Hepatitis B virus (HBV) infection remains a leading global cause of advanced liver disease and imposes a substantial economic burden. Early prevention is critical, as perinatally acquired HBV carries a high risk of progression to cirrhosis or hepatocellular carcinoma (HCC). Hepatitis B vaccination has been proven effective in preventing cancer, yet coverage of the complete vaccine series remains suboptimal. This implementation gap perpetuates the clinical burden, manifesting decades later as hepatic decompensation and liver cancer. This narrative review synthesizes the current HBV landscape, highlighting how gaps in vaccination policy and delivery contribute to real-world gastrointestinal outcomes. By reframing HBV vaccination as a core component of gastrointestinal and hepatology practice, clinicians can play a pivotal role in preventing cirrhosis and HCC while improving population health.
Purpose:To assess cervical cancer awareness and willingness to receive HPV vaccination among females aged 9-45 years in an urban community of Faridabad, Haryana, India. Materials and Methods:A community-based cross-sectional study was conducted among 302 female residents of Prem Nagar, Faridabad. Participants were assessed for their knowledge about cervical cancer and their willingness for HPV vaccination, screened for cervical cancer-related symptoms, and those symptomatic were referred for appropriate diagnostic evaluation. Descriptive statistics were calculated, and associations between variables were tested using chi-square tests. Results:The mean age of participants was 27.14 (standard deviation, 8.32) years; most were married 239 (79.1%). Awareness of cervical cancer was low, with only 73 (24.2%) having heard of the disease and very limited knowledge of its etiology and prevention. Awareness of HPV vaccination was extremely poor 32 (10.6%). Despite this, 219 (72.5%) expressed willingness to receive the vaccine. The main barriers among those unwilling 83 (27.5%) were lack of interest or motivation 44 (53.0%) and limited decision-making autonomy 25 (30.1%), while fear and knowledge deficits were less common. Conclusion:Awareness regarding cervical cancer and HPV vaccination was markedly inadequate in this urban community; however, willingness to accept vaccination was high. Further rollout of vaccination by government, targeted health education, community engagement, and empowerment of women in health decision-making could substantially improve vaccine uptake and prevent cervical cancer.
Purpose:Rabies immunoglobulin (RIG) will offer immediate passive protection after exposure to suspected rabid animals. These include human RIG and equine RIG, both having constraints for usage. Recombinant technology produced monoclonal antibodies (mAbs) have demonstrated greater availability and safety as a substitute for RIG in post-exposure prophylaxis (PEP). Presently 2 mAb products have been merchandised; World Health Organization has advised monitoring of both the rabies monoclonal antibodies (RmAb) products' in clinical use. To assess the safety and clinical effectiveness of RmAbs for PEP in category III animal exposures. Materials and Methods:All patients with category III exposure who visited the study site and gave their consent were included. A case record form was used to gather information on the sociodemographic profile, bite wound features, PEP given, and specifics of adverse events that occurred after PEP. For a further 6 months, all the research participants were monitored to determine the clinical effectiveness of PEP. Results:The present study included 475 animal bite victims. Among them 41.2% were children, 49.7% were adults and 9.1% were elderly. The adverse events (AEs) among single mAb and cocktail of 2 mAbs were 8.7% and 8.1%, respectively. All the patients who received either of the RmAb experienced mild AEs that resolved on their own or by symptomatic treatment, without any complications. All the trial participants were alive after 6 months following PEP, indicating therapeutic success. Conclusion:The presently available RmAbs are safe and clinically effective in preventing rabies in suspected exposures.
Purpose:Evidence on whether influenza vaccination reduces disease severity in children with breakthrough infections in community settings is limited. Materials and Methods:This prospective study enrolled 388 children (aged 6 months-6 years) diagnosed with influenza at a community health center in Shenzhen from May 2024 to October 2025. Participants were grouped by vaccination status within the prior year: vaccinated (n=196) and unvaccinated (n=192). Clinical characteristics, healthcare utilization, and outcomes were compared. Results:Vaccinated children showed significantly lower peak body temperature (38.81°C±0.58°C vs. 39.03°C±0.64°C), shorter fever duration (2.01±1.21 days vs. 2.45±1.55 days), and fewer symptoms like myalgia and gastrointestinal issues (all p<0.01). They also had fewer outpatient visits, lower outpatient costs, and markedly reduced rates of hospitalization (4.1% vs. 21.9%) and antibiotic use (5.6% vs. 15.1%) (all p<0.05). Conclusion:Influenza vaccination could mitigate symptoms, reduce hospitalization and antibiotic use, and lessen the healthcare burden from breakthrough infections.
Microneedle patches (MNPs) represent a transformative transdermal delivery platform capable of painlessly penetrating the superficial layers of the skin to enable efficient delivery of vaccines, antiviral therapeutics, genetic payloads, and diagnostic agents. By directly targeting the epidermal and dermal compartments, which are densely populated with antigen-presenting cells, microneedle (MN)-based delivery can enhance immune activation while reducing antigen dose requirements and improving patient acceptability. These attributes are particularly relevant in virology, where rapid, scalable, and user-friendly delivery systems are essential for routine immunization programs, outbreak response, and pandemic preparedness. Recent advances have expanded MN applications beyond vaccination to include controlled antiviral drug delivery, transdermal administration of nucleic acid-based platforms, and minimally invasive viral diagnostics through interstitial fluid sampling. The solid-state stability of many MN formulations further offers the potential to reduce cold-chain dependence, addressing a major logistical barrier in global vaccine distribution. This review critically examines the design principles, immunological rationale, and virology-specific applications of MNP technologies, spanning preventive, therapeutic, and diagnostic domains. Current translational challenges-including manufacturing scalability, regulatory classification, dose precision, and user variability-are also discussed to provide a balanced assessment of the clinical readiness and future potential of MNPs in virology.
The intestinal microbiota plays a critical role in shaping host immune responses to pathogens and vaccines. Dextran sulfate sodium-treated mice showed reduced vaccinal response following prime-boost immunization with purified ovalbumin, as confirmed by decreased specific immunoglobulin (Ig)G and IgM, confirming the negative impact of dysbiosis and associated inflammation. Two probiotic strains were selected, Bifidobacterium breve and Hafnia alvei, but none of them showed any enhancement of antibody or T cell responses following prime-boost influenza vaccination in mice. While probiotics remain promising for improving vaccine efficacy, especially in vulnerable populations, further research is needed to identify effective strains and optimize treatment protocols.
Purpose:Although several randomized controlled trials (RCTs) have examined the efficacy of rotavirus vaccines, few have comprehensively assessed their reporting quality and risk of bias. This study aimed to evaluate the reporting quality and methodological rigor of RCTs on rotavirus vaccines using the CONsolidated Standards Of Reporting Trials (CONSORT) 2010 checklist and the Cochrane Risk of Bias 2.0 (RoB 2.0) tool. Materials and Methods:We systematically searched PubMed and Cochrane Central for phase 3 randomized controlled trials of rotavirus vaccines administered as monotherapy. Reporting quality was assessed using the CONSORT 2010 checklist and risk of bias was evaluated with the Cochrane RoB 2.0 tool across five domains to determine overall methodological rigor. Results:A total of 29 phase 3 RCTs were included after screening 1,066 records. Most trials were conducted in Asia and funded by industry. Adherence to the CONSORT 2010 checklist was high for trial design and outcome reporting but poor for protocol availability, allocation concealment, and blinding procedures. Overall, 62% of studies had a low risk of bias, while 34% were rated high. Trials published after 2010 and those with low risk of bias showed significantly higher reporting quality. Conclusion:Adherence to the CONSORT 2025 guidelines is essential for future rotavirus vaccine trials, enhancing the quality of individual studies while reinforcing the broader evidence base that informs immunization strategies and public health policies.
Purpose:This study aimed to evaluate the primary vaccination status against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the administration of variant-modified vaccine boosters and the 1-year survival due to coronavirus disease 2019 (COVID-19) in individuals over 65 years old diagnosed with chronic obstructive pulmonary disease (COPD). Materials and Methods:This cross-sectional study was conducted between July 2021 and February 2023. Among 108 COPD patients registered with the home healthcare unit, 97 were included after informed consent. Demographic and clinical characteristics (age, sex, vaccine type, dose count, smoking, diabetes, hypertension) were evaluated for their impact on mortality and survival. The Log-rank test assessed associations with one-year mortality, and Cox regression evaluated independent effects. Results:Among participants, 64% were aged 65-75 and 52% were male. Of these, 41% completed only the primary vaccination series (2 doses) and 29% received a booster dose. By one-year follow-up, 38% (n=37) had died due to COVID-19. Vaccination status (p=0.018), number of doses (p=0.017), and diabetes (p=0.001) were significantly associated with mortality. Cox analysis indicated diabetes (Exp[β]=3.125) and incomplete vaccination (Exp[β]=0.456) significantly decreased survival (p<0.05). Conclusion:Completing at least the primary vaccination series was associated with improved survival, while incomplete primary vaccination and comorbid diabetes had negative effects on outcomes. Booster dose uptake was lower than completion of the primary series. Routine SARS-CoV-2 vaccination remains essential for protecting vulnerable populations, especially amid the ongoing emergence of new variants.
Purpose:Pseudomonas aeruginosa is a common opportunistic pathogen and a leading cause of hospital-acquired pneumonia, yet there is currently no approved vaccine to prevent its infections. This study utilizes immunoinformatics to identify cytotoxic T-lymphocyte (CTL) epitopes derived from conserved regions of 6 key virulence factors: Pili, FliD, AlgF, PelG, Exoenzyme T, and XcpQ. Materials and Methods:Conserved peptide fragments were identified using the Protein Variability Server. The CTL epitopes were evaluated for immunogenicity, antigenicity, post-translational modifications, allergenicity, cross-reactivity, toxicity, and population coverage analysis. Molecular docking between human leukocyte antigens (HLAs) and the corresponding CTL epitopes, along with binding affinity analysis, was also conducted. A multi-epitope vaccine (PaMEV) construct was designed using selected epitopes, and its secondary and tertiary structures were predicted, refined, and validated. Results:All selected epitopes were highly conserved (Shannon index ≤0.1) and showed strong HLA binding (half maximal inhibitory concentration ≤500 nM). They were predicted to be non-allergenic, non-toxic, and non-cross-reactive. Molecular docking revealed stable HLA-epitope complexes with 8-14 hydrogen bonds and high binding affinity (values of the binding free energy <0 and dissociation constant <100 nM). A PaMEV was designed using the 6 CTL epitopes, and structure analysis confirmed its stability and effective epitope presentation. Conclusions:The selected epitopes showed strong potential for inclusion in a peptide-based PaMEV, with favorable immunogenicity and docking results supporting its design. The final construct exhibited structural stability and strong HLA interactions, suggesting it as a promising vaccine candidate against P. aeruginosa. Experimental validation through in vitro and in vivo studies is recommended.
Purpose:Adult immunization is underutilized in India due to limited awareness, inconsistent provider recommendations, and vaccine hesitancy. This study aimed to assess knowledge, attitudes, and practices (KAP) toward adult vaccination and evaluate the impact of educational interventions on vaccine uptake. Materials and Methods:An exploratory cross-sectional survey was conducted among 539 adults (≥18 years) attending inpatient and outpatient services in a tertiary care private hospital, Hyderabad, between September and December 2023. Data on awareness, attitudes, and vaccination history were collected using a structured questionnaire. Vaccine consumption rates in 2023 (pre-intervention) and 2024 (post-intervention) were compared to assess behavioural change. Descriptive statistics were applied for analysis. An educational intervention was carried out by the clinical pharmacist and physicians on the prominence of adult immunization for the participants. Adult immunizations were offered to all participants, subject to purchase, and were subsequently administered at the Adult Immunization Center. Results:Of the respondents, 61% were male and 39% female. A majority (94%) agreed that adults should be vaccinated, and 92% recognized the importance of timely immunization. However, only 62% reported receiving provider recommendations, and 66% had been educated on vaccination. Coronavirus disease 2019 vaccination was the most common (n=493), followed by hepatitis B (n=92), tetanus, diphtheria, and pertussis (Tdap) (n=68), and Influenza (n=63). Post-intervention analysis showed substantial increases in vaccine uptake: human papillomavirus (+116.9%), shingles (+421.4%), hepatitis A (+74.5%), and Tdap (+34.1%). Conclusion:While awareness and positive attitudes toward adult immunization are high, gaps persist in education and provider recommendation. Educational interventions significantly improved vaccine uptake, underscoring the role of clinical pharmacists in bridging the knowledge-practice gap and enhancing adult vaccination uptake.
Purpose:This study aimed to examine the relationship between coronavirus disease 2019 (COVID-19) vaccination status and psychiatric symptoms, illness perceptions, avoidance behaviors, and familial vaccination patterns in adolescents referred to a child and adolescent psychiatry outpatient clinic. Materials and Methods:This cross-sectional observational study included adolescents (n=168) aged 12-18 years. Participants were categorized as vaccinated (n=74, 44%) or unvaccinated (n=94, 56%). Data were collected using validated instruments, including the Coronavirus Anxiety Scale, Clinical Global Impression-Severity, Strengths and Difficulties Questionnaire-Parent version, and several scales evaluating COVID-19 perceptions, control beliefs, avoidance attitudes, and vaccine attitudes. Mann-Whitney U and χ2 tests were used for group comparisons. Binary logistic regression was performed to identify predictors of vaccination status. Results:Vaccinated adolescents were significantly older, more likely female, and more frequently had vaccinated siblings and mothers (p<0.05). They reported higher behavioral avoidance and more positive attitudes toward vaccination, while displaying lower hyperactivity/inattention symptoms (p<0.05). Logistic regression revealed that female gender (odds ratio [OR], 5.11; 95% confidence interval [CI], 1.67-15.64), older age (OR, 1.82; 95% CI, 1.38-2.40), sibling vaccination (OR, 4.53; 95% CI, 1.55-13.25), and increased peer problems (OR, 1.40; 95% CI, 1.02-1.93) significantly predicted vaccination status (p<0.05). Conclusion:In psychiatrically referred adolescents, COVID-19 vaccination is associated with demographic, familial, and psychological variables. Positive vaccine attitudes, behavioral avoidance, and family modeling increase the likelihood of vaccination, whereas hyperactivity/inattention symptoms may reduce it.
Background:During the coronavirus disease 2019 (COVID-19) pandemic, we conducted a cohort study analyzing changes in immunoglobulin (Ig) M and IgG antibody levels before and after COVID-19 vaccination. Methods:The study compared two groups: participants who were infected with severe acute respiratory syndrome coronavirus 2 within 14 days of vaccination and those who were not. We evaluated dynamic changes in IgM and IgG levels immediately following vaccination and assessed their potential correlation with infection risk. Results:Participants who contracted COVID-19 within 14 days of vaccination exhibited significantly higher IgM antibody levels than uninfected individuals, likely due to combined stimulation by both the vaccine and the virus. In the infected group, IgG antibody levels were lower than those in the uninfected group during the first 1 to 5 days post-vaccination. Moreover, across all participants, IgG antibody levels were generally lower than baseline during the first 1 to 3 days post-vaccination. Conclusions:These findings suggest that, in the early stages following vaccination, the immune system may experience a temporary "immune trough," potentially even below pre-vaccination levels. As a result, individuals should exercise additional caution during this period to mitigate infection risk.
Purpose:To synthesize and analyze the current available evidence on the development of new-onset endocrine disorders associated with coronavirus disease 2019 (COVID-19) vaccination. Materials and Methods:We performed a systematic review of literature by searching PubMed, Scopus, Embase and Web of Science. Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were applied, the Joanna Briggs Institute tool and New Castle-Ottawa score were used to assess the risk of bias and quality. SPSS 25.0 software was used for statistical analysis. Results:A total of 245 patients were reported from the selected studies. The most frequently reported endocrine disorders associated with COVID-19 vaccination were thyroid conditions (70.6%), primarily subacute thyroiditis (69.9%) and Graves' disease (28.9%). Cases of type 1 diabetes mellitus (10.2%), adrenal disorders (9.8%), and pituitary disorders (9.4%) were also identified. Most cases occurred in women (64%) and following the first vaccine dose (50.6%). Messenger ribonucleic acid-based vaccines primarily Pfizer-BioNTech and Moderna were the most reported (56.7%). Additionally, studies on fertility found no significant adverse effects on ovarian reserve or semen quality. Clinical outcomes were favorable in most cases (82%), with no significant mortality reported. Conclusion:Overall, although cases of endocrine disorders following COVID-19 vaccination have been reported, a causal relationship has not been definitively established. The benefits of vaccination significantly outweigh the potential risks of endocrinological complications at both the individual and population levels. Nevertheless, clinicians should remain alert to the possibility of endocrine manifestations following vaccination. Trial Registration:PROSPERO identifier: CRD42024512710.
Tick-borne diseases are an emerging public health concern in South Korea, driven by climate change, ecological shifts, and increasing contact between humans, wildlife, and companion animals. This review aimed to provide an updated synthesis of 3 tick-borne infections of concern-Lyme disease, human granulocytic anaplasmosis, and babesiosis. Relevant literature, national surveillance data, and international guidelines were reviewed to describe pathogen characteristics, tick ecology, epidemiology, diagnosis, treatment, prevention, and climate-related risk. Evidence indicates that Ixodes nipponensis and Haemaphysalis longicornis are widely distributed and carry medically important pathogens. Reports of pathogen detection in humans, ticks, and animals suggest a growing ecological risk. Limited clinical awareness, insufficient diagnostic capacity, and underdeveloped surveillance systems remain major challenges. Climate change is expected to further extend tick activity periods, broaden their geographic distribution, and elevate infection risks. Strengthening diagnostic capabilities, integrating human-animal-environment data within a One Health framework, and advancing preventive strategies are critical to reducing the future burden of tick-borne diseases in South Korea.
Accurate vaccine distribution remains central to epidemic management, particularly when resources are limited and public response varies. This revised review evaluates three epidemiological modeling approaches that guide vaccine allocation decisions: DELPHI-V-OPT (an integrated epidemiological-optimization framework), a hybrid Agent-Based plus Differential Equation model, and Probabilistic (stochastic) Control models. Building on the original manuscript, this revision adds a transparent literature-search methodology, a strengthened, chronological literature review, clearer technical descriptions (especially the bidirectional coupling between agent-based simulations and compartmental equations), and a comprehensive limitations and future-work section for each model. We justify the selection of DELPHI-V-OPT as the primary practical framework for policy use, then introduce and analytically integrate a behavioral variable representing vaccine hesitancy into the allocation optimization. The extension recalibrates effective demand, reduces dose wastage, and provides operational recommendations for estimating hesitancy and adapting allocations in resource-limited and resource-rich settings. The revised manuscript includes a summary comparison table of model features, explicit search strategy, and targeted references that support methodological choices and model adaptations.
Purpose:The development of a universal avian influenza vaccine remains a critical issue for both the global public health and poultry industries. The hemagglutinin (H) stem/stalk region of highly pathogenic avian influenza viruses (HPAIVs) is capable of inducing broadly neutralizing antibodies but is limited by its poor immunogenicity. Materials and Methods:To increase the immunogenicity of the stem domain, we engineered a recombinant fusion construct consisting of the stem domain of the H5 subtype and the nontoxic cholera toxin B subunit (CTB), a well-characterized mucosal adjuvant and immunomodulator. C57BL/6 mice were immunized intraperitoneally with the CTB-H5 stem fusion protein. Humoral immune responses and virus-neutralizing activities were subsequently assessed. Results:Mice immunized with CTB-H5 stem fusion protein developed significantly higher serum immunoglobulin G titers and increased binding affinity to the native trimeric H5 antigen. Sera from the CTB-H5 stem group demonstrated enhanced virus-neutralizing activity in plaque reduction assays against the H5N2 virus. These results suggest that CTB fusion significantly enhances the immunogenicity and protective potential of the conserved H5 stem domain against the H5N2 virus. Conclusion:These findings support the use of CTB as an effective adjuvant platform for the development of stem-based influenza vaccines targeting HPAIVs.
The coronavirus disease 2019 pandemic has accelerated the global adoption and development of messenger RNA (mRNA) vaccine technology. While traditional manufacturing approaches rely on centralized and batch-based processes that are limited in scalability and accessibility, recent innovations in modular, decentralized, and continuous-flow production systems offer promising alternatives. This review summarizes the evolution of mRNA manufacturing, examines technological advances such as BioNTech's BioNTainer and Quantoom's Ntensify, and critically evaluates persistent barriers including raw material supply, regulatory compliance, sustainability, and cold-chain requirements. The implementation of artificial intelligence, thermostable formulations, and self-amplifying mRNA technologies are discussed as future directions. Collectively, these innovations offer a pathway to equitable, scalable, and rapid vaccine deployment in the context of both pandemics and routine immunization.
Purpose:The coronavirus disease 2019 (COVID-19) pandemic led to the rapid development of vaccines to control the spread of infection. The inactivated severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Sinopharm BIBP vaccine was introduced in the United Arab Emirates (UAE) and registered by the Ministry of Health and Prevention before the final data of the phase III clinical trial was released. Hence, a post-authorization effectiveness and safety study was required to evaluate the effectiveness and safety profile of the vaccine. Materials and Methods:An observational Phase IV study was conducted in Sheikh Khalifa Medical City, UAE, for 18 months. The effectiveness of the BIBP vaccine was evaluated in individuals who received at least the first 2 doses and those who received the full vaccine course (with booster dose) based on immunogenicity assessment of anti-SARS-CoV-2 antibodies and protection against COVID-19. Results:About 96% of the participants showed positive results for the neutralizing antibody and anti-S antibody against the SARS-CoV-2, 14 days after the second dose of the vaccine. The participants showed similar positive results after the booster vaccine, and the antibodies remained at that level at the one-year follow-up. Only 16 participants who received at least one dose of the vaccine experienced COVID-19. Safety outcomes showed that all serious adverse events reported were unrelated to the vaccine. No death was reported in this study period. Conclusion:The inactivated BIBP Sinopharm vaccine proved safe and effective in protecting against COVID-19.
Respiratory syncytial virus (RSV) maternal vaccination has emerged as a preventive strategy to confer passive immunity to newborn during their early vulnerable months of life. In this review, we aim to assess the efficacy and safety of maternal RSV vaccines. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement guidelines for systematic reviews and meta-analyses. Our literature search covered MEDLINE via PubMed, Scopus, Web of Science, and Cochrane. We included randomized controlled trial (RCTs) that assessed the safety and efficacy of maternal RSV vaccines. The overall effect estimates for efficacy outcomes, including RSV-associated lower respiratory tract infection (LRTI), severe LRTI, and hospitalizations, demonstrated statistically significant benefits favoring the maternal RSV vaccine group (risk ratio [RR], 0.44, 95% confidence interval [CI], 0.31, 0.62, p=0.0001; RR, 0.30, 95% CI, 0.19, 0.48, p=0.0001; RR, 0.53, 95% CI, 0.37, 0.75, p=0.0004, respectively). Additionally, no statistically significant differences were identified for fetal or neonatal safety outcomes, including congenital abnormalities, intrauterine growth restriction, stillbirth, or infant death. Regarding preterm birth, the overall effect estimate did not show a significant difference between the vaccine and control groups (RR, 1.16, 95% CI, 0.96, 1.41, p=0.12). Maternal RSV vaccination provides protection against RSV-associated lower respiratory tract illness in infants with no major safety concerns. However, current evidence remains limited, and additional data from high-quality RCTs are required to confirm or refute these findings. Trial Registration:PROSPERO Identifier: CRD42024541771.
