Feasibility and Effectiveness of Vaccines for COVID-19: An Umbrella Review.

Introduction: In January 2020, WHO declared the 2019 Coronavirus Disease (COVID-19) a pandemic. Though COVID-19 vaccines are recommended, ongoing surveillance is crucial due to potential unforeseen events. Evaluation of long-term effectiveness and safety and addressing emerging variants are vital. This study integrates systematic reviews to assess COVID-19 vaccine efficacy, immunogenicity, and safety comprehensively. Methods: This study was an umbrella review study on the feasibility and effectiveness of vaccines for COVID-19. We conducted a comprehensive search in PubMed, Web of Sciences, and Scopus, using MeSH terms and keywords related to COVID-19 vaccines. Inclusion criteria comprised peer-reviewed systematic reviews and meta-analyses in English, focusing on feasibility and effectiveness. Exclusion criteria targeted non-systematic reviews exclusively on vaccine safety and duplicates. Two independent reviewers screened and resolved discrepancies. Data extraction included key details. Methodological quality was assessed using the ROBIS tool. Data synthesis involves narrative and, if applicable, quantitative synthesis (meta-analysis). Reporting followed PRISMA guidelines. Results: A total of 32 systematic reviews were included in the study, of which 20 also conducted a meta-analysis. The studies investigated in the included reviews ranged from 7 to 74. The included articles were conducted in various countries around the globe. The findings indicated that COVID-19 vaccines are generally safe and effective for individuals with various medical conditions. The overall risk of bias for the included studies was assessed as low risk. Conclusion: The study outcomes indicated that mRNA vaccines exhibit a higher incidence of adverse events but demonstrate greater efficacy. Conversely, inactivated and protein subunit vaccines are safer but exhibit lower efficiency. Moreover, the vaccine is considered safe for individuals with specific conditions such as inflammatory bowel disease, solid organ transplant recipients, children, pregnant individuals, and those with hematologic problems. Ultimately, the acceptance of the COVID-19 vaccine among individuals is influenced by various factors, including geographic, socioeconomic, and pandemic-related considerations.

Recent Advances in Nanodrug Delivery Systems Production, Efficacy, Safety, and Toxicity.

In the last three decades, the development of nanoparticles or nano-formulations as drug delivery systems has emerged as a promising tool to overcome the limitations of conventional delivery, potentially to improve the stability and solubility of active molecules, promote their transport across the biological membranes, and prolong circulation times to increase efficacy of a therapy. Despite several nano-formulations having applications in drug delivery, some issues concerning their safety and toxicity are still debated. This chapter describes the recent available information regarding safety, toxicity, and efficacy of nano-formulations for drug delivery. Several key factors can influence the behavior of nanoparticles in a biological environment, and their evaluation is crucial to design non-toxic and effective nano-formulations. Among them, we have focused our attention on materials and methods for their preparation (including the innovative microfluidic technique), mechanisms of interactions with biological systems, purification of nanoparticles, manufacture impurities, and nano-stability. This chapter places emphasis on the utilization of in silico, in vitro, and in vivo models for the assessment and prediction of toxicity associated with these nano-formulations. Furthermore, the chapter includes specific examples of in vitro and in vivo studies conducted on nanoparticles, illustrating their application in this field.

Análise da vacinação contra Covid-19 na população privada de liberdade: estudo ecológico / Covid-19 vaccination analysis in the population deprived of liberty: an ecological study / Análisis de la vacunación contra el Covid-19 en la población privada de libertad: estudio ecológico

Objetivo: analisar o cenário de vacinação contra Covid-19 na população privada de liberdade em um estado do Nordeste brasileiro. Método: estudo do tipo observacional e ecológico, com os dados extraídos do Sistema de informações penitenciário brasileiro e dos boletins publicados pelo Conselho Nacional de Justiça, referentes a outubro de 2021 a junho de 2022, submetidos à análise estatística descritiva, por meio de frequências absolutas e relativas. Resultados: verificou-se que, entre 4.345 pessoas privadas de liberdade com a primeira dose de vacinação contra Covid-19, apenas 573 possuíam a segnda dose e nenhuma a terceira dose. Conclusão: evidenciou-se que, apesar da vacinação ser um benefício, ainda é um grande desafio para ser implementada para a população privada de liberdade, visto que, mesmo sendo considerados grupos prioritários, o acesso a esse direito foi prejudicado para esses indivíduos.

Objective: to analyze the Covid-19 vaccination scenario in the population deprived of liberty in a state in the Brazilian Northeast. Method: observational and ecological study, with data extracted from the Brazilian Penitentiary Information System and the bulletins published by the National Council of Justice, referring to October 2021 to June 2022, submitted to descriptive statistical analysis, using absolute and relative frequencies. Results: it was found that of the 4,345 people deprived of their liberty who had received the first dose of Covid-19 vaccination, only 573 had received the second dose and none had received the third dose. Conclusion: it was evident that, although vaccination is a benefit, it is still a major challenge to implement it for the population deprived of their liberty, since even though they are considered priority groups, access to this right has been hampered for these individuals.

Objetivo: analizar el escenario de vacunación contra el Covid-19 en la población privada de libertad en un estado del Nordeste brasileño. Método: estudio observacional y ecológico, con datos extraídos del Sistema de Información Penitenciaria de Brasil y boletines publicados por el Consejo Nacional de Justicia, correspondientes al periodo entre octubre de 2021 y junio de 2022, sometidos a análisis estadístico descriptivo, utilizando frecuencias absolutas y relativas. Resultados: se encontró que, de las 4.345 personas privadas de libertad con la primera dosis de la vacuna contra el Covid-19, solo 573 contaban con la segunda dosis y ninguna tenía la tercera dosis. Conclusión: se observó que, pese a que la vacunación es un beneficio, sigue siendo un gran desafío implementarla para la población privada de libertad, ya que, si bien se los consideran grupos prioritarios, el acceso a este derecho se vio afectado para estos individuos.

Estudio cualitativo sobre información, confianza y acceso a la vacunación contra COVID-19 en adolescentes en un centro de salud de Buenos Aires / Qualitative study on information, trust in and access to COVID-19 vaccines among adolescents at a healthcare center in Buenos Aires

Introducción. En la adolescencia, se comienzan a tomar decisiones autónomas sobre la salud. En la vacunación intervienen dimensiones contextuales, grupales y relativas a cada vacuna. Se busca conocer el proceso de información, confianza y decisión de vacunarse contra COVID-19 en adolescentes usuarios de un centro de salud en Buenos Aires. Objetivos. Identificar ámbitos y canales a través de los cuales los adolescentes accedieron a información sobre la vacuna contra COVID-19 en un centro de salud de Buenos Aires. Describir sus opiniones respecto a los distintos discursos sobre vacunación. Describir su participación en la vacunación contra COVID-19. Identificar barreras y facilitadores respecto del acceso a la vacunación contra COVID-19 en esta población. Población y métodos. Investigación cualitativa. Se hicieron entrevistas semiestructuradas a adolescentes usuarios del efector. La muestra fue heterogénea; su tamaño se definió por saturación teórica. Se realizó un análisis temático de los datos. Resultados. Se realizaron 14 entrevistas. Los entrevistados recibieron información sobre la vacuna contra COVID-19 de sus familias, la televisión y las redes sociales. Todos recibieron tanto publicidad oficial como discursos reticentes a la vacunación. Analizaron la información recibida y formaron opinión autónoma. Su decisión sobre vacunarse no siempre fue respetada. La desconfianza, la baja percepción del riesgo, el temor a las inyecciones, las barreras administrativas y geográficas fueron motivos de no vacunación. Conclusiones. Se requieren estrategias de comunicación destinadas a adolescentes que promuevan su participación en el acceso a la vacunación.

Introduction. During adolescence, individuals start to make autonomous decisions about their health. Vaccination involves contextual, group, and vaccine-specific dimensions. We sought to know the information, trust, and decision to receive the COVID-19 vaccine among adolescents who attended a healthcare center in Buenos Aires. Objectives. To identify settings and channels through which adolescents accessed information about the COVID-19 vaccine at a healthcare center in Buenos Aires. To describe their opinions about the different statements on vaccination. To describe their participation in COVID-19 vaccination. To identify barriers and facilitators to COVID-19 vaccination in this population. Population and methods. Qualitative study. Semi-structured interviews with adolescents who attended this healthcare facility. The sample was heterogeneous; the sample size was estimated by theoretical saturation. A thematic analysis of data was done. Results. A total of 14 interviews were conducted. Interviewees obtained information about the COVID-19 vaccine from their families, TV, and social media. All received information from both official campaigns and anti-vaccine communications. They analyzed the information they received and formed their own opinion. Their decision about the vaccine was not always respected. Hesitancy, a low perception of risk, fear of needles, administrative and geographic barriers were reasons for not receiving the vaccine. Conclusions. Communication strategies targeted at adolescents are required that encourage their involvement in access to vaccination.

Bacillus Calmette-Guerin (BCG) Vaccine Impact on Dementia Risk in Bladder Cancer Patients: A Systematic Review and Meta-Analysis.

BACKGROUND: The BCG vaccine has been traditionally administered to prevent TB. It has been additionally used in bladder cancer patients as a therapy with success. Some observational studies found that bladder cancer patients receiving BCG may have reduced dementia risk, however, the evidence is not conclusive. OBJECTIVE: To investigate the impact of BCG vaccine on dementia risk in bladder cancer patients. METHODS: Six databases were searched from inception to January 13, 2024, for published and unpublished studies that examine the association between BCG and dementia risk in bladder cancer patients. We conducted meta-analyses using a random-effects model. RESULTS: Eight retrospective cohort studies were included in the systematic review and seven in the meta-analyses. Because there were studies with overlapping populations, two separate main analyses were performed reassuring the avoidance of overlap. The first analysis showed that compared to controls, BCG did not reduce dementia risk [5 studies pooled, n=88,852, HR = 0.65, 95% CI (0.40, 1.06), I2 = 85%] whereas there was a marginally significant risk reduction in the second analysis [6 studies pooled, n=70,025, HR = 0.63, 95% CI (0.40, 0.97), I2 = 83%]. Sensitivity analysis excluding the unpublished studies did not affect the outcome importantly. Additional meta-analysis showed that BCG did not reduce the risk of Alzheimer's disease. CONCLUSION: This meta-analysis of observational studies found that BCG administration in bladder cancer patients has likely a minimally positive impact on dementia risk if any. To better understand the effect of BCG on dementia, randomized controlled trials are needed.

[Current vaccination and immunization strategies in dermatology]. / Aktuelles zu Impfungen und Immunisierungsstrategien in der Dermatologie.

Vaccinations are an important pillar of public health. They have high benefits for individuals and society as a whole by specifically preventing or mitigating infectious diseases. In many cases, they offer benefits that go beyond protection against the disease in question, e.g., protective cardiovascular effects. Vaccination recommendations in Germany are drawn up by the Standing Committee on Vaccination (STIKO), while the European Medicines Agency (EMA) is responsible for the approval of vaccines in the EU. Vaccinations may be carried out by physicians regardless of their specialty. In dermatology, vaccinations against varicella (chickenpox), herpes zoster, and human papillomavirus are established. The development of vaccines against other dermatologically relevant diseases and cancer vaccines is the subject of intensive research. Particularly in the case of immunosuppression, the physician must also take into consideration which vaccinations are possible and useful or contraindicated. Type I or type IV allergies to components of vaccinations are very rare, but reactions at the injection site often occur as a dermatological side effect. Urticarial reactions are also possible, as does the worsening of underlying dermatological conditions such as psoriasis vulgaris.

The challenging concept of eradication: A core concept guiding and frustrating public health.

The celebrated 1980 announcement that smallpox had been eradicated was made using the following definition of eradication: "Permanent reduction to zero of the worldwide incidence of infection caused by a specific agent as a result of deliberate efforts: intervention measures are no longer needed." Public health around the world works with this definition of "eradication," setting it as a goal for other infectious disease control programs. The definition is simple. Its application, however, has produced long-running and complex public health campaigns that threaten the commitment of funders, health care providers, and governments. In this paper, the authors demonstrate the disease-specific challenges of eradication through the example of the Global Polio Eradication Initiative (GPEI). While many deem eradication worth its high costs because it is the end of morbidity and mortality from a disease, it does not mean the end of disease control efforts. Public health must be prepared for the possibility of disease reoccurrence in the form of undetected natural reservoirs of disease, lab leaks from stored samples, bioterror attacks using stolen samples, and the synthetic recreation of microbes. This paper clarifies the role of reoccurrence prevention in eradication, calling for its addition in the definition of eradication.

RéSUMé: L'annonce célèbre de 1980 que la variole a été éradiquée utilisait la définition d'éradication suivante : « Réduction permanente à zero de l'incidence mondiale d'infection causée par un agent spécifique en conséquence d'efforts délibérés : mesures d'intervention ne sont plus nécessaires. ¼ La santé publique globale emploie cette définition de « éradication ¼, la fixant comme objectif pour d'autres programmes de contrôle des maladies transmissibles. La définition est simple. Pourtant, son application a produit des campagnes de santé publique complèxes et de longues durées, qui menacent l'engagement des bailleurs de fonds, les prestataires des soins de santé, et les gouvernements. Dans cet article savant, les auteurs démontrent les obstacles d'éradication spécifiques à une maladie transmissible à travers l'exemple de la Global Polio Eradication Initiative (GPEI). Tandis que l'éradication pourrait peut-être mériter les côuts élevés associés puisqu'elle signifie la fin de la morbidité et la mortalité d'une infection, ceci ne représente pas la fin des efforts de contrôle des maladies. La santé publique doit se préparer pour la possibilité de la réapparition d'une maladie infectieuse en forme de reservoir de maladie naturel non-détecté, fuites de laboratoires des échantillons conservés, attaques bioterroristes utilisant des échantillons volés, et la récréation synthétique des microbes. Cet article savant clarifie le rôle de la prévention de réocurrence dans l'éradication, et demande que ce role soit ajouté à la definition d'éradication.

Empowering Unvaccinated Youth: Feasibility, Acceptability, and Efficacy of a COVID-19 Serious Game-Based Intervention.

Objective: To evaluate a serious game-based intervention's feasibility, acceptability, and efficacy in encouraging coronavirus disease (COVID-19) vaccination among 11-14-year-olds in the United States and assess participant experiences. Materials and Methods: The study, grounded in social cognitive theory and health belief model, recruited and engaged 32 English-speaking parent-child dyads with unvaccinated youths via snowball sampling and social media outreach. These dyads were randomly assigned to either the COVID-19 serious game-based intervention group (n = 16) or a usual care group (n = 16). The study measured beliefs, self-efficacy, and intentions regarding vaccination using surveys before and after the intervention, with follow-up at 2 months to evaluate vaccine uptake. Semistructured interviews provided insights into the gaming experience and study process. Results: All 32 eligible parent-youth dyads (16 in each group) completed the study with full participation. Most participants were Black or African American fathers, making up 75% and 81.3% of the intervention and control groups, respectively. The intervention impacted vaccine uptake, with 75% of the intervention group vaccinating their children compared with 37.5% of the control group [χ2(1, n = 32) = 4.57, P = 0.033]. Key factors for vaccine uptake included parents' motivation and youths' perceived susceptibility, with correlations of r(30) = 0.66, P = 0.006, and r(30) = 0.55, P = 0.029, respectively. The intervention reshaped youth perceptions about self and community protection. Participants expressed overall satisfaction with both the intervention and the study process. Conclusions: The intervention was found to be feasible and acceptable, with potential for integration into youth vaccination strategies to support COVID-19 vaccine decision-making.

Refueling a Quiet Fire: Old Truthers and New Discontent in the Wake of COVID-19.

This article investigates the factors that contributed to the proliferation of online COVID skepticism on Twitter across Italian municipalities in 2020. We demonstrate that sociodemographic factors were likely to mitigate the emergence of skepticism, whereas populist political leanings were more likely to foster it. Furthermore, pre-COVID anti-vaccine sentiment, represented by "old truthers" on Twitter, amplified online COVID skepticism in local communities. Additionally, exploiting the spatial variation in restrictive economic policies with severe implications for suspended workers in nonessential economic sectors, we find that COVID skepticism spreads more in municipalities significantly affected by the economic lockdown. Finally, the diffusion of COVID skepticism is positively associated with COVID vaccine hesitancy.

Mobile Apps for Vaccination Services: Content Analysis and Quality Assessment.

BACKGROUND: Vaccination services are increasingly in demand by the public, and mobile apps are an effective tool to meet that demand. However, the characteristics and quality of these apps are unknown. OBJECTIVE: Commonly used vaccination service apps on the market were surveyed with regard to quality, service content, and user experience to evaluate and guide users. METHODS: The Qimai Data mobile app data analytics platform was used to search for common vaccination service apps by keyword, and the WeChat and Alipay platforms were searched for apps. The apps included in the study were independently evaluated by two reviewers using the Mobile Application Rating Scale, and the service content and user experience of the apps were analyzed. The intragroup correlation coefficient between raters was used to measure interrater reliability. RESULTS: In the app stores of the four major Android platforms and the iOS app store, 1092 and 207 apps were found, respectively; 189 WeChat applets and 30 Alipay applets were also found. A total of 29 apps was ultimately included in this study according to the inclusion criteria, including 21 independent apps, 4 WeChat applets, and 4 Alipay applets. Significant differences were found between independent apps and applets in terms of the quality score (t449.57=-5.301; P<.001) and the subjective quality score (z=-4.753; P<.001). No significant differences were found between iOS and Android platforms in terms of the quality score (t1404=-2.55; P=.80) and the subjective quality score (z=-0.137; P=.89). There was good intragroup consistency among the raters. CONCLUSIONS: In this study, independent apps and nonindependent apps that rely on social and payment platforms for implementation were included in the vaccination services category. The overall quality of these apps was acceptable. Nonindependent running apps were found to have slightly lower scores and showed room for improvement, and scores for the participatory apps were found to be generally low overall.

Long-term predominance in childhood colonization of the multidrug-resistant lineage 6C/ST386 of Streptococcus pneumoniae after universal immunization with the 10-valent pneumococcal conjugate vaccine in Brazil.

BACKGROUND: A study conducted in the city of Niterói/RJ, four years after the introduction of the pneumococcal conjugate vaccine in Brazil, reported the emergence of non-vaccine serotype 6C Streptococcus pneumoniae associated with carriage in children. The multidrug-resistant (MDR) lineage ST386 was predominant among 6C isolates. A subsequent study, in 2019, reported the continued prevalence of 6C as the main serotype. This study aims to determine the genetic lineages of serotype 6C S. pneumoniae obtained from the 2019 study and evaluate the status of ST386 in this population. METHODS: Serotype 6C S. pneumoniae isolates were obtained during the 2019 study. Lineages were determined by MLST and changes in ST386 status between 2014 and 2019 were verified by a two-tailed Fisher's exact test. RESULTS: Of the 16 serotype 6C isolates recovered during 2019, 10 (62.5 %) belonged to ST386, remaining predominant in the population. The second most frequent was ST2777 represented by four (25 %) isolates. Both ST63 and ST3280 only had one (6.25 %) isolate each. Comparison of ST386 proportion between 2014 and 2019 showed no significant changes within the population. CONCLUSIONS: This study was able to confirm the stability on the occurrence of the MDR lineage ST386 in children in our setting nine years after the introduction of PCV10 in Brazil.

Effect of O-acetylation on the antigenicity and glycoconjugate immunogenicity of the Streptococcus pneumoniae serotype 7F capsular polysaccharide.

Streptococcus pneumoniae is a bacterial pathogen causing diseases as severe as pneumonia, sepsis and meningitis. Commercial pneumococcal conjugate vaccines contain the 7F serotype, which is epidemiologically relevant and highly invasive. This serotype contains an O-acetyl group at the internal L-rhamnose of its polysaccharide repeating unit. Herein we report on the role of the O-acetyl moiety of 7F polysaccharide in both antigen recognition and the induction of a protective antibody response against 7F. Fully and partially de-O-acetylated 7F polysaccharides were chemically prepared and compared with the O-acetylated counterpart in their antigenicity and immunogenicity of their tetanus toxoid glycoconjugates. These comparative studies showed a slight but consistent decrease in the antigenicity for the fully de-O-acetylated polysaccharide, but not for the partly de-O-acetylated variant. The glycoconjugates derived from the O-acetylated and the fully de-O-acetylated polysaccharides had similar sizes and polysaccharide-to-protein ratio, and all proved both to be immunogenic and induce opsonophagocytic responses in mice. Nevertheless, the immune response elicited by the O-acetylated glycoconjugate was better in both quantity and quality, proving that the O-acetyl group is not strictly necessary but also not irrelevant for the antigenicity and immunogenicity of the 7F serotype polysaccharide and its glycoconjugates.

Human and hamster sera correlate well in identifying antigenic drift among SARS-CoV-2 variants, including JN.1.

Antigenic assessments of SARS-CoV-2 variants inform decisions to update COVID-19 vaccines. Primary infection sera are often used for assessments, but such sera are rare due to population immunity from SARS-CoV-2 infections and COVID-19 vaccinations. Here, we show that neutralization titers and breadth of matched human and hamster pre-Omicron variant primary infection sera correlate well and generate similar antigenic maps. The hamster antigenic map shows modest antigenic drift among XBB sub-lineage variants, with JN.1 and BA.4/BA.5 variants within the XBB cluster, but with fivefold to sixfold antigenic differences between these variants and XBB.1.5. Compared to sera following only ancestral or bivalent COVID-19 vaccinations, or with post-vaccination infections, XBB.1.5 booster sera had the broadest neutralization against XBB sub-lineage variants, although a fivefold titer difference was still observed between JN.1 and XBB.1.5 variants. These findings suggest that antibody coverage of antigenically divergent JN.1 could be improved with a matched vaccine antigen.IMPORTANCEUpdates to COVID-19 vaccine antigens depend on assessing how much vaccine antigens differ antigenically from newer SARS-CoV-2 variants. Human sera from single variant infections are ideal for discriminating antigenic differences among variants, but such primary infection sera are now rare due to high population immunity. It remains unclear whether sera from experimentally infected animals could substitute for human sera for antigenic assessments. This report shows that neutralization titers of variant-matched human and hamster primary infection sera correlate well and recognize variants similarly, indicating that hamster sera can be a proxy for human sera for antigenic assessments. We further show that human sera following an XBB.1.5 booster vaccine broadly neutralized XBB sub-lineage variants but titers were fivefold lower against the more recent JN.1 variant. These findings support updating the current COVID-19 vaccine variant composition and developing a framework for assessing antigenic differences in future variants using hamster primary infection sera.

Immuno-protective effect of commercial IBD vaccines against emerging novel variant infectious bursal disease virus in specific-pathogen-free chickens.

IMPORTANCE: Infectious bursal disease (IBD) is an important viral poultry disease that vaccination can control. OBJECTIVE: This study examined the immune protection of immune-complex (Vaccine A) and attenuated live (Vaccine B) IBD vaccines in specific-pathogen-free (SPF) chickens against a novel Malaysian variant IBD virus (vaIBDV) challenge. METHODS: One-day-old (n =75) SPF chickens were divided randomly into the following three groups of 25 chicks each: Control, Vaccine A, and Vaccine B groups. The vaIBDV strain, UPM1432/2019, was used for the challenge at 21 and 28days post-vaccination (dpv). Five birds from unchallenged and challenged groups were sacrificed seven days post-challenge, and blood, bursa, spleen, and cloacal swabs were collected. The IBD antibodies (Abs), lymphoid lesions, and viral load were determined. RESULTS: The UPM1432/2019 virus induced bursal damage in vaccinated SPF chickens despite Ab titers. The mean Ab titers of the Vaccine A challenged group were significantly lower (p < 0.002) than in the unchallenged group at 28 dpv. The bursal indices of the vaccinated unchallenged groups did not differ significantly from those of the vaccinated challenged groups (p = 0.94). Microscopically, the bursae of the challenged groups showed significant atrophy. The bursal lesion score was higher (p < 0.05) in the control and Vaccine B challenged groups than the Vaccine A challenged group. The challenged group had a higher viral load than the vaccinated groups (p < 0.001). CONCLUSIONS AND RELEVANCE: Neither vaccine fully protected against a vaIBDV challenge, highlighting the limitations of current vaccines and the need for further research.

Recent progress in cancer vaccines and nanovaccines.

Vaccine science, nanotechnology, and immunotherapy are at the forefront of cancer treatment strategies, each offering significant potential for enhancing tumor-specific immunity and establishing long-lasting immune memory to prevent tumor recurrence. Despite the promise of these personalized and precision-based anti-cancer approaches, challenges such as immunosuppression, suboptimal immune activation, and T-cell exhaustion continue to hinder their effectiveness. The limited clinical success of cancer vaccines often stems from difficulties in identifying effective antigens, efficiently targeting immune cells, lymphoid organs, and the tumor microenvironment, overcoming immune evasion, enhancing immunogenicity, and avoiding lysosomal degradation. However, numerous studies have demonstrated that integrating nanotechnology with immunotherapeutic strategies in vaccine development can overcome these challenges, leading to potent antitumor immune responses and significant progress in the field. This review highlights the critical components of cancer vaccine and nanovaccine strategies for immunomodulatory antitumor therapy. It covers general vaccine strategies, types of vaccines, antigen forms, nanovaccine platforms, challenges faced, potential solutions, and key findings from preclinical and clinical studies, along with future perspectives. To fully unlock the potential of cancer vaccines and nanovaccines, precise immunological monitoring during early-phase trials is essential. This approach will help identify and address obstacles, ultimately expanding the available options for patients who are resistant to conventional cancer immunotherapies.

Assessing vaccinated persons' intention to take the COVID-19 boosters using a combined theoretical framework: an online survey in Egypt.

Vaccines, like the Corona Virus Disease-2019 (COVID-19) vaccines, can control diseases, but vaccine hesitancy reduces their use. It is important to assess the intention to use COVID-19 vaccines boosters and the determinants of this intention to help in developing programs to promote the uptake of boosters. An online survey collected data from adults in Egypt between March and June 2022 using a questionnaire that assessed demographic characteristics, and constructs of the Theory of Planned Behaviour (TPB) and the Health Belief Model (HBM). The survey was uploaded to SurveyMonkey and the links were posted on social media platforms. Binary regression analysis was used and the dependent variable was intention to use boosters of COVID-19 vaccines. The independent variables were indicators of the HBM including perceived susceptibility to COVID-19 infection (medical history) and possibility of disease prevention (awareness of the availability of types of COVID-19 vaccines); and indicators of the TPB including attitude toward COVID-19 vaccines (that they are harmful, that they may lead to death and confidence in locally and foreign manufactured vaccines), perceived norms (the percentage of vaccinated persons in one's circle) and perceived control over booster uptake (presence of government mandates for COVID-19 vaccination). The confounders were sociodemographic factors (age, sex, education, and place of residence). Complete responses were available from 1113 out of 1401 participants (79.4%), with mean (SD) age = 25 (9.5) years, of whom, 66.7% (n = 742) were females and 68.6% (n = 764) were university students. About 39.4% and 31.2% indicated that they would get or would definitely get the booster dose of the COVID-19 vaccines. In multiple regression, intention to use a booster dose was significantly related to not agreeing (AOR = 4.87, P < 0.001) or not agreeing at all (AOR = 8.46, P = 0.001) that vaccines are harmful and to having no confidence (AOR = 0.21, P < 0.001) or no confidence at all (AOR = 0.14, P < 0.001) in foreign-manufactured vaccines. Most university-educated Egyptians in the study intended to take the COVID-19 vaccine booster dose and this intention was associated with attitude toward the harm of the vaccine and confidence in foreign-manufactured vaccines. Awareness campaigns are needed to counteract misinformation and promote booster dose uptake.

Drivers and barriers of seasonal influenza vaccination 2015/16 & 2019/20 to 2022/23 - a survey on why most Norwegians don't get the flu vaccine.

BACKGROUND: This study aimed to explore the reasons adults in the general population, influenza risk groups (RGs) and health care workers (HCWs) in Norway give for their vaccination choices and whether these reasons vary between groups or over time in order to further improve influenza vaccination coverage. METHODS: Respondents of a nationally representative telephone survey conducted by Statistics Norway were asked "What was the most important reason why you did/did not get vaccinated?". The question on influenza non-vaccination was included in 2016 and in 2020 to 2023 and the question on influenza vaccination in 2021 to 2023. RESULTS: The study included 9 705 individuals aged 18-79 years. Influenza vaccination coverage in the RGs increased from 20.6% in 2016 to 63.1% in 2022, before a reduction to 58.3% in 2023. Common reasons for non-vaccination were similar in all groups. The most cited reasons were "no need" for the vaccine and "no specific reason", followed by "not recommended/offered the vaccine", "worry about side effects" and "vaccine refusal". The most frequent reasons for vaccination among the general population and RGs were protection against influenza and belonging to a RG, while the most frequent responses among HCWs were being offered the vaccine at work/work in health care, followed by a desire for protection against influenza. Receiving a vaccine recommendation from a health professional was mentioned in all groups. We also observed that the proportion reporting "no need" for the vaccine decreased over time, especially among HCWs, and that the proportions reporting vaccine refusal and worry about side effects as reasons for non-vaccination were temporarily reduced during the COVID-19 pandemic. CONCLUSIONS: The general population and RGs cite protection against influenza as their primary incentive for vaccination, while HCWs mainly refer to their professional role or workplace vaccination. For non-vaccination we see a similar pattern in all groups, with "no need" and "no specific reason" as the main reasons. Of note, worry about side effects and vaccine refusal is as frequent among HCWs as in other groups. Continued efforts to maintain and increase vaccine confidence are needed.

Mechanotransduction-Piloted Whole-Cell Vaccines for Spatiotemporal Modulation of Postoperative Antitumor Immunity.

Whole tumor cell vaccines hold promise by presenting a broader spectrum of autologous-origin tumor antigens to combat postoperative recurrence and metastasis. However, challenges such as intractable adjuvant modification and obscure interactions with antigen-presenting cells in the postoperative microenvironment impede their translation into effective personalized immunotherapies. In this study, we propose cancer vaccines derived from manganese oxide-immobilized resected tumor cells, featuring whole tumor antigens and adjustable stiffness to modulate interactions with antigen-presenting cells in the postoperative microenvironment. These vaccines effectively stimulate dendritic cell phagocytosis and function through sequential stiffness-mediated mechanotransduction and interferon signaling. We evaluated their efficacy using an orthotopic triple-negative breast cancer mouse model and found that combining the vaccines with radiotherapy effectively inhibits postoperative tumor recurrence and metastasis. Our study underscores the potential of utilizing mechanotransduced adjuvants alongside directly inactivated whole-cell vaccines as a universal solution for preventing postoperative tumor recurrence.

Provider Perceptions and Use of Audit-Feedback and Communication Strategies to Improve Human Papillomavirus Vaccine Uptake.

OBJECTIVE: Human papillomavirus (HPV) vaccine uptake remains suboptimal among US adolescents. A cluster randomized trial was conducted at six primary care practices in southeast Minnesota to assess the impact of parent reminder-recall letters and provider audit-feedback reports on 11-12-year-old HPV vaccine uptake. Audit-feedback reports included access to a web toolkit with instruction on two communication approaches. We evaluated the process of the audit-feedback report intervention to inform future adaptations. METHODS: We sent a survey to providers assigned to the intervention and asked about their use and perceptions of the reports, web toolkit, the communication approaches, and HPV vaccine recommendation. RESULTS: Surveys from 95 providers were analyzed. Most (97.9%) recalled receiving audit-feedback reports, with 92.4% finding them somewhat to very easy to understand, 86% somewhat to very familiar with their content and objectives, and 69.9% using them five or more times in the past year. Few respondents (11.6%) recalled receiving access to the web toolkit. Web analytics showed that the toolkit was rarely used. Most reported familiarity with communication approaches but less than half reported that these positively impacted the tone of the clinical encounter. Higher familiarity with audit-feedback reports (OR=2.58) and perceived peer approval about using presumptive language (the first of two communication approaches) to recommend HPV vaccination (OR=2.16) correlated with higher frequency of vaccine recommendation. CONCLUSIONS: Implementation of the audit-feedback reports showed good acceptability. Low utilization of the web toolkit suggests a need to further examine provider preferences on delivery and usability of training materials.