Search Results (291)

The Crimean–Congo hemorrhagic fever virus (CCHFV) is a single-stranded, segmented RNA virus belonging to the Nairoviridae family, and it is rapidly expanding across Africa, Asia, and southern Europe, probably favored by climate change and livestock trade. Its fatality rate in humans reaches up to 40%, and there is currently no specific treatment or vaccine available. Therefore, the development of therapies against CCHFV is essential, and their design requires understanding of the molecular evolution and genetic distribution of the virus. Motivated by these concerns, we present a comprehensive review of the molecular evolution, genetic characterization, and phylogeography of CCHFV, and we discuss their potential implications for therapeutic design. Specifically, we describe the virus’s capacity to increase its genetic diversity through numerous mutations, recombination events, and genomic reassortments, which affect fundamental viral functions such as RNA binding, host–virus interactions, viral entry, and polymerase activity. We also assess the presence of temporal heterogeneous rates of evolution and molecular adaptation among CCHFV coding regions, where purifying selection is generally predominant but diversifying selection is observed in molecular regions associated with host adaptation and transmission. We emphasize the importance of understanding the complex molecular evolution of CCHFV for the rational design of therapies and highlight the need for efforts in surveillance, evolutionary prediction, and therapeutic development. Full article

Classical epidemic models treat vaccine uptake as an exogenous parameter, yet real-world coverage emerges from strategic choices made by individuals facing uncertain risks. During the last two decades, vaccination games, which combine epidemic dynamics with game theory, behavioural economics, and network science, have become a very important tool for analysing this problem. Here, we synthesise more than 80 theoretical, computational, and empirical studies to clarify how population structure, psychological perception, pathogen complexity, and policy incentives interact to determine vaccination equilibria and epidemic outcomes. Papers are organised along five methodological axes: (i) population topology (well-mixed, static and evolving networks, multilayer systems); (ii) decision heuristics (risk assessment, imitation, prospect theory, memory); (iii) additional processes (information diffusion, non-pharmacological interventions, treatment, quarantine); (iv) policy levers (subsidies, penalties, mandates, communication); and (v) pathogen complexity (multi-strain, zoonotic reservoirs). Common findings across these studies are that voluntary vaccination is almost always sub-optimal; feedback between incidence and behaviour can generate oscillatory outbreaks; local network correlations amplify free-riding but enable cost-effective targeted mandates; psychological distortions such as probability weighting and omission bias materially shift equilibria; and mixed interventions (e.g., quarantine + vaccination) create dual dilemmas that may offset one another. Moreover, empirical work surveys, laboratory games, and field data confirm peer influence and prosocial motives, yet comprehensive model validation remains rare. Bridging the gap between stylised theory and operational policy will require data-driven calibration, scalable multilayer solvers, and explicit modelling of economic and psychological heterogeneity. This review offers a structured roadmap for future research on adaptive vaccination strategies in an increasingly connected and information-rich world. Full article

Background/Objectives: Influenza vaccination plays a crucial role in reducing morbidity and mortality among older adults; however, uptake remains suboptimal, particularly in the post-COVID-19 pandemic. In many settings, countries have not recovered their influenza vaccine coverage rates to the same level as pre-COVID. Therefore, this scoping review systematically identified the behavioral and social drivers (BeSD) influencing influenza vaccination among older adults using the BeSD framework. Methods: A systematic search across five databases included quantitative, qualitative, and mixed-methods studies involving individuals aged 60 years and older. Data were charted across four BeSD domains: thinking and feeling, social processes, motivation, and practical issues. Results: Thirty-nine studies from 24 countries were included. Key barriers encompassed safety concerns, misinformation, financial burdens, logistical challenges, and cultural and language barriers. While motivation was positively associated with vaccination intentions, the transition from intention to behavior remains underexplored, and practical issues have received comparatively limited research attention. Conclusions: These findings underscore the need for multifaceted, behaviorally informed interventions and greater inclusion of under-resourced settings to support equitable influenza vaccination strategies for healthy aging. Full article

Background/Objectives: Vaccine hesitancy is one of the top ten threats to global health. It is necessary to develop appropriate strategies to address vaccine hesitancy. This systematic review aimed to analyze strategies used to improve the acceptance of vaccines, address doubts, and/or increase confidence and motivation in routine vaccination across all age groups. Methods: A systematic review was conducted of the MEDLINE, Dialnet, Scielo, CINAHL, and CENTRAL databases between 2018 and 2023. The inclusion criterion was full-text studies in English or Spanish that improve the degree of acceptance of vaccines and were evaluated by vaccination rate or pre- or postintervention tests. For data extraction, each study was categorized as community education, tailored messages, media, and new technologies. Results: A total of 1938 studies were identified, 38 of which were selected. New technology-based interventions used in the adult population for several vaccines offer broad reach, user interaction, and data accessibility. Tailored message strategies were used mainly among parents to foster strong relationships through respectful and empathetic dialog. Community education programs were targeted mainly at adolescents, emphasizing the use of structured, appropriate and interactive materials. Media campaigns were used as a support strategy for community education and new technology strategies due to their simplicity, wide coverage, and reach. Conclusions: The best strategies for reducing hesitancy are multicomponent interventions with structured and organized educational content based on the reasons for hesitancy and tailored to the target population. Therefore, caution must be taken when applying interventions, given that no single strategy can address this issue. Full article

Background: Despite the significant global disease burden associated with HPV infection, the vaccination coverage among female college students in China remains suboptimal. This study aimed to examine HPV vaccination coverage, knowledge levels, and determinants influencing vaccination behavior among female college students in northern China, utilizing the Health Belief Model (HBM) as a theoretical framework. Methods: A cross-sectional online survey was conducted from December 2024 to January 2025, involving 4076 female students from six universities in Jinan, China. The participants were categorized into three groups: vaccinated (VG), willing-to-vaccinate (WTG), and unwilling-to-vaccinate (UTG). Data on sociodemographic characteristics, HPV knowledge, health beliefs, and vaccination behavior were analyzed using ANOVA, chi-square tests, correlation analysis, and multivariate logistic regression. Results: The vaccination rate was 18.11%, with 40.19% expressing willingness to vaccinate and 41.71% expressing unwillingness. Vaccinated students demonstrated higher levels of HPV knowledge (6.66 ± 2.67 compared to 4.76 ± 3.10 in the UTG, p < 0.001) and were predominantly from urban areas (OR = 0.64, p < 0.001). The key determinants of vaccination uptake included perceived benefits (OR = 1.54, p < 0.001), perceived barriers (OR = 3.34, p < 0.001), self-decision-making ability (OR = 1.80, p < 0.001), and social motivation (OR = 0.21, p < 0.001). Notably, increased knowledge was associated with vaccine hesitancy in the WTG group (OR = 0.45, p < 0.001), indicating that information overload may adversely affect decision-making processes. Structural barriers, such as cost (42.63%), safety concerns (46.59%), and misconceptions (e.g., 57.76% cited “no sexual activity” as a reason for refusal), significantly impeded vaccine uptake. Conclusions: The low coverage of HPV vaccination is indicative of deficiencies in knowledge, socioeconomic disparities, and cultural perceptions. Tailored interventions should focus on educational efforts to correct misconceptions, provide subsidized access to vaccines, and implement empowerment strategies that enhance self-efficacy and informed decision-making. Policymakers should incorporate these findings into national cervical cancer prevention programs to address the gap between vaccination intention and behavior among young women in China. Full article

Background: Maternal vaccination is a critical primary preventive approach and an integral part of life-course immunization strategy, influencing the infection-associated morbidity and mortality in pregnant women, foetuses, and young infants. Despite clear guidelines for the administration of vaccines against tetanus, diphtheria, pertussis (Tdap), influenza, and COVID-19 during pregnancy, maternal vaccination rates remain suboptimal in Ireland as per the National Immunisation Office of the Health Service Executive (HSE). Aim: This review explores the prevailing status, uptake factors, and maternal immunization-specific vaccine hesitancy in Ireland. Method: A scoping review was conducted, searching nine electronic databases, including the Irish health research repository Lenus. The search strategy utilised a Population–Concept–Context framework (pregnant women—vaccine uptake/hesitancy—Ireland). Key factors identified and categorised according to the 5A framework: access, affordability, awareness, acceptance, and activation. Results: Searches yielded 2457 articles, and 12 eligible studies were included for review. Influencing factors were identified in each of the 5A dimensions, with the majority relating to acceptance and awareness. Positively associated factors included healthcare provider (HCP) recommendation and knowledge of vaccine safety. Potential antenatal barriers were maternal lack of knowledge of vaccine-preventable illness severity, infection risks, and vaccine safety concerns. A pregnant woman’s primary motivation for antenatal immunization was protection of her infant; however, the reluctance of HCPs to prescribe all recommended antenatal vaccines, inadequate immunization-specific discussion during antenatal consultations, and suboptimal knowledge of pregnancy-specific vaccine safety hampered potential positive influences. The Irish national immunization policy was a facilitator of affordability. Activation can be achieved through public health awareness campaigns and interdisciplinary promotion of maternal vaccination uptake. Conclusions: Maternal vaccination uptake in Ireland remains suboptimal, and a coordinated, targeted approach updating HCP recommendations, enhancing maternal awareness, and highlighting vaccine safety in pregnancy would be required to meet the life-course immunization goals recommended by WHO. By adopting a life-course immunization approach for healthy living, with maternal vaccination as the pivotal central point, vaccination programmes could close immunity gaps at various life stages. Full article

Background: The COVID-19 pandemic highlighted the crucial role of community preventive behaviors in controlling the virus’ spread. Studies show that people’s risk perceptions and awareness significantly contribute to the containment and prevention of infections by motivating adoption of desired actions and behaviors. This study aimed at assessing the role of risk communication and factors that influenced responses during the COVID-19 pandemic in rural communities in Western Kenya. Methods: A descriptive cross-sectional study was conducted using a quantitative research approach, collecting data from 806 individuals across Kisumu, Vihiga, and Kakamega counties. Descriptive statistics were used to detail the demographic characteristics of the study population, while logistic regression analysis estimated the associations between risk communication and demographic characteristics on COVID-19 vaccine acceptance, compliance with mitigation behaviors, perceived severity, and perceived susceptibility. Results: The results showed that 55% of participants were male and 45% were female, with an average moderate compliance with safety measures (mean = 5.15). A significant portion of participants wore face masks (85.3%), practiced hand hygiene (78.9%), and avoided close contact behaviors (66.6%). Most respondents received information through mass media (86.1%) and health workers (72.9%). Compliance with COVID-19 mitigation measures was highest among those who trusted information from official institutions, health professionals, and mass media, compared to social media, with increased odds of 2.7 times and 2.5 times, respectively. Higher risk perception was significantly associated with older age groups (above 50 years), being male, and working in the private sector. Effective risk communication significantly influenced risk perception, compliance with COVID-19 measures, and vaccination acceptance. Conclusions: The findings suggest that effective risk communication strategies are critical during public health emergencies and hence implications for future public health crises. The results underscore the importance of targeted communication and tailored interventions to improve compliance and vaccine acceptance among different demographic groups, ensuring a more robust public health response during outbreaks and pandemics. Full article

Background: The introduction of the human papilloma virus (HPV) vaccine has allowed for incredible strides in the reduction in HPV-related cancers. Despite widespread availability and a recent age group expansion for the vaccine, uptake remains low. Particularly, concerning disparities exist in the state of Tennessee and among minority women. This study aimed to identify key influences of decision-making to receive the HPV vaccine in minority women living in Tennessee. Methods: This study used a prospective, observational, qualitative methods approach. Minority women residing in Tennessee were recruited through flyers posted in various community-based locations around the state. Narrative interviews of participants were conducted until thematic saturation was achieved. Interviewing occurred telephonically, with questions focused on participant perceptions of HPV and its vaccine. Verbatim transcripts were created via external software, and then inductively coded by three researchers. These codes were grouped into categories based on similarities, which facilitated the emergence of themes. Results: A total of 21 participants were interviewed between July and October 2024. Thematic analysis revealed two themes: (1) Awareness of HPV: Determining if the Vaccine is Right for Me; and (2) Intrinsic Motivators for HPV Vaccine adoption: “Like going to the salon and getting your hair half-done”. While some participants had an accurate understanding of HPV, its health consequences, and had received the vaccine, most were unvaccinated and had little understanding of the benefits of this preventative method. Those who received the HPV vaccination were influenced by proactive healthcare workers who provided in-depth education about its benefits. Those who did not elect to receive the vaccine described how its lack of mandate and seldom informational opportunities impacted their decision. Conclusions: Overall, minority women in Tennessee could benefit from improved access to information regarding HPV and its vaccine, as well as direct provider influence and counseling on receiving the vaccine to avoid detrimental health consequences. Full article

Background: In recent years, tumor vaccines have demonstrated unexpected success in cancer treatment. However, it still faces several challenges, including insufficient antigen and adjuvant delivery, unsuitable antigen delivery system, and inadequate antigen-presenting cell (APC) maturation. Antigenic adjuvant co-delivery tactics could be one way to enhance APC maturation. Methods: Membrane-fused nanovesicles were synthesized by separating melanoma cell membranes from BCG cytoplasmic membranes. Dynamic light scattering and transmission electron microscopy were used for measuring the vesicles’ size and shape. The uptake of vesicles by mouse bone marrow-derived dendritic cells and the activation of DC cells by vesicles were verified in vitro. In order to further confirm the material’s capacity to activate the immune system and its ability to inhibit tumor growth, the activation of DC and T cells in mouse draining lymph nodes and the concentration of anti-tumor cytokines were measured. Results: The hybrid vesicles were homogeneous in size and could facilitate phagocytosis by dendritic cells (DCs). They could also effectively activate DCs and T cells in vitro and in vivo, eliciting anti-tumor immunity. Moreover, the vesicles demonstrated satisfying biosafety with no major side effects. Conclusions: Motivated by the myth of the Trojan Horse, we created an antigen-adjuvant-integrated nanovesicle that merges the BCG cytomembrane with the tumor cell membrane, which can achieve immune cell stimulation and tumor antigen delivery simultaneously. In conclusion, these findings support the potential application of dual-membrane fusion nanovesicles as tumor vaccines. Full article

Background and Aim: This study evaluated Turkish women’s health beliefs and motivations for participating in cervical cancer screening using the Health Belief Model Scale for Cervical Cancer and Pap Smear Test (HBMS-CCPST). Although the HPV vaccine has proven effective, Turkey has not integrated it into the national health program, but it provides free HPV-DNA screenings for women at family health centers (FHCs). This study evaluated Turkish women’s health beliefs and motivations for participating in cervical cancer screening using the Health Belief Model Scale for Cervical Cancer and Pap Smear Test (HBMS-CCPST) with the aim of understanding and enhancing screening uptake. Methods: This cross-sectional study was conducted at the family health centers in the Kartal and Pendik districts of Istanbul and involved women aged 30–65 years. The participants were randomly selected from the FHCs’ 2023 lists. Data were collected through face-to-face interviews, using a structured questionnaire based on the HBMS-CCPST. Results: A randomly selected sample of 422 women from 8003 registered FHCs was approached to participate; 354 agreed, 25 declined, and 43 were excluded because they did not meet the inclusion criteria. The mean age was 44.58 years (range: 30–64), and 51% had previously undergone a smear test. Correlations were found between age and the total HBMS-CCPST score (r = −0.207, p = 0.001), perceived benefits (r = −0.106, p = 0.046), health motivation (r = −0.195, p = 0.001), and perceived barriers (r = 0.132, p = 0.013). Social security status influenced the HBMS-CCPST scores (p = 0.019), health motivation (p = 0.011), and perceived barriers (p = 0.002). Employment status affected the total score (p = 0.001), health motivation (p = 0.001), and perceived barriers (p = 0.001), with employed women showing higher health motivation and lower perceived barriers. Alcohol use and physical activity levels affected the total score (p = 0.001 and p = 0.007, respectively) and health motivation (p = 0.011 and p = 0.001, respectively). STD risk perception affected the HBMS-CCPST scores (p = 0.001, p = 0.001) and perceived barriers (p = 0.001 and p = 0.001, respectively). Conclusions: Sociodemographic factors and daily habits significantly influenced the participants’ health beliefs and motivations for cervical cancer screening. Full article

Background/objectives: Attitudes towards COVID-19 vaccination vary globally, influenced by political and cultural factors. This research aimed to assess the views of people without a healthcare qualification in Europe on COVID-19 vaccination safety, effectiveness, and necessity as well as how well informed they felt. The secondary outcomes focused on how respondents’ views were affected by demographic and context factors and included a comparison by country of the level of feeling well informed. Methods: A mixed-method cross-sectional online survey in eight European countries, using convenience sampling. Results: A total of 1008 adults completed the survey, 60% of whom were female. While only 44.1% considered the vaccines safe, 43.5% effective, and 44.9% necessary, 80.0% had been vaccinated. Four in ten adults strongly agreed that they were well informed, while over a quarter did not answer the question. Younger respondents, well-informed individuals, and German respondents were more inclined to perceive COVID-19 vaccination as both effective and necessary. Conclusions: Motivations for vaccination included perceived health and social benefits, while concerns included a preference for “natural immunity”, the rapid development of the vaccine, and potential unknown long-term effects. A correlation existed between respondents feeling well informed about the different COVID-19 vaccines in their country and the likelihood of having been vaccinated. Full article

Vaccine hesitancy presents a significant challenge to public health, particularly in culturally diverse regions, such as South Tyrol, Italy. This article examines the interplay between political influences, conspiracy theories, and vaccine hesitancy in South Tyrol, an autonomous province characterised by its linguistic diversity and historical scepticism toward central authority. This study aimed to identify the important drivers of vaccine hesitancy and propose targeted strategies to enhance vaccine acceptance. Peer-reviewed and grey literature was examined to explore the sociocultural factors, political dynamics, and conspiracy narratives influencing vaccine hesitancy in South Tyrol. The analysis incorporated publicly available materials, including propaganda from anti-vaccine organisations, and regional public health data to contextualise the findings. Vaccine hesitancy in South Tyrol was influenced by historical tensions with the central government, cultural alignment with Austrian healthcare practices, and politically motivated opposition to vaccination. Conspiracy theories disseminated by local organisations and political entities exploit concerns regarding governmental overreach and personal autonomy. These dynamics are compounded by the selective misrepresentation of scientific discourse, which further polarises public opinion. Addressing vaccine hesitancy in South Tyrol requires culturally sensitive communication, community engagement through trusted local figures, transparency in health policies, and the proactive monitoring of misinformation. These strategies can mitigate mistrust and promote vaccine acceptance in regions with similar sociopolitical complexities. Full article

Vaccine hesitancy is a significant global issue and is recognized by the World Health Organization (WHO) as one of the most pressing threats to public health. Defined as the delay in acceptance or refusal of vaccines despite their availability, vaccine hesitancy undermines decades of progress in preventing vaccine-preventable diseases. The issue is complex, influenced by misinformation, distrust in healthcare systems, cultural beliefs, and access barriers. These challenges require innovative and empathetic solutions to increase vaccine acceptance. Addressing this growing epidemic requires a multifaceted approach, which involves broader strategies and policymaking and in addition, effective communication tools for clinicians. Motivational Interviewing (MI), a patient-centered communication technique, offers an effective strategy to address pediatric vaccine hesitancy by fostering trust, understanding, and informed decision-making. This review aims to explore the problem of pediatric vaccine hesitancy in the United States, examine its underlying factors, and highlight evidence-based strategies, including Motivational Interviewing, to address this growing concern in clinical and public health settings. It offers practical guidance for healthcare providers and pediatricians to tackle this growing problem effectively and emphasizes the need for a combined effort of communication, community outreach, education, and systemic policy to overcome vaccine hesitancy. Full article

The elicitation of broadly neutralizing antibodies (bnAbs) is a major goal of vaccine design for highly mutable pathogens, such as influenza, HIV, and coronavirus. Although many rational vaccine design strategies for eliciting bnAbs have been devised, their efficacies need to be evaluated in preclinical animal models and in clinical trials. To improve outcomes for such vaccines, it would be useful to develop methods that can predict vaccine efficacies against arbitrary pathogen variants. As a step in this direction, here, we describe a simple biologically motivated model of antibody reactivity elicited by nanoparticle-based vaccines using only antigen amino acid sequences, parametrized with a small sample of experimental antibody binding data from influenza or SARS-CoV-2 nanoparticle vaccinations. Results: The model is able to recapitulate the experimental data to within experimental uncertainty, is relatively insensitive to the choice of the parametrization/training set, and provides qualitative predictions about the antigenic epitopes exploited by the vaccine, which are testable by experiment. For the mosaic nanoparticle vaccines considered here, model results suggest indirectly that the sera obtained from vaccinated mice contain bnAbs, rather than simply different strain-specific Abs. Although the present model was motivated by nanoparticle vaccines, we also apply it to a mutlivalent mRNA flu vaccination study, and demonstrate good recapitulation of experimental results. This suggests that the model formalism is, in principle, sufficiently flexible to accommodate different vaccination strategies. Finally, we show how the model could be used to rank the efficacies of vaccines with different antigen compositions. Conclusions: Overall, this study suggests that simple models of vaccine efficacy parametrized with modest amounts of experimental data could be used to compare the effectiveness of designed vaccines. Full article

Background: During the COVID-19 pandemic, migrant populations remained under-immunized due to limited access to health care, language barriers, and vaccine hesitancy. The USAID-funded MOMENTUM Routine Immunization Transformation and Equity project supported the government in collaborating with various local health and non-health partners to identify and vaccinate migrants. This case study examines the roles of project partners and the strategies each entity implemented to increase COVID-19 vaccine uptake among migrants, as well as the perceptions regarding the effectiveness of these strategies. Methods: We designed a qualitative explanatory case study guided by the Behavioral and Social Drivers framework and RE-AIM implementation science frameworks. We conducted 31 focus group discussions and 50 in-depth interviews with migrants, project partners, community leaders, and government stakeholders in Tamil Nadu and Punjab. Results: In both states, partnerships with health departments, private employers, and community-based organizations were essential for identifying and vaccinating un- and under-vaccinated migrant groups. In Tamil Nadu, collaboration with the Department of Labor and mobile medical units facilitated vaccination camps at construction sites. In Punjab, religious institutions organized sessions at places of worship, and the Border Security Force enabled health workers to reach migrants living near the border. In both states, key strategies—involving influencers to discuss the importance of vaccine safety and value, bringing vaccination services to migrants’ workplaces and homes at flexible times and mandating workplace vaccination to encourage vaccination—shifted perceptions towards vaccination and increased vaccine uptake among migrants. Conclusions: The strategies and partnerships identified in this study highlight the broader implications for future public health interventions, demonstrating that collaboration with the private sector and faith-based organizations can enhance routine immunization efforts, particularly when localized to organizations that understand community needs and can address specific barriers and motivators. Full article