Human papillomavirus (HPV) vaccination is an effective strategy for preventing cervical cancer, yet vaccine uptake in Malawi remains low because of misinformation, limited awareness, and parental hesitancy. This study describes the implementation of a youth-led school and community engagement initiative to promote HPV vaccine awareness in Lilongwe, Malawi, and highlights lessons for future immunization programs. We conducted a descriptive implementation case study of a two-day youth-led engagement initiative coordinated by fellows of the 2025-2026 Global Health Corps Malawi Leadership Accelerator in collaboration with the Lilongwe District Health Office, Kawale Primary School, and partner organizations. Activities included stakeholder meetings, school health education, myth-busting sessions, learner-centered activities, community dialogs, distribution of educational materials, and on-site HPV vaccination services. Girls aged 9-14y were the primary vaccination beneficiaries, while parents, caregivers, teachers, religious leaders, and community stakeholders were engaged to strengthen vaccine acceptance. Implementation data were collected through attendance records, field notes, dialogue summaries, and reflections. Descriptive statistics and qualitative content analysis were used. The initiative reached over 500 adolescent girls through school awareness activities and engaged 45 community stakeholders across six sites. Two community dialogue sessions were conducted, 1,000 educational materials distributed, and 100 eligible girls received HPV vaccination. Community discussions identified concerns about fertility, vaccine safety, and gender targeting, while trust in health workers, school involvement, participatory dialogue, and community leader support facilitated engagement. Youth-led, community-centered engagement highlighted lessons for improving HPV vaccination through addressing misinformation, building trust, and strengthening health system readiness.
Dupilumab is effective for the treatment of moderate‑to‑severe type 2 inflammatory diseases; however, its real‑world safety profile in pediatric patients remains to be further clarified. This retrospective pharmacovigilance study analyzed U.S. Food and Drug Administration Adverse Event Reporting System (FAERS) data from 2017 to 2025, including 44,593 reports where dupilumab was the primary suspect drug in children. Disproportionality analyses (ROR, PRR, BCPNN, MGPS), time-to-onset analysis, stratified analysis, and Weibull modeling assessed adverse event (AE) distribution and patterns. Results showed balanced sex distribution (male 50.1%, female 48.6%), with adolescents (12-17y) most common (45.3%), and report counts increasing over time. 93 positive safety signals were detected. The most common core AEs were rash (4,105 cases; ROR = 4.55, 95% CI: 4.38-4.72), injection site pain (3,582 cases; ROR = 8.59, 95% CI: 8.22-8.97), and skin exfoliation (1,834 cases; ROR = 3.41, 95% CI: 3.23-3.59). Potential unlisted signals included vitiligo (33 cases; ROR = 10.46, 95% CI: 6.52-16.78), skin depigmentation (32 cases; ROR = 13.04, 95% CI: 7.85-21.66), and eye color change (13 cases; ROR = 7.06, 95% CI: 3.54-14.11). Stratified analyses indicated distinct patterns of adverse‑event reporting across age and sex strata. Among cases with complete temporal information, most AEs occurred within 30d after dupilumab initiation, with a median time‑to‑onset of 14d. In conclusion, this large-scale spontaneous-reporting study detected potential safety signals in children. Given FAERS data limitations, the associations should be viewed as hypothesis-generating rather than confirmatory, and may inform future signal validation and prospective studies.
Although vaccines remain a mainstay tool for the prevention of infectious diseases, their efficacy, safety, and trust among the population remain controversial. For an effective rollout of the HPV vaccine in Pakistan, financial constraints, health system fragility, and complex cultural values should be kept in mind, and these should be apprehended as both facilitators and barriers, since these findings will help policymakers to design effective interventions and improve public trust. To explore barriers and motivators to HPV vaccine uptake in Pakistan, the study used a descriptive qualitative study design. It was conducted from February 2025 to August 2025 across districts of Northern Punjab and Southern Punjab. Inclusion of diverse stakeholders such as community workers/religious scholars, healthcare providers, teachers/school administrators, adolescent girls, and their parents/guardians allowed us a better understanding of multilevel influencers on HPV vaccine acceptance. Barriers to HPV vaccination were summarized under BeSD framework, including fear of side effects, vaccine skepticism, misinformation via social media, religious perception, restricted social and peer norms, fear-based motivation, long waiting time, service dissatisfaction, patriarchal decision-making, and community resistance. Conversely, facilitators included recognition of vaccine need and benefits, supportive family and community norms, health worker counseling, public health advocacy, trust in school authorities, religious belief, self-determination, effective outreach and door-to-door services, and gender-neutral vaccine acceptance. The findings underscore the need for culturally sensitive, trust-building strategies that go beyond a clinical approach to effectively strengthen equitable HPV vaccine uptake, improved vaccine confidence, and ultimately reduced HPV-related diseases.
Adjuvants can enhance the elicited immune responses to recombinant hemagglutinin (HA) proteins following intramuscular vaccination. In this study, computationally optimized broadly reactive antigen (COBRA) designed HA proteins were adjuvanted with the W805EC oil-in-water nanoemulsion ("NE01") and used to vaccinate mice. The elicited influenza-specific humoral and cellular immune responses were evaluated. Mice vaccinated with adjuvanted COBRA H1 and H3 HA vaccine candidates had higher antibody titers compared to mice vaccinated with unadjuvanted HA proteins. Mice administered COBRA HA plus NE01 had higher hemagglutination inhibition (HAI) specific antibody titers against a panel of H1N1 and H3N2 influenza viruses, as well as higher levels of interferon-gamma (IFN-γ) secreting splenocytes. Mice vaccinated with adjuvanted COBRA HA proteins had statistically less weight loss following challenge, as well as undetectable viral lung titers compared to mice administered unadjuvanted vaccine.
Infant RSV prevention is undergoing a public-health paradigm shift toward scalable, broad-eligibility passive immunization. This review examines nirsevimab (Beyfortus®), a long-acting recombinant IgG1κ monoclonal antibody targeting the conserved site Ø of prefusion RSV F protein. Its extended half-life enables season-long protection with a single dose, overcoming key limitations of palivizumab. A validated manufacturing platform and stringent release specifications ensure consistent quality and potency. Pivotal trials demonstrated high efficacy against RSV-associated lower respiratory tract infection hospitalization (RSVH), while the pragmatic HARMONIE trial confirmed an 83.2% reduction in RSVH under routine conditions. Postlicensure studies across multiple countries report 70-90% effectiveness against RSVH and substantial reductions in intensive care admissions. Comparative 2024-2025 data further suggest greater protection than maternal RSVpreF vaccination. Nirsevimab represents a scalable public-health intervention that can be used alone or complement maternal RSV vaccination, warranting continued surveillance of effectiveness, safety, and viral escape.
Human papillomavirus (HPV) vaccination is a key preventive measure against cervical cancer. In Japan, proactive recommendations for HPV vaccination were suspended from 2013 to 2022, resulting in persistently low coverage. We explored the post-intervention knowledge, attitudes, and short -term self-reported HPV vaccination behavior following a near-peer educational intervention by medical students. Between February 2022 and March 2024, medical students conducted 1-hour sessions covering HPV transmission, cervical cancer prevention, and vaccine efficacy. The sessions incorporated quizzes, discussions, and workshops in which high school students created role-play scenarios or social media messages to promote HPV vaccination. A follow-up survey was administered 1-2 weeks after the sessions to assess vaccination uptake, knowledge, and self-reported explanatory ability. Of 864 junior and senior high school students who participated in the sessions, 332 were included in the followed-up analysis. Of these, 248 were unvaccinated before the session: 134 females and 114 males. Within two weeks, 10 female (7.5%) and one male (0.9%) reported receiving HPV vaccination. Students with positive vaccination intentions demonstrated higher comprehension scores than those without such intentions. Voluntary participants had higher knowledge scores than whole-class attendees. Subjective and objective comprehension scores were positively correlated, although there were some discrepancies. Vaccinated respondents were more likely than unvaccinated respondents to correctly identify HPV-preventable cancers. Near-peer outreach sessions delivered by medical students may represent a useful approach to enhancing adolescents' understanding of HPV vaccination. Leveraging the near-peer position of medical students may be a promising approach to address vaccine hesitancy in Japan.
Human papillomavirus (HPV) is a major global public health concern, causing genital warts and cancers of the cervix, anus, oropharynx, vulva, and penis. People living with HIV (PLWH) face a disproportionately elevated burden of HPV infection and HPV-related malignancies due to chronic immunosuppression. We conducted a systematic review and meta-analysis searching six databases from January 2006 to June 2026 without language restrictions. Twenty-five studies were included in the systematic review; 12 independent studies (N = 1,493 for HPV16) were included in the quantitative meta-analysis. Using a DerSimonian-Laird random-effects model with logit transformation, pooled seroconversion rates were: HPV16 97.8% (95% CI: 94.9-99.1%; I2 = 89.6%; 15 datasets), HPV18 94.2% (95% CI: 86.1-97.7%; I2 = 95.8%; 13 datasets), HPV6 97.0% (95% CI: 93.7-98.6%; I2 = 66.1%; 10 studies), and HPV11 97.1% (95% CI: 90.5-99.1%; I2 = 95.5%; 10 studies). CD4 count was the most consistently reported modifier of immunogenic response: HPV16 seroconversion was 98.5% in PLWH with CD4 > 350 cells/μL vs. 71.1% in those with CD4 ≤ 200 cells/μL (ACTG A5240). All three vaccine generations demonstrated high immunogenicity. Two doses of the nonavalent vaccine were non-inferior to three doses in virologically suppressed women (Papillon RCT). No vaccine-related serious adverse events were reported. GRADE certainty of evidence was moderate for HPV16, HPV6, and HPV11, and low for HPV18. Prophylactic HPV vaccination achieves high seroconversion rates across all vaccine generations in PLWH. CD4 count significantly modifies vaccine response, underscoring the importance of vaccination before severe immunosuppression develops. These findings support current international recommendations advocating HPV vaccination for all PLWH.
This study aimed to determine the prevalence and correlates of adequate tetanus toxoid (TT) immunization among married women in Afghanistan. This cross-sectional study analyzed data from the 2022-2023 Afghanistan Multiple Indicator Cluster Survey (MICS), focusing on 12,450 married women aged 15-49y who had a live birth in the two years preceding the survey. Multivariable logistic regression determined the correlates of adequate TT immunization. The prevalence of adequate TT immunization was 49.9% (95% CI 48.2%-51.6%). The odds of adequate TT immunization were higher in women with primary (AOR 1.32) and secondary/higher (AOR 1.57) education, in women who used 1-3 (AOR 3.06) and ≥4 (AOR 4.67) antenatal care (ANC) visits, those living in Central High region (AOR 4.20), those with access to media (AOR 1.29), and in women belonging to second (AOR 1.33), third (AOR 1.25) and fourth (AOR 1.26) household wealth quintiles. On the other hand, the likelihood of adequate TT immunization was lower in women aged 40-49y (AOR 0.76) and those living in the East (AOR 0.76) and West (AOR 0.68) regions of Afghanistan. Only half of married women in Afghanistan had adequate TT immunization, highlighting substantial gaps in coverage. Strengthening health education, improving equitable access to immunization services, and enhancing communication through mass media; particularly targeting older, less-educated, and economically disadvantaged women, are essential to improve TT coverage and progress toward maternal and neonatal tetanus elimination in Afghanistan.
Varicella remains a common childhood infection worldwide. Understanding long-term trends and identifying key determinants of disease burden are essential for informing vaccination strategies and public health planning. Data were obtained from the Global Burden of Disease (GBD) 2021 study and the global varicella vaccination policy information. Extreme Gradient Boosting (XGBoost) model was trained to predict the disease burden for 2030. This model estimated the incidence, prevalence, and disability-adjusted life years (DALYs) for varicella among children aged 5-9 y worldwide. Shapley Additive exPlanations (SHAP) was employed to identify key factors and inform public health strategies. From 1990 to 2021, the rate of global incidence rose from 1,028.46/100,000 to 1,048.24/100,000, prevalence from 30.81/100,000 to 31.07/100,000, and DALYs declined from 21.09/100,000 to 12.36/100,000. By 2030, these metrics are projected to fall to 897.01/100,000, 28.96/100,000, and 11.71/100,000, respectively. From 1990 through 2030, Southeast and South Asia had the highest varicella incidence, Asian and Pacific Island nations had the highest prevalence, and sub-Saharan Africa and South Asia had the highest DALYs. SHAP identified population as the strongest predictor (mean absolute SHAP value: 0.167 for incidence and 0.103 for prevalence), and higher vaccination program tier may be associated with lower DALYs. Varicella burden among children aged 5-9 y has declined globally, but model projections indicate that regional disparities will persist. The lack of vaccination coverage and cohort-level immunization data limits interpretation of vaccine effects; future studies should incorporate both coverage and cohort exposure information to strengthen policy evaluation.
Cervical cancer is a preventable threat to women's health, and human papillomavirus (HPV) vaccination is key primary prevention. Caregiver hesitancy may affect vaccination of age-eligible girls.We examined caregivers' willingness to vaccinate primary and secondary school girls against HPV and factors in six ethnic autonomous prefectures of Qinghai Province. From December 2024 to February 2025, we conducted a cross-sectional survey of caregivers of girls in selected classes at 12 schools, using multistage cluster convenience sampling. The questionnaire included Health Belief Model (HBM), Theory of Planned Behavior (TPB), and Perceived Social Support Scale (PSSS) items. Factors were assessed with univariable and four-step hierarchical multiple linear regression, sequentially entering sociodemographic, HBM, TPB, and PSSS blocks. Willingness correlated with perceived susceptibility and severity, cues to action, attitudes, perceived behavioral control, and subjective norms. In univariable analyses, all HBM, TPB, and social-support dimensions except perceived barriers were positively associated with willingness. Hui caregivers had lower willingness, while higher education, middle income, and party/government-agency or public-institution employment predicted higher willingness. In hierarchical multiple regression, Hui ethnicity vs. Han ethnicity predicted lower willingness (B = -0.229, P = .003). Cues to action (β = 0.121, P = .024), perceived barriers (β = 0.128, P < .001), attitudes (β = 0.203, P < .001), perceived behavioral control (β = 0.107, P = .001), and subjective norms (β = 0.323, P < .001) were positively associated. HPV vaccination promotion should be tailored to Qinghai's ethnic autonomous prefectures, with authoritative school and primary-care recommendations, clear vaccine information, and vaccination-process support, while identifying barriers. Future qualitative and prospective implementation studies should clarify decision-making mechanisms and assess intervention acceptability and effects on vaccine uptake in resource-limited settings.
This scoping review consolidates survey research conducted among university students across the League of Arab States to understand the nature and extent of COVID-19 vaccine hesitancy and acceptance. Using PRISMA-ScR guidelines, a search was conducted across 10 databases covering publications from 2020 to 2024. Fifty-three studies met the inclusion criteria. Reported determinants of vaccine acceptance and hesitancy aligned with key constructs of the Health Belief Model, including perceived susceptibility, perceived severity, perceived benefits, and perceived barriers. Concerns regarding vaccine safety, effectiveness, and side effects were among the most frequently reported reasons for hesitancy, while perceived protection of self and others, trust in health authorities, and institutional requirements were associated with vaccine acceptance. Findings suggest that vaccine decision-making among university students was influenced by an interaction of individual, familial, social, and informational factors. These results help inform future vaccination communication, education, and public health strategies in university settings across the region.
The gut microbiota-tryptophan (TRP) metabolism-immune axis is one of the core pathogenic mechanisms in inflammatory bowel disease (IBD). Physiologically, gut microbes convert dietary TRP into bioactive metabolites that regulate intestinal immune balance and barrier function via AHR. In IBD, this axis enters a vicious cycle of dysbiosis, metabolic disruption, and immune imbalance - characterized by reduced beneficial bacteria, excessive 5‑HT production, and kynurenine pathway overactivation - which drives T‑cell dysregulation, aberrant macrophage polarization, and compromised barrier integrity. Therapeutic strategies are shifting from single‑target to integrated approaches, combining probiotics, engineered bacteria, AHR agonists, IDO1 inhibitors, immunomodulators, and ROS‑responsive nanomedicines. By achieving multi‑node synergistic remodeling, this review provides a theoretical foundation for systemic strategies that coordinate microbial regulation, metabolic intervention, and immune targeting, thereby offering new avenues for the effective treatment of IBD.
Adverse reactions are closely associated with vaccination sites, making site selection vital for clinical administration of the diphtheria, tetanus, and acellular pertussis (DTaP) vaccine. This retrospective observational study enrolled 636,169 DTaP inoculations in Wuxi from 2020 to 2024. Adverse reaction data were extracted from the National Adverse Events Following Immunization Surveillance System of China, and dose data were obtained from the Jiangsu Province Vaccination Integrated Service Management Information System. We compared adverse reaction reporting rates stratified by overall incidence, severity, vaccine dose, and clinical manifestations, as well as constituent proportions of adverse reactions according to onset time between upper arm and buttock injection groups. The upper arm group had slightly higher reporting rates of adverse reactions and common reactions than the buttock group, at 23.88 (95% CI: 22.54-25.22) vs. 17.89 (95% CI: 15.56-20.21) and 23.13 (95% CI: 21.81-24.45) vs. 16.94 (95% CI: 14.68-19.20) per 10,000 doses, both p < .001, while rare reaction rates were comparable, at 0.75 (95% CI: 0.51-0.98) vs. 0.95 (95% CI: 0.41-1.48) per 10,000 doses, p = .473. Slightly elevated adverse reaction rates were also found in upper arm administration for the first and second doses. Redness and swelling, induration, and fever were the predominant adverse symptoms, all showing modestly elevated rates after upper arm injection. The adverse reactions at both sites were predominantly common reactions within expected range. Despite a slightly elevated risk of common reactions, upper arm injection may be the preferred site for DTaP vaccination for overall safety.
Recent articles claim that randomized clinical trials (RCTs) have not documented non-specific effects of vaccines (NSE), i.e. broader immunomodulatory effects of vaccines. We reviewed the role of RCTs in the discovery of NSEs. The articles claiming no NSEs misread the literature, disregarded non-RCT data, and did not take interactions with other interventions into consideration. RCTs have played a limited role in the discovery of the NSEs of vaccines. Instead, contradictions in non-RCT data have helped to document NSEs; most important have been abrupt mortality changes, sex-differential effects, differential effects by sequence of vaccinations, maternal priming effects, beneficial boosting, negative boosting, mortality effects after disease eradication/elimination, and interacting interventions changing the mortality ratio (MR) in RCTs. Vaccine efficacy studies assume that true protective effects are independent of context; in contrast, the immunological mechanisms underlying NSEs are context-dependent as other vaccines, micronutrients and immune history may affect the capacity of the immune system to protect against unrelated infections. Thus, NSEs do exist. The way forward will be to intensify studies of the contextual factors affecting the NSEs to optimize their usefulness for vaccine programmes.
CAR-T cell therapy has dramatically changed the treatment paradigm for relapsed/refractory multiple myeloma (R/R MM). Nevertheless, there is a notable paucity of comprehensive bibliometric analyses within this specialized domain. On January 26, 2026, publications on CAR-T cell therapy for MM (2013-2025) were retrieved from the Web of Science Core Collection using: TS = (CAR-T OR "chimeric antigen receptor T*" OR "chimeric antigen receptor modified T" OR "chimeric antigen receptor engineered T" OR "chimeric antigen receptor transduced T" OR "chimeric antigen receptor redirected T") AND TS = ("multiple myeloma*" OR "plasma cell myeloma*" OR "Kahler Disease"). English articles and reviews were included. Bibliometric and visual analyses used CiteSpace 6.2.R1 and VOSviewer 1.6.17. A total of 1,661 eligible documents (including 874 articles and 787 reviews) were included. The annual publication volume showed a continuous upward trend. The United States, Harvard University, Frontiers in Immunology, and Hermann Einsele were the leading contributors by country, institution, journal, and author, respectively. Research focuses on BCMA-CAR-T cell therapy efficacy and safety, comparisons with standard regimens, toxicity management, and combinatorial strategies with bispecific antibodies. Citation burst analysis highlighted emerging directions, including GPRC5D-CAR-T cell therapy and allogeneic "off-the-shelf" CAR-T cell products. The field of research concerning CAR-T cell therapy for multiple myeloma is experiencing rapid advancement. This study systematically summarizes the global research trends, research hotspots and emerging directions in this field, which provides valuable reference for researchers in this field.
This study investigated Hepatitis B virus (HBV) infection prevalence and disease-related knowledge among spouses of reported HBV cases in Quzhou City to support family-based interventions reducing intra-familial transmission. In 2024, a cross-sectional survey was conducted in three randomly selected counties. Spouses (≥18y) of cases reported from Jan 2023 to Sep 2024 were interviewed with a structured questionnaire and tested for serological markers. Among 344 valid respondents, 161 provided blood samples. The HBsAg positivity rate was 11.80%. The rates for anti-HBs, anti-HBe, and anti-HBc were 60.87%, 23.60%, and 77.02%, respectively. No participant tested positive for HBeAg. Based on serological patterns, 12.42% were classified as susceptible, 9.94% had immunity from vaccination, and 50.93% had evidence of past infection. Overall HBV knowledge awareness rate was 36.69% with a pass rate of 22.09%. The awareness rates for the 10 specific knowledge items ranged from 6.40% to 62.21%. Multivariate logistic regression analysis showed that older age (≥60y: OR = 0.102, 95%CI:0.040 - 0.261), farmers/workers(OR = 0.335, 95%CI:0.155 - 0.723), and unawareness of personal infection status(OR = 0.364, 95%CI:0.159 - 0.833) were independently associated with lower knowledge. Most respondents preferred obtaining information through "hospitals/medical staff"(61.63%) and "online platforms/WeChat official accounts"(38.95%). Spouses have high HBsAg prevalence and poor HBV knowledge, indicating a substantial risk of intra-family transmission. Targeted health education, especially for the elderly, farmers/workers, and those unaware of their status, should be delivered through medical institutions to promote vaccination and regular testing, thereby reducing family‑clustered transmission.
Synthetic saponin-based adjuvants hold promise for overcoming the supply instability and purity limitations inherent to naturally derived QS-21. However, establishing their toxicological and functional equivalence to the natural reference is a necessary step before clinical use. This study systematically evaluated the safety and immunogenicity of a recombinant tuberculosis vaccine (named LYB007) formulated with a synthetic QS-21-Api compared to an identical formulation using a naturally-derived reference via single- and repeated-dose toxicity assessments in Sprague-Dawley (SD) rats. Both synthetic and naturally-derived formulations exhibited highly comparable safety and immunological profiles. Injection site reactogenicity was self-limiting, with complete histological resolution by Day 58. Systemic physiological adaptations, including transient thermal shifts and acute-phase protein fluctuations, were consistent with the potent immunostimulatory activity of QS-21 and did not have long-term toxicological significance. Notably, both formulations induced robust, uniform (100%) seroconversion with identical kinetics of antibody development and persistence, with peak geometric mean titers (GMTs) consistently attained between Day 29 and Day 43. The strict seronegativity in negative and mock-vaccine control groups confirmed that the humoral response was exclusively driven by the LYB007-adjuvant complex. Histopathological findings, such as splenic germinal center expansion and extramedullary hematopoiesis, were identified as expected immunological adaptations rather than manifestations of systemic toxicity. In conclusion, these findings confirm that the synthetic QS-21-Api possesses a safety and efficacy profile equivalent to the naturally-derived reference. The use of a chemically defined and standardized adjuvant component overcomes key constraints in vaccine scalability and quality control, supporting the development of future high-efficacy subunit vaccines.
The RC48-C016 trial conducted in China demonstrated that disitamab vedotin plus toripalimab (DV+Torip) significantly extended overall survival and progression-free survival in comparison to chemotherapy for patients with HER2-expressing advanced urothelial cancer. However, the economic value of this combination regimen remains uncertain. This study aimed to assess the cost-effectiveness of DV+Torip vs. chemotherapy as a first-line treatment for HER2-expressing advanced urothelial cancer from the Chinese healthcare system perspective. A partitioned survival model with a 10 y time horizon was developed to evaluate the cost-effectiveness. The primary outcomes included costs, quality-adjusted life-years (QALYs), and incremental cost-effectiveness ratios (ICERs). Sensitivity, subgroup, and scenario analyses were employed to examine the uncertainty associated with the model results. The ICER of DV+Torip vs. chemotherapy was estimated at $18,448.74 per QALY, which was below the willingness-to-pay (WTP) threshold of $40,334 per QALY. In the majority of sensitivity, subgroup, and scenario analyses, the ICER values remained below the WTP threshold, thereby affirming the robustness of these findings. However, in one scenario analysis, where treatment durations were not aligned with the median treatment cycles and subsequent drug treatment costs were excluded, the economic advantage of the DV+Torip group was nullified, resulting in an ICER of $66,303.62 per QALY. These results suggest that DV+Torip is cost-effective, though its economic advantage may be influenced by treatment duration and subsequent therapy costs.
Although prophylactic vaccination is highly effective against human papillomavirus (HPV), HPV vaccine uptake among Chinese college students remains insufficient, and evidence among medical university students, particularly males, remains limited. Following the recent approval of male HPV vaccines in China, this study evaluated vaccine awareness, acceptance, and potential barriers among both sexes. A cross-sectional online survey of 831 full-time undergraduate students at Anhui Medical University was conducted from October to December 2025. While overall HPV vaccine awareness was high (88.33%), the actual vaccination rate remained low at 25.55% (54.40% among females). Overall vaccination intention was 67.27%, exhibiting a profound gender disparity (92.80% in females vs. 46.27% in males, P < .001). Multivariable analyses showed that female vaccination uptake was significantly associated with familial socioeconomic factors, particularly monthly living allowance and maternal educational attainment. In male students, neutral or opposing attitudes toward a national male HPV vaccination policy were associated with lower vaccination intention (OR = 0.61, 95% CI: 0.409-0.898; OR = 0.27, 95% CI: 0.084-0.756), whereas a maximum acceptable vaccine cost of RMB 1,000-2,000 was associated with higher intention (OR = 1.61, 95% CI: 1.003-2.592). Additionally, female students showed higher HPV-related knowledge scores and greater reliance on interpersonal and professional information sources. Ultimately, these findings suggest that improving HPV vaccine uptake among medical university students in China may require targeted educational strategies and more accessible vaccination support, particularly for male students and those with fewer socioeconomic resources.
Critically ill adults are often older and have multiple chronic conditions, but data on prior pneumococcal vaccination in this population are limited. We aimed to assess pneumococcal vaccination coverage among eligible patients and identify factors associated with pneumococcal vaccination among ICU patients. We performed a cross-sectional study in an ICU at a tertiary care hospital in Japan. We included patients admitted to the ICU from May 15, 2023, to January 4, 2024. Eligibility for pneumococcal vaccination was defined with reference to the Japanese routine vaccination program during the study period. Vaccination status for pneumococcal, influenza, and coronavirus disease 2019 (COVID-19) vaccines was assessed using a structured questionnaire administered to patients or family members during ICU admission. Multivariable logistic regression analysis was performed among eligible patients with known pneumococcal vaccination status. Among 982 patients, 757 (77.1%) met pneumococcal vaccination eligibility criteria. After excluding 32 non-responders, vaccination status was assessed for 725 eligible patients. Of these, 124 (17.1%) reported pneumococcal vaccination, 371 (51.2%) reported no pneumococcal vaccination, and 230 (31.7%) reported unknown status. In the multivariable analysis, influenza vaccination was the only factor independently associated with reported pneumococcal vaccination status (odds ratio, 31.8, 95% confidence interval, 4.3-236.7, p < .001). Our study highlights that most ICU patients were eligible for pneumococcal vaccination, but a minority of eligible patients reported vaccination, and approximately one-third had unknown vaccination status. These findings support the need for more reliable vaccination records and routine opportunities to assess eligibility and history in this population.
