SARS-CoV-2, Influenza and Other Respiratory Viruses: Preventive Measures Affecting the Determinants of Health and Disease

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

Deadline for manuscript submissions: 31 December 2025 | Viewed by 1676

Special Issue Editors


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Guest Editor
Netherlands Institute for Health Services Research (Nivel), 3513 Utrecht, The Netherlands
Interests: epidemiology; SARS-CoV-2; human influenza; respiratory syncytial virus; respiratory infections; public health
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Special Issue Information

Dear Colleagues,

Respiratory viruses are a common cause of illness in humans. They have a significant impact on global morbidity and mortality rates. This Special Issue focuses on "SARS-CoV-2, Influenza and Other Respiratory Viruses: Preventive Measures Affecting the Determinants of Health and Disease". The goal is to understand recent scientific advancements in this field.

We welcome new research, review papers, and viewpoints.

Dr. Marco Del Riccio
Dr. Saverio Caini
Guest Editors

Manuscript Submission Information

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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.

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Keywords

  • respiratory
  • viruses
  • SARS-CoV-2
  • human influenza
  • respiratory syncytial virus
  • vaccines
  • vaccination strategies
  • disease burden

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Related Special Issue

Published Papers (4 papers)

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Research

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13 pages, 833 KiB  
Article
Exploring Patient Trust in Healthcare Provider Influenza Vaccine Information and Recommendations in a Medically Underserved Area of Washington State
by Damianne Brand, Megan Giruzzi, Nick Giruzzi, Kavya Vaitla, Rose Krebill-Prather, Juliet Dang and Kimberly McKeirnan
Vaccines 2025, 13(5), 505; https://doi.org/10.3390/vaccines13050505 - 10 May 2025
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Abstract
Background/Objective: Patients have historically trusted healthcare providers to be a reliable source of health information. However, with the recent pandemic and subsequent recovery, understanding and developing patients’ trust has become even more important, especially regarding vaccine acceptance. The objective of this work [...] Read more.
Background/Objective: Patients have historically trusted healthcare providers to be a reliable source of health information. However, with the recent pandemic and subsequent recovery, understanding and developing patients’ trust has become even more important, especially regarding vaccine acceptance. The objective of this work is to explore the current level of trust that rural patients have in their healthcare providers concerning influenza vaccination and related recommendations and its impact on vaccine uptake in a rural county in Washington State. Methods: An anonymous survey was conducted by a survey research center using a random sampling of 3000 addresses for people living in Yakima County in Washington State. Yakima County has a high percentage of people who identify as Hispanic or Latino/a and is a medically underserved area. The survey was designed to evaluate factors influencing the decision to be vaccinated against influenza and the level of trust in information from healthcare providers. Results: Results showed that participants who had been vaccinated against influenza in the previous five years were more likely to trust the advice of their primary care provider (p < 0.001), specialty care provider (p < 0.001), pharmacist (p = 0.02), and nurse (p = 0.002). People who were not vaccinated against influenza in the last five years were statistically more likely to report that a recommendation from a healthcare provider would not make a difference in their decision (p < 0.001). People who were vaccinated were more likely to utilize healthcare providers as a source of information about the influenza vaccine (p < 0.001) and people who were unvaccinated were more likely to use their own personal research as a trusted information source (p = 0.04). Conclusions: Healthcare providers continue to be well regarded and trusted by their patients, especially in rurally located counties, though work still needs to be carried out around influenza vaccination importance messaging. This work identified that all healthcare providers need to work collaboratively to reinforce vaccination guideline recommendations and to both provide education and continue successful access-to-vaccination strategies to promote influenza prevention. Full article
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10 pages, 531 KiB  
Article
Influenza Vaccine Uptake and Associated Hospitalization Risk in Older Adults with or Without Dementia: Differences Between at Home-Living and Nursing Home Residents in Lombardy, Italy
by Lorenzo Blandi and Carlo Signorelli
Vaccines 2025, 13(5), 489; https://doi.org/10.3390/vaccines13050489 - 30 Apr 2025
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Abstract
Objective: Our population-based cohort study aims to compute the uptake of the influenza vaccine and the associated risk of hospitalization for respiratory diseases of infectious origin based on the residency setting and dementia status of people aged 65 or over. Methods: We conducted [...] Read more.
Objective: Our population-based cohort study aims to compute the uptake of the influenza vaccine and the associated risk of hospitalization for respiratory diseases of infectious origin based on the residency setting and dementia status of people aged 65 or over. Methods: We conducted a retrospective cohort study on the whole population of residents aged ≥65 in Lombardy, the most populated Italian region. Using region-wide administrative data, we computed the seasonal prevalence of vaccination for influenza from 1 October 2022 to 30 April 2023. To estimate the risk of hospitalization, we applied Fine-Gray sub-distribution hazard models, accounting for the competing risk of death and adjusting for confounders. Results: Our study analyzed 2,420,279 individuals aged 65+ in Lombardy. Overall, 51.4% received an influenza vaccination in 2022–2023. Among residents living at home, 50.8% were vaccinated, while nursing home residents had an uptake of 74.0%. People living with dementia reported a vaccination coverage of 62.6%, and vaccination rates were higher among those residing in nursing homes than those who lived at home. The adjusted sub-hazard ratios (SHRs) showed higher hospitalization risks of 1.88 for unvaccinated individuals with dementia and 1.74 for unvaccinated individuals without dementia living at home. In nursing homes, the SHR for respiratory hospitalization was 2.20 for individuals without dementia and 2.40 for dementia patients. Vaccination reduced risks across all groups, but disparities persisted. Conclusions: People living with dementia were more likely to be hospitalized for respiratory diseases. However, they reported an influenza vaccination coverage that was below expectations and similar to the general population, both in nursing homes and home-living settings. Public health institutions should extend and mention dementia as a higher-risk condition. Full article
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Review

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15 pages, 271 KiB  
Review
The Number Needed to Immunize (NNI) to Assess the Benefit of a Prophylaxis Intervention with Monoclonal Antibodies Against RSV
by Sara Boccalini, Veronica Gironi, Primo Buscemi, Paolo Bonanni, Barbara Muzii, Salvatore Parisi, Marta Borchiellini and Angela Bechini
Vaccines 2025, 13(8), 791; https://doi.org/10.3390/vaccines13080791 - 25 Jul 2025
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Abstract
Introduction: Respiratory Syncytial Virus (RSV) is the leading cause of lower respiratory tract infections in infants and children, as well as hospitalizations for respiratory infections in the pediatric population, representing a significant public health concern. Nirsevimab, a long-acting anti-RSV monoclonal antibody, has recently [...] Read more.
Introduction: Respiratory Syncytial Virus (RSV) is the leading cause of lower respiratory tract infections in infants and children, as well as hospitalizations for respiratory infections in the pediatric population, representing a significant public health concern. Nirsevimab, a long-acting anti-RSV monoclonal antibody, has recently been approved by the European Medicines Agency (EMA). The aim of this study is to assess the utility of certain parameters, such as the Number Needed to Immunize (NNI), in supporting decision-makers regarding the introduction of nirsevimab as a universal prophylactic measure. Methods: A literature review was conducted to identify the definition and application of the NNI in the context of infectious disease prevention. The following online databases were consulted: Scopus, MEDLINE, Google Scholar, Web of Science, and Cochrane Library. The search was restricted to English-language texts published between 1 January 2000 and 30 January 2025. Results: The NNI represents the number of individuals who need to be immunized to prevent clinical outcomes such as medical visits and hospitalizations caused by infectious diseases. Six studies were identified that utilized this parameter to outline the benefits of immunization and describe the advantages of using monoclonal antibodies for RSV disease. Finelli and colleagues report that to prevent one RSV-related hospitalization, 37–85 infants aged 0–5 months and 107–280 infants aged 6–11 months would need to be immunized with long-acting anti-RSV antibodies. A recent study by Mallah et al. on the efficacy of nirsevimab estimates that the NNI required to prevent one RSV-related hospitalization is 25 infants. Studies by Francisco and O’Leary report NNI values of 82 and 128 infants, respectively, to prevent one RSV-related hospitalization with nirsevimab. Mallah et al. describe NNI as a metric useful to quantify the immunization effort needed to prevent a single RSV hospitalization. A recent Italian study reports that 35 infants need to be immunized to prevent one hospitalization due to RSV-LRTI and 3 infants need to be immunized to prevent one primary care visit due to RSV-LRTI. The studies indicate that the NNI for anti-RSV monoclonal antibodies is lower than the corresponding Number Needed to Vaccinate (NNV) for vaccines already included in national immunization programs. The main limitations of using this parameter include the absence of a shared threshold for interpreting results and the lack of consideration for the indirect effects of immunization on the population. Conclusions: The NNI is an easily understandable tool that can be used to convey the value of an immunization intervention to a variety of stakeholders, thereby supporting public health decision-making processes when considered in association with the uptake of the preventative strategy. At the current status, the estimated NNI of monoclonal antibodies against RSV results favourable and confirms the use in the first year of life for the prevention of RSV disease. Full article

Other

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15 pages, 413 KiB  
Systematic Review
Interventions to Improve Vaccination Uptake Among Adults: A Systematic Review and Meta-Analysis
by Anelisa Jaca, Lindi Mathebula, Thobile Malinga, Kimona Rampersadh, Masibulele Zulu, Ameer Steven-Jorg Hohlfeld, Charles Shey Wiysonge, Julie C. Jacobson Vann and Duduzile Ndwandwe
Vaccines 2025, 13(8), 811; https://doi.org/10.3390/vaccines13080811 - 30 Jul 2025
Abstract
Background: Immunization is a highly effective intervention for controlling over 20 life-threatening infectious diseases, significantly reducing both morbidity and mortality rates. One notable achievement in vaccination efforts was the global eradication of smallpox, which the World Health Assembly declared on 8 May 1980. [...] Read more.
Background: Immunization is a highly effective intervention for controlling over 20 life-threatening infectious diseases, significantly reducing both morbidity and mortality rates. One notable achievement in vaccination efforts was the global eradication of smallpox, which the World Health Assembly declared on 8 May 1980. Additionally, there has been a remarkable 99.9% reduction in wild poliovirus cases since 1988, decreasing from more than 350,000 cases that year to just 30 cases in 2022. Objectives: The objective of this review was to assess the effects of various interventions designed to increase vaccination uptake among adults. Search Methods: A thorough search was conducted in the CENTRAL, Embase Ovid, Medline Ovid, PubMed, Web of Science, and Global Index Medicus databases for primary studies. This search was conducted in August 2021 and updated in November 2024. Selection Criteria: Randomized trials were eligible for inclusion in this review, regardless of publication status or language. Data Analysis: Two authors independently screened the search outputs to select potentially eligible studies. Risk ratios (RR) with 95% confidence intervals (CI) were calculated for each randomized controlled trial (RCT). A meta-analysis was conducted using a random-effects model, and the quality of the evidence was assessed using the GRADE approach. Main Results: A total of 35 randomized controlled trials met the inclusion criteria and were included in this review, with the majority conducted in the United States. The interventions targeted adults aged 18 and older who were eligible for vaccination, involving a total of 403,709 participants. The overall pooled results for interventions aimed at increasing influenza vaccination showed a risk ratio of 1.41 (95% CI: 1.15, 1.73). Most studies focused on influenza vaccination (18 studies), while the remaining studies examined various other vaccines, including those for hepatitis A, COVID-19, hepatitis B, pneumococcal disease, tetanus, diphtheria, pertussis (Tdap), herpes zoster, and human papillomavirus (HPV). The results indicate that letter reminders were slightly effective in increasing influenza vaccination uptake compared to the control group (RR: 1.75, 95% CI: 0.97, 1.16; 6 studies; 161,495 participants; low-certainty evidence). Additionally, participants who received education interventions showed increased levels of influenza vaccination uptake compared to those in the control group (RR: 1.88, 95% CI: 0.61, 5.76; 3 studies; 1318 participants; low-certainty evidence). Furthermore, tracking and outreach interventions also led to an increase in influenza vaccination uptake (RR: 1.87, 95% CI: 0.78, 4.46; 2 studies; 33,752 participants; low-certainty evidence). Conclusion: Letter reminders and educational interventions targeted at recipients are effective in increasing vaccination uptake compared to control groups. Full article
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