What Is Already Known About This Topic?:Combination vaccines enhance health system efficiency and caregiver compliance by reducing the number of clinic visits and injections required for routine childhood immunization. What Is Added by This Report?:In 2024, eight types of combination vaccines were in use worldwide, grouped into two categories: diphtheria-tetanus-pertussis (DTP)-containing vaccines (trivalent, quadrivalent, pentavalent, and hexavalent) and measles-containing vaccines (two bivalent types, trivalent, and quadrivalent). Pentavalent DTP-containing vaccines and measles-mumps-rubella (MMR) vaccines were the most widely used globally, yet 15 countries still lacked any measles-containing combination vaccine. Significant coverage gaps and service drop-offs persisted in low-income countries in Africa and the Americas, reflecting economic disparities in access to advanced formulations such as hexavalent vaccines. What Are the Implications for Public Health Practice?:To align with Immunization Agenda 2030 (IA2030), tailored strategies should integrate combination vaccines with strengthened primary healthcare delivery and sustainable financing mechanisms. This approach is essential for improving service continuity and reducing dropout rates in underperforming regions.

Background:Children are vulnerable to influenza virus due to their developing immune systems, particularly children aged 6 months-5 years (preschool children). To improve the uptake of influenza vaccine in preschool children, it is important to determine the influencing factors of Chinese parents/guardians' (P/Gs) intention and behavior for children to receive. We implemented an investigation to determine coverage of influenza vaccination in preschool children and the influencing factors of being vaccinated against influenza among preschool children in Fuzhou. Methods:This is a cross-sectional study. Using a hierarchical approach, based on the coverage of influenza vaccination in preschool children, the 12 districts/counties in Fuzhou were divided into two levels. In each level, two urban districts and two counties were selected, including 2 randomly selected vaccination clinics and 2 kindergartens. A standardized anonymous questionnaire was used to collect information on P/Gs. Chi-square testing and multivariate logistic regression were used to analyze factors that may be associated with influenza. Results:The coverage rate of influenza vaccination was 7.38% among preschool children in 2022 in Fuzhou City. A total of 8,768 guardians completed the questionnaire. 54.70% of the responders had received at least one dose of flu. Only 23.56% of the P/Gs involved were able to correctly list the influenza clinical feature. Higher education status had higher coverage (p-values < 0.05). Multivariate analysis showed birth order [odds ratio (OR) = 0.76, 95% confidence interval (CI): 0.63, 0.92], medical insurance [OR = 1.42, 95% CI: 1.22, 1.65], occupation [OR = 0.84, 95% CI: 0.75, 0.93], average monthly household income ≥ 10,000 [OR = 0.66, 95% CI: 0.56, 0.79], vaccine prices > 200 [OR = 1.66, 95% CI: 1.41, 1.97], and total duration of each vaccination session [OR = 0.49, 95% CI: 0.42, 0.58] were associated with flu vaccination. Conclusion:Influenza vaccination coverage among preschoolers was low, and parental/guardian knowledge regarding influenza prevention was inadequate. Enhanced awareness, vaccine understanding, and recommendation policies correlated with higher coverage. Authorities should implement sustainable financing and incentives to ensure access and affordability, while promoting education to convert vaccination intentions into actual uptake.

Introduction:Eliminating hepatitis B virus (HBV) as a major public health threat is a global health priority that requires cost-effective screening strategies. This study evaluated the cost-effectiveness of sequential birth cohort HBV screening strategies in China. Methods:Using a Markov model, we compared five screening strategies with current practice, calculating HBV-related deaths averted, quality-adjusted life years (QALYs) gained, and incremental cost-effectiveness ratios (ICER). One-way deterministic and probabilistic sensitivity analyses were conducted to evaluate the robustness of the results. Results:The sequential birth cohort screening strategy (Sequential Screening 1: screening the 1991-2000 cohort in 2025-2026, the 1971-1990 cohort in 2027-2028, and the 1951-1970 cohort in 2029-2030) was the most cost-effective, with an ICER of 58,523 Chinese Yuan (CNY) per QALY at a willingness-to-pay threshold of three times the per-capita Gross Domestic Product (GDP). An alternative strategy that prioritized the 1951-1970 cohort in 2025-2026 averted the most HBV-related deaths (approximately 3.44 million) and gained 24.9 million QALYs, with an ICER of 60,113 CNY per QALY, also showing cost-effectiveness. Discussion:Our findings support sequential birth cohort screening as an optimal and innovative approach to achieving the WHO HBV elimination targets, offering evidence-informed guidance for policymakers to optimize screening programs and resource allocation.

OBJECTIVES:This study aimed to evaluate the prevalence of Hepatitis B Virus (HBV) infection among patients attending Jazeera Specialist Hospital in Mogadishu, Somalia, between January 2022 and December 2024. PATIENTS AND METHODS:A retrospective cross-sectional study was conducted using laboratory records of 18,745 patients tested for HBsAg. Descriptive statistics and Pearson Chi-Square tests were employed to evaluate prevalence patterns and infer associations between HBV status and variables such as gender, age, marital status, district of residence, and year of testing. RESULTS:The overall HBV prevalence was 3.1 % (n = 576), classifying the region as being under intermediate endemicity. Males exhibited a higher positivity rate (4.4 %) compared to females (2.5 %) (χ² = 51.665, p < .001). Age-stratified analysis showed the highest infection rate among older adults aged 51-70 (6.5 %), followed by middle-aged adults aged 31-50 (5.3 %) (χ² = 250.314, p < .001). Marital status was significantly associated with HBV positivity, with singles demonstrating a 3.6 % positivity versus 2.6 % among married individuals (χ² = 19.798, p < .001). Notable geographic disparities were observed; districts such as Dharkeynley and Dayniile recorded higher positivity rates (5.4 % and 4.0 %, respectively) (χ² = 95.462, p = .001). Annual positivity varied, peaking in 2020 (3.9 %) and remaining statistically significant across years (χ² = 22.923, p = .028). CONCLUSIONS:HBV remains a substantial health concern in Mogadishu, particularly among males, older adults, and residents of specific districts. The findings emphasise the urgent need for demographically targeted HBV prevention strategies, including vaccination, public health education, and enhanced district-level screening initiatives.

The effectiveness of 23-valent pneumococcal polysaccharide vaccine (PPSV23) against hospitalization risk due to all-cause community-acquired pneumonia (CAP) in older individuals in China is limited. A hospital-based case-control study was conducted on this issue in Suzhou City, Jiangsu Province, China. Cases were individuals who were newly diagnosed with CAP based on International Classification of diseases 10 (ICD10 code: J15.902, J15.903, J13.x00 x 001) from January 2023 to June 2023, while patients with other respiratory tract infections were the control group. The vaccination data of PPSV23 was obtained from Suzhou Center for Disease Control and Prevention. The results showed CAP group had a lower vaccination rate of PPSV23 within last 5 years than controls (3.27% vs. 4.81%). Both the severe CAP and non-severe CAP groups had lower vaccination rates of PPSV23 than controls. Logistic regression demonstrated that PPSV23 vaccination within 5 years in individuals aged >= 60 years prevented 26.7% hospitalization risks of all-cause CAP, with adjusted OR of 0.733 (95% CI = 0.605-0.887). PPSV23 vaccination could prevent 25.2% (adjusted OR = 0.748, 95% CI = 0.616-0.909) and 44.0% (adjusted OR = 0.560, 95% CI = 0.309-1.012) hospitalization risks due to non-severe CAP and severe CAP, respectively. PPSV23 vaccination is effective in reducing hospitalization risk due to CAP in older individuals.

What is already known about this topic?:The incidences of vaccine-preventable diseases (VPDs) included in the Expanded Program on Immunization in China have decreased significantly in recent decades.What is added by this report?:This study summarizes the national incidences of nine VPDs and the seroprevalence of hepatitis B surface antigen (HBsAg) under different immunization strategies from 1950 through 2021 in China. The sharpest decreases in VPD incidence and under-5-year HBsAg seroprevalence occurred during the latest stage of the National Immunization Program. The decreases in VPD incidence were most prominent among children under five years of age.What are the implications for public health practice?:These findings provide valuable insights for vaccine value assessment and emphasize the importance of implementing immunization strategies in targeted populations.

Background:Since 1992, when recombinant hepatitis B vaccine was introduced in China, government health officials have used nationally representative serological surveys to monitor progress in prevention and control of hepatitis B. In 2020, we conducted the fourth seroepidemiological survey, which for the first time included medical evaluation of the clinical status of HBsAg positive subjects over the age of 15 and their medical management. We report survey results in comparison with the three previous surveys. Methods:Consistent with previous national surveys, the 2020 survey used a stratified, three-stage cluster random sampling method to select for evaluation 1-69-year-olds in 120 national disease surveillance points. Blood samples were tested for HBsAg, anti-HBV surface antigen (anti-HBs), and anti-HBV core antigen (anti-HBc) in the National Hepatitis Laboratory of the Institute for Viral Disease Control and Prevention of China CDC. HBsAg positive subjects aged ≥15-year were evaluated for evidence of liver disease, and through face-to-face questionnaire-based survey, we determined the healthcare management cascade of HBV-infected individuals. Findings:HBsAg prevalence in 1-69-year-olds was 5.86%; in children 1-4 years of age, seroprevalence was 0.30%; 75 million people were living with HBV nationwide. Among HBsAg-positive individuals 15 years and older, expert medical examination found that 78.03% were HBsAg carriers with no evidence of liver damage, 19.63% had chronic HBV with liver enzyme abnormalities, 0.84% had evidence of cirrhosis, and 0.15% had evidence of liver cancer. 59.78% of HBsAg + individuals were aware that they were positive before the survey, 30 million were unaware; 38.25% of those who knew they were positive (17 million) had medical indications for antiviral treatment, and 17.33% of these individuals (3 million) were being treated with antivirals. Interpretation:The decline in HBsAg prevalence in the general population, from 9.72% in 1992 to 5.86% in 2020, and in 1-4-year-olds from 9.67% in 1992 to 0.30% in 2020, shows progress that continues on track toward WHO targets for prevention of new infections. Implementation of acceptable strategies to identify infected individuals and offer long-term medical monitoring and management will be important to prevent complications from hepatitis B infection and for meeting WHO cascade-of-care targets. Funding:The study was funded by the Major Science and Technology Special Project of China's 13th 5-Year Plan (grant no. 2017ZX10105015); Central finance-operation of public health emergency response mechanism of Chinese Center for Disease Control and Prevention (131031001000200001, 102393220020010000017).

Introduction : Detecting poliovirus infections proves to be highly challenging due to their asymptomatic nature and infectious potential, highlighting the crucial importance of effective detection methods in the context of polio eradication efforts. In many countries, including China, the primary approach for identifying polio outbreaks has been through acute flaccid paralysis (AFP) surveillance. In this study, we conducted an evaluation spanning three decades (1993-2022) to assess the effectiveness of AFP surveillance in China. Methods : Data on all AFP cases identified since 1993 and national -level AFP surveillance system quality indicators aligned with the World Health Organization (WHO) standards were collected for analysis. The quality indicators assess surveillance sensitivity, completeness, timeliness of detection notification, case investigation, and laboratory workup. Surveillance sensitivity is determined by the non -polio AFP (NPAFP) detection rate among children under 15 years of age. Results : Between 1993 and 2022, a total of 150,779 AFP cases were identified and reported. Within this pool, surveillance identified 95 cases of wild poliovirus (WPV) and 24 cases due to vaccinederived poliovirus. From 1995 onwards, the detection rate of NPAFP cases consistently adhered to the WHO and national standards of >= 1 case per 100,000, falling between 1.38 and 2.76. Starting in 1997, all timeliness indicators consistently achieved the criteria of 80 % , apart from the consistency in meeting standards set for the rate of positive specimens sent to the national laboratory. Conclusions : AFP surveillance has been instrumental in China's accomplishment of maintaining a polio -free status. The ongoing adherence to key performance indicators, ensuring sensitivity and prompt specimen collection, demonstrates that AFP surveillance is proficient in detecting poliovirus in China. As we move into the post -eradication phase, AFP surveillance remains crucial for the sustained absence of polioviruses in the long term.

Introduction:The current study aims to assess the performance of data mining techniques in detecting safety signals for adverse events following immunization (AEFI) using routinely obtained data in China. Four different methods for detecting vaccine safety signals were evaluated.Methods:The AEFI data from 2011 to 2015 was collected for our study. We analyzed the data using four different methods to detect signals: the proportional reporting ratio (PRR), reporting odds ratio (ROR), Bayesian confidence propagation neural network (BCPNN), and multi-item gamma Poisson shrinker (MGPS). Each method was evaluated at 1-3 thresholds for positivity. To assess the performance of these methods, we used the published signal rates as gold standards to determine the sensitivity and specificity.Results:The number of identified signals varied from 602 for PRR1 (with a threshold of 1) to 127 for MGPS1. When considering the common reactions as the reference standard, the sensitivity ranged from 0.9% for MGPS1/2 to 38.2% for PRR1/2, and the specificity ranged from 85.2% for PRR1 and ROR1 to 96.7% for MGPS1. When considering the rare reactions as the reference standard, PRR1, PRR2, ROR1, ROR2, and BCPNN exhibited the highest sensitivity (73.3%), while MGPS1 exhibited the highest specificity (96.9%).Discussion:For common reactions, the sensitivities were modest and the specificities were high. For rare reactions, both the sensitivities and specificities were high. Our study provides valuable insights into the selection of signal detection methods and thresholds for AEFI data in China.

[Objective]Congenital heart disease(CHD)is a common birth defect in children,with its incidence increasing annually.Because of their special health status,the vaccination situation for children with CHD has become a focal point of attention.This paper systematically reviews the current status of vaccination among children with CHD in China to identify existing issues in vaccination efforts for children with CHD,provide guidance for increasing vaccination rates among children with CHD,reduce the incidence of vaccine-preventable diseases,and provide ideas for subsequent research.[Methods]Literature on the vaccination of children with CHD in China was searched in both Chinese and English databases,including CNKI,Wanfang Data Knowledge Service Platform,VIP,Chinese Biomedical and Web of Science,PubMed,EmBase,and the Cochrane Library.Relevant literature was identified based on inclusion and exclusion criteria,and data extraction was carried out to summarize the research results.[Results]A total of 15 studies were included.Three articles focusing on expert consensus(guideline recommendations)for vaccination of children with CHD in China all agreed that vaccination is both feasible and necessary for children with CHD.Systematic analysis found that the overall timely vaccination rate for children with CHD was between 34%and 50%,with a notable delay in vaccination.However,after professional outpatient assessment,the vast majority of children with CHD were advised to be vaccinated according to the national recommended schedule,with only about 2%of them being advised to delay vaccination.The proportion of children with CHD who reported suspected adverse events following immunization(AEFI)was low and not significantly different from that of healthy/control children.[Conclusion]The safety of vaccinations for children with CHD in China is relatively high,but the total timely vaccination rate is currently low.In order to improve the coverage and timeliness of vaccination in children with CHD,it is recommended that relevant departments provide vaccination policy support.There is a lack of research on the effectiveness of vaccination in children with CHD,so further studies are urgently needed to further improve the vaccination strategy for children with CHD in China.

Introduction:This study analyzed long-term trends in the incidence of acute hepatitis B (AHB) in China, focusing on age, period, and cohort effects on incidence. Methods:Data on AHB from 2005 to 2021 were extracted from the National Notifiable Disease Reporting System (NNDRS) of China for analysis. Incidences of AHB were calculated by gender and age group using population denominators from the 2000, 2010, and 2020 censuses. Joinpoint regression was employed to evaluate trends, and an age-period-cohort model was used to assess the age, period, and cohort effects. Results:The annual average incidence of reported AHB in children aged 14 years and below in low, intermediate, and high endemic areas decreased from 1.65, 2.33, and 2.56 per 100,000 in 2005-2010 to 0.56, 0.58, and 0.48 per 100,000 in the 2016-2021 period. The 15-39-year age group in high endemic areas exhibited the most significant decline in incidence, dropping from 23.14 per 100,000 in 2005 to 4.59 per 100,000 in 2021 among males and from 10.62 per 100,000 to 3.21 per 100,000 among females. Age-period-cohort analysis indicated decreasing age, period, and cohort effects for reported AHB incidence in each endemic area, except for a slight upward trend in the 15-19-year age group and in the cohort born between 1951 and 1955. Conclusions:This study demonstrated a rapid decline in AHB incidence across various endemic areas since 2005. Children aged 14 years and below exhibited very low AHB incidences, while the incidence among individuals over 15 years was higher. To further reduce AHB incidence, hepatitis B vaccine (HepB) coverage should be enhanced among adolescents and adults.

Measles, an acute respiratory infectious disease caused by the measles virus, was responsible for millions of deaths annually before the introduction of the measles vaccine (MV) ( 1 ). Widespread availability of measles vaccines and the initiation of the Expanded Program on Immunization, approved at the 27th World Health Assembly in 1974 ( 2 ), have significantly improved global measles control. In China, measles has been

What is already known on this topic?:Chronic obstructive pulmonary disease (COPD) exacerbations increase household economic burden, but there is limited evidence from prospective cohort studies in China about the impact of vaccination on economic burden.What is added by this report?:This study demonstrated the economic burden of COPD exacerbations, pneumonia, and hospitalization in COPD patients in China is substantial. Influenza vaccine and 23-valent pneumococcal polysaccharide vaccine (PPSV23), separately or together, were significantly associated with decreased economic burden.What are the implications for public health practice?:Our study supports evidence on recommendations that COPD patients in China are offered both influenza vaccine and PPSV23.

Herpes zoster（HZ） is a serious public health problem threatening the health of human beings. As the global population ages and HZ vaccine use increases, many countries and regions have updated HZ vaccine recommendations and published new, relevant research data. In this paper, we systematically review clinical characteristics, epidemiology, risk factors, and disease burden of HZ based on recent national and international research to deliver the latest knowledge about HZ to clinicians and disease control and vaccination staff, improve HZ prevention and control, and provide evidence-based reference for the use of HZ vaccine.

目的 了解北京市某养老机构老年群体肺炎球菌多糖疫苗接种情况,分析对该疫苗安全性和有效性的认同情况及相关影响因素,为探索我国老年人群中较低肺炎球菌疫苗接种率的原因,制定科普宣传策略和寻找宣教干预重点提供参考依据.方法 自行设计调查问卷于2021年3月对北京市某养老机构中≥60岁的老年人进行面对面调查,将调查对象同时认为肺炎球菌多糖疫苗是安全且有效,定义为"认同",并对数据进行分析.结果 共纳入297名调查对象,中位年龄是83岁,文化程度在大专及以上的有242人(占81.48％).年龄≥80岁、有北京户籍、有肺炎球菌多糖疫苗接种史、了解肺炎疾病危害的老年人不认同肺炎球菌多糖疫苗安全性和有效性的可能性分别是年龄＜80岁、无北京户籍、无肺炎球菌多糖疫苗接种史、不了解肺炎疾病危害者的 1.827 倍(95％CI:1.056～3.160)、0.493 倍(95％CI:0.264～0.921)、0.574 倍(95％CI:0.335～0.983)和0.457倍(95％CI:0.214～0.976)(均P＜0.05).结论 将年龄≥80岁、外地户籍、无肺炎球菌多糖疫苗接种史、不了解肺炎疾病危害的老年人群作为重点宣教对象,宣教内容应注重疾病危害、疫苗的安全性和有效性,采用多种科普宣传策略增加老年人群对疫苗的了解程度,可能会对北京市老年群体提高对该疫苗的认同程度和疫苗接种率起到积极推进作用.

A comprehensive review of the research of the effectiveness of influenza vaccine and 23 valent pneumococcal polysaccharide vaccine (PPV23) in patients with chronic obstructive pulmonary disease (COPD) both at home and abroad in recent years showed that influenza vaccine and PPV23 immunization can significantly reduce the risk for influenza and pneumonia in COPD patients, and reduce the acute exacerbation of disease and related hospitalization. In particular, the influenza vaccination can also reduce the risk for ischemic heart disease, acute coronary syndrome, ventricular arrhythmia, lung cancer, dementia and death in the patients, and the immunization of both vaccines has a more significant protective effect. It is recommended by authoritative guidelines both at home and abroad that COPD patients can receive influenza vaccine and PPV23. At present, the coverage of domestic influenza and pneumococcal vaccines are low, and there are less studies in the applications of both vaccines in patients with COPD. Effective measures should be taken to strengthen the health education and increase the vaccination coverage. Additionally, the clinical research of influenza vaccine and PPV23 for COPD patients, especially the analysis on clinical benefit of immunization of both vaccines, should be further strengthened to effectively improve the survival and prognosis of COPD patients.

Background and objective: Single-study evidence of separate and combined effectiveness of influenza and pneumococcal vaccination in patients with chronic obstructive pulmonary disease (COPD) is limited. To fill this gap, we studied the effectiveness of trivalent seasonal influenza vaccine (TIV) and 23-valent pneumococcal polysaccharide vaccine (PPSV23), separately and together, at preventing adverse COPD outcomes. Methods: Our study used a self-controlled, before-and-after cohort design to assess the effectiveness of TIV and PPSV23 in COPD patients. Patients were recruited from hospitals in Tangshan City, Hebei Province, China. Subjects self-selected into one of the three vaccination schedules: TIV group, PPSV23 group and TIV&PPSV23 group. We used a physician-completed, medical record-verified questionnaire to obtain data on acute exacerbations of COPD (AECOPD), pneumonia and related hospitalization. Vaccine effectiveness was determined by comparing COPD outcomes before and after vaccination, controlling for potential confounding using Cox regression. Results: We recruited 474 COPD patients, of whom 109 received TIV, 69 received PPSV23 and 296 received TIV and PPSV23. Overall effectiveness for preventing AECOPD, pneumonia and related hospitalization were respectively 70%, 59% and 58% in the TIV group; 54%, 53% and 46% in the PPSV23 group; and 72%, 73% and 69% in the TIV&PPSV23 group. The vaccine effectiveness without COVID-19 non-pharmaceutical intervention period were 84%, 77% and 88% in the TIV group; 63%, 74% and 66% in the PPSV23 group; and 82%, 83% and 91% in the TIV&PPSV23 group. Conclusion: Influenza vaccination and PPSV23 vaccination, separately and together, can effectively reduce the risk of AECOPD, pneumonia and related hospitalization. Effectiveness for preventing AECOPD was the greatest.

目的 评价慢性阻塞性肺疾病(COPD)患者接种三价季节性流感疫苗(TIV)和23价肺炎球菌多糖疫苗(PPV23)的安全性.方法 在河北省唐山市10家医院招募COPD患者,接种1剂次TIV和/或1剂次PPV23,主动观察接种后28d不良事件,分析不良事件发生率.结果 COPD患者接种TIV、PPV23后不良事件总发生率分别为5.13％(22/429)、6.44％ (25/388),其中局部不良事件发生率分别为2.80％(12例)、6.19％(24例),全身不良事件发生率分别为2.33％(10例)、0.26％(1例).两种疫苗最常见的局部不良事件均为接种部位疼痛,发生率分别为2.80％(12例)、6.19％(24例),最常见的全身不良事件为发热,发生率分别为1.63％(7例)、0.26％(1例).所有不良事件的严重程度均为1级或2级.结论 本研究COPD患者接种1剂次TIV和PPV23的安全性良好.