Search Results (8,857)

Neutralizing antibodies (NABs) play a critical role in assessing the immune response elicited by vaccines, providing insight into their protective efficacy. Despite their importance, there is a notable gap in research directly comparing NAB levels among individuals vaccinated with different vaccines, across diverse ethnicities, and between genders. The study aimed to compare NAB levels across variables such as vaccination status, vaccine type, age, gender, and ethnicity. The NAB levels among different study groups were measured using the Finecare RBD Antibody Test and the cPass kit (ELISA). The data was analyzed statistically using SPSS version 27. A total of 172 study subjects were analyzed. The mean age of participants was 45.03 ± 16.72 years, with 50.9% male and 77.3% of Malay ethnicity. Median NAB levels, assessed by both assays, were highest in females, vaccinated healthy participants, and those who received the Pfizer vaccine. Age-group comparisons revealed variations in median NAB levels across studied groups. Participants aged 10–25 years in the vaccinated healthy (VH) group exhibited the highest median antibody levels; on the other hand, the 26–45 year age group showed the highest median levels in the breakthrough infection (BI) and certain non-vaccinated categories. Ethnic group comparisons highlighted that Malays consistently had the highest median NAB levels. Significant differences in antibody levels were found across vaccination status, ethnicity, and vaccine type (p < 0.001). This study underscores the influence of vaccination status, demographic factors, and vaccine type on NAB levels. The Finecare RBD Antibody Test and cPass kit demonstrated comparable trends, highlighting their utility in evaluating vaccine-induced immunity. The findings of this study highlight the need for tailored immunization strategies to optimize protective immunity. Full article

Public health policy foundationally impacts how pathogens spread, yet despite multiple pathogens of broader societal concern emerging, little research has examined how policy affects pathogen evolution. To evaluate this connection, we examine how varying public health approaches impact how viral immune susceptibility, including resistance to vaccines, evolves. Integrating evolutionary epidemiological modeling and critical geography, we compare how distinct public health responses early in the COVID-19 pandemic affected the potential evolution of immune evasion in SARS-CoV-2 across four territories: Costa Rica, Panama, Texas, and Uruguay. We use parameter estimates inferred from confirmed case and vaccination time series via stochastic ensemble Kalman filtering in each territory. Our analyses suggest viral immune resistance was most likely to emerge in Texas, which relied almost exclusively on vaccines for disease control. In contrast, regions with comparatively fewer health disparities that also rigorously applied interventions, such as shelter-in-place orders and household support, may have better prevented vaccine resistance from evolving. These comparative analyses highlight the key role policy choices play, potentially representing different governance goals for population health and wellbeing. We argue that such choices impact not only disease spread but also pathogen evolution along epidemiologically critical dimensions like viral immune susceptibility. Our study thus demonstrates how public health priorities drive social–evolutionary feedbacks. Full article

Background: Since 2014, all Australian jurisdictions have progressively amended legislation to authorise pharmacists to administer vaccines, evolving from restricted pilots to an essential public health pillar. Objective: This review analyses the longitudinal evolution of pharmacist-administered vaccinations (PAVs), documenting changes in authorised vaccines, age eligibility, and regulatory frameworks across all Australian jurisdictions. Methods: A retrospective review of Australian jurisdictional legislation, regulations, and policy documents was undertaken. Searches included official legislative registers, Government Gazettes, Health Department protocols, and professional guidance published by Pharmaceutical Society of Australia (PSA) and The Pharmacy Guild of Australia between 2014 to 2026. Documents were independently reviewed by five authors, followed by secondary verification and consensus-based adjudication to resolve discrepancies and confirm findings. Results: PAVs scope was expanded from a single influenza pilot in 2014 to include over 21 vaccine-preventable diseases by 2026. The COVID-19 pandemic catalysed rapid reform, leading to the standardisation of age eligibility (largely ≥5 years). A landmark milestone occurred in 2025 when South Australia enabled pharmacists to administer any vaccine within their professional scope. Conclusion: Legislative reforms have significantly enhanced vaccine accessibility. However, jurisdictional fragmentation persists. National harmonisation, using a competency-based model similar to South Australia, is recommended to streamline delivery and optimise public health outcomes. Full article

Viral vaccine development requires both mechanistic understanding of protective immunity and translational study designs that connect preclinical data with human outcomes. Animal models remain important for early assessment of safety, immunogenicity and protective efficacy, but their predictive value depends on the question being asked, the pathophysiology of infection, the immune mechanisms expected to mediate protection, and the biomarkers chosen to bridge animal and human data. This review focuses on viral vaccines and examines innate and adaptive mechanisms of vaccine-induced protection, including B cell and antibody responses, Fc-mediated functions, Fc glycosylation, T cell memory and CD8+ cytotoxic responses. We discuss common reasons for clinical failure and show how preclinical endpoints can be classified as human-counterpart, surrogate or comparative/mechanistic readouts. Influenza and COVID-19 examples illustrate how different models can be combined across discovery, challenge, transmission and late-stage bridging studies. Emerging tools such as systems serology, omics, AI/ML and new approach methods can improve candidate prioritization, but their value depends on assay standardization, biological validation and cautious interpretation. A mechanism-driven model cascade, paired with human-relevant immunological readouts, can improve preclinical interpretation and reduce the risk of advancing candidates that are unlikely to succeed in clinical trials. Full article

The 2019 coronavirus disease pandemic (COVID-19) showed how genetic mutations can alter coronavirus characteristics. However, the evolution of livestock coronaviruses remains understudied. We analyzed 15 bovine coronavirus (BCoV), three porcine hemagglutinating encephalomyelitis virus (PHEV) and 18 porcine respiratory coronavirus (PRCV) isolates, mainly from Belgian livestock collected between 2020 and 2023. Spike gene phylogenetic analysis showed nucleotide substitution rates comparable between BCoV and PRCV, while PHEV appeared slower. Unlike severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), synonymous substitutions were preferred, limiting amino acid variation across decades in the animal coronaviruses. Virus neutralization assays with swine antisera indicated minimal antigenic change in PHEV and PRCV. Recent BCoV isolates showed antigenic divergence from the classical Mebus vaccine strain. The impact of this divergence on vaccine efficacy may warrant further research. Our findings underscore the need for periodic surveillance, as changes in surface proteins may affect pathogenicity, tissue tropism, host range and vaccine efficacy. Full article

The continuous evolution of the SARS-CoV-2 virus, marked by the emergence of new variants, poses a significant threat to the efficacy of existing vaccines. However, a promising approach to addressing vaccine failure caused by viral mutations (particularly in the spike protein) is the development of a variant-proof (conserved), non-spike, multiepitope universal nanostructure vaccine with multifunctionality, biocompatibility, self-adjuvanticity, and structural similarity to pathogens in terms of size and shape. This study aimed to design a self-assembled nanostructure vaccine (SANV) featuring pentameric and trimeric coiled-coil peptide motifs, as well as other functional motifs, including epitopes, TAT, PADRE, and adjuvant. The cytotoxic T lymphocyte (CTL), helper T lymphocyte (HTL), and B lymphocyte (BL) epitopes of SANV were screened from the IEDB with more than 50% individual predicted population coverage (PPC) and fused using linkers to enable self-assembly. The multimerization of the 24 SANV monomers was modeled using the GalaxyHomomer and AlphaFold web servers. Subsequently, the leading SANV constructs with (SANVa9) and without (SANVb6) adjuvant were analyzed for their physicochemical profiles and assessed for antigenicity, allergenicity, solubility, and antioxidant potential. Furthermore, the molecular interactions, specificity, and stability of SANVa9 and SANVb6 with the broadly neutralizing sarbecovirus antibody 5817 and toll-like receptors (TLR2, TLR3, and TLR7) were analyzed using molecular docking and simulation over a 100-nanosecond time scale. Finally, the comparative immune simulation profiles of SANVa9 and SANVb6 with controls indicated stronger, broad-spectrum immune responses that could be translated into in vitro and in vivo studies and warrant further evaluation before clinical use. Full article

Neonatal defense against pathogens relies on maternal antibodies transferred both through the placenta (IgG) and through breast milk (primarily secretory IgA). Maternal IgG antibodies are transferred across the placenta to the fetus mainly via the neonatal Fc receptor (FcRn), which is expressed at high levels in placental syncytiotrophoblasts, and results in the acquisition of maternal-fetal IgG. Transplacental transfer via the FcRn pathway can provide therapeutic proteins and protective antibodies following maternal vaccination. However, maternal IgG antibodies can bind to vaccine antigens such as measles, tetanus, and poliovirus, resulting in rapid clearance through FcgRIIB-mediated inhibition and inadequate B cell activation. In this way, they can inhibit de novo immune responses and significantly reduce vaccine response. On the other hand, the interference that breast milk-derived antibodies may have on vaccine-induced immunity is still largely unknown. Vaccination against influenza, pertussis, and COVID-19 during pregnancy or lactation has been shown to induce the production of protective, pathogen-specific, secretory IgA and IgG antibodies in breast milk. Conversely, studies found that breast milk-derived antibodies of vaccinated mothers reduced vaccine-induced immunity in breastfed infants by accelerating the clearance of vaccine antigen, resulting in reduced antigen availability and reduced plasma cell formation after vaccination. Additional factors in middle- and low-income countries, including environmental (increased microbiome diversity, environmental intestinal dysfunction, malnutrition, co-infections) and breastfeeding practices, may exacerbate the interference effect of maternal antibodies. Current evidence supports that breastfeeding is associated with a reduced immunological response exclusively to the rotavirus vaccine. However, the limited evidence base to date precludes definitive conclusions regarding the role of breast milk-derived antibodies in modulating vaccine-induced immunity. Nevertheless, the evidence suggests that although maternal antibodies may theoretically reduce vaccine immunogenicity, the overall protective benefits of breastfeeding outweigh any potential interference with vaccine responses. Full article

Introduction: From 12 March 2020, when the first cases of COVID-19 were registered in Kosovo, to 9 March 2023, there were a total of 273,310 reported cases of COVID-19 and 3211 reported deaths in Kosovo (CFR: 1.17%). Health care workers (HCWs) have been at a higher risk of contracting SARS-CoV-2 infection; nevertheless, data on seroprevalence of SARS-CoV-2 antibodies among HCWs in Kosovo are very limited. Methodology: A cross-sectional serology study with 1654 healthcare professionals throughout Kosovo was conducted to determine the presence of antibodies against the spike antigen of SARS-CoV-2. In addition, a structured questionnaire was administered to study participants to obtain basic demographic data, and information on prior infection and COVID-19 vaccination status. Results: Antibodies against the spike antigen of SARS-CoV-2 were detected in almost all (99.8%) HCWs that participated in the study. The average antibody titer was 8030.8 AU/mL in women and 9533.7 AU/mL in men. Sixty-four percent of HCWs in this study reported prior infection with SARS-CoV-2, 6% of whom were hospitalized. Over 98% of study participants had received SARS-CoV-2 vaccination. Conclusions: Almost all HCWs participating in the study had antibodies against the spike antigen of SARS-CoV-2. This is most probably the result of the high COVID-19 vaccination rate in Kosovo as well as infection with SARS-CoV-2. Full article

Background/Objectives: Vaccine hesitancy is a complex and growing phenomenon worldwide, posing a serious threat to public health achievement in disease control and prevention. This study aimed to assess willingness to uptake and factors linked to shifts between different categories of willingness and uptake regarding the COVID-19 and influenza vaccines. Methods: Prospective cohort study with a representative sample of 1400 individuals aged ≥60 years residing in mainland Portugal, randomly selected. Two telephone surveys were conducted: one at the start of the 2023/2024 vaccination campaign, assessing patients’ characteristics and willingness for vaccination (using an 11-point Likert scale), and another at the end, assessing vaccination status and reasons for uptake/non-uptake. Results: Shifts were observed among both acceptance and refusal groups—12.93% of the individuals within these categories shifted to an opposite decision. Hesitancy presents divergent attitudes: for the COVID-19 vaccine, 56.50% declined vaccination, while for the influenza vaccine, non-uptake was only 30.60%. Age, presence of chronic disease, level of education, household dimension, and previous uptake of booster doses are significantly associated with shifting attitudes, playing different roles for each category of willingness and uptake outcome. For the acceptance category, non-uptake relates to confidence factors. For hesitancy, non-uptake is mainly due to complacency. For refusal, the decision is influenced by all domains. Conclusions: Vaccine hesitancy remains an important public health concern in the Portuguese population and appears to differ between COVID-19 and influenza vaccination. Attitudes toward COVID-19 and influenza vaccines can vary in all directions over a short period. Acceptance does not guarantee uptake, and refusal can shift towards uptake. These findings highlight the importance of reinforcing public health strategies and interventions for uptake across a population, taking into consideration the specificities of each willingness group. Full article

Introduction: Inequities in access to medicines persist for asylum seekers, refugees, and undocumented migrants in Europe. For vaccines, access gaps not only exist for these groups in childhood routine immunization, but also for life-course and catch-up vaccinations. As part of a broader project examining access to medicines and vaccines for migrants across all stages of the migration cycle, this scoping review synthesizes evidence on the determinants of access to vaccines. Methods: We conducted a scoping review across PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Cochrane Database of Systematic Reviews, Scopus, and grey literature sources, covering the period 2000–2024. Sources were eligible if they addressed access to vaccines among migrants. We examined access to vaccines along the life course, and across phases of the migratory cycle, including departure, transit, reception and settlement, and return or deportation. Results: A total of 47 research studies and grey literature reports were included. Most studies focused on migrants in reception and settlement (destination) settings, with only twelve sources addressing other phases of the migratory cycle. Across European countries, migrants were frequently reported to have lower uptake of routine vaccines (e.g., measles–mumps–rubella (MMR), polio, diphtheria–tetanus–pertussis (DTP), and human papillomavirus (HPV)) and COVID-19 vaccines than host populations. The most frequently reported barriers were related to migrants’ legal status, administrative requirements, and lack of documentation, alongside poor affordability of vaccination, limited awareness of their rights, and mistrust in the health system. Conclusions: Health systems need to adopt innovative approaches to expand vaccine access for migrant populations. Further, protecting confidentiality is essential for building trust and reducing ethical and legal risks. Flexible and coordinated vaccination strategies are required to address migrants’ mobility across the different migration stages and settings. Our findings appeal for sustained improvements in access to vaccines among migrants in Europe, contingent on strong policy commitments to equity, data protection, and the adoption of life-course and catch-up vaccination strategies. Full article

Background/Objectives: COVID-19, caused by the SARS-CoV-2 virus, can lead to widespread neurological and cognitive complications, even in the absence of significant structural brain abnormalities. Understanding the evolving health concerns in the context of viral infections is critical to service member readiness, fitness, and mission completion. The potential neuroprotective effects of SARS-CoV-2 vaccination remain underexplored. Methods: Using a cross-sectional, non-human primate model (female cynomolgus macaques), we employed magnetoencephalography (MEG) to assess resting-state brain activity following vaccination with escalating doses of a novel psoralen-inactivated SARS-CoV-2 vaccine (PsIV) or a combination of PsIV and a DNA vaccine (prime boost), and subsequent challenge with the Delta variant (SARS-CoV-2 B.1.617.2). MEG scans were acquired 41 days after inoculation. Source series were constructed for 42 regions of interest for each subject, and band power was computed. Results: Band power demonstrated substantial preservation of neural activity across multiple brain regions in vaccinated subjects compared to unvaccinated controls following viral challenge. Significantly lower power was observed across the brain at all bandwidths in the unvaccinated group relative to the prime boost group. As PsIV concentration increased, spectral power increased, with the prime boost group having the greatest power. Conclusions: This approach not only underscores the role of vaccination in mitigating neuropathology but also highlights the capability of MEG to detect subtle yet significant changes in brain function that may be overlooked by other imaging modalities. These findings advance our understanding of vaccine-induced neuroprotection and establish MEG as a powerful tool for monitoring brain function in the context of viral infections. Full article

Introduction: Vaccination against COVID-19 has been crucial in controlling the pandemic. While side effects are typically mild, rare neurological complications have been reported. This is a case series of ten patients who reported of persistent fasciculations after COVID-19 vaccination. Methods: We describe the clinical presentation and diagnostic work-up of ten patients with new-onset fasciculations in temporal proximity to COVID-19 vaccination. Patients with prior SARS-CoV-2 infection or known alternative causes of fasciculations were excluded. Routine clinical data, including neurological examination, laboratory results, and electrophysiology (electromyography and nerve conduction studies), were analyzed. Results: Ten patients (5 male, 5 female; mean age 42.4 years) reported fasciculations beginning within 6 h to 13 days post-vaccination and persisting for 2–12 months at the time of presentation. Fasciculations were accompanied by additional symptoms such as paresthesia and fatigue. Laboratory results were mostly unremarkable; two patients had positive myositis antibodies without clinical correlates. Electrophysiology was unremarkable in six patients, while fasciculation potentials were detected in four patients. Nine were diagnosed with probable benign fasciculation syndrome (BFS), and one met diagnostic criteria for amyotrophic lateral sclerosis (ALS). Discussion: In this small, retrospective case series, most cases of post-vaccination fasciculations were benign and compatible with BFS. Whether BFS onset was causally linked to vaccination or due to a nocebo effect remains unclear. One patient was diagnosed with ALS, though a causal link remains speculative given the study’s limitations and rarity of similar reports. Larger, prospective studies are needed to validate these observations and explore underlying pathophysiological mechanisms. Full article

Type I interferons (IFN-I), including IFN-α, IFN-β, and IFN-ω, are central to antiviral defence and immune regulation. Autoantibodies targeting IFN-I (anti-IFN-I AAbs) have emerged as key pathogenic factors in severe coronavirus disease 2019 (COVID-19) and are detectable in systemic lupus erythematosus (SLE), a prototypic IFN-driven autoimmune disease. Here we compare the prevalence and clinical impact of anti-IFN-I autoantibodies (Aabs) in COVID-19 and SLE based on a structured review of 53 studies from 2014 to 2025 and highlight the clinical associations and therapeutic opportunities presented by these autoantibodies. In COVID-19, neutralising anti-IFN-α and/or anti-IFN-ω AAbs were consistently associated with severe disease and impaired antiviral responses, particularly in older male populations. In SLE, anti-IFN-α AAbs were variably detected; neutralising antibodies were associated with reduced interferon gene signatures in some cohorts but inconsistent correlations with disease activity. Therapeutically, anti-IFN-I AAbs in COVID-19 may inform risk stratification and early antiviral strategies, whereas in SLE, IFN-α blockade, including IFN-α kinoid vaccination, demonstrates modulation of IFN signatures but variable clinical benefit. Notably, these findings reveal an immunological paradox: the same neutralising mechanism that impairs antiviral defence in COVID-19 may attenuate chronic IFN-driven inflammation in SLE. Taken together, anti-IFN-I AAbs exert context-dependent effects: pathogenic in acute viral infection yet potentially modulatory in chronic IFN-driven autoimmunity. Prospective longitudinal studies are required to further clarify their translational utility and long-term clinical impact. Full article

Background/Objectives: Childhood vaccine refusal may negatively affect immunization programs in Türkiye, where regional clusters of hesitancy have emerged despite high national coverage. This study aimed to identify sociodemographic, behavioral, and vaccine confidence-related factors independently associated with childhood vaccine refusal in Konya, Türkiye. Methods: An unmatched case–control study was conducted between July and October 2025 in family health centers across Konya. Cases were parents who had refused at least one routine childhood vaccine (n = 406); controls were parents whose children had completed all routine vaccinations (n = 412). Data were collected through face-to-face interviews using a 47-item structured questionnaire and the Turkish version of the Vaccine Hesitancy Scale (VHS). Independent associations were assessed using multivariable logistic regression, with multicollinearity evaluated by variance inflation factors. Results: Maternal employment (aOR = 0.371, 95% CI: 0.218–0.633), parental COVID-19 vaccination (aOR = 0.131, 95% CI: 0.086–0.200), mother’s complete childhood immunization (aOR = 0.418, 95% CI: 0.262–0.667), tetanus vaccination during pregnancy (aOR = 0.259, 95% CI: 0.159–0.421), and neonatal vitamin K administration (aOR = 0.256, 95% CI: 0.132–0.497) were independently associated with lower refusal odds. Higher number of children (aOR = 1.281) and perceived vaccine-related adverse events in the social environment (aOR = 16.982, 95% CI: 9.914–29.089) increased refusal odds. VHS scores were significantly lower in the refusal group (22.2 ± 6.4 vs. 39.8 ± 6.5; p < 0.001), indicating greater hesitancy. Notably, 21.9% of refusing parents reported being advised by a healthcare professional not to vaccinate. Conclusions: Childhood vaccine refusal in Konya was associated with sociodemographic, behavioral, preventive health-related, and vaccine confidence-related factors. The findings suggest relatively reduced engagement with selected preventive health practices, greater reliance on non-professional information sources, and lower vaccine confidence among refusing parents. Interventions should focus on strengthening healthcare-professional communication, trust-building, transparent risk communication, and evidence-based social media strategies. Full article

Objectives: This study aims to assess the acceptance of vaccinations among pregnant women, particularly against influenza, pertussis, COVID-19, and RSV, and to identify factors influencing their willingness to get vaccinated. It also seeks to evaluate the impact of the COVID-19 pandemic on maternal attitudes and behaviors regarding vaccination. Methods: The analysis involved a review of existing literature and studies to evaluate the level of vaccine acceptance among pregnant women before and after the COVID-19 pandemic. Factors contributing to vaccine hesitancy, including misinformation, lack of knowledge, and the influence of healthcare professionals, were examined. Results: The findings indicated that, despite scientific evidence supporting the safety and efficacy of vaccines during pregnancy, public concerns remain about their impact on the developing fetus. The outbreak of the COVID-19 pandemic has increased awareness of the risk of infectious diseases, but at the same time, its impact on vaccination rates among pregnant women is ambiguous and geographically diverse. Misinformation and decreased access to healthcare during the pandemic negatively affected vaccine uptake. Trustworthy information provided by healthcare professionals emerged as a key factor in promoting vaccine acceptance. Conclusions: To improve vaccination rates among pregnant women, it is essential to provide clear, evidence-based information through healthcare professionals, particularly those directly caring for pregnant women. Educational campaigns should address concerns calmly and without judgment, emphasizing the safety and benefits of vaccinations. Enhanced access to healthcare and vaccinations, along with strategic information dissemination, can significantly improve vaccine acceptance during pregnancy. Lessons learned from past pandemics should be incorporated into the development of healthcare strategies aimed at implementing recommended vaccinations for pregnant women in the future. Full article