Search Results (1,516)

Background: Influenza poses a serious threat to the health of older adults, and vaccination is a key strategy for prevention. As an economically developed city, Suzhou has a rapidly aging population, yet the influenza vaccination rate among older adults remains substantially lower than that in developed countries. There is an urgent need to understand the current vaccination status and its associated factors to inform future strategies for improving vaccination coverage. Objectives: To compare influenza- and vaccine-related knowledge, attitudes, practices, and information access channels between vaccinated and unvaccinated older adults (≥60 years) in Suzhou, and to identify factors associated with vaccination behavior in economically developed areas. Methods: A comparative cross-sectional survey was conducted from April to August 2024 across six districts or county-level cities randomly selected from Suzhou’s ten county-level administrative divisions. Participants were divided into vaccinated and unvaccinated groups based on their influenza vaccination status during the 2023–2024 influenza season. A two-stage sampling method was employed: the six districts were selected as primary sampling units; within each district, eligible older adults (aged ≥60 years) were randomly selected from two independent sampling frames—the vaccination information system for the vaccinated group and the basic public health service system for the unvaccinated group. Face-to-face structured interviews were conducted using a questionnaire consisting of four sections; data were entered using EpiData 13.1 and analyzed using SPSS 27.0. The χ² test, t-test, and multivariable logistic regression were used for statistical analysis. Results: Among 4622 valid older adults (vaccinated: n = 2007; unvaccinated: n = 2615), the vaccinated group scored significantly higher on influenza-related knowledge (4.06 ± 2.21 vs. 3.16 ± 2.33, p < 0.001), vaccine-related knowledge (2.10 ± 1.18 vs. 0.67 ± 1.07, p < 0.001), and perceived influenza risk scores (2.72 ± 1.42 vs. 2.26 ± 1.64, p < 0.001). Vaccine safety and efficacy endorsement were also markedly higher among the vaccinated group (70.3% vs. 22.0%; 49.7% vs. 9.3%). Regarding information sources, the vaccinated group relied more on healthcare institutions (54.56% vs. 46.92%), whereas the unvaccinated group relied more on television (60.34% vs. 51.17%). Multivariable logistic regression revealed that awareness of the influenza vaccine (aOR = 9.151, 95%CI: 6.32–13.25), having a planned vaccination site (aOR = 2.66, 95%CI: 2.01–3.54), and perceiving the vaccine as safe (aOR = 1.81, 95%CI: 1.31–2.49) were positively associated with vaccination, while rural household registration (aOR = 0.76, 95%CI: 0.63–0.93), full-time employment (aOR = 0.41, 95%CI: 0.28–0.60), and hypertension (aOR = 0.79, 95%CI: 0.65–0.94) were inversely associated. Conclusions: Compared with the unvaccinated group, the vaccinated group demonstrated significantly better influenza- and vaccine-related knowledge, risk perception, and recognition of vaccine safety and efficacy, and relied more on healthcare institutions for information. Multivariable regression analysis identified awareness of the influenza vaccine as the strongest associated factor. These findings suggest that vaccination coverage could be improved by strengthening vaccine knowledge promotion through healthcare professionals and increasing awareness of vaccination policies that integrate medical insurance reimbursement. Full article

Background/Objectives: Respiratory infections are a major cause of morbidity and mortality among older adults. However, vaccination coverage against respiratory pathogens remains suboptimal, particularly in rural and vulnerable populations. This study aimed to identify factors associated with respiratory vaccination uptake among older adults living in rural Amazonian communities in Peru. Methods: We conducted an observational, analytical, cross-sectional study using secondary data from the Amazon Frail Project. A total of 429 adults aged ≥60 years from rural and suburban communities in San Martín, Loreto, and Ucayali were included. Vaccination coverage for influenza, pneumococcal disease, pertussis, and COVID-19, as well as vaccine combinations, was assessed. Multiple linear and Poisson regression models with robust variance were used to identify associated factors. Results: Complete vaccination coverage was 42.89% for influenza, 23.08% for pneumococcal disease, 4.43% for pertussis, and 70.16% for COVID-19. Only 3.50% of participants had received all four respiratory vaccines. Higher educational attainment, multimorbidity, social frailty, greater muscle mass, better physical performance, and healthcare center attendance were associated with higher vaccination uptake. Depressive symptoms, cognitive impairment, functional dependency, physical frailty, dynapenia, and higher body mass index were associated with lower vaccination uptake. Conclusions: Respiratory vaccination coverage was suboptimal among older adults living in rural Amazonian communities. Educational, functional, physical, social, and healthcare access factors significantly influenced vaccine uptake, highlighting the need for targeted immunization strategies in vulnerable rural populations. Full article

Vaccinations are a cornerstone of primary prevention in pediatric otolaryngology and play a critical role in reducing the burden of pediatric infectious diseases, particularly acute otitis media (AOM) and HPV-related infections. The introduction and widespread use of pneumococcal conjugate vaccines (PCVs) have been associated with substantial changes in the epidemiology of pediatric AOM, particularly through reductions in vac-cine-serotype disease and complicated forms, while contributing to changes in pathogen distribution with an increased role of non-vaccine serotypes and non-pneumococcal bac-teria, requiring continuous epidemiological surveillance. Prophylactic human papillomavirus (HPV) vaccination in adolescents and young adults effectively prevents oral infection with vaccine-type high-risk HPV, a necessary step in the pathogenesis of HPV-related oropharyngeal carcinoma. Clinical and epidemiological studies demonstrate robust antibody responses and significant reductions in oral HPV prevalence among vaccinated individuals. Although direct evidence of a reduction in oropharyngeal cancer incidence is not yet available, vaccination may consequently reduce the future burden of HPV-related oropharyngeal cancers. Long-term surveillance remains essential to confirm this potential benefit. Barriers to optimal vaccine coverage include unequal access, incomplete vaccination uptake, and limited awareness of HPV-related oral disease. In conclusion, vaccinations provide direct and clinically relevant benefits in pediatric otolaryngology by reducing recurrent AOM, severe complications and surgical interventions. HPV vaccination also reduces vaccine-type oral HPV infection and may consequently contribute to reducing the future burden of HPV-related oropharyngeal cancers. Achieving high vaccination coverage, coupled with continuous epidemiological monitoring, is essential to maximize individual and public health benefits and to inform the development of vaccines with broader serotype coverage. Full article

Background: Neonates and young infants are susceptible to vaccine-preventable diseases because of immature immune responses and delayed acquisition of vaccine-induced protection. As household members and caregivers are a major source of exposure, international organizations recommend cocooning, i.e., vaccination of susceptible individuals who are in regular contact with infants, to provide complementary indirect neonatal protection. To evaluate cocooning implementation, we assessed influenza and pertussis vaccination uptake among mothers and close contacts of hospitalized neonates and identified factors associated with vaccine uptake. Methods: Mothers of neonates hospitalized in a Neonatal Intensive Care Unit (NICU) between 1 January 2022 and 31 December 2024 were invited to complete a structured questionnaire. Mothers reported their own vaccination status and that of the neonate’s close contacts. Associations between maternal characteristics and vaccine uptake were examined using logistic regression. Results: In total, 405 mothers participated. Influenza vaccination uptake was 47.6% among mothers, and at least one adult close contact was vaccinated in 53.6% of families. Pertussis vaccination uptake was 40.5% among mothers, and at least one adult close contact was vaccinated in 32.3% of families. The most frequently reported reason for non-vaccination was low perceived need among unvaccinated mothers (74.1% for influenza and 83.4% for pertussis) and among families with incompletely vaccinated adult close contacts (81.8% for influenza and 89.7% for pertussis). In multivariable analyses, higher maternal education was associated with increased uptake of both influenza (OR 2.36, 95% CI: 1.47–3.80, p < 0.001) and pertussis vaccination (OR 4.25, 95% CI 2.02–8.94, p < 0.001), whereas younger maternal age (≤25 years) was associated with lower influenza vaccine acceptance (OR 0.24, 95% Cl: 0.1–0.60, p = 0.002). Conclusions: Vaccination uptake among mothers and adult close contacts of NICU-admitted neonates was suboptimal for both influenza and pertussis vaccines. Targeted counseling before delivery, reinforced during maternity or NICU hospitalization as a catch-up opportunity, and system-level implementation measures aligned with the dominant barrier of low perceived need are needed to strengthen cocooning in this high-risk population. Full article

Background: Despite noteworthy progress in the Expanded Program on Immunization (EPI) for improving vaccination coverage worldwide, inequalities in vaccine uptake and accessibility persist in several middle- and low-income states. Pakistan’s routine vaccination uptake varies greatly between federal geographical regions and continues to fall below the standard threshold needed to attain optimal herd immunity. The Federal Directorate of Immunization (FDI) in collaboration with the provincial Expanded Program on Immunizations implemented Enhanced Outreach Activities (EOAs) to boost immunization delivery in selected districts in order to address immunization coverage gaps in marginalized and difficult-to-reach communities. The purpose of this secondary data research was to evaluate whether EOAs improved immunization coverage in the country. Methods: The Federal Directorate of Immunization’s longitudinal panel analysis of district–month administrative data for the years 2011–2021 have been analyzed. The research investigation reviewed 158 districts’ monthly vaccination records for multiple antigens, covering regions where EOAs were successfully carried out in particular months. National and subnational analyses were carried out to measure geographical variations in the impact of Enhanced Outreach Activities (EOAs). The average vaccination coverage during EOAs and non-EOAs months was compared using the paired t-test. Results: An aggregate of 2430 months with EOAs were included in the analysis of 19,068 monthly district observations. National level analysis revealed higher average vaccinations during the EOA months for all antigens, but a statistically significant increase was observed for IPV and measles second dose (p < 0.05) only. Provincial-level results indicate that the impact was more evident in underserved regions. Khyber Pakhtunkhwa, Balochistan, Punjab, and Sindh demonstrated statistically significant increases in vaccination counts for most antigens. Due to variations in baseline population coverage, as well as health care sector capability, the extent of improvements differed throughout regions. Conclusions: In Pakistan, routine immunization counts has been improved via enhanced outreach initiatives, especially in provinces with lower initial vaccination rates and restricted accessibility to services. Strengthening outreach strategies, together with consistent fixed-site immunization services, is likely to accelerate progress toward equitable immunization coverage and contribute to achieving the Immunization Agenda 2030 goals. Full article

Background: Men who have sex with men (MSM) experience a disproportionate burden of human papillomavirus (HPV)-related disease, yet vaccination uptake remains uneven. With MSM as the key population of interest, this review synthesized evidence on uptake, willingness, multilevel barriers and opportunities, and vaccine-oriented outcomes among MSM and related sexual and gender minority populations when MSM-relevant findings could be extracted. Methods: Six databases were searched for original English- or Chinese-language studies published from 1 January 2010 to 31 December 2025. Findings were synthesized narratively. Barriers and opportunities were mapped using a five-level socio-ecological model; study-level willingness–uptake patterns were explored using K-means clustering as an exploratory analysis among the nine studies reporting both outcomes; and genotype-specific and immunogenicity findings were summarized separately. Results: Fifty-three studies involving 169,241 participants were included; 87.2% of participants were MSM, and 79% of studies were cross-sectional. Barriers and opportunities occurred across individual, provider-related interpersonal, organizational/institutional, community, and policy/societal levels. Recurrent paired mechanisms involved knowledge and trust, provider recommendation and communication, service accessibility, community support, and eligibility and affordability. Nine studies contributed data to the exploratory clustering analysis; seven fell into low-uptake clusters, including three with high willingness but low uptake, which may indicate a possible study-level implementation gap. Two studies reporting genotype prevalence and antibody responses provided limited biological context supporting vaccination before exposure and suggesting potential benefit from catch-up vaccination. Discussion: Among MSM and related sexual and gender minority populations, HPV vaccination is shaped by interacting individual and structural conditions, with MSM remaining the principal focus of the evidence base. Improving uptake is likely to require complementary strategies: universal, gender-neutral routine vaccination in adolescence before their sexual debut, and targeted catch-up for MSM who missed routine vaccination, supported by trusted provider endorsement, convenient service delivery, community engagement, and inclusive, affordable policy. The thematic counts were study-level and unweighted, and the nine-study clustering analysis was exploratory rather than definitive. Full article

Recent advances in vaccinology have accelerated the shift from conventional live-attenuated and inactivated vaccines toward subunit and nucleic acid-based platforms. Although these next-generation vaccines offer improved safety, rapid adaptability, and manufacturing flexibility, their relatively low intrinsic immunogenicity often requires efficient adjuvants and delivery systems. Nanoparticle-based vaccine platforms have therefore emerged as versatile tools capable of protecting antigens, improving targeted delivery, and modulating both innate and adaptive immune responses. This review summarizes the major classes of nanovaccine platforms, including lipid and polymeric nanoparticles, self-assembling protein nanostructures such as virus-like particles and ferritin nanocages, saponin-based self-assembling complexes, and inorganic nanomaterials. Particular attention is given to how vaccine performance is determined not only by material composition but also by nanoparticle physicochemical properties, biodistribution, cellular uptake, and mechanisms of immune activation. We further discuss the major challenges limiting clinical translation, including scalable manufacturing, safety evaluation, quality control, regulatory requirements, and long-term biocompatibility. Finally, emerging strategies involving hybrid and personalized nanovaccine platforms are highlighted, illustrating how nanotechnology and immunoengineering are transforming vaccine development for both prophylactic and therapeutic applications. Full article

Background: Human papillomavirus (HPV) vaccine has been proven a safe, necessary, and effective measure against HPV infection. However, HPV vaccine uptake remains limited among university students in China. This study investigated HPV vaccine intent among university freshmen in the largest university town in China. Methods: A cross-sectional online survey was conducted among unvaccinated female and male freshmen attending seven universities in Songjiang University Town, Shanghai, during 2024–2025. The questionnaire collected sociodemographic characteristics, HPV and HPV-vaccine-related knowledge, awareness, and vaccine intent. Factors associated with HPV vaccine intent were determined. Results: A total of 3397 valid questionnaires were collected, including female (60.02%) and male (39.98%) university freshmen. Overall, 76.12% were aware of HPV, 80.98% were aware of the HPV vaccine, and 84.31% expressed vaccine intent, with significantly higher rates among females than males (each p < 0.001). Socioeconomics, knowledge, awareness, sexual behavior, and HPV testing history were significantly associated with vaccine intent (each p < 0.05). The most common reason for no intent was perceived low risk of HPV-related diseases (40.53%). The most expected improvement measures were regulatory confirmation of vaccine safety and effectiveness (37.71%) and healthcare professionals’ recommendations (37.71%), with no gender difference (each p > 0.05). Notably, 4.00% refused HPV vaccination, regardless of improvement measures. Additionally, most respondents preferred financial supporting policies, regardless of gender or vaccine intent (each p > 0.05). Conclusions: University freshmen showed the disparity between high awareness/intent and low knowledge. Financial considerations may influence HPV vaccination decisions. Thus, improving knowledge, particularly among males, and providing financial support may enhance HPV vaccine intent. Full article

Background: Vaccinations are highly effective in preventing infectious diseases, which otherwise present a serious challenge to the health of individuals and public health. To identify potential gaps in vaccination coverage, we examined childhood vaccination levels in Frankfurt am Main (FFM) and the Rhein Neckar district (including Heidelberg city, RNHD) prior to, during and following the COVID-19 pandemic. Moreover, we explored various factors that appear to contribute to lower vaccination levels in specific communities in either or both locations. The results are intended to guide strategies for designing and improving vaccination services for specific groups in local health settings. Methods: A retrospective analysis was conducted to examine the vaccination rates of children in Frankfurt am Main and the Rhein Neckar district (including Heidelberg city) by using anonymized data from school entry examinations spanning the years 2017 to 2024. Data pre-processing, analysis, and visualization were performed using R (5.4.2). Frequencies and percentages were calculated for sociodemographic and vaccination rates (the completeness of the vaccination schedule recommended by STIKO for children). Multivariate logistic regression was performed to determine factors with a significant impact on vaccination uptake. Results: Multinomial logistic regression with ‘measles-only’ (Measles) as the reference category revealed distinct predictor patterns across vaccination levels. In both regions, children who completed preventive medical check-ups had higher odds of completing the schedule of vaccination plus at least one additional vaccine (ScheduledPlus) versus, measles-only vaccination. In RNHD, children from Eastern European language families and low- and medium-social-status backgrounds showed higher odds of completing the scheduled vaccinations without the recently introduced rotavirus vaccination (ScheduledNotRota), versus measles-only vaccination. In FFM, strong interaction effects were observed between medical examination completion and migration background, with children from non-German birthplaces showing dramatically reduced odds of complete vaccination when preventive care was incomplete. Discussion: The proportion of children with a complete vaccination status remained stable over the study period in both locations, with no evidence of post-pandemic decline. Nevertheless, this stability masks important heterogeneity in vaccine coverage patterns across sociodemographic groups. Systematic identification and modeling of interactions between nationality, parental employment, and healthcare utilization tell a compelling “double jeopardy” story that the effects of these risk factors are not additive but synergistic. Regular medical check-ups remain an important factor in ensuring high vaccination coverage among children until they start school and underscore the justification for such established preventive care programs. A nuanced understanding, however, is crucial for moving beyond simplistic, one-size-fits-all public health messaging. Full article

Background/Objective: African swine fever (ASF), caused by African swine fever virus (ASFV), is a highly contagious viral disease affecting domestic pigs and wild boars, causing severe economic losses. Although commercial ASF vaccines have recently been approved in Vietnam, controlling ASF transmission remains challenging. Since injection-based vaccination is impractical for wild boars, oral vaccination is considered essential. This study aimed to evaluate the safety, immunogenicity, protective efficacy, and dose-related outcomes of ASFV-G-ΔI177L/ΔLVR, a live attenuated ASFV vaccine candidate with deletion in the I177L gene and left variable region (LVR), administered orally to convention pigs. Methods: The ASFV-G-ΔI177L/ΔLVR vaccine candidate was orally administered to conventional pigs at three dose levels (10^2.25, 10^5.0, and 10^6.0 TCID₅₀/dose). At 28 days post-vaccination, pigs were challenged intramuscularly with a virulent ASFV field strain at 10^2.0 HAD₅₀/mL and monitored clinically. Protection was assessed by ASFV-specific antibody responses (p32) and survival following challenge. Results: Oral immunization was well tolerated, with no vaccine-associated clinical signs observed before challenge. Following challenge, vaccinated pigs showed different protective outcomes among the tested dose groups, with survival rates of 1/4 (10^2.25 TCID₅₀/dose), 4/4 (10^5.0 TCID₅₀/dose), and 3/4 (10^6.0 TCID₅₀/dose), respectively. Pigs that succumbed to infection showed neither detectable viremia nor ASFV-specific antibodies before challenge, suggesting incomplete vaccine uptake may have resulted in insufficient immune induction rather than an adverse effect associated with vaccination. In contrast, pigs that seroconverted prior to challenge were fully protected and exhibited lower viral loads than the control animals. Conclusions: ASFV-G-ΔI177L/ΔLVR was well tolerated as an oral live attenuated vaccine candidate and induced protective immunity against virulent ASFV challenge under the present experimental conditions. Notably, complete protection was observed in the 10^5.0 TCID₅₀/dose group, supporting the potential of this vaccine candidate for oral immunization strategies against ASF. However, the present data do not allow a definitive conclusion regarding the dose–response relationship, and further studies with larger group sizes and field-relevant models are needed to refine dose selection and practical applicability, particularly for wild boar vaccination. Full article

Background: West Virginia is of particular concern regarding HPV vaccine hesitancy, currently ranking 45th among U.S. states in HPV vaccine uptake. General vaccine hesitancy and HPV- and HPV vaccine-specific misinformation, both associated with lower vaccination, have increased in recent years, complicating efforts to identify key drivers of HPV vaccine acceptance and effective intervention targets. Methods: This study used a Qualtrics survey of n = 330 parents of children aged 0–14 in West Virginia. Measures included parental HPV vaccine acceptance for their youngest child (reflecting either completed vaccination or intention to vaccinate), general vaccine hesitancy measured using the Vaccine Hesitancy Scale (VHS), and endorsement of nine common HPV- and HPV vaccine-specific misinformation statements. Misinformation items were summed and demonstrated good internal reliability (Cronbach’s α = 0.868). Results: Hierarchical logistic regression analyses indicated significant racial/ethnic differences across all model steps, with non-White parents less likely to report HPV vaccine acceptance for their child (p < 0.001). In Step 2, lower levels of general vaccine hesitancy predicted higher HPV vaccine acceptance (p < 0.001). In the final model, higher endorsement of HPV- and HPV vaccine-specific misinformation was associated with lower HPV vaccine acceptance (p = 0.035). Conclusions: These findings underscore the independent and additive influence of general vaccine hesitancy and HPV- and HPV vaccine-specific misinformation on parental HPV vaccine acceptance in West Virginia. Community-engaged public health strategies should prioritize strengthening vaccine confidence and directly addressing HPV- and HPV vaccine-specific misinformation, particularly among underserved populations. Full article

Objectives: To identify factors influencing influenza vaccination willingness and uptake among adults aged ≥60 years in Henan Province and to evaluate the effect of a brief educational intervention on vaccination willingness and behavior. Methods: In September 2024, a cross-sectional survey based on the Behavioral and Social Drivers (BeSD) framework was conducted among adults aged ≥60 years across five counties in Henan. For participants without baseline willingness, a 3 min one-on-one educational intervention was delivered. In May 2025, following the end of the 2024–2025 influenza vaccination season (which runs from 1 October to 31 March in Henan Province), we retrieved vaccination records for all participants from the Henan Provincial Immunization Information System. This system captures all influenza vaccinations administered at designated vaccination clinics across the province. To ensure completeness for doses administered outside the provincial system (e.g., in other provinces or at private healthcare facilities), we conducted telephone follow-up interviews with all participants whose baseline vaccination intention was inconsistent with their actual vaccination behavior (i.e., willing but unvaccinated or unwilling but vaccinated). During these interviews, for those who reported receiving the vaccine outside Henan Province or at private facilities, we inquired about the specific date and location of vaccination to supplement the registry data. We also explored the reasons behind the intention–behavior discrepancy. For these participants, we requested vaccination certificates or other supporting documentation to confirm their vaccination status. Results: Baseline vaccination willingness was 68.20% (1630/2390), whereas the actual vaccination rate was only 6.95% (166/2390), yielding a willingness-to-behavior conversion rate of 9.51% (155/1630) among those with baseline willingness. Of the 760 participants without baseline willingness, 543 (71.45%) completed the 3 min one-on-one instant educational intervention and the follow-up assessment; the remaining 217 were excluded due to refusal or loss to follow-up. Among these 543 completers, 46 (8.47%) became willing to vaccinate, and eight (1.47%) were subsequently vaccinated. Multivariate analysis identified the social processes dimension as the strongest correlate of both willingness (OR = 1.38 per 1-point increase, 95% CI: 1.33–1.44) and uptake (OR = 1.12, 95% CI: 1.03–1.22). Urban residence was associated with higher willingness (OR = 1.41, 95% CI: 1.12–1.78) and higher uptake (OR = 1.64, 95% CI: 1.11–2.42). Current smokers had a significantly lower uptake than never smokers (OR = 0.43, 95% CI: 0.22–0.85). Among the 11 participants without baseline willingness who were eventually vaccinated (eight from the intervention group and three from the non-intervention group), family/friend influence (63.64%, 7/11) and physician recommendation (36.36%, 4/11) were the primary drivers. For those with willingness but no action (n = 1475), the main barriers were perceived good health (33.29%), high vaccine cost (27.12%), and lack of time (26.31%). Conclusions: Influenza vaccination among older adults in Henan exhibits a “high willingness, low conversion” pattern, with social processes as the strongest driver bridging the intention–behavior gap. A brief educational intervention improved willingness but failed to translate into meaningful uptake, underscoring that knowledge transfer alone is insufficient. We recommend a multi-component strategy that (1) mobilizes family members and community doctors as trusted vaccine advocates; (2) leverages family and village doctor networks to reduce urban–rural disparities; (3) counters the “perceived good health” barrier with age-specific risk communication; and (4) integrates vaccine recommendations into routine care for high-risk groups, particularly frequent outpatient attendees and smokers. Full article

Background: Monkeypox (MP) is an emerging disease with the capacity for worldwide dissemination, endangering all nations. Healthcare workers (HCWs) frequently act as the initial point of contact for MP patients; therefore, evaluating their understanding of the disease and their perspectives on MP immunisation is crucial for effective prevention and control. This study aimed to assess HCWs’ knowledge of and attitudes toward MP and associated vaccines. Methods: A cross-sectional study was performed, focusing on HCWs in Makkah, Saudi Arabia. Data were collected through a standardised, self-administered online questionnaire provided in both English and Arabic. The questionnaire gathered the participants’ sociodemographic information and assessed their knowledge, opinions, and attitudes concerning MP infection and vaccination. The questionnaire included multiple-choice items with response possibilities such as “Yes”, “No” and “Don’t know”. Results: In total, 428 HCWs participated in this study; 60.7% had adequate knowledge of MP, while 39.3% had inadequate knowledge. Some knowledge of specific aspects of the disease was reported to be variable, with 67.5% correctly identifying MP as a viral infection, 55.1% aware of the endemic nature of the disease in parts of Western and Central Africa, and 65.0% recognising skin rash as a common symptom. In terms of attitudes towards MP vaccination, 47.9% had a positive attitude, while 52.1% had a negative attitude. In total, 65.7% of the respondents indicated that vaccination is essential to controlling MP, while only 23.1% (95% CI: 19.1–27.1%) had received vaccination. Furthermore, 57.0% reported concerns about potential adverse effects. Educational level was significantly associated with knowledge of MP (p = 0.001), while job title (p = 0.008) and years of work experience (p = 0.018) were significantly associated with attitudes towards MP vaccination. Age group was significantly associated with MP vaccination status (p = 0.002), while gender, educational level, job title, and years of work experience were not significantly associated with vaccination status. Conclusions: HCWs demonstrated an adequate level of knowledge about MP; however, important knowledge gaps and negative attitudes towards MP vaccination remained. Despite recognising the importance of vaccination, vaccine uptake was low. Educational level was associated with knowledge about MP, while job title and years of work experience were associated with attitudes towards MP vaccination, and age group was associated with MP vaccination status. Targeted educational interventions and evidence-based awareness programmes may enhance knowledge, improve preparedness for future MP outbreaks, and decrease vaccine hesitancy among HCWs. Full article

Background/Objectives: People living in prison are at increased risk of communicable diseases due to overcrowding and suboptimal living conditions. This study aimed to estimate the uptake of recommended vaccinations among people living in prison, investigate their willingness to be vaccinated during detention, and identify factors influencing both uptake and willingness. Methods: This cross-sectional survey was conducted from October 2023 to July 2024 in four penitentiary institutions in Southern Italy. Results: Of the 1137 participants, 13.8% self-reported having received at least one vaccination schedule during their current detention. Those with chronic disease, who had received information about vaccines in prison, and with a longer detention were significantly more likely to have received a vaccination. Conversely, women, those not-at-risk from alcohol consumption, and those having at least one child were significantly less likely to have received at least one vaccination schedule in prison. Less than half of the participants (41.9%) expressed willingness to receive recommended vaccinations if offered in prison. Willingness was significantly higher in subjects of Italian nationality and with a longer detention. Moreover, heterosexuals and those who were married or cohabitant were significantly less willing to receive at least one vaccination schedule in prison. Conclusions: Implementing routine proactive vaccination activities could be effective, and should focus on both standard adult vaccinations and immunizations for individuals with specific risk conditions. Full article

Respiratory mucosal vaccination can induce robust humoral and cellular immune responses, as well as effective mucosal immunity at the primary site of pathogen entry, and has been shown to provide superior protection against respiratory viral infections compared with traditional approaches. Among current vaccine technologies, mRNA vaccines offer unique advantages, including rapid development, flexible antigen design, and potent immunogenicity. However, efficient mucosal delivery of mRNA remains challenging due to biological barriers within the respiratory tract, including mucus clearance, limited cellular uptake, and instability during aerosolization. Furthermore, mRNA formulations intended for respiratory mucosal delivery require more stringent safety and tolerability profiles. Recent advances in nanoparticle engineering have accelerated the development of mRNA delivery systems optimized for respiratory mucosal immunization. This review aims to evaluate how nanoparticle engineering strategies can overcome respiratory mucosal barriers and improve the safety, stability, delivery efficiency, extrahepatic expression, and immunogenicity of mRNA vaccines and therapeutics. We summarize recent progress in engineered mRNA nanoparticle platforms for respiratory mucosal immunity, encompassing modified lipid nanoparticles (LNPs), polymer-based mRNA nanoparticles, and hybrid nanoparticle systems, including lipid-inorganic, polymeric hybrid, and lipid-extracellular vesicle (EV) nanoparticles. We further discuss optimization strategies for mucosal mRNA delivery, including the incorporation of appropriate adjuvants, the development of polyethylene glycol (PEG) alternatives, and advanced delivery approaches. Finally, we highlight current challenges and future directions for the rational design of next-generation mRNA nanoparticle platforms that can induce durable and broadly protective mucosal immunity against respiratory viral infections. Full article