Streptococcus pneumoniae remains a global health concern, causing diseases from sinusitis, otitis media, to invasive pneumococcal diseases (IPD), such as bacteremia, bacteremic pneumonia, empyema, and meningitis. Key IPD risk factors include age under five or over 50 years, chronic medical conditions, and lifestyle factors. In Taiwan, IPD incidence has declined following national immunization program. However, morbidity and mortality remain substantial, particularly among older adults. There are two types of pneumococcal vaccines, polysaccharide conjugate vaccines (PCV) and pneumococcal polysaccharide vaccines (PPSV). These vaccines target specific IPD serotypes but may lead to serotype replacement. In Taiwan, the available/forthcoming vaccines include PCV13, PCV15, PCV20, PCV21, and PPSV23, with numbers indicating serotype coverage. This guidance, developed and endorsed by eight national academic societies, serves as an adjunct to the Taiwan Advisory Committee on Immunization Practices recommendations. Using the GRADE framework, it provides evidence-based recommendations for adult pneumococcal vaccination. It emphasizes health promotion to assist healthcare professionals in vaccine selection tailored to current local epidemiology and individual vaccination history. A shared decision-making approach is encouraged, considering individual vulnerabilities, exposure risks, and lifestyle factors. This guidance addresses optimal timing, dosing schedules, coadministration, and safety; grounded in immunological evidence on efficacy, effectiveness, and immunogenicity. In recognition of feasibility of implementation, single-dose PCV20 or PCV21 is proposed as a simplified alternative to complex sequential strategies. However, PCV21 is recommended only where PCV7 serotypes are well controlled or no longer prevalent. This guidance reflects evolving pneumococcal vaccination strategies in response to serotype dynamics and availability of higher-valency conjugate vaccines.

BACKGROUND:Respiratory syncytial virus (RSV) is a leading cause of respiratory infections in infants and young children. The COVID-19 pandemic significantly disrupted global RSV epidemiology. This study aimed to investigate the impact of the pandemic on RSV epidemiology in northern Taiwan from 2018 to 2023. METHODS:We retrospectively enrolled children aged <5 years with positive RSV antigen tests from 2018 to 2023, dividing into four study periods based on the COVID-19 pandemic timeline: 2018-2019, 2020-2021, 2022, 2023. RESULTS:The number of RSV positive cases was 1155 in 2018-2019, 780 in 2020-2021, 784 in 2022, and 1116 in 2023. The proportion of RSV-positive children aged 2-5 years increased progressively from 23.9 % (2018-2019) to 52.0 % (2023) (P < 0.001). The mean age of infected children increased over time (P < 0.001). Among children under 2 years old, hospitalization rates declined from 82.0 % (2018-2019) to 68.1 % (2023) in subsequent intervals (P < 0.001). Compared to 2018-2019, seasonal peaks delayed by 2 months in 2020, absent in 2021, and delayed by 3 and 2 months in 2022 and 2023, respectively. The RSV seasonal peaks varied with shortened peaks during the COVID pandemic. ICU admission rates declined from 2.9 % to 1.9 % while mortality declined from 0.2 % to 0 %. Independent risk factors for severe disease included age under 3 months, bronchopulmonary dysplasia, congenital heart disease, cerebral palsy, neurodevelopmental disorders, and co-infection with Streptococcus pneumoniae. CONCLUSIONS:The COVID-19 pandemic significantly altered the seasonality and clinical characteristics of RSV infections in northern Taiwan, likely due to the varying intensity of public health interventions.

The treatment of infantile hydrocephalus required consideration of age and etiology, as well as close follow-up and care. Cranial ultrasound examination is a noninvasive, operable, and cost-effective tool for assessing brain anatomy and establishing a diagnosis in neonates and infants. Because the success rates of endoscopic third ventriculostomy (ETV) for infantile hydrocephalus ranged widely between 40% and 90%, regular cranial ultrasound examinations are necessary after ETV due to the risk of higher failure rate in younger infants. This report presents two newborn cases of hydrocephalus presenting with aqueductal stenosis. Due to early detection of progressive ventricular dilatation, both require additional shunt treatment following failed ETV. These cases highlight the challenges of the diverse etiologies of infantile hydrocephalus and the importance of not ignoring the progression of the disease.

Kawasaki disease (KD), also known as mucocutaneous lymph node syndrome, is a leading cause of vasculitis in children aged < 5 years. The HLA complex has been investigated for its association with KD since 1978 without conclusive results due to limitations such as small sample sizes. This study aimed to evaluate the associations and genetic linkage between HLA-DRB1 and KD, as well as its complications. The case-control and family-based studies enrolled 795 patients with KD and 946 healthy controls. Of the 795 patients, 180 trios were included. Genotypes of HLA-DRB1 were identified by sequence-based typing according to the International ImMunoGeneTics database. Allele frequencies were calculated using PyPop 7.0. The transmission/disequilibrium test (TDT) was used to verify the genetic linkage between HLA-DRB1 and KD. HLA-DRB1*15:01 was significantly associated with KD (OR, 1.44, Pc = 0.03) and with KD without CALs (OR = 1.46, Pc = 0.04). HLA-DRB1*14:01 was a risk factor for KD with CALs (OR = 2.47, Pc = 0.004) whereas HLA-DRB1*12:02 was a protective factor against CALs (OR = 0.49, Pc = 0.01). In the family-based study, HLA-DRB1*15:01 demonstrated significant overtransmission to KD patients (OR = 3.35; 95% CI, 2.20-5.78; Pc = 1.19E-06) and to KD patients without CALs (OR = 4.42; 95% CI, 2.59-10.08; Pc = 6.24E-06). The overtransmission remained significant in male KD patients (OR = 2.81; 95% CI, 1.68-5.58; Pc = 0.003), and in male KD patients without CALs (OR = 3.22; 95% CI, 1.69-8.84; Pc = 0.02). Our study identified significant associations between HLA-DRB1*15:01, *14:01, and *12:02 with KD. The association between HLA-DRB1*15:01 and KD was further verified by TDT, indicating a genetic linkage between the HLA-DRB1 locus and KD susceptibility.

Melioidosis, caused by Burkholderia pseudomallei, is a potentially fatal bacterial infection endemic to Southeast Asia and northern Australia. The disease often resurges after extreme weather events, such as typhoons. In this study, we investigated the epidemiological trends of melioidosis in Taiwan from 2015 to 2024, focusing on the impact of typhoon-associated precipitation. A total of 396 confirmed cases were reported over the decade, with 123 cases (31.1%) occurring in 2024 alone. Statistical analysis revealed a weak but significant correlation between precipitation and melioidosis incidence (Spearman rho: 0.275, P = 0.002), whereas leptospirosis incidence exhibited a stronger correlation with rainfall (Spearman rho: 0.477, P <0.01). These findings suggest that although increased rainfall may facilitate the dissemination of B. pseudomallei, other environmental and host-related factors likely contribute to disease outbreaks. A multiple linear regression analysis was performed to identify the relationship between meteorological and socioeconomic variables and the log-transformed melioidosis incidence across regions. Among the predictors, 10-minute sustained wind speed was significantly associated with higher melioidosis incidence (β = 1.769, P = 0.025), whereas maximum wind speed showed a significant negative association (β = -1.366, P = 0.049). Given the potential influence of climate change and globalization on infectious disease transmission, continuous surveillance and proactive public health measures are essential to mitigate future outbreaks. Physicians should remain vigilant for melioidosis and leptospirosis, particularly after typhoons and among travelers returning from affected regions.

BACKGROUND:Respiratory syncytial virus (RSV) is a major cause of infant hospitalizations, with limited prophylactic options historically available. Nirsevimab, a long-acting monoclonal antibody, has emerged as a promising agent for preventing RSV. OBJECTIVE:To evaluate the efficacy and safety of nirsevimab through a systematic review and meta-analysis of randomized controlled trials (RCTs) and investigate current global recommendations. METHODS:Databases, including PubMed, Embase, and Cochrane CENTRAL, were searched from inception to January 31, 2025. Eligible RCTs assessing nirsevimab efficacy in RSV prevention were included. Outcomes encompassed RSV-related hospitalization, severe infection, and adverse events. Meta-analysis employed random-effects models. RESULTS:Six RCTs (n = 12,086) were included. Nirsevimab significantly reduced RSV-related hospitalization (odds ratio [OR], 0.19; 95 % confidence interval [CI], 0.13-0.30) and severe RSV infection (OR, 0.23; 95 % CI, 0.12-0.44), with no increase in adverse events. Country-specific recommendations varied, ranging from seasonal to year-round strategies. CONCLUSION:Nirsevimab exhibits excellent efficacy and safety in RSV prevention. Although most countries align administration with RSV seasonality, Taiwan distinctively endorses year-round prophylaxis. Customized immunization policies considering local epidemiology and seasonality may optimize protection and inform global RSV prevention strategies.

Human papillomavirus (HPV) is the most prevalent viral infection globally, transmitted primarily through sexual or intimate skin-to-skin contact. Certain HPV types can cause anogenital warts and has the potential to cause cervical cancer, other anogenital, and oropharyngeal cancers. Adjuvanted, non-live, HPV recombinant vaccines, including the bivalent, quadrivalent, and 9-valent vaccines, are widely recommended for adolescents and young adults to prevent HPV infection and lower the incidence of HPV-related cancers. However, recommendations for adults aged 26 years or older have been lacking due to insufficient evidence until recently. The Working Group on Adult Immunization Practice of the Infectious Diseases Society of Taiwan (IDSTAIP working group) addressed this gap and drafted recommendations for HPV vaccination in adults using the Grading of Recommendation, Assessment, Development and Evaluation (GRADE) system. These recommendations were then reviewed and revised by expert panels and endorsed by eight national medical societies. This document is positioned as a guidance to provide recommendations for HPV vaccination in adults, considering gender, age, immune status, and prior HPV vaccination history. Safety evaluations, dosing schedules, and special considerations regarding the occupational exposure of healthcare providers, based on potential modes of HPV transmission, are provided. In summary, a 3-dose HPV vaccination schedule is recommended for all adults through age 45 years, regardless of sex, to prevent genital warts, anogenital cancers, as well as oropharyngeal infections and cancers. This guidance serves to assist healthcare providers in facilitating shared decision-making but does not supersede clinical judgment in assessing individual risk and making specific recommendations.

The potential adverse effects of coronavirus disease 2019 (COVID-19) vaccinations raise public concerns. Data from Taiwan’s Vaccine Injury Compensation Program (VICP) can provide valuable insights. This study analyzed the preliminary application data for COVID-19 vaccine compensation in Taiwan’s VICP, focusing on applicants receiving vaccines between March 2021 and June 2022. Among the 2941 adverse events, 113 cases (3.8%) were deemed causally associated with vaccination, 313 (10.6%) were indeterminate, and 2515 (85.5%) had no causal association. Nearly half (47.6%) of the applicants were over 60 years old, and 76.6% had a history of pre-existing chronic diseases. Among the 426 vaccine-associated or indeterminate cases, the most common causes were hematological diseases and thrombosis. There were 920 mortality cases reported, and 97.4% were unassociated with vaccination. Only five deaths were judged to be associated with the COVID-19 vaccination, all involving the adenovirus vector vaccine and thrombosis with thrombocytopenia syndrome. In conclusion, most compensation applications were not causally linked to vaccination. Compared to other countries, the number of applications in Taiwan’s VICP is relatively high. These findings may indicate a need to adjust the application requirements for compensation in Taiwan’s program.

Abstract Background Safe and effective respiratory syncytial virus (RSV) vaccines remain elusive. This was a phase I/II trial (NCT02927873) of ChAd155-RSV, an investigational chimpanzee adenovirus-RSV vaccine expressing 3 proteins (fusion, nucleoprotein, and M2-1), administered to 12–23-month-old RSV-seropositive children followed up for 2 years after vaccination. Methods Children were randomized to receive 2 doses of ChAd155-RSV or placebo (at a 1:1 ratio) (days 1 and 31). Doses escalated from 0.5 × 1010 (low dose [LD]) to 1.5 × 1010 (medium dose [MD]) to 5 × 1010 (high dose [HD]) viral particles after safety assessment. Study end points included anti–RSV-A neutralizing antibody (Nab) titers through year 1 and safety through year 2. Results Eighty-two participants were vaccinated, including 11, 14, and 18 in the RSV-LD, RSV-MD, and RSV-HD groups, respectively, and 39 in the placebo groups. Solicited adverse events were similar across groups, except for fever (more frequent with RSV-HD). Most fevers were mild (≤38.5°C). No vaccine-related serious adverse events or RSV-related hospitalizations were reported. There was a dose-dependent increase in RSV-A Nab titers in all groups after dose 1, without further increase after dose 2. RSV-A Nab titers remained higher than prevaccination levels at year 1. Conclusions Three ChAd155-RSV dosages were found to be well tolerated. A dose-dependent immune response was observed after dose 1, with no observed booster effect after dose 2. Further investigation of ChAd155-RSV in RSV-seronegative children is warranted. Clinical Trials Registration NCT02927873.

Background Children are susceptible to severe or fatal enterovirus 71 (EV71) infections. We aimed to evaluate the efficacy, safety, and immunogenicity of EV71vac, an aluminium phosphate-adjuvanted inactivated EV71 vaccine in children aged 2-71 months. Methods We did a randomised, double-blinded, placebo-controlled, phase 3 trial at five hospitals in Taiwan and two in Vietnam. Children aged 2-71 months were stratified by country and age, and randomly assigned (1:1) to receive two doses of EV71vac or placebo via intramuscular injection 56 days apart. Children aged 2-23 months received a third booster dose on day 366. The primary endpoint was the clinical efficacy of the total vaccinated cohort against EV71-associated diseases during the follow-up period, from 14 days after the second dose to when 15 cases of EV71 infections were confirmed in the per-protocol population. Our safety analysis included all participants who received at least one dose of EV71vac. This trial is registered with ClinicalTrials.gov, NCT03865238, and is complete. Findings Between April 23 and Dec 25, 2019, of 3663 children assessed, 3061 were randomly assigned, of whom 3049 were vaccinated: 1521 children in the EV71vac group and 1528 in the placebo group. By May 20, 2021, our primary efficacy analysis included 2959 children, with 1476 children in the EV71vac group and 1483 children in the placebo group. The vaccine efficacy of EV71vac was 96middot8% (95% CI 85middot5-100) against EV71 associated diseases (p<0middot0001). The percentage of participants who reported solicited adverse events were similar in both groups: 865 (56middot9%) in the EV71vac group and 852 (55middot8%) in the placebo group. Almost all reported solicited adverse events were mild and self-limited. Interpretation EV71vac is safe, well-tolerated, and highly effective in preventing EV71 associated diseases in children aged 2-71 months. Funding Medigen Vaccine Biologics and A+ Industrial Innovative R&D Program of the Ministry of Economic Affairs, Taiwan. Copyright (c) 2022 Elsevier Ltd. All rights reserved.

Purpose: This study examined the efficacy of prescribing antibiotics, specifically a single dose of vancomycin, in reducing the incidence of culture-positive and culture-negative sepsis prior to the removal of peripherally inserted central catheters (PICCs). Materials and methods: We retrospectively reviewed charts of infants who had PICCs in a ter-tiary level hospital during the period from 2010 to 2019. The incidence of post-catheter removal clinical sepsis between the groups with or without antibiotics was compared. The anti-biotic group was defined by receiving a single dose of vancomycin or any other antibiotic prior to line removal. Results: We enrolled 585 PICC removal episodes in 546 infants for analysis. Antibiotics were given prior to removal in 257 cases (43.9% ) and not given prior to removal in 328 cases (56.1%). There were 13 episodes of post-catheter removal clinical sepsis detected within 72 h (2.2%), 2 of which were culture-positive (0.3%). A 9.3-fold decrease in the odds for clinical sepsis was observed in the antibiotic group (p Z 0.01). The incidence of post-catheter removal sepsis was decreased by a single prophylactic dose of vancomycin (p = 0.02), whereas the use of other antibiotics showed no effect (p = 0.35). Logistic regression analysis demonstrated that comorbidities with gastrointestinal diseases (p = 0.01), PICC insertion sites in the scalp and neck (p = 0.04), and no vancomycin administration prior to line removal (p = 0.02) were independent risk factors for subsequent clinical sepsis.Conclusion: A single prophylactic dose of vancomycin prior to PICC line removal might reduce clinical sepsis events in infants.Copyright 2021, Taiwan Society of Microbiology. Published by Elsevier Taiwan LLC. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

Adolescents and children play an important role in SARS-CoV-2 transmission and epidemiology. MVC-COV1901 is a subunit SARS-CoV-2 vaccine based on stabilized spike protein adjuvanted with CpG 1018 and aluminum hydroxide that has received emergency use approval (EUA) for adults in Taiwan. In this study, we have investigated the safety and immunogenicity of two doses of MVC-COV1901 in adolescents. Healthy adolescents from the age of 12–17 years were randomly assigned to receive two intramuscular doses of either MVC-COV1901 or placebo at 28 days apart. Adverse events were mostly mild and were similar in MVC-COV1901 and placebo groups, with the most commonly reported adverse events being pain/tenderness and malaise/fatigue. All immunogenicity endpoints in the adolescent group were non-inferior to the endpoints seen in the young adult and placebo groups. The results here advocate the use of MVC-COV1901 in adolescents in the ongoing efforts to control the pandemic. ClinicalTrials.gov registration : NCT04951388.

BackgroundCOVID-19 vaccines have been highly effective in reducing morbidity and mortality during the pandemic. While primary series vaccination rates are generally high in Southeast Asian (SEA) countries, various factors have limited the rollout and impact of booster doses. MethodsTo objectively review the evidence for vaccine effectiveness (VE), we extracted data from 79 studies identified in the publicly-available International Vaccine Access Center (IVAC) VIEW-hub platform reporting VE after a primary immunisation with two-dose schedules for three important clinical outcomes. We evaluated VE after primary immunisation against SARS-CoV-2 infection, and COVID-19-related hospitalisations and deaths for the most widely reported vaccines, stratified across variants of concern (VOC), age, study design and prior SARS-CoV-2 infection. The majority of studies evaluated mRNA vaccines (58 BNT162b2 studies, 34 mRNA-1273 studies and 14 combinations of both) and vector vaccines [25 COVID-19 Vaccine AstraZeneca, Vaxzevria studies (AZD1222)] with only 5 other studies available (all CoronaVac). For simplicity, mRNA studies were grouped together irrespective of which vaccine was used. VE point estimates were presented graphically with pooled means and confidence intervals were compared using standard t-tests for expert discussion.FindingsVE was high and equally effective for both AZD1222 and mRNA vaccines types (91%-93%) in protecting against hospitalisation and death from COVID-19, regardless of age. VE against symptomatic infections trended higher (though not significantly) for mRNA-based vaccines compared to AZD1222. Waning of VE since time of vaccination was observed for symptomatic infections but was limited for serious COVID-19 outcomes. A sub-analysis of studies with comparative arms evaluating the VE of different vaccines in the same settings also confirmed these observations for all VOC assessed, with all vaccines conferring a high level of protection against serious outcomes. For Omicron, there is limited comparative data within the IVAC dataset, however, expert review of emerging data suggests that VE against all outcomes is lower for all COVID-19 vaccines, than for the Delta variant. Importantly, data from the UK indicates that VE improves with a booster dose and that VE continues to be very similar, irrespective of the type of vaccine used. Importantly, all COVID-19 vaccines evaluated here have favourable benefit/risk profiles. Interpretation Our review of the robust real-world VE data collated through the IVAC VIEW-hub platform confirms that the most studied COVID-19 vaccines in this database provide consistently high (>90%) protection against serious clinical outcomes like hospitalisations and deaths, and regardless of variant. Additionally, our observation that this protection appears equivalent for mRNA vaccines and vector vaccines like AZD1222 is supported by our analysis of local Asian and relevant international data, and by insights from SEA experts. Given the continued impact of COVID-19 hospitalisations and deaths on healthcare systems worldwide, encouraging vaccination strategies that can reduce this burden is more relevant than attempting to prevent broader but milder infections with specific variants, including Omicron. What this study adds This additional context reinforces the value of real-world evidence to support efforts advocating for the completion of primary series and booster vaccinations where appropriate, especially to restore VE against emerging VOC such as Omicron. However, data gaps still persist, given the lag between the emergence of new variants, updated vaccine schedules and VE data to inform their impact.

BACKGROUND:During the COVID-19 pandemic, the need for influenza vaccine significantly increased in the initial weeks of the 2020-2021 influenza vaccination campaign season in Taiwan. To meet this demand, the Taiwanese government therefore purchased additional influenza vaccines via special import, including 350,000 doses of quadrivalent recombinant influenza vaccines (RIV4, Flublok Quadrivalent). Approved in the United States since 2016, there were limited numbers of published studies regarding RIV4 outside America. We utilized the national passive surveillance system consisting adverse event (AE) reports following RIV4 immunization to describe its safety profiles in Taiwan. METHODS:We obtained the database from the Taiwan National Adverse Drugs Reactions Reporting System and collected reports from January 2021 to July 2021, which was at least one month after RIV4 immunization. AE reporting rates were calculated based on the total administered doses. RESULTS:Eight AEs were reported among 200,287 administered doses, which led to a reporting rate of 3.99 AEs per 100,000 doses administered. The mean age of the reported individuals were 47.53 years, and women (75%) were the predominant gender. Most adverse events started within the first day after immunization, with one reported as starting 4 days after vaccination. Among the 8 cases, 75% (n = 6) were non-serious and the most common symptoms were erythematous skin rashes with pruritus. Two cases were listed as serious based on the criteria of "other clinically significant medical conditions", but neither was judged to have a causal relationship with RIV4 immunization. CONCLUSION:The Taiwan national passive surveillance data supported the safety profiles of RIV4 in Taiwan population.

Although past studies have identified predictors related to child injuries with developmental disorders, national-level research in Asia is limited. The objective of this study was to explore the risk factors for child injuries with developmental disorders in Taiwan using a national-level integrated database for the period between 2004–2015 (The Maternal and Child Health Database, National Health Insurance Research Database, Census Registry, and Indigenous Household Registration). Children younger than 12 years old who had records of visiting the ER or being hospitalized due to injury or without injury were included in this study. A 1:1 nested case-control study (injury vs. noninjury) to examine the risk factors for child injury with developmental disorder was performed. A total of 2,167,930 children were enrolled. The risk factors were associated with repeated ER visits or hospitalization: being indigenous (adjusted odds ratio [AOR]: 1.51; CI: 1.45–1.57); having a developmental disorder (AOR: 1.74; CI: 1.70–1.78); and having parents with illicit drug use (AOR: 1.48; CI: 1.32–1.66), alcohol abuse (AOR: 1.21; CI: 1.07–1.37), or a history of mental illness (AOR: 1.43; CI: 1.41–1.46). Being indigenous, having developmental disorders, and having parents with history of illicit drug use, alcohol abuse, or mental illness were predictors related to injuries in children.

Introduction COVID-19 vaccines have been highly effective in reducing morbidity and mortality during the pandemic. While primary series vaccination rates are generally high in Southeast Asian (SEA) countries, various factors have limited the rollout and impact of booster doses. Areas covered We reviewed 79 studies in the International Vaccine Access Center (IVAC) VIEW-hub platform on vaccine effectiveness (VE) after primary immunizations with two-dose schedules. VE data were reported for SARS-CoV-2 infection, COVID-19-related hospitalizations and deaths, and stratified across variants of concern, age, study design and prior SARS-CoV-2 infection for mRNA vaccines (BNT162b2, mRNA-1273, and combinations of both), vector vaccines (AstraZeneca, AZD1222 [ChAdOx1 nCoV-19] 'Vaxzevria'), and inactivated virus vaccines (CoronaVac). Expert opinion The most-studied COVID-19 vaccines provide consistently high (>90%) protection against serious clinical outcomes like hospitalizations and deaths, regardless of variant. Additionally, this protection appears equivalent for mRNA vaccines and vector vaccines like AZD1222, as supported by our analysis of Asian and relevant international data, and by insights from SEA experts. Given the continued impact of COVID-19 hospitalizations and deaths on health-care systems worldwide, encouraging vaccination strategies that reduce this burden is more relevant than attempting to prevent broader but milder infections with specific variants, including Omicron.

Introduction COVID-19 vaccines have been highly effective in reducing morbidity and mortality during the pandemic. However, the emergence of the Omicron variant and subvariants as the globally dominant strains have raised doubts about the effectiveness of currently available vaccines and prompted debate about potential future vaccination strategies. Areas covered Using the publicly available IVAC VIEW-hub platform, we reviewed 52 studies on vaccine effectiveness (VE) after booster vaccinations. VE were reported for SARS-CoV-2 symptomatic infection, severe disease and death and stratified by vaccine schedule and age. In addition, a non-systematic literature review of safety was performed to identify single or multi-country studies investigating adverse event rates for at least two of the currently available COVID-19 vaccines. Expert opinion Booster shots of the current COVID-19 vaccines provide consistently high protection against Omicron-related severe disease and death. Additionally, this protection appears to be conserved for at least 3 months, with a small but significant waning after that. The positive risk-benefit ratio of these vaccines is well established, giving us confidence to administer additional doses as required. Future vaccination strategies will likely include a combination of schedules based on risk profile, as overly frequent boosting may be neither beneficial nor sustainable for the general population.

The coronavirus disease 2019 (COVID-19) pandemic has had substantial impacts, including disruptions in routine vaccinations. In Taiwan, COVID-19 was relatively controllable, and the reduction in routine vaccinations was not profound. The impact of the pandemic on vaccination remained unclear. We collected vaccination uptake data at our hospital and analyzed the weekly trends of different vaccines. We calculated the monthly number of vaccinations and compared consumption before and during the COVID-19 pandemic (year 2019 vs years 2020 and 2021). Except for self-paid pneumococcal conjugate vaccines (PCV13), a mild (14.6%, p < .001) monthly decrease in government-funded routine vaccination and a moderate (28.2%, p = .018) monthly decrease in self-paid vaccination were observed during the COVID-19 pandemic. Interestingly, an unexpected surge of PCV13 vaccination occurred with a 355.8% increase. The shortage of COVID-19 vaccines and the potential benefits of PCV13 against COVID-19 may have contributed to this surge. In conclusion, our study found an obvious disruption of vaccination rates in Taiwan during the COVID-19 epidemic. However, an increase in PCV13 vaccination was also observed, and the important role of the infodemic was emphasized.

San Lazaro Hospital, Manila, Philippines; Infectious Diseases Unit, Facultad de Medicina, Universidad Nacional de Colombia, Bogotá, Colombia; Faculty of Medicine Universitas Indonesia, RSUP Persahabatan, Jakarta, Indonesia; Faculty of Public Health, Chiang Mai University, Chiang Mai, Thailand; MacKay Memorial Hospital, Taipei, Taiwan; National Vaccine Institute, Nonthaburi, Thailand; University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam; China Medical University Children’s Hospital, Taichung, Taiwan; Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand; Department of Pediatrics, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan; Philippine Children’s Medical Center, Manila, Philippines; Universidad de Guanajuato, Guanajuato, Mexico; Institute Pasteur, Ho Chi Minh City, Vietnam; College of Medicine Philippine General Hospital, University of the Philippines, Manila, Philippines; Hospital Materno Perinatal Monica Pretelini Sáez, Toluca de Lerdo, México; Santa Joana Hospital and Maternity, the Institute of Infectious Diseases Emílio Ribas in Sao Paulo, Sao Paulo, Brazil; Grupo de Investigacion Biomedicina, Faculty of Medicine, Fundacion Universitaria Autónoma de las Americas, Pereira, Colombia; Master of Clinical Epidemiology and Biostatistics, Universidad Cientifica del Sur, Lima, Peru; Santa Casa de Sao Paulo School of Medical Sciences, Sao Paulo, Brazil; Division of Infectious Diseases and Tropical Pediatrics, Department of Child Health Medical Faculty, University of Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia