP vaccines,with a particular emphasis on financial incentives.Methods A cross-sectional survey was conducted using a multi-stage sampling method in 2019 from August to October.627 public health workers were recruited from 148 community healthcare centers in ten provincial-level administrative divisions in China.An anonymous questionnaire was used to collect demographic information,attitudes towards vaccination,and recommendation behaviors towards non-NIP vaccines,includingHaemophilus influenzae type b(Hib)vaccine,pneumococcal conjugate vaccine,varicella vaccine,and rotavirus vaccine.Descriptive analysis and multivariate logistic regression analysis were adopted in this study.Results Of the 610 public health workers with complete survey data,53.8%,57.4%,84.1%,and 54.1%often recommended Hib vaccine,pneumococcal pneumonia vaccine(PCV),varicella vaccine,and rotavirus vaccine,respectively.Logistic regression revealed that gender(Hib vaccine:OR=0.4,95%CI:0.2-0.8;PCV:OR=0.4,95%CI:0.2-0.8;rotavirus vaccine:OR=0.3,95%CI:0.2-0.6),financial incentives for non-NIP vaccination(Hib vaccine:OR=1.9,95%CI:1.1-3.6;PCV:OR=2.1,95%CI:1.1-3.9;rotavirus vaccine:OR=2.0,95%CI:1.1-3.8)and perception of vaccine safety(Hib vaccine:OR=2.7,95%CI:1.1-7.0;PCV:OR=3.2,95%CI:1.2-8.0;rotavirus vaccine:OR=3.0,95%CI:1.2-7.7)were associated with public health workers’recommendation towards Hib vaccine,PCV and rotavirus vaccine.Conclusions The findings highlighted public health workers’recommendation behaviors of non-NIP vaccines in China and revealed strong association between vaccine recommendation and financial incentives.This highlights the importance of financial incentives in public health workers’recommendation toward non-NIP vaccines in China.Proper incentives are recommended for public health workers to encourage effective health promotion in immunization practices.展开更多
Background Immunization is a cornerstone of public health.Despite great success,China’s National Immunization Program(NIP)faces challenges,such as the integration of several World Health Organization-recommended vacc...Background Immunization is a cornerstone of public health.Despite great success,China’s National Immunization Program(NIP)faces challenges,such as the integration of several World Health Organization-recommended vaccines and other systemic issues.The Innovation Laboratory for Vaccine Delivery Research(VaxLab),supported by the Bill&Melinda Gates Foundation and established in 2021 at Duke Kunshan University,focuses on enhancing China’s NIP through research and policy advocacy.This editorial aims to summarize the key findings of the manuscripts published in the collection contributed by VaxLab team and set the future research agenda.Key findings The collection contains eleven manuscripts discussing China’s immunization landscape and strategies to improve coverage,particularly for non-NIP vaccines like human papillomavirus vaccine(HPV),pneumococcal conjugate vaccine(PCV),Haemophilus influenzae type b vaccine(Hib),and rotavirus vaccines.Key findings include:(i)The COVID-19 vaccination campaign demonstrated China’s capacity for rapid,large-scale immunization efforts,suggesting potential for broader vaccine coverage improvements;(ii)Efforts in combating cervical cancer through the HPV vaccine indicate progress but also highlight challenges like vaccine supply and equitable access;(iii)The lag in adopting higher-valent paediatric combination vaccines in China needs attention to address regulatory and health system hurdles;(iv)Disparities in access to non-NIP vaccines underscore the need for government initiatives to improve vaccine coverage,especially for remote areas and marginalized populations;(v)Original studies emphasize the influence of caregivers’knowledge,health workers’financial incentives,and concerns about vaccine efficacy on immunization rates;(vi)Case studies from the Weifang City of China and Indonesia to introduce PCV offer insights on successful vaccine introduction strategies and the impact of innovative financing and government support.Conclusion The articles emphasize the need for government leadership,strategic policymaking,and public awareness to enhance vaccine coverage and equity.The VaxLab will continue strengthening China’s NIP by focusing on vaccine financing,emphasizing diversity,equity,and inclusion,and improving maternal vaccination coverage.Research will extend to Southeast Asian and Western Pacific regions,especially in middle-income countries facing challenges in vaccine financing and delivery.The collective efforts outlined in this collection show a commitment to evolving and adapting immunization strategies to meet global health goals and to provide equitable access to vaccines for all.展开更多
Objective:To assess levels of HBs Ab amongst infants who received hepatitis B vaccine in the Expanded Program on Immunization in Vietnam.Methods:A cross-sectional study was carried out at 16 community health centers f...Objective:To assess levels of HBs Ab amongst infants who received hepatitis B vaccine in the Expanded Program on Immunization in Vietnam.Methods:A cross-sectional study was carried out at 16 community health centers from February 2016 to July 2017.Eligible infants were tested for HBs Ab and HBs Ag.Structured questionnaires were used to collect relevant information about the demographics of the parents/caregivers and their infants after physical examination.Results:A total of 199 eligible infants were selected with a mean age of(17.3±4.5)months.Protective antibody levels with HBs Ab≥10 m IU/m L were detected in 68.3%of infants.Of these,antibody levels from 10 to 99 m IU/m L were 48.5%of those tested and antibody levels≥100 ml U/m L were recorded as 51.5%.No cases were recorded of being infected with hepatitis B virus.The rate of positive HBs Ab level in those who were not wasting and≥18 months old was less than that among those who were<18 months old(OR 0.49,95%CI:0.26-0.92,P<0.05)while the infants with wasting and<18 months were less likely to be positive HBs Ab than those who were not wasting and of the same age group(OR 0.15,95%CI:0.04-0.55,P<0.05).Conclusions:Seroprotection against hepatitis B virus was low in the infants tested(at 68.3%),which suggests that the hepatitis B vaccine should be administered with one additional dose for infants between 12 and 24 months of age,particularly those with wasting.展开更多
Pancreatic ductal adenocarcinoma(PDAC) is an almost uniformly lethal disease with less than 5% survival at five years. This is largely due to metastatic disease, which is already present in the majority of patients wh...Pancreatic ductal adenocarcinoma(PDAC) is an almost uniformly lethal disease with less than 5% survival at five years. This is largely due to metastatic disease, which is already present in the majority of patients when diagnosed. Even when the primary cancer can be removed by radical surgery, local recurrence occurs within one year in 50%-80% of cases. Therefore, it is imperative to develop new approaches for the treatment of advanced cancer and the prevention of recurrence after surgery. Tumour-targeted oncolytic viruses(TOVs) have become an attractive therapeutic agent as TOVs can kill cancer cells through multiple mechanisms of action, especially via virus-induced engagement of the immune response specifically against tumour cells. To attack tumour cells effectively, tumour-specific T cells need to overcome negative regulatory signals that suppress their activation or that induce tolerance programmes such as anergy or exhaustion in the tumour microenvironment. In this regard, the recent breakthrough in immunotherapy achieved with immune checkpoint blockade agents, such as anti-cytotoxic T-lymphocyte-associate protein 4, programmed death 1(PD-1) or PD-L1 antibodies, has demonstrated the possibility of relieving immune suppression in PDAC. Therefore, the combination of oncolytic virotherapy and immune checkpoint blockade agents may synergistically function to enhance the antitumour response, lending the opportunity to be the future for treatment of pancreatic cancer.展开更多
目的分析2018—2024年辽宁省非免疫规划(non-national immunization program,nNIP)疫苗使用情况,对全省nNIP疫苗接种现状进行评估,为制定公共卫生政策和优化疫苗接种策略提供科学依据。方法通过“中国免疫规划信息管理系统”和“辽宁省...目的分析2018—2024年辽宁省非免疫规划(non-national immunization program,nNIP)疫苗使用情况,对全省nNIP疫苗接种现状进行评估,为制定公共卫生政策和优化疫苗接种策略提供科学依据。方法通过“中国免疫规划信息管理系统”和“辽宁省免疫规划综合信息平台-预防接种信息系统”提取2018—2022年以及2023—2024年nNIP疫苗接种数据,其中包括nNIP疫苗替代记录。利用SPSS 13.0软件进行Pearson相关系数矩阵分析,并采用描述性分析方法对数据进行综合分析。结果2018—2024年辽宁省nNIP疫苗共接种25726024剂次,人均接种剂次为866剂次/万人,nNIP疫苗人均接种剂次、占所有疫苗接种总剂次比例均为逐年递增趋势。使用量居前3位的nNIP疫苗品种为人用狂犬病疫苗(rabies vaccine for human use,Rab)、流感疫苗(influenza vaccine,InfV)、水痘减毒活疫苗(varicella attenuated live vaccine,VarV)。在NIP中,替代率最高的为脊髓灰质炎疫苗(poliomyelitis vaccine,PV)(30.40%),其次为甲型肝炎减毒活疫苗(hepayitis A attenuated live vaccine,HepA-L)(29.08%)、无细胞百白破联合疫苗(diphtheria,tetanus and acellular pertussis combined vaccine,DTaP)(16.37%)。结论nNIP疫苗在公共卫生中的重要性日益凸显,作为预防接种的重要组成部分,需进一步加强监测质量;nNIP疫苗能够弥补NIP疫苗覆盖的不足,还可在一些NIP疫苗供应暂时短缺时发挥重要作用,在优化NIP疫苗的供应及分配的基础上提高nNIP疫苗接种水平,可有效防控疫苗可预防传染病的流行。展开更多
文摘Introduction: As new vaccines become available, countries must assess the relevance to introduce them into their vaccination schedules. Malawi has recently introduced several new vaccines and plans to introduce more. This study was conducted to identify key factors that need to be considered when deciding to introduce a new vaccine and current challenges faced by low and middle income countries using Malawi as an example. Methodology: The study employed a desk review approach, examining published literature from various sources such as PubMed, Medline, and Google Scholar. Policy documents from organizations like the World Health Organization, GAVI the Alliance, and the Ministry of Health for Malawi were also included. A total of 99 articles and documents on new vaccine introduction, challenges of immunization, policy documents in immunization and health systems strengthening were included. The review focused on addressing five key areas critical to new vaccine introduction namely: the need for a vaccine, availability of the vaccine, safety and effectiveness of the vaccine, demand for the vaccine, and the prudent use of public or private funds. Results: Malawi considered the burden of cervical cancer and the significance of malaria in the country when introducing the HPV and malaria vaccines. The country opted for vaccines that can be handled by the cold chain capacity and available human resources. Despite that malaria vaccine and Typhoid Conjugate Vaccine trials were done in country, there are limited vaccine safety and efficacy trials conducted in Malawi, leading to a reliance on WHO-prequalified vaccines. Demand for newly introduced vaccines varied, with high demand for Oral Cholera Vaccine during a cholera outbreak, while demand for COVID-19 vaccines decreased over time. Although cost-effectiveness studies were limited in the country, 2 studies indicated that Typhoid Conjugate Vaccine and malaria vaccine would be cost effective. All these have been implemented despite having challenges like lack of accurate surveillance data, inadequate cold chain capacity, limited safety and efficacy vaccine clinical trials, political influence, and limited funding. Conclusion: Despite several challenges Malawi set a good example of the careful considerations required before introducing a new vaccine. The process involves data review, priority setting, precise planning, and consultation with stakeholders. Low-income countries should invest in vaccine safety, efficacy, and cost-effectiveness trials.
文摘Objective:To explore the changes in the epidemiological characteristics of varicella before and after implementing the two-dose varicella vaccine(VarV)immunization program in the Banan District of Chongqing and to provide a reference for future epidemic prevention and control.Methods:The data of reported varicella cases in Banan District from 2014 to 2023 were collected and analyzed using the China Disease Prevention and Control Information System.Descriptive epidemiological methods were employed to assess the changes in the reported incidence of varicella before(2014-2018)and after(2019-2023)the implementation of the two-dose VarV immunization program.Results:The average annual reported incidence rate of varicella in Banan District from 2014 to 2023 was 81.53 per 100,000.From 2014 to 2018,the reported incidence rate showed an upward trend year by year(trend x2=223.96,P<0.05).However,the reported incidence rate decreased from 2019 to 2023(trend x?=189.51,P<0.05).Before and after the adjustment of the immunization program,the reported incidence rate for the 5-9 years old group was 774.62 per 100,000 and 476.98 per 100,000,respectively,with a statistically significant difference(x2=161.26,P<0.05).The onset of varicella showed a bimodal distribution,with peak incidence periods in May-June and October-December.From 2014 to 2023,a total of 155,181 doses of VarV were administered in Banan District.The estimated annual vaccination rate for the first varicella vaccine(VarV1)from 2019 to 2023 was 86.28%,and for the second dose(VarV2)was 59.18%.The primary vaccination targets were the 5-9-year-old group,accounting for 64.21%.Conclusion:After implementing the two-dose VarV immunization program in Banan District,the vaccination rate increased yearly,and the reported incidence of varicella showed a downward trend.The incidence rate of varicella in children aged 5-9 years reduced significantly,but the overall downward trend for the entire population was not as pronounced.Therefore,it is necessary to increase the vaccination rate of VarV2.
基金supported by the Viragh Foundation(L.Z.)National Institutes of Health(NIH)(Grant No.K23 CA148964,L.Z.)the NCI SPORE in Gastrointestinal Cancers(Grant No.P50 CA062924,L.Z.)
文摘Immune checkpoint inhibitors are increasingly drawing much attention in the therapeutic development for cancer treatment. However, many cancer patients do not respond to treatments with immune checkpoint inhibitors, partly because of the lack of tumor-infiltrating effector T cells. Cancer vaccines may prime patients for treatments with immune checkpoint inhibitors by inducing effector T-ceU infiltration into the tumors and immune checkpoint signals. The combination of cancer vaccine and an immune checkpoint inhibitor may function synergistically to induce more effective antitumor immune responses, and clinical trials to test the combination are currently ongoing.
文摘Human papillomavirus(HPV)vaccination administered before viral exposure(i.e.,prior to sexual debut)effectively prevents infection with vaccine-type HPV strains and associated diseases,including cervical cancer.To advance HPV vaccination efforts and cervical cancer prevention,China has incorporated the bivalent HPV vaccine(types 16/18)into its National Immunization Program(NIP)as a program vaccine.This Policy Note presents comprehensive technical and implementation guidelines for HPV vaccine deployment,encompassing guidance development methodology,target population definition,routine vaccination schedules,catch-up vaccination protocols,implementation strategies,vaccine coverage and adverse event monitoring plans,and anticipated implementation challenges with proposed mitigation measures.The Vaccine Technical Working Groups of the China CDC developed relevant technical recommendations and guidelines,which were officially issued in November 2025.
基金This study was funded by the Bill&Melinda Gates Foundation(INV-034554)。
文摘Background Migrant and left-behind families are vulnerable in health services utilization,but little is known about their disparities in immunization of non-National Immunization Program(NIP)vaccines.This study aims to evaluate the immunization coverage,knowledge,satisfaction,and associated factors of non-NIP vaccines among local and migrant families in the urban areas and non-left-behind and left-behind families in the rural areas of China.Methods A cross-sectional survey was conducted in urban areas of Zhejiang and rural areas of Henan in China.A total of 1648 caregivers of children aged 1-6 years were interviewed face-to-face by a pre-designed online questionnaire,and their families were grouped into four types:local urban,migrant,non-left-behind,and left-behind.Non-NIP vaccines includedHemophilus influenza b(Hib)vaccine,varicella vaccine,rotavirus vaccine,enterovirus 71 vaccine(EV71)and 13-valent pneumonia vaccine(PCV13).Log-binomial regression models were used to calculate prevalence ratios(PRs)and 95%confidence intervals(CIs)for the difference on immunization coverage of children,and knowledge and satisfaction of caregivers among families.The network models were conducted to explore the interplay of immunization coverage,knowledge,and satisfaction.Logistic regression models with odds ratios(ORs)and 95%CIs were used to estimate the associated factors of non-NIP vaccination.Results The immunization coverage of all non-NIP vaccines and knowledge of all items of local urban families was the highest,followed by migrant,non-left-behind and left-behind families.Compared with local urban children,thePRs(95%CIs)for getting all vaccinated were 0.65(0.52-0.81),0.29(0.22-0.37)and 0.14(0.09-0.21)among migrant children,non-left-behind children and left-behind children,respectively.The coverage-knowledge-satisfaction network model showed the core node was the satisfaction of vaccination schedule.Non-NIP vaccination was associated with characteristics of both children and caregivers,including age of children(>2 years-OR:1.69,95%CI:1.07-2.68 for local urban children;2.67,1.39-5.13 for migrant children;3.09,1.23-7.76 for non-left-behind children);and below caregivers’characteristics:family role(parents:0.37,0.14-0.99 for non-left-behind children),age(≤35 years:7.27,1.39-37.94 for non-left-behind children),sex(female:0.49,0.30-0.81 for local urban children;0.31,0.15-0.62 for non-left-behind children),physical health(more than average:1.58,1.07-2.35 for local urban children)and non-NIP vaccines knowledge(good:0.45,0.30-0.68 for local urban children;7.54,2.64-21.50 for left-behind children).Conclusions There were immunization disparities in non-NIP vaccines among migrant and left-behind families compared with their local counterparts.Non-NIP vaccination promotion strategies,including education on caregivers,and optimization of the immunization information system,should be delivered particularly among left-behind and migrant families.
基金supported by the Bill&Melinda Gates Foundation(INV-034554).
文摘Background Non-National Immunization Program (NIP) vaccines have played an important role in controlling vaccine-preventable diseases (VPDs) in China. However, these vaccines are paid out of pocket and there is room to increase their coverage. We focused on four selected non-NIP vaccines in this study, namely Haemophilus influenzae type b (Hib) vaccine, human papillomavirus (HPV) vaccine, pneumococcal conjugate vaccine (PCV), and rotavirus vaccine. We aimed to conduct a scoping review of their vaccination rates and the major barriers faced by health systems, providers, and caregivers to increase coverage.Methods We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR). We searched five English databases (PubMed, Web of Science, EMBASE, Scopus, and WHO IRIS) and four Chinese databases using the search strategy developed by the study team. Two independent reviewers screened, selected studies, and examined their quality. We summarized the non-NIP vaccine coverage data by vaccine and applied the 5A framework (Access, Affordability, Acceptance, Awareness, Activation) to chart and analyze barriers to increasing coverage.Results A total of 28 articles were included in the analysis (nine pertaining to vaccine coverage, and another 19 reporting challenges of increasing uptake). Among the four selected vaccines, coverage for the Hib vaccine was the highest (54.9-55.9% for 1 dose or more from two meta-analyses) in 2016, while the coverage of the other three vaccines was lower than 30%. Eight of the nine included articles mentioned the regional disparity of coverage, which was lower in under-developing regions. For example, the three-dose Hib vaccination rate in eastern provinces was 38.1%, whereas the rate in central and western provinces was 34.3% and 26.2%, respectively in 2017. Within the 5A framework, acceptance, awareness, and affordability stood out as the most prominent themes. Among the 12 identified sub-themes, high prices, low vaccine awareness, concerns about vaccine safety and efficacy were the most cited barriers to increasing the uptake.Conclusions There is an urgent need to increase coverage of non-NIP vaccines and reduce disparities in access to these vaccines across regions. Concerted efforts from the government, the public, and society are required to tackle the barriers and challenges identified in this study, both on the demand and supply side, to ensure everybody has equal access to life-saving vaccines in China. Particularly, the government should take a prudent approach to gradually incorporate non-NIP vaccines into the NIP step by step, and make a prioritizing strategy based on key factors such as disease burden, financial resources, and market readiness, with special attention to high-risk populations and underdeveloped regions.
基金This work was supported by the Bill&Melinda Gates Foundation(INV034554)。
文摘Background Immunization is a crucial preventive measure to safeguard children under five years old against a range of diseases.In China,the coverage rate of non-National Immunization Program(non-NIP)vaccines can be improved by leveraging the recommendation from public health workers.Hence,understanding the influencing factors of recommendation behaviors assume paramount importance.This study aims to investigate influencing factors of public health workers’recommendation behaviors towards non-NIP vaccines,with a particular emphasis on financial incentives.Methods A cross-sectional survey was conducted using a multi-stage sampling method in 2019 from August to October.627 public health workers were recruited from 148 community healthcare centers in ten provincial-level administrative divisions in China.An anonymous questionnaire was used to collect demographic information,attitudes towards vaccination,and recommendation behaviors towards non-NIP vaccines,includingHaemophilus influenzae type b(Hib)vaccine,pneumococcal conjugate vaccine,varicella vaccine,and rotavirus vaccine.Descriptive analysis and multivariate logistic regression analysis were adopted in this study.Results Of the 610 public health workers with complete survey data,53.8%,57.4%,84.1%,and 54.1%often recommended Hib vaccine,pneumococcal pneumonia vaccine(PCV),varicella vaccine,and rotavirus vaccine,respectively.Logistic regression revealed that gender(Hib vaccine:OR=0.4,95%CI:0.2-0.8;PCV:OR=0.4,95%CI:0.2-0.8;rotavirus vaccine:OR=0.3,95%CI:0.2-0.6),financial incentives for non-NIP vaccination(Hib vaccine:OR=1.9,95%CI:1.1-3.6;PCV:OR=2.1,95%CI:1.1-3.9;rotavirus vaccine:OR=2.0,95%CI:1.1-3.8)and perception of vaccine safety(Hib vaccine:OR=2.7,95%CI:1.1-7.0;PCV:OR=3.2,95%CI:1.2-8.0;rotavirus vaccine:OR=3.0,95%CI:1.2-7.7)were associated with public health workers’recommendation towards Hib vaccine,PCV and rotavirus vaccine.Conclusions The findings highlighted public health workers’recommendation behaviors of non-NIP vaccines in China and revealed strong association between vaccine recommendation and financial incentives.This highlights the importance of financial incentives in public health workers’recommendation toward non-NIP vaccines in China.Proper incentives are recommended for public health workers to encourage effective health promotion in immunization practices.
文摘Background Immunization is a cornerstone of public health.Despite great success,China’s National Immunization Program(NIP)faces challenges,such as the integration of several World Health Organization-recommended vaccines and other systemic issues.The Innovation Laboratory for Vaccine Delivery Research(VaxLab),supported by the Bill&Melinda Gates Foundation and established in 2021 at Duke Kunshan University,focuses on enhancing China’s NIP through research and policy advocacy.This editorial aims to summarize the key findings of the manuscripts published in the collection contributed by VaxLab team and set the future research agenda.Key findings The collection contains eleven manuscripts discussing China’s immunization landscape and strategies to improve coverage,particularly for non-NIP vaccines like human papillomavirus vaccine(HPV),pneumococcal conjugate vaccine(PCV),Haemophilus influenzae type b vaccine(Hib),and rotavirus vaccines.Key findings include:(i)The COVID-19 vaccination campaign demonstrated China’s capacity for rapid,large-scale immunization efforts,suggesting potential for broader vaccine coverage improvements;(ii)Efforts in combating cervical cancer through the HPV vaccine indicate progress but also highlight challenges like vaccine supply and equitable access;(iii)The lag in adopting higher-valent paediatric combination vaccines in China needs attention to address regulatory and health system hurdles;(iv)Disparities in access to non-NIP vaccines underscore the need for government initiatives to improve vaccine coverage,especially for remote areas and marginalized populations;(v)Original studies emphasize the influence of caregivers’knowledge,health workers’financial incentives,and concerns about vaccine efficacy on immunization rates;(vi)Case studies from the Weifang City of China and Indonesia to introduce PCV offer insights on successful vaccine introduction strategies and the impact of innovative financing and government support.Conclusion The articles emphasize the need for government leadership,strategic policymaking,and public awareness to enhance vaccine coverage and equity.The VaxLab will continue strengthening China’s NIP by focusing on vaccine financing,emphasizing diversity,equity,and inclusion,and improving maternal vaccination coverage.Research will extend to Southeast Asian and Western Pacific regions,especially in middle-income countries facing challenges in vaccine financing and delivery.The collective efforts outlined in this collection show a commitment to evolving and adapting immunization strategies to meet global health goals and to provide equitable access to vaccines for all.
文摘Objective:To assess levels of HBs Ab amongst infants who received hepatitis B vaccine in the Expanded Program on Immunization in Vietnam.Methods:A cross-sectional study was carried out at 16 community health centers from February 2016 to July 2017.Eligible infants were tested for HBs Ab and HBs Ag.Structured questionnaires were used to collect relevant information about the demographics of the parents/caregivers and their infants after physical examination.Results:A total of 199 eligible infants were selected with a mean age of(17.3±4.5)months.Protective antibody levels with HBs Ab≥10 m IU/m L were detected in 68.3%of infants.Of these,antibody levels from 10 to 99 m IU/m L were 48.5%of those tested and antibody levels≥100 ml U/m L were recorded as 51.5%.No cases were recorded of being infected with hepatitis B virus.The rate of positive HBs Ab level in those who were not wasting and≥18 months old was less than that among those who were<18 months old(OR 0.49,95%CI:0.26-0.92,P<0.05)while the infants with wasting and<18 months were less likely to be positive HBs Ab than those who were not wasting and of the same age group(OR 0.15,95%CI:0.04-0.55,P<0.05).Conclusions:Seroprotection against hepatitis B virus was low in the infants tested(at 68.3%),which suggests that the hepatitis B vaccine should be administered with one additional dose for infants between 12 and 24 months of age,particularly those with wasting.
基金Supported by The United Kingdom Charity pancreatic Cancer Research Fundpancreatic Cancer Research United Kingdom+1 种基金Ministry of Sciences and Technology of ChinaNo.2013DFG32080
文摘Pancreatic ductal adenocarcinoma(PDAC) is an almost uniformly lethal disease with less than 5% survival at five years. This is largely due to metastatic disease, which is already present in the majority of patients when diagnosed. Even when the primary cancer can be removed by radical surgery, local recurrence occurs within one year in 50%-80% of cases. Therefore, it is imperative to develop new approaches for the treatment of advanced cancer and the prevention of recurrence after surgery. Tumour-targeted oncolytic viruses(TOVs) have become an attractive therapeutic agent as TOVs can kill cancer cells through multiple mechanisms of action, especially via virus-induced engagement of the immune response specifically against tumour cells. To attack tumour cells effectively, tumour-specific T cells need to overcome negative regulatory signals that suppress their activation or that induce tolerance programmes such as anergy or exhaustion in the tumour microenvironment. In this regard, the recent breakthrough in immunotherapy achieved with immune checkpoint blockade agents, such as anti-cytotoxic T-lymphocyte-associate protein 4, programmed death 1(PD-1) or PD-L1 antibodies, has demonstrated the possibility of relieving immune suppression in PDAC. Therefore, the combination of oncolytic virotherapy and immune checkpoint blockade agents may synergistically function to enhance the antitumour response, lending the opportunity to be the future for treatment of pancreatic cancer.
文摘目的分析2018—2024年辽宁省非免疫规划(non-national immunization program,nNIP)疫苗使用情况,对全省nNIP疫苗接种现状进行评估,为制定公共卫生政策和优化疫苗接种策略提供科学依据。方法通过“中国免疫规划信息管理系统”和“辽宁省免疫规划综合信息平台-预防接种信息系统”提取2018—2022年以及2023—2024年nNIP疫苗接种数据,其中包括nNIP疫苗替代记录。利用SPSS 13.0软件进行Pearson相关系数矩阵分析,并采用描述性分析方法对数据进行综合分析。结果2018—2024年辽宁省nNIP疫苗共接种25726024剂次,人均接种剂次为866剂次/万人,nNIP疫苗人均接种剂次、占所有疫苗接种总剂次比例均为逐年递增趋势。使用量居前3位的nNIP疫苗品种为人用狂犬病疫苗(rabies vaccine for human use,Rab)、流感疫苗(influenza vaccine,InfV)、水痘减毒活疫苗(varicella attenuated live vaccine,VarV)。在NIP中,替代率最高的为脊髓灰质炎疫苗(poliomyelitis vaccine,PV)(30.40%),其次为甲型肝炎减毒活疫苗(hepayitis A attenuated live vaccine,HepA-L)(29.08%)、无细胞百白破联合疫苗(diphtheria,tetanus and acellular pertussis combined vaccine,DTaP)(16.37%)。结论nNIP疫苗在公共卫生中的重要性日益凸显,作为预防接种的重要组成部分,需进一步加强监测质量;nNIP疫苗能够弥补NIP疫苗覆盖的不足,还可在一些NIP疫苗供应暂时短缺时发挥重要作用,在优化NIP疫苗的供应及分配的基础上提高nNIP疫苗接种水平,可有效防控疫苗可预防传染病的流行。
