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Search Results (421)

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32 pages, 1753 KB  
Review
Vaccination Strategies Against Hepatic Diseases: A Scoping Review
by Zahra Beyzaei, Bita Geramizadeh, Sara Karimzadeh and Ralf Weiskirchen
Vaccines 2026, 14(1), 49; https://doi.org/10.3390/vaccines14010049 (registering DOI) - 31 Dec 2025
Abstract
Background/Objectives: Viral hepatitis remains a significant global cause of chronic liver disease, highlighting the importance of effective vaccination strategies. This review assesses recent evidence on vaccine safety and effectiveness. Methods: A comprehensive search of PubMed, Embase, Web of Science, and Scopus [...] Read more.
Background/Objectives: Viral hepatitis remains a significant global cause of chronic liver disease, highlighting the importance of effective vaccination strategies. This review assesses recent evidence on vaccine safety and effectiveness. Methods: A comprehensive search of PubMed, Embase, Web of Science, and Scopus identified English-language studies published from January 2000 to September 2025. Eligible studies evaluated vaccination for hepatitis A, B, C, or E, as well as vaccine responses in individuals with chronic liver disease or HIV infection. Of 5254 records screened, 166 studies met the inclusion criteria. Results: Hepatitis A vaccines demonstrated excellent safety, 95–100% short-term seroprotection, and durable immunity for both inactivated and live-attenuated formulations, with population-level reductions in disease incidence. Hepatitis B vaccines showed consistently strong immunogenicity across age groups, with over 90% seroprotection from recombinant and CpG-adjuvanted formulations. Effective prevention of mother-to-child transmission required maternal antiviral therapy, timely birth-dose vaccination, hepatitis B immunoglobulin (HBIG) administration, and post-vaccination serologic testing. Long-term data demonstrated immune persistence for up to 35 years and significant reductions in liver cancer following neonatal HBV vaccination. Limited studies in hepatitis C populations showed impaired responses, partially improved with higher or booster doses. Hepatitis E vaccines showed excellent safety and over 99% seroconversion. In non-viral liver disease and post-transplant populations, vaccine responses were reduced but remained clinically meaningful, especially with adjuvanted or higher-dose HBV vaccines. Among HIV-infected individuals, HAV vaccination was generally effective, while enhanced HBV regimens markedly improved seroprotection. Conclusions: Hepatitis A, B, and E vaccines are safe, immunogenic, and effective, with neonatal hepatitis B vaccination critical for preventing maternal transmission. No licensed HCV vaccine exists, and therapeutic HCV vaccines show limited efficacy. Optimized and targeted vaccination strategies are needed for individuals with chronic liver disease, HIV infection, HCV infection, transplant recipients, and other immunocompromised populations to maximize public health impact. Full article
(This article belongs to the Special Issue Vaccination and Public Health in the 21st Century)
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20 pages, 277 KB  
Article
Trends in Women’s Empowerment and Their Association with Childhood Vaccination in Cambodia: Evidence from Demographic and Health Surveys (2010–2022)
by Haizhu Song, Yanqin Zhang and Qian Long
Vaccines 2026, 14(1), 48; https://doi.org/10.3390/vaccines14010048 (registering DOI) - 31 Dec 2025
Abstract
Background: Women’s empowerment has been significantly associated with improved child health outcomes. Cambodia, amid a rapid socioeconomic transition, offers a critical setting to examine how advancements in women’s empowerment over the past decade have influenced child immunization completion within the first two [...] Read more.
Background: Women’s empowerment has been significantly associated with improved child health outcomes. Cambodia, amid a rapid socioeconomic transition, offers a critical setting to examine how advancements in women’s empowerment over the past decade have influenced child immunization completion within the first two years of life. Methods: Data from the Cambodia Demographic and Health Surveys conducted in 2010, 2014, and 2021–22, encompassing 9222 women with recent births, were analyzed. Empowerment was measured across literacy and information access, employment, and decision-making domains. Multinomial logistic regression assessed associations between empowerment factors and completion of oral polio (OPV), diphtheria–tetanus–pertussis (DTP), pneumococcal conjugate (PCV), and measles–rubella (MR) vaccines, adjusting for demographic and socioeconomic variables. Results: Between 2010 and 2022, women’s empowerment in Cambodia improved significantly, marked by higher literacy rates, nearly half of women completing primary education, and expanded digital access, with 82.4% owning mobile phones and approximately 50% using the internet daily. While non-working women slightly increased, agricultural employment declined by 20%, and cash earnings rose from 48.7% to 82.5%. Most women participated in major household decision-making, either independently or jointly. Completion rates for OPV, DTP, and PCV ranged from 79% to 83%, while just over half of children were fully vaccinated against measles. Higher maternal education and cash earnings were positively associated with OPV, DTP, and PCV completion but negatively associated with measles vaccination. Women in agricultural work were less likely to complete measles vaccination for their children than non-working women. Joint decision-making regarding the use of respondents’ income was associated with a higher likelihood of measles non-completion (OR = 2.26, 95% CI: 1.13–4.51), whereas joint decision-making about respondents’ health care was associated with a higher likelihood of measles completion (OR = 0.42, 95% CI: 0.21–0.83). Conclusions: Women’s empowerment remains a key determinant of vaccination outcomes in Cambodia. The distinct pattern observed for measles suggests that vaccines scheduled for older ages encounter greater structural and behavioral barriers. To overcome these challenges, strategies should focus on enhancing defaulter tracking, implementing reminder systems, expanding outreach and catch-up programs, and improving the convenience of vaccination services. Full article
(This article belongs to the Special Issue Vaccination and Public Health Strategy)
15 pages, 567 KB  
Systematic Review
Impact of Social Media on HPV Vaccine Knowledge and Attitudes Among Adolescents and Young Adults: A Systematic Literature Review
by Blessing Oluwatofunmi Apata, Anagha Hemant Tupe, Oluwabusayomi Akeju and Kelly L. Wilson
Healthcare 2026, 14(1), 73; https://doi.org/10.3390/healthcare14010073 - 27 Dec 2025
Viewed by 220
Abstract
Objective: Human Papillomavirus (HPV), a leading cause of sexually transmitted infections (STIs) and various cancers, including cervical cancer, remains prevalent in the US. Despite the HPV vaccine’s effectiveness in preventing persistent HPV infections, vaccination rates remain low. Given the significant role of [...] Read more.
Objective: Human Papillomavirus (HPV), a leading cause of sexually transmitted infections (STIs) and various cancers, including cervical cancer, remains prevalent in the US. Despite the HPV vaccine’s effectiveness in preventing persistent HPV infections, vaccination rates remain low. Given the significant role of social media in reaching younger populations, this systematic review examines its influence on adolescents’ and young adults (AYAs) awareness, knowledge, and attitudes toward HPV vaccination. Methods: Following the PRISMA guidelines, we conducted a comprehensive search across six electronic databases (ERIC, APA PsycInfo, Child Development & Adolescent Studies, CINAHL Ultimate, MEDLINE Ultimate, and PubMed) from 2011 to 2024. Empirical studies that examined the association between social media use and HPV were included. Data extraction captured the study’s purpose, design, population, outcome measures, and key results. Results: Seven studies satisfied the review’s inclusion criteria. Our findings reveal mixed effects of social media on AYAs’ knowledge and vaccination intentions. Some studies indicated positive associations between social media interventions and increased vaccination knowledge and intentions, while others found no significant impact. Additionally, exposure to anti-vaccine content was linked to lower vaccination intentions, especially among individuals with lower knowledge who were more vulnerable to misinformation. Interventions incorporating interactive content and loss-framed messaging were more effective in increasing vaccine intentions. Conclusions: This review underscores the potential of social media to influence AYAs knowledge and perceptions regarding HPV vaccination, while also highlighting the challenges posed by misinformation. Further research is needed to optimize social media interventions and combat misinformation to improve vaccination uptake. Full article
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28 pages, 861 KB  
Systematic Review
Mapping Pediatric Seasonal Influenza Vaccine Safety and Immunogenicity Evidence: A Systematic Review of Clinical Trials
by Alejandra Munoz, Briana Olivares, Yoelis Yepes-Perez, Yanping Chen, Jorge Ortiz, Maryam Amin and Mingtao Zeng
Vaccines 2026, 14(1), 32; https://doi.org/10.3390/vaccines14010032 - 26 Dec 2025
Viewed by 156
Abstract
Background: Influenza poses a significant health threat to children under nine, who are at high risk of severe complications. Influenza vaccination is a key prevention strategy, but pediatric trials use heterogeneous safety and immunogenicity outcomes, follow-up windows, and dosing strata that hinder meaningful [...] Read more.
Background: Influenza poses a significant health threat to children under nine, who are at high risk of severe complications. Influenza vaccination is a key prevention strategy, but pediatric trials use heterogeneous safety and immunogenicity outcomes, follow-up windows, and dosing strata that hinder meaningful cross-trial comparison. Objective: To map how safety and immunogenicity outcomes are defined, collected, stratified, and reported across clinical trials of seasonal influenza vaccines in healthy children aged 6 months to 8 years, and to identify reporting patterns and gaps that limit cross-trial comparability. Methods: Studies were identified through a structured PubMed/MEDLINE search first conducted 20 April 2025 and last conducted June 2025, following JBI and PRISMA 2020 guidelines. We included clinical trials reporting at least one safety outcome in healthy children 6 months to 8 years old. Heterogeneity in outcome definitions, follow-up windows, and dose strata precluded meta-analysis; we conducted a narrative and per-study synthesis. Risk of bias was evaluated with RoB 2 for randomized trials and ROBINS-I (V2) for non-randomized studies following Cochrane guidance. Descriptive and visual syntheses were utilized. Results: Of 293 records, 20 studies comprising approximately [n = 12,267] pediatric participants met the inclusion criteria. All included studies evaluated inactivated, egg-based seasonal influenza intramuscular vaccines. Reporting windows and dose handling varied widely. Vaccine-related serious adverse events (SAEs) were rare (only four events, with reported SAEs happening in children 6–35 months old immunized with quadrivalent formulations; all SAEs resolved and did not result in participant withdrawal from the study). No SAEs were reported in children 3–8 years old. Immunogenicity outcomes are presented as reported by each trial, with baseline and post-vaccination sampling days reproduced; no cross-trial synthesis was performed. Conclusions: Seasonal, inactivated intramuscular influenza vaccines show a favorable safety and immunogenicity profile in healthy children 6 months to 8 years old. However, heterogeneous outcome definitions, variable safety follow-up windows, limited dose- and priming-specific reporting, and inconsistent immunogenicity schedules substantially constrain cross-trial comparability. Funding and Registration: Primary funding was provided by the Eunice Kennedy Shriver National Institute of Child Health and Human Development (Grant HD109732). This review was registered in PROSPERO (registration number: CRD420251237499). Full article
(This article belongs to the Special Issue Vaccine Development for Influenza Virus: 2nd Edition)
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17 pages, 281 KB  
Article
Vaccine Hesitancy and Refusal Among Parents of Children Aged 5–11 Years: Evidence from the COVID-19 Pandemic in the Calabria Region
by Francesca Licata, Concetta Arianna Scicchitano, Emma Antonia Citrino and Aida Bianco
Vaccines 2026, 14(1), 17; https://doi.org/10.3390/vaccines14010017 - 23 Dec 2025
Viewed by 251
Abstract
Background/Objectives: This study aims to evaluate COVID-19 parental vaccine hesitancy (CPVH) and refusal among parents of children between 5 and 11 years and to identify potential factors influencing them. A secondary aim was to assess knowledge, concerns, and beliefs associated with COVID-19 and [...] Read more.
Background/Objectives: This study aims to evaluate COVID-19 parental vaccine hesitancy (CPVH) and refusal among parents of children between 5 and 11 years and to identify potential factors influencing them. A secondary aim was to assess knowledge, concerns, and beliefs associated with COVID-19 and immunization. Methods: This cross-sectional study was conducted among parents of children between 5 and 11 years using an anonymous, self-administered questionnaire. Sociodemographic characteristics, knowledge, concerns, and beliefs regarding COVID-19 and immunization in children; CPVH according to Parent Attitudes about Childhood Vaccines short scale; COVID-19 vaccination status and intention; and sources of information about COVID-19 vaccination were investigated. Results: Among 506 participating parents, only 12.7% correctly answered all six knowledge items. High CPVH was found in 60.1% of respondents and was more prevalent among younger parents and those with lower knowledge levels. Compared to having received no information on COVID-19 vaccination, high CPVH was positively associated with having received information from informal sources and trusting them and negatively associated with information from formal ones. More than half (58.3%) had vaccinated their child, and 38.5% had no intention to vaccinate their child against COVID-19. High CPVH, lower knowledge levels, and a need for further information were significant predictors of vaccine refusal. Conversely, refusal was negatively associated with parental COVID-19 vaccination status, and with having received information from formal and from both formal and informal sources compared to not having received information. Conclusions: The findings highlight the need for establishing and investing in platforms to promote vaccine awareness and dispelling misinformation among parents. Full article
12 pages, 224 KB  
Article
Socioeconomic Disparities in Childhood Vaccination Coverage in the United States: Evidence from a Post-COVID-19 Birth Cohort
by Xiaoyang Lv, Antong Long, Yansheng Chen and Hai Fang
Vaccines 2025, 13(12), 1256; https://doi.org/10.3390/vaccines13121256 - 18 Dec 2025
Viewed by 376
Abstract
Background: Childhood immunization is one of the most effective public health strategies for reducing morbidity and mortality from vaccine-preventable diseases. Although overall vaccination coverage in the United States remains high, disparities persist across socioeconomic and healthcare access groups. Understanding these disparities is [...] Read more.
Background: Childhood immunization is one of the most effective public health strategies for reducing morbidity and mortality from vaccine-preventable diseases. Although overall vaccination coverage in the United States remains high, disparities persist across socioeconomic and healthcare access groups. Understanding these disparities is particularly important in the post-COVID-19 era, when increased vaccine hesitancy may threaten progress in maintaining equitable coverage. Materials and Methods: We analyzed data from the National Immunization Survey–Child (NIS-Child), focusing on U.S. children aged 19–35 months in 2023, corresponding to cohorts reaching this age during or after the COVID-19 pandemic. The primary outcome was receipt of the up-to-date combined 7-vaccine series (4:3:1:3:3:1:3: ≥4 doses of DTaP, ≥3 doses of polio, ≥1 dose of measles-containing vaccine, full Hib series, ≥3 doses of hepatitis B, ≥1 dose of varicella, and ≥3 doses of PCV). Logistic regression models were used to estimate associations between vaccination coverage and key explanatory variables: household income-to-poverty ratio, maternal education, health insurance type, and provider facility type, controlling for demographic and regional covariates. Disparities were quantified using concentration indices (CIs). Results: Among children in the analytic sample, overall coverage for the 7-vaccine series was only 78.5%. Nonetheless, disparities were evident. Children from households with lower income-to-poverty ratios (<1 × FPL: OR = 0.44, 95% CI = 0.37–0.53; 100–200%: OR = 0.66, 95% CI = 0.56–0.79), those covered by Medicaid (OR = 0.54, 95% CI = 0.45–0.64), other insurance (OR = 0.48, 95% CI = 0.37–0.61), or uninsured (OR = 0.27, 95% CI = 0.18–0.42), and those whose mothers had lower educational attainment (<12 years: OR = 0.35, 95% CI = 0.28–0.44) had significantly lower odds of being up-to-date. Similar associations were observed across specific vaccines. Unadjusted CIs for income-to-poverty ratio (0.04, p < 0.01), maternal education (0.04, p < 0.01), health insurance (0.03, p < 0.01), and provider type (0.03, p < 0.01) decreased but remained statistically significant after adjustment (0.02, 0.02, 0.01, and 0.02, respectively; all p < 0.01). No significant disparities were found by census region or race/ethnicity. Discussion: Despite relatively high overall vaccination coverage among U.S. children born during and after the COVID-19 pandemic, disparities by socioeconomic and healthcare access factors persisted. However, the absolute magnitude of these disparities was very small (concentration indices ≤ 0.04). These findings suggest that while inequities remain statistically measurable, their scale is limited in absolute terms. Targeted efforts to address income, insurance, maternal education, and provider-related barriers will be important to sustain equitable immunization coverage in the post-pandemic era. Full article
14 pages, 439 KB  
Article
Impact of SARS-CoV-2 Infection and Vaccination on Pregnancy Outcome and Passive Neonatal Immunity
by Gina Marie Uehre, Valeriia Grabar, Evelin Grage-Griebenow, Oliver Klemens, Laura Scholz, Nils Hoymann, Suzan Alboradi, Atanas Ignatov, Svetlana Tchaikovski and Mandy Busse
Cells 2025, 14(22), 1812; https://doi.org/10.3390/cells14221812 - 19 Nov 2025
Viewed by 753
Abstract
Background: During the SARS-CoV-2 pandemic, many women were infected or received vaccinations against the virus before or during their pregnancy. Little is known about the possible consequences of vaccination or infection on obstetric outcomes, as well as antibody levels against other infectious [...] Read more.
Background: During the SARS-CoV-2 pandemic, many women were infected or received vaccinations against the virus before or during their pregnancy. Little is known about the possible consequences of vaccination or infection on obstetric outcomes, as well as antibody levels against other infectious agents, such as the TORCH pathogens. Methods: A total of 136 pregnant women were included in our study between March 2022 and February 2024. The concentrations of antibodies against nucleocapsid (NCP), the spike protein of SARS-CoV-2, as well as IgG and IgM antibodies against TORCH, were assessed in the maternal and umbilical cord blood. Results: The patients were grouped into the following categories according to responses given in the questionnaire and antibody titer: controls (neither infected nor vaccinated; N = 17), infected only (N = 35), vaccinated only (N = 21), acutely infected (N = 15), and both vaccinated and experienced a COVID-19 infection (N = 47). No differences between the groups in terms of pregnancy outcomes were found. The presence of IgG antibodies against NCP or spike protein in maternal blood was dependent on the patient’s vaccination status or previous infection, correlating with that in cord blood. The level of maternal IgG against spike protein correlated negatively with TORCH antibodies. Conclusions: The present study demonstrates the infection- and vaccination-dependent formation of SARS-CoV-2-specific antibodies in the mother and their transfer to the unborn child. Further studies are necessary to investigate the interaction between SARS-CoV-2-specific antibodies and antibodies formed by infection (e.g., CMV) or vaccination against other pathogens in the mother and transmitted transplacentally to the unborn child. Full article
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24 pages, 416 KB  
Review
Preconception Care and Genetic Screening: A Global Review and Strategic Perspectives for Implementation in Bulgaria
by Eleonora Hristova-Atanasova, Martina Micallef, Julia Stivala, Georgi Iskrov and Elitsa Gyokova
Children 2025, 12(11), 1538; https://doi.org/10.3390/children12111538 - 14 Nov 2025
Viewed by 1326
Abstract
Background: Preconception care (PCC) is a key element of preventive reproductive health, aiming to optimise maternal and child outcomes by addressing biomedical, behavioural, psychosocial, and genetic risks before conception. International frameworks provide clear guidance, yet implementation in many low- and middle-income countries remains [...] Read more.
Background: Preconception care (PCC) is a key element of preventive reproductive health, aiming to optimise maternal and child outcomes by addressing biomedical, behavioural, psychosocial, and genetic risks before conception. International frameworks provide clear guidance, yet implementation in many low- and middle-income countries remains inconsistent. Methods: A structured narrative review was conducted across PubMed, Web of Science, Cochrane Library, and Google Scholar, focusing on literature published between 2010 and 2025. Eligible sources included empirical studies, clinical guidelines, policy documents, and high-quality grey literature from health authorities. Quality, relevance, and applicability were assessed, with particular emphasis on European and Bulgarian contexts. Results: Evidence from diverse settings demonstrates that PCC interventions—such as chronic disease management, vaccination, lifestyle optimisation, and expanded carrier screening (ECS)—can reduce adverse pregnancy outcomes and prevent severe genetic disorders. Effective international models integrate PCC into primary care, leverage digital health tools, and ensure equitable access through public funding. In Bulgaria, PCC remains underdeveloped: genetic screening is not part of routine care, there are no national guidelines or surveillance systems, and only ~4% of women initiate folic acid supplementation before pregnancy. NGOs and EU-funded digital initiatives provide partial outreach but cannot replace state-supported services. Conclusions: Bulgaria urgently requires a coordinated national PCC strategy, incorporating standardised guidelines, provider training, digital platforms, and phased ECS introduction. Strengthening PCC delivery can reduce preventable maternal and neonatal morbidity, advance reproductive justice, and enhance the long-term sustainability of public health systems. These findings support the development of a publicly funded, guideline-driven national PCC strategy with phased introduction of expanded carrier screening under NHIF to improve equity and long-term system sustainability. Full article
(This article belongs to the Section Pediatric Neonatology)
23 pages, 1239 KB  
Review
Determinants of Parental Adherence to Childhood Immunization Among Children Under Five in Marginalized Asian Populations
by Nitima Nulong, Nirachon Chutipattana, Lan Thi Kieu Nguyen, An Dai Tran, Uyen Thi To Nguyen and Cua Ngoc Le
Int. J. Environ. Res. Public Health 2025, 22(11), 1692; https://doi.org/10.3390/ijerph22111692 - 9 Nov 2025
Viewed by 1059
Abstract
Childhood immunization is one of the most effective public health measures, yet inequities remain in marginalized populations across Asia, where parental adherence is essential to sustaining the Expanded Program on Immunization. This narrative review examines determinants of adherence among under-five children in disadvantaged [...] Read more.
Childhood immunization is one of the most effective public health measures, yet inequities remain in marginalized populations across Asia, where parental adherence is essential to sustaining the Expanded Program on Immunization. This narrative review examines determinants of adherence among under-five children in disadvantaged communities. Following PRISMA guidelines, searches of PubMed, Scopus, and Google Scholar identified studies published between 2015 and 2025, with earlier key works included as relevant. Twenty-one studies from South, Southeast, and East Asia were analyzed. Five domains were associated with adherence: socioeconomic and access factors, where maternal education, household income, and possession of immunization cards were positive predictors, while remote residence was a barrier; trust, cultural beliefs, and social norms, with misinformation and vaccine controversies reducing uptake, and provider trust and supportive norms improving it; migration and mobility, as migrant, stateless, and left-behind children had lower coverage due to weak registration and disrupted caregiving; household and caregiver dynamics, where decision-making by family or community members shaped uptake, while large family size and maternal employment limited adherence; and health system capacity, with inadequate infrastructure and follow-up hindering coverage and integration with maternal–child health services facilitating it. Addressing these intersecting barriers through equity-focused strategies is critical to achieving universal immunization coverage. Full article
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14 pages, 288 KB  
Article
Factors Associated with Missed Opportunities for Vaccination in Children During the First Year of Life: A Cross-Sectional Study
by Wágnar Silva Morais Nascimento, Eugênio Barbosa de Melo Júnior, Ana Raisla de Araújo Rodrigues, Beatriz Mourão Pereira, Joaquim Guerra de Oliveira Neto, Paulo de Tarso Moura Borges, Antonio Rosa de Sousa Neto and Telma Maria Evangelista de Araújo
Vaccines 2025, 13(11), 1129; https://doi.org/10.3390/vaccines13111129 - 1 Nov 2025
Viewed by 1140
Abstract
Background: Addressing Missed Opportunities for Vaccination (MOV) contributes to increased vaccination rates in children, reinforcing the need to investigate and intervene in the related factors. Objective: To analyze factors associated with missed opportunities for vaccination in children under one year of age in [...] Read more.
Background: Addressing Missed Opportunities for Vaccination (MOV) contributes to increased vaccination rates in children, reinforcing the need to investigate and intervene in the related factors. Objective: To analyze factors associated with missed opportunities for vaccination in children under one year of age in a Brazilian capital. Methods: This was a cross-sectional, analytical study conducted in seven Basic Health Units in Teresina, Piauí, Brazil. A previously validated questionnaire was applied to parents or guardians of a sample of 316 children. Data were collected from March to June 2025. Multivariable Logistic Regression was performed, and results were expressed as Odds Ratios. Results: Among the children, 53.5% had at least one MOV. The associated factors were: parents with two or more children (95% CI: 1.06–2.96), false contraindications (95% CI: 1.29–8.73), inadequate assessment of vaccination cards by health professionals (95% CI: 1.78–29.00), vaccine shortages in health units (95% CI: 1.57–18.28), and refusal to open multidose vaccine vials (95% CI: 1.81–19.31). Receiving information about vaccination in the previous month was a protective factor against MOV (95% CI: 0.25–0.77). The vaccines most frequently contributing to MOV were BCG (15.8%) and the COVID-19 vaccine, with 15.5% for the first dose and 14.9% for the second. Conclusions: The high prevalence of MOV found in this study indicates weaknesses in the immunization process and suggests the need for implementing measures to interrupt the chain of causes leading to MOV, thereby contributing to the achievement of the objectives of the Brazilian National Immunization Program. Full article
(This article belongs to the Special Issue The Role of Vaccination on Public Health and Epidemiology)
17 pages, 722 KB  
Article
Parental Vaccine Hesitancy, Trust in Physicians, and Future Vaccination Intentions: A PACV Cross-Sectional Study
by Sandra Janiak, Elwira Piszczek, Agnieszka Buczkowska and Krzysztof Buczkowski
Vaccines 2025, 13(11), 1127; https://doi.org/10.3390/vaccines13111127 - 1 Nov 2025
Viewed by 938
Abstract
Background/Objectives: Parents’ vaccine hesitancy constitutes a global challenge, strongly associated with trust in healthcare professionals. This study aimed to identify socio-demographic predictors of parental pro- and anti-vaccination behaviors and investigate the association between these factors and intentions regarding children’s future immunizations. Methods: We [...] Read more.
Background/Objectives: Parents’ vaccine hesitancy constitutes a global challenge, strongly associated with trust in healthcare professionals. This study aimed to identify socio-demographic predictors of parental pro- and anti-vaccination behaviors and investigate the association between these factors and intentions regarding children’s future immunizations. Methods: We conducted a cross-sectional online survey using the Parent Attitudes about Childhood Vaccines (PACV) questionnaire. Participants were recruited purposively and via snowballing through parenting groups and educational institutions. Results: We surveyed 1.046 parents and provided attitudes for 1.701 children; 85.1% of child-specific responses reflected positive attitudes (PACV ≤ 50; median 16.7). In univariate regression, employment (OR = 2.172, 95% CI: 1.530–3.084; p < 0.001) and healthcare employment (OR = 2.907, 95% CI: 1.983–4.262; p < 0.001) increased the odds of positive attitudes, whereas each additional household member (OR = 0.693, 95% CI: 0.597–0.805; p < 0.001) and child (OR = 0.677, 95% CI: 0.579–0.792; p < 0.001) reduced them. Multivariable models confirmed higher odds for suburban/rural residence (OR = 1.614, 95% CI: 1.037–2.513; p = 0.034), employment (OR = 1.869, 95% CI: 1.284–2.721; p = 0.001), and healthcare employment (OR = 2.785, 95% CI: 1.872–4.144; p < 0.001). Among prior non-vaccinators (n = 114), 39.5% planned to vaccinate, 41.2% did not. Those who planned showed greater trust than non-planners in the child’s doctor (mean: 7.49 vs. 3.74) and schedule (mean: 7.89 vs. 1.40), p < 0.001, with lower trust correlating with greater hesitancy and safety concerns. Conclusions: Trust in physicians was strongly associated with both current attitudes and future intentions. Trust-focused, patient-centered communication may be related to more positive vaccination attitudes among parents. However, longitudinal research is needed to determine whether such trust could influence changes in vaccination behavior, especially since parents’ attitudes toward vaccinations can evolve with the arrival of subsequent children. Full article
(This article belongs to the Special Issue Acceptance and Hesitancy in Vaccine Uptake: 2nd Edition)
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16 pages, 424 KB  
Review
Digital Twins in Pediatric Infectious Diseases: Virtual Models for Personalized Management
by Susanna Esposito, Beatrice Rita Campana, Hajrie Seferi, Elena Cinti and Alberto Argentiero
J. Pers. Med. 2025, 15(11), 514; https://doi.org/10.3390/jpm15110514 - 30 Oct 2025
Viewed by 950
Abstract
Digital twins (DTs), virtual replicas that integrate mechanistic modeling with real-time clinical data, are emerging as powerful tools in healthcare with particular promise in pediatrics, where age-dependent physiology and ethical considerations complicate infectious disease management. This narrative review examines current and potential applications [...] Read more.
Digital twins (DTs), virtual replicas that integrate mechanistic modeling with real-time clinical data, are emerging as powerful tools in healthcare with particular promise in pediatrics, where age-dependent physiology and ethical considerations complicate infectious disease management. This narrative review examines current and potential applications of DTs across antimicrobial stewardship (AMS), diagnostics, vaccine personalization, respiratory support, and system-level preparedness. Evidence indicates that DTs can optimize antimicrobial therapy by simulating pharmacokinetics and pharmacodynamics to support individualized dosing, enable Bayesian therapeutic drug monitoring, and facilitate timely de-escalation. They also help guide intravenous-to-oral switches and treatment durations by integrating host-response markers and microbiological data, reducing unnecessary antibiotic exposure. Diagnostic applications include simulating host–pathogen interactions to improve accuracy, forecasting clinical deterioration to aid in early sepsis recognition, and differentiating between viral and bacterial illness. Immune DTs hold potential for tailoring vaccination schedules and prophylaxis to a child’s unique immune profile, while hospital- and system-level DTs can simulate outbreaks, optimize patient flow, and strengthen surge preparedness. Despite these advances, implementation in routine pediatric care remains limited by challenges such as scarce pediatric datasets, fragmented data infrastructures, complex developmental physiology, ethical concerns, and uncertain regulatory frameworks. Addressing these barriers will require prospective validation, interoperable data systems, and equitable design to ensure fairness and inclusivity. If developed responsibly, DTs could redefine pediatric infectious disease management by shifting practice from reactive and population-based toward proactive, predictive, and personalized care, ultimately improving outcomes while supporting AMS and health system resilience. Full article
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19 pages, 567 KB  
Article
Digital Storytelling to Reduce Hispanic Parents’ COVID-19 Vaccine Hesitancy: A Pilot Randomized Controlled Trial
by Sunny W. Kim, Fernanda Lozano, Michael Todd, Linda Larkey, Raheleh Bahrami, Kavya Juwadi and Alexis Koskan
Vaccines 2025, 13(11), 1093; https://doi.org/10.3390/vaccines13111093 - 24 Oct 2025
Cited by 1 | Viewed by 1111
Abstract
Background/Objectives: Hispanic children in the U.S. experience disproportionately low COVID-19 vaccination rates, largely due to parental vaccine hesitancy. Digital storytelling offers a culturally relevant approach to address concerns through first-hand narratives. This study examined the feasibility and acceptability of a community-driven digital storytelling [...] Read more.
Background/Objectives: Hispanic children in the U.S. experience disproportionately low COVID-19 vaccination rates, largely due to parental vaccine hesitancy. Digital storytelling offers a culturally relevant approach to address concerns through first-hand narratives. This study examined the feasibility and acceptability of a community-driven digital storytelling intervention to reduce vaccine hesitancy among Hispanic parents. Methods: Ten formerly vaccine-hesitant Hispanic parents developed digital stories about their reasons for vaccinating their child(ren) against COVID-19. We then enrolled 80 Hispanic parents whose children were not up to date with COVID-19 vaccines in a randomized feasibility trial. Intervention group participants (n = 40) viewed four digital stories selected by a community advisory board, while control group participants (n = 40) viewed four length- and format-matched videos about nutrition. Surveys were completed pre-intervention (T1), immediate post-intervention (T2), and at 2-month follow-up (T3). A subsample of intervention participants also joined focus groups at T3. Results: Qualitative data suggested that DST was an acceptable and engaging method of health education. Intervention group parents showed moderately larger increases in intention to vaccinate than did controls at T2 (d = 0.41) and T3 (d = 0.30). At T3, intervention group parents were more likely to have vaccinated their children than were controls (OR = 5.20, 95% CI = 1.63–16.57; RR = 3.10, 95% CI = 1.30–7.37). Conclusions: The community-driven digital storytelling intervention was feasible and acceptable, and findings suggest moderate effects on increasing vaccine intentions and uptake. Future work should evaluate its effectiveness in reducing parental vaccine hesitancy and, in turn, vaccine uptake for other childhood immunizations. Full article
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15 pages, 266 KB  
Article
Parents’ Attitudes and Beliefs Towards Human Papillomavirus Vaccination
by Ivana Kotromanovic Simic, Darko Kotromanovic, Nika Lovrincevic Pavlovic, Jelena Kovačević, Marija Olujic, Danijela Nujic, Matea Matic Licanin, Ivon Matić, Jelena Sakic Radetic, Ilijan Tomas, Vlatko Kopic, Ivan Miskulin and Maja Miskulin
Vaccines 2025, 13(11), 1085; https://doi.org/10.3390/vaccines13111085 - 22 Oct 2025
Viewed by 1216
Abstract
Background/Objectives: The Human Papillomavirus (HPV) is one of the most common causes of STIs, posing a significant public health problem. Today, the transmission of HPV can be very effectively prevented, making it important to vaccinate the target population at a young age. [...] Read more.
Background/Objectives: The Human Papillomavirus (HPV) is one of the most common causes of STIs, posing a significant public health problem. Today, the transmission of HPV can be very effectively prevented, making it important to vaccinate the target population at a young age. The aim of this study was to examine the attitudes and beliefs of parents regarding the HPV vaccine and the HPV vaccination of their child. Methods: This cross-sectional study was conducted in Osijek, Croatia, from June 2021 to September 2022 via a self-administered questionnaire and included 215 respondents. Results: The results showed that respondents who would vaccinate their child were significantly more likely to be those who work in the healthcare field, who had heard of the term HPV, who had sought information about the HPV vaccine on their own, and who had received information about vaccination from school doctors. The attitude towards vaccination was more negative among respondents who did not intend to vaccinate their child. In predicting the decision not to vaccinate one’s child against HPV, bivariate logistic regression revealed that the probability of non-vaccination increases with working outside the field of healthcare (OR = 4.61) and a negative attitude towards vaccination (OR = 1.46), while the probability of non-vaccination decreases if information was received from a school doctor (OR = 0.46). Furthermore, multivariate logistic regression showed that there is a significant model in predicting non-vaccination against HPV, consisting of two predictors: working outside the healthcare field (OR = 8.15) and a negative attitude towards vaccination (OR = 1.49). Conclusions: Given that parents are responsible for making the decision about HPV vaccination, it is necessary to invest additional efforts in educating them about the importance of preventing HPV infections and the benefits of HPV vaccination itself. Full article
(This article belongs to the Special Issue The Role of Vaccination on Public Health and Epidemiology)
30 pages, 3776 KB  
Systematic Review
Vertical Transmission of Hepatitis B and C—Then and Now—A Comprehensive Literature Systematic Review
by Ruxandra Dobritoiu, Daniela Pacurar, Raluca Maria Vlad and Doina Anca Plesca
Viruses 2025, 17(10), 1395; https://doi.org/10.3390/v17101395 - 20 Oct 2025
Viewed by 2300
Abstract
Background: According to a WHO global hepatitis report, the global prevalence of hepatitis B in 2022 was 254 million and for hepatitis C it was 50 million. The estimated number of people newly infected by viral hepatitis declined from 3 million in 2019 [...] Read more.
Background: According to a WHO global hepatitis report, the global prevalence of hepatitis B in 2022 was 254 million and for hepatitis C it was 50 million. The estimated number of people newly infected by viral hepatitis declined from 3 million in 2019 to 2.2 million in 2022. Of these, 1.2 million are hepatitis B infections and nearly 1.0 million are hepatitis C infections. Regarding vertical transmission, it is estimated that 4 to 5 million children are infected worldwide every year from HBV-positive mothers. The United States declared that hepatitis C is the commonest chronic blood-borne infection, with an increase in HCV birth infections from 1.8 to 4.7 per 1000 births. Objectives: This systematic review focuses on highlighting the most suitable screening methods and maternal interventions to prevent HBV/HCV mother-to-child transmission, as well as the appropriate prophylactic strategies for newborns. Materials and methods: We searched a medical database (PubMed) to find papers regarding mother-to-child transmission of hepatitis B and C. Inclusion criteria were human-based studies, studies with large cohorts of subjects, studies conducted in different parts of the globe and position papers from various international associations. Exclusion criteria were non-human-based studies and non-English publications. To present and synthesize results we made use of thematic analysis and narrative synthesis. Results: We included 103 publications. For hepatitis B, the combination of maternal antiviral therapy during pregnancy and timely administration of HBV vaccine alongside HBIG to the newborn has proven to be highly effective in lowering transmission rates. Hepatitis C vertical transmission lacks an effective vaccine or immuno-prophylaxis, turning prevention strategies into a continuous battle. Conclusions: Vertical transmission of hepatitis B and C continues to be a major contributor to the global burden of chronic viral hepatitis. Strengthening prenatal care programs, improving access to diagnostic and therapeutic resources and enhancing public health policies are essential to curb vertical transmission of both hepatitis B and C. Full article
(This article belongs to the Section Human Virology and Viral Diseases)
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