Seasonal influenza poses an enormous burden worldwide, with older adults facing preventable morbidity and mortality. However, seasonal influenza vaccination coverage is poor among older populations in China. Pay-it-forward (giving a person a free vaccine and an opportunity to donate to support others) and financial incentives (e.g. free vaccination) could be effective in improving influenza vaccine uptake, but there are no prospective comparisons of these two strategies among older adults. The proposed study aims to compare the effectiveness of the pay-it-forward strategy in increasing influenza vaccination against free vaccination and user-paid vaccination among older adults in China. This study is a three-arm cluster randomized controlled trial, which will be conducted in 21 community health centers across seven cities in China. A total of 1113 eligible older adults aged ≥ 60 years will be recruited. Three clusters in each city (total of 21 clusters in 7 cities) will be randomized into three arms in a 1:1:1 ratio, including (1) pay-it-forward arm: free vaccination and participants donate any amount of money to help other people; (2) free vaccination arm; and (3) standard-of-care arm (user-paid vaccination). The primary outcome is influenza vaccination verified by administrative records. Secondary outcomes include willingness to be vaccinated, willingness to donate, amount of donation, and incremental cost-effectiveness ratio. The primary outcome will be calculated for each arm and compared using one-way variance analysis. This study will examine the effectiveness of pay-it-forward strategy in comparison to the free vaccination and user-paid vaccination in improving influenza vaccination among older adults. Our findings will provide insights into better strategies for enhancing influenza vaccination, and support evidence-based policy decisions for promoting influenza vaccination. Chinese Clinical Trial Registry (No. ChiCTR2400086840). Registered on 11 July 2024.

BackgroundThe benefits of improving coverage and timeliness of varicella vaccination need to be quantified in countries where varicella vaccine (VarV) has not yet been included in national immunization programs. This longitudinal study analyzed the vaccine effectiveness (VE) of the varicella vaccination program implemented in Changzhou City during the transitional period (2017-2022).MethodsUsing the Immunization Information System and National Notifiable Infectious Disease Surveillance System registry data, this retrospective case-cohort study assessed the VEs of varicella vaccination for Changzhou children born from 2016 to 2021. The subcohort was sampled using inverse probability weighting for the survival analysis design to evaluate the VEs under different dosages and cost types, eliminating confounding by age and location area. Sensitivity analysis for the exclusion part assessed the study's robustness.ResultsA total of 5,172 children (1.12%) were sampled to the subcohort for studies, including 2,299 cases. VEs significantly rose with each successive dose, reaching 82.54% and 97.91%. VEs were lower for the single-dose subgroups until 2020, with significant increases in VEs in all subgroups in 2020 and after that. Most children who did not benefit from the "1-4" Vaccination Program had lower VEs due to delayed vaccination.ConclusionImproving 2-dose VarV vaccine coverage and timely vaccination could enhance the immune barrier for susceptible children. During the transitional period, the "1-4" Vaccination Program of VarV positively impacted coverage and timeliness in Changzhou.

Background Although 13-valent pneumococcal conjugate vaccine (PCV13) is available in China's private market, it has yet to be introduced into the National Immunization Programme (NIP) and is therefore not available to large parts of the population. This study aimed to estimate the cost-effectiveness of including PCV13 in China's NIP at national and provincial levels.Methods We adopted a decision-tree Markov model to estimate the cost-effectiveness of adding 3-dose PCV13 in the NIP compared to the status quo in the private market from a societal perspective. The model hypothesized a birth cohort for five years after vaccine introduction. Treatment costs and vaccine program costs were calculated from Chinese Center for Disease Control and Prevention (CDC) and national insurance databases. Disease burden data, incidence rate ratios, and other parameters were derived from published and grey literature. Cases and deaths averted, quality-adjusted life years (QALYs) gained, and incremental cost-effectiveness ratios (ICERs) were estimated at the provincial, regional, and national levels. One-way, scenario and probabilistic sensitivity analyses were conducted to explore model uncertainty. Findings At the national level, introducing PCV13 in the NIP was predicted to prevent approximately 4807 pneu-mococcal deaths (66% reduction) and 1,057,650 pneumococcal cases (17% reduction) in the first five years of the 2019 birth cohort. Under the assumed base case price of US$ 25 per dose in the NIP, PCV13 in the NIP was cost-effective nationally with ICER of US$ 5.222 per QALY gained, and was cost-effective in 17 and cost-saving in 4 of the 31 provinces compared to the status quo. One-way and scenario sensitivity analyses indicated robust results when varying all model parameters, and probabilistic sensitivity analysis showed a 98% probability of cost-effectiveness nationally.Interpretation Our findings highlight the cost-effectiveness of introducing PCV13 in China's NIP. Provincial results supported subnational introduction of PCV13, and priority should be given to less socioeconomically developed provinces. Since vaccination cost is the most influential model parameter, efforts to improve PCV affordability after pooled procurement will benefit public health in a cost-effective manner. Health 2023;32: Published December https://doi.org/10. 1016/j.lanwpc.2022. 100666

Chinese government has implemented a series of prevention and control strategies and measures in the face of COVID-19, the spread of the local epidemic has been basically stopped, prevention and control of the epidemic has entered a normal stage. This paper analyzes and summarizes the successful experience of Chinese government in combating the COVID-19 epidemic since January 2020, and puts forward relevant suggestions, adapt to local conditions and apply them to the current fight against the epidemic. It is hoped to provide useful reference for fighting the epidemic under the new situation and contribute wisdom to jointly winning the fight against the virus.

COVID-19 was declared a pandemic by WHO on March 11, 2020, the first non-influenza pandemic, affecting more than 200 countries and areas, with more than 5·9 million cases by May 31, 2020. Countries have developed strategies to deal with the COVID-19 pandemic that fit their epidemiological situations, capacities, and values. We describe China's strategies for prevention and control of COVID-19 (containment and suppression) and their application, from the perspective of the COVID-19 experience to date in China. Although China has contained severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and nearly stopped indigenous transmission, a strong suppression effort must continue to prevent re-establishment of community transmission from importation-related cases. We believe that case finding and management, with identification and quarantine of close contacts, are vitally important containment measures and are essential in China's pathway forward. We describe the next steps planned in China that follow the containment effort. We believe that sharing countries' experiences will help the global community manage the COVID-19 pandemic by identifying what works in the struggle against SARS-CoV-2.

全球通过多技术路线研发新型冠状病毒疫苗以应对新型冠状病毒肺炎疫情,其中重组蛋白疫苗项目数量最多.本文通过综述重组蛋白疫苗的工艺原理、优势和不足,以及乙型肝炎病毒、严重急性呼吸综合征冠状病毒和中东呼吸综合征冠状病毒重组蛋白疫苗研发经验,阐述目前新型冠状病毒重组蛋白疫苗研发现状,总结其预期问题和挑战.