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A special issue of Vaccines (ISSN 2076-393X). This special issue belongs to the section "Vaccine Efficacy and Safety".

Deadline for manuscript submissions: closed (31 January 2025) | Viewed by 33510

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Special Issue Editor

Dr. Pedro Plans-Rubió

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1. Public Health Agency of Catalonia, Department of Health of Catalonia, 08005 Barcelona, Spain
2. Ciber of Epidemiology and Public Health (CIBERESP), 28028 Madrid, Spain
Interests: vaccination programs; preventive interventions; epidemiology of vaccine-preventable diseases; seroepidemiology; cost-effectiveness analysis of vaccines and health programs; metabolic risk factors of chronic diseases; health policy
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Special Issue Information

Dear Colleagues,

This Special Issue seeks to collect high-quality review papers on vaccine research, vaccination, and public health. Vaccines are among the most cost-effective medicines, but vaccination programs must overcome multiple challenges to achieve their expected outcomes. In this Special Issue, we will collect comprehensive review articles (5000 words or more) that include the most recent research results and findings in relation to vaccination and public health; effectiveness, relative effectiveness, herd immunity and cost-effectiveness of vaccines; factors associated with the vaccination coverage at the national, regional, and local level; disease modelling; factors associated with vaccination hesitancy and vaccination confidence; the management of vaccination programs; advanced vaccination information systems; and the quality assessment of vaccination programs.

Dr. Pedro Plans-Rubió
Guest Editor

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Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Vaccines is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2700 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

vaccine research
vaccination
public health
effectiveness
herd immunity
cost-effectiveness of vaccines
factors associated with the vaccination coverage
disease modelling
factors associated with vaccination hesitancy and vaccination confidence
management of vaccination programs
advanced vaccination information systems
quality assessment of vaccination programs

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Published Papers (10 papers)

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Research

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14 pages, 1143 KiB

Open AccessArticle

Measles Vaccination Coverage and Anti-Measles Herd Immunity Levels in the World and WHO Regions Worsened from 2019 to 2023

by Pedro Plans-Rubió

Vaccines 2025, 13(2), 157; https://doi.org/10.3390/vaccines13020157 - 5 Feb 2025

Viewed by 1413

Abstract

Objectives: The objectives of this study were as follows: to determine mean percentages of measles vaccination coverage with zero, one and two doses of vaccine and anti-measles herd immunity levels in World Health Organization (WHO) regions in 2023; to assess variations in measles vaccination coverage and anti-measles herd immunity-related indicators from 2019 to 2023; and to assess whether zero-dose measles vaccination coverage indicators were on track to achieve the Immunization Agenda 2030 objective. Methods: Mean percentages of vaccination coverage with two, one and zero doses of measles vaccine in WHO regions in 2023 were calculated using data from the WHO/UNICEF global and regional immunization information system. Results: In 2023, the global mean two-dose measles vaccination coverage was 65.3%, and mean two-dose vaccination coverage was lower than 95% in all WHO regions; the mean prevalence of measles-protected individuals in the target vaccination population was 87.6%, and anti-measles herd immunity levels in the target vaccination population were sufficient to block the transmission of measles viruses with greater transmissibility (R_o ≥ 15) only in the Western Pacific and European WHO regions. The global mean two-dose measles vaccination coverage decreased by 3.7% from 2019 to 2023. In 2023, the mean zero-dose measles coverage and number of zero-dose measles children were, respectively, 36.7% and 40.6% greater than the values required to be on track to achieve the 2030 objective. Conclusion: This study found that all measles-vaccination-coverage-related indicators worsened from 2019 to 2023, and the zero-dose measles vaccination coverage and number of zero-dose measles children in 2023 were not on track to achieve the AI2030 objective. Interventions to increase routine two-dose measles vaccination coverage should be developed in all WHO regions. Full article

(This article belongs to the Special Issue Vaccines and Vaccination: Feature Papers)

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13 pages, 1965 KiB

Open AccessArticle

Development of a Recombinant Fusion Vaccine Candidate Against Lethal Clostridium botulinum Neurotoxin Types A and B

by Eun-Sun Choi, Seong-Wook Pyo, So-Hyeon Kim, Jun-Ho Jeon, Gi-Eun Rhie, Mi-Ran Yun, Hwajung Yi and Yoon-Seok Chung

Vaccines 2025, 13(1), 39; https://doi.org/10.3390/vaccines13010039 - 6 Jan 2025

Viewed by 1222

Abstract

Background: Botulinum neurotoxins (BoNTs), produced by Clostridium botulinum, are potent protein toxins that can cause botulism, which leads to death or neuroparalysis in humans by targeting the nervous system. BoNTs comprise three functional domains: a light-chain enzymatic domain (LC), a heavy-chain translocation domain (HC_N), and a heavy-chain receptor-binding domain (HC_C). The HC_C domain is critical for binding to neuronal cell membrane receptors and facilitating BoNT internalization via endocytosis. Accordingly, it may serve as a vaccine candidate, inducing anti-BoNT-neutralizing antibodies in animals. Here, we aimed to develop a vaccine capable of simultaneously defending against both BoNT/A and B. Methods: We combined the HC_C domains of botulinum neurotoxin type A (BoNT/A) and botulinum neurotoxin type B (BoNT/B) in Escherichia coli to produce a recombinant protein (rHC_CB-L-HC_CArHCcB) that offers dual protection against both toxins by inhibiting their receptor binding. To evaluate the efficacy of the vaccine, mice were immunized intramuscularly with rHC_CB-L-HC_CA plus alum thrice at 2-week intervals, followed by the assessment of immunogenicity and protective efficacy. Results: The antibody titer in mice immunized with rHC_CB-L-HC_CA was significantly higher than that in mice immunized with alum alone, protecting them from the lethal challenges of BoNT/A (10⁵ 50% lethal dose, LD₅₀) and B (10³ LD₅₀). Conclusion: These findings suggest that rHC_CB-L-HC_CA may simultaneously be an effective vaccine candidate against BoNT/A and B. Full article

(This article belongs to the Special Issue Vaccines and Vaccination: Feature Papers)

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13 pages, 453 KiB

Open AccessFeature PaperArticle

Vaccination Coverage of People Living with HIV: Before and after Interventional Action

by Larissa Gerin, Elucir Gir, Lis Aparecida de Souza Neves, Luzia Márcia Romanholi Passos, Renato de Ávila Kfouri, Bruno Spire and Renata Karina Reis

Vaccines 2024, 12(8), 897; https://doi.org/10.3390/vaccines12080897 - 8 Aug 2024

Viewed by 1596

Abstract

This is a quasi-experimental study that assessed PLHIV vaccination coverage before and after health professionals participated in a training course on PLHIV immunization. The vaccination coverage of 645 PLHIV was assessed in the pre-intervention phase. The vaccine with the best coverage was diphtheria and tetanus (82.64%) and the one with the lowest rate of adequately vaccinated was measles, mumps, and rubella (38.27%). Individuals aged between 30 and 39 years had a 74.00% (1–0.26) lower chance of having the full vaccination schedule when compared to those aged between 10 and 19 years, and among those over 40 years, the chance was 87.00% (1–0.13) lower. Those who were vaccinated in Specialized Care Services (SCS) were 5.77 times more likely to be adequately vaccinated when compared to those who were vaccinated in other health services. Regarding the entire vaccination schedule evaluated, the number of adequately vaccinated increased from 47 (7.29%) to 76 (11.78%). Interventions targeting health professionals were effective in increasing vaccination coverage among PLHIV; however, the achieved coverage remained below the desired level. It is necessary to act on health professionals’ knowledge and other aspects to effectively increase vaccination coverage. Full article

(This article belongs to the Special Issue Vaccines and Vaccination: Feature Papers)

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15 pages, 799 KiB

Open AccessArticle

Acceptance of the COVID-19 Vaccine by Prisoners and Staff in Spanish Prisons

by Nancy Vicente-Alcalde, Sorina Madalina Sferle, Carlos Franco-Paredes and José Tuells

Vaccines 2023, 11(10), 1547; https://doi.org/10.3390/vaccines11101547 - 29 Sep 2023

Cited by 2 | Viewed by 1565

Abstract

The COVID-19 vaccination of prisoners and prison staff represents a public health intervention to reduce the impact of the pandemic in conglomerate settings. In Spanish prisons, the road map of the Ministry of Health was followed to protect the population at risk. We conducted a cross-sectional study to assess the acceptance of COVID-19 vaccination by prisoners and prison staff in a prison in Alicante, Spain. We analyzed data obtained through a standardized, self-administered, and anonymous questionnaire; 1016 prisoners and 288 prison staff responded to the survey. The majority of inmates and staff reported no history of symptomatic COVID-19, 90.15% and 91.66%, respectively. Respondents reported that 88.72% agreed to be vaccinated and 89.64% would recommend the vaccine to others. Approximately 89% believe that the benefit of getting vaccinated against COVID-19 is greater than the risk, and 70.55% reported that vaccination should be mandatory for inmates and staff to participate in some activities. The acceptance of COVID-19 vaccination among prisoners and prison staff is high in a Provincial Prison in Spain. Elevated acceptance of COVID-19 vaccination in prisons is a major factor in public health intervention and vaccine equity. Full article

(This article belongs to the Special Issue Vaccines and Vaccination: Feature Papers)

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Review

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27 pages, 5708 KiB

Open AccessReview

Manufacturing and Financial Evaluation of Peptide-Based Neoantigen Cancer Vaccines for Triple-Negative Breast Cancer in the United Kingdom: Opportunities and Challenges

by Adriana Novakova, Stephen A. Morris, Ludovica Vaiarelli and Stefanie Frank

Vaccines 2025, 13(2), 144; https://doi.org/10.3390/vaccines13020144 - 29 Jan 2025

Viewed by 1592

Abstract

This review evaluates the financial burden of current treatments for triple-negative breast cancer (TNBC) and projects potential financial scenarios to assess the feasibility of introducing a peptide-based neoantigen cancer vaccine (NCV) targeting the disease, using the UK as a healthcare system model. TNBC, the most aggressive breast cancer subtype, is associated with poor prognosis, worsened by the lack of personalised treatment options. Neoantigen cancer vaccine therapies present a personalised alternative with the potential to enhance T-cell responses independently of genetic factors, unlike approved immunotherapies for TNBC. Through a systematic literature review, the underlying science and manufacturing processes of NCVs are explored, the direct medical costs of existing TNBC treatments are enumerated, and two contrasting pricing scenarios for NCV clinical adoption are evaluated. The findings indicate that limited immunogenicity is the main scientific barrier to NCV clinical advancement, alongside production inefficiencies. Financial analysis shows that the UK spends approximately GBP 230 million annually on TNBC treatments, ranging from GBP 2200 to GBP 54,000 per patient. A best-case pricing model involving government-sponsored NCV therapy appears financially viable, while a worst-case, privately funded model exceeds the National Institute for Health and Care Excellence (NICE) cost thresholds. This study concludes that while NCVs show potential clinical benefits for TNBC, uncertainties about their standalone efficacy make their widespread adoption in the UK unlikely without further clinical research. Full article

(This article belongs to the Special Issue Vaccines and Vaccination: Feature Papers)

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17 pages, 827 KiB

Open AccessReview

Vaccine Hesitancy and Associated Factors Amongst Health Professionals: A Scoping Review of the Published Literature

by Antonios Christodoulakis, Izolde Bouloukaki, Antonia Aravantinou-Karlatou, Michail Zografakis-Sfakianakis and Ioanna Tsiligianni

Vaccines 2024, 12(12), 1411; https://doi.org/10.3390/vaccines12121411 - 13 Dec 2024

Viewed by 1568

Abstract

Background/Objectives: Healthcare professionals (HCPs) hold significant influence over public attitudes toward vaccinations. Studies suggest that HCPs are hesitant towards the coronavirus disease 2019 (COVID-19) vaccines. This hesitancy could lead to lower vaccination rates in the community. Therefore, this scoping review aimed to assess the extent of hesitancy towards COVID-19 booster doses among HCPs and identify the associated factors. Methods: A comprehensive search was conducted in the PubMed and Scopus databases from April to August 2024, using keywords related to COVID-19, vaccine hesitancy, HCPs, and booster vaccination. Studies that had been peer-reviewed, published in English after 2022, and focused on the hesitancy of the COVID-19 booster dose hesitancy among HCPs were included. Out of the 6703 studies screened, 24 studies were included. Results: Most of the HCPs have received their initial series of COVID-19 vaccinations. However, there is a lower rate of uptake for booster doses, with hesitancy rates ranging from 12% to 66.5%. Hesitancy rates varied significantly across continents, with Asia, Africa, and Europe ranging from 19.7% to 66.5%, 27% to 46.1%, 14% to 60.2%, respectively. Hesitancy was reported to be influenced by various factors, including concerns about vaccine safety, necessity, and effectiveness of these vaccines. In addition, the hesitancy regarding booster doses was also found to be influenced by factors like age, gender, profession, and previous COVID-19. Physicians, nurses, and pharmacists exhibited vaccine hesitancy rates ranging from 12.8% to 43.7%, 26% to 37%, and 26% to 34.6%, respectively. Conclusions: Our review underscores the hesitancy among HCPs towards receiving booster doses across countries around the world and explores the underlying factors. These findings provide valuable insights for the design of future pandemic vaccination programs. Full article

(This article belongs to the Special Issue Vaccines and Vaccination: Feature Papers)

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20 pages, 2939 KiB

Open AccessReview

Oncolytic Viruses: An Inventory of Shedding Data from Clinical Trials and Elements for the Environmental Risk Assessment

by Sheela Onnockx, Aline Baldo and Katia Pauwels

Vaccines 2023, 11(9), 1448; https://doi.org/10.3390/vaccines11091448 - 1 Sep 2023

Cited by 5 | Viewed by 4604

Abstract

Attenuated and/or genetically modified oncolytic viruses (OV) gain increasing interest as a promising approach for cancer therapy. Beside the assessment of subject safety, quality and efficacy aspects of medicinal products for human use, genetically modified viruses are also governed by EU regulatory frameworks requiring an environmental risk assessment (ERA). An important element to be assessed as part of the ERA is the incidence of exposure to OV of individuals, other than the trial subjects, and the environment. The evidence-based evaluation of shedding data is considered to be decisive in that context, as it may impact the OV capacity to be transmitted. This is particularly true for OV still able to (conditionally) replicate as opposed to replication-defective viral vectors commonly used in gene therapy or vaccination. To our knowledge, this article presents the most extensive and up-to-date review of shedding data reported with OV employed in clinics. Besides the identification of a topical need for improving the collection of shedding data, this article aims at providing an aid to the design of an appropriate shedding study, thereby relying on and further complementing principles described in existing guidelines issued by European and international institutions. Full article

(This article belongs to the Special Issue Vaccines and Vaccination: Feature Papers)

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34 pages, 527 KiB

Open AccessReview

Living with HIV and Getting Vaccinated: A Narrative Review

by Andrea De Vito, Agnese Colpani, Mattia Trunfio, Vito Fiore, Giulia Moi, Marco Fois, Nicola Leoni, Stefano Ruiu, Sergio Babudieri, Andrea Calcagno and Giordano Madeddu

Vaccines 2023, 11(5), 896; https://doi.org/10.3390/vaccines11050896 - 25 Apr 2023

Cited by 8 | Viewed by 3345

Abstract

After 40 years of its appearance, human immunodeficiency virus (HIV) infection remains a leading public health challenge worldwide. Since the introduction of antiretroviral treatment (ART), HIV infection has become a chronic condition, and people living with HIV could have life expectancies close to those of the general population. People with HIV often have an increased risk of infection or experience more severe morbidity following exposure to vaccine-preventable diseases. Nowadays, several vaccines are available against bacteria and viruses. However, national and international vaccination guidelines for people with HIV are heterogeneous, and not every vaccine is included. For these reasons, we aimed to perform a narrative review about the vaccinations available for adults living with HIV, reporting the most updated studies performed for each vaccine among this population. We performed a comprehensive literature search through electronic databases (Pubmed—MEDLINE and Embase) and search engines (Google Scholar). We included English peer-reviewed publications (articles and reviews) on HIV and vaccination. Despite widespread use and guideline recommendations, few vaccine trials have been conducted in people with HIV. In addition, not all vaccines are recommended for people with HIV, especially for those with low CD4 cells count. Clinicians should carefully collect the history of vaccinations and patients’ acceptance and preferences and regularly check the presence of antibodies for vaccine-preventable pathogens. Full article

(This article belongs to the Special Issue Vaccines and Vaccination: Feature Papers)

26 pages, 4975 KiB

Open AccessReview

Regulatory T Cells (Tregs) and COVID-19: Unveiling the Mechanisms, and Therapeutic Potentialities with a Special Focus on Long COVID

by Manish Dhawan, Ali A. Rabaan, Sara Alwarthan, Mashael Alhajri, Muhammad A. Halwani, Amer Alshengeti, Mustafa A. Najim, Ameen S. S. Alwashmi, Ahmad A. Alshehri, Saleh A. Alshamrani, Bashayer M. AlShehail, Mohammed Garout, Saleh Al-Abdulhadi, Shamsah H. Al-Ahmed, Nanamika Thakur and Geetika Verma

Vaccines 2023, 11(3), 699; https://doi.org/10.3390/vaccines11030699 - 19 Mar 2023

Cited by 38 | Viewed by 9016

Abstract

The COVID-19 pandemic has caused havoc all around the world. The causative agent of COVID-19 is the novel form of the coronavirus (CoV) named SARS-CoV-2, which results in immune system disruption, increased inflammation, and acute respiratory distress syndrome (ARDS). T cells have been important components of the immune system, which decide the fate of the COVID-19 disease. Recent studies have reported an important subset of T cells known as regulatory T cells (Tregs), which possess immunosuppressive and immunoregulatory properties and play a crucial role in the prognosis of COVID-19 disease. Recent studies have shown that COVID-19 patients have considerably fewer Tregs than the general population. Such a decrement may have an impact on COVID-19 patients in a number of ways, including diminishing the effect of inflammatory inhibition, creating an inequality in the Treg/Th17 percentage, and raising the chance of respiratory failure. Having fewer Tregs may enhance the likelihood of long COVID development in addition to contributing to the disease’s poor prognosis. Additionally, tissue-resident Tregs provide tissue repair in addition to immunosuppressive and immunoregulatory activities, which may aid in the recovery of COVID-19 patients. The severity of the illness is also linked to abnormalities in the Tregs’ phenotype, such as reduced expression of FoxP3 and other immunosuppressive cytokines, including IL-10 and TGF-beta. Hence, in this review, we summarize the immunosuppressive mechanisms and their possible roles in the prognosis of COVID-19 disease. Furthermore, the perturbations in Tregs have been associated with disease severity. The roles of Tregs are also explained in the long COVID. This review also discusses the potential therapeutic roles of Tregs in the management of patients with COVID-19. Full article

(This article belongs to the Special Issue Vaccines and Vaccination: Feature Papers)

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21 pages, 1656 KiB

Open AccessSystematic Review

How Well the Constructs of Health Belief Model Predict Vaccination Intention: A Systematic Review on COVID-19 Primary Series and Booster Vaccines

by Yam B. Limbu and Rajesh K. Gautam

Vaccines 2023, 11(4), 816; https://doi.org/10.3390/vaccines11040816 - 7 Apr 2023

Cited by 21 | Viewed by 5688

Abstract

This systematic review synthesizes the findings of quantitative studies examining the relationships between Health Belief Model (HBM) constructs and COVID-19 vaccination intention. We searched PubMed, Medline, CINAHL, Web of Science, and Scopus using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and identified 109 eligible studies. The overall vaccination intention rate was 68.19%. Perceived benefits, perceived barriers, and cues to action were the three most frequently demonstrated predictors of vaccination intention for both primary series and booster vaccines. For booster doses, the influence of susceptibility slightly increased, but the impact of severity, self-efficacy, and cues to action on vaccination intention declined. The impact of susceptibility increased, but severity’s effect declined sharply from 2020 to 2022. The influence of barriers slightly declined from 2020 to 2021, but it skyrocketed in 2022. Conversely, the role of self-efficacy dipped in 2022. Susceptibility, severity, and barriers were dominant predictors in Saudi Arabia, but self-efficacy and cues to action had weaker effects in the USA. Susceptibility and severity had a lower impact on students, especially in North America, and barriers had a lower impact on health care workers. However, cues to action and self-efficacy had a dominant influence among parents. The most prevalent modifying variables were age, gender, education, income, and occupation. The results show that HBM is useful in predicting vaccine intention. Full article

(This article belongs to the Special Issue Vaccines and Vaccination: Feature Papers)

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