polio vaccine (Polymilex)

Attitudes to mandatory COVID-19 vaccination in early life: findings from the multi-country cross-sectional CANDOUR study.

Porter Georgia G, Roope Laurence S J LSJ, Violato Mara M, Duch Raymond R et al.

We examined variation in attitude toward mandatory COVID-19 vaccination in early life by sociodemographic characteristics, personal COVID-19 experience, health risk attitude, political ideology, and other COVID-19 vaccine mandate attitudes. For this purpose, we used data from 19 928 participants from 16 countries surveyed in March-November 2022 for the second wave of the COVID-19 vaccine preference and opinion survey (CANDOUR). Analyses were adjusted for poststratification weighting. Participants who disagreed with early life mandatory COVID-19 vaccination were more likely to decline vaccination against COVID-19 (14.5%) compared with those who were neutral (1.8%) and those who agreed (0.5%). Disagreement with early life mandatory vaccination was associated with more unwillingness to take risks with their own health, being centre or left-wing on the left-right political spectrum, believing COVID-19 vaccination should be a personal choice, and being opposed to vaccine mandates for schoolchildren and the public. Neutrality or agreement with early life mandatory vaccination was associated with neutrality or agreement with a vaccine mandate for schoolchildren or a governmental COVID-19 vaccine mandate for everybody. Pandemic preparedness governance needs to focus on attitudes toward vaccine mandates. Further research and commitment by governments at various levels are needed to identify social, cultural, and system-level factors that could inform vaccination strategies to be implemented for the next pandemic.

Persistence and booster response of rabies antibodies among health care workers with multiple vaccinations.

Castellano Mark Joseph MJ, Sornillo Johanna Beulah JB, Saito Nobuo N, Nishizono Akira A et al.

Rabies is a fatal but vaccine-preventable disease. Health care workers (HCWs) in endemic areas may receive repeated rabies vaccination because of occupational exposure, yet data on long-term antibody persistence and booster response after multiple prior vaccine regimens remain limited. This study aimed to determine the rabies antibody profile of HCWs previously vaccinated with rabies vaccine. We analyzed 126 HCWs from the Research Institute for Tropical Medicine (RITM) and Muntinlupa Animal Bite Treatment Centers (ABTCs) in the Philippines. Vaccination records were reviewed, and booster doses consisting of 0.1 mL purified Vero cell rabies vaccine (PVRV) were administered intradermally on days 0 and 3. Pre- and post-booster rabies antibody levels were measured using the rapid fluorescent focus inhibition test (RFFIT). All HCWs vaccinated within the previous year retained pre-booster antibody titers ≥ 0.5 IU/mL. Participants who had received three or more prior rabies vaccine regimens also maintained protective pre-booster antibody levels within 3-5 years after the last vaccination. After booster administration, all participants achieved antibody titers above the protective threshold ≥ 0.5 IU/mL, regardless of prior vaccination history or time since last vaccination. Repeated rabies vaccination was linked to sustained antibody persistence, while previous vaccination history was associated with preserved booster responsiveness among HCWs. These findings suggest that, in addition to time since last vaccination, the number of prior rabies vaccine regimens may help inform about the persistence of protective antibody levels in previously immunized individuals.

Inclusion of young adolescents in policy development for new tuberculosis vaccines.

Hatherill Mark M, Clark Rebecca A RA, Martinez Leonardo L, Fiore-Gartland Andrew L AL et al.

The infant tuberculosis vaccine, BCG, prevents severe tuberculosis disease, but protection is rarely durable beyond childhood. New tuberculosis vaccines are being developed for the prevention of infectious pulmonary tuberculosis in older adolescents and adults, but younger adolescents have been historically excluded from clinical trials of new tuberculosis vaccines. Reasons to include young adolescents (aged 9-14 years) in tuberculosis vaccine policy development include the opportunity to vaccinate before the age-related increase in risk of tuberculosis disease, as well as increased rates of HIV acquisition and pregnancy, which are both independently associated with tuberculosis risk, and the opportunity to implement tuberculosis vaccination with delivery of other school-age vaccines, such as human papillomavirus. These advantages are offset by several challenges, including testing vaccine efficacy in an age group with low rates of tuberculosis case accrual; low rates of Mycobacterium tuberculosis sensitisation, which might compromise bridging of immune correlates of protection from adults; and modest modelled population impact of vaccination of young adolescents, compared with mass campaigns in older age groups with higher tuberculosis incidence. Notably, if a tuberculosis vaccine that was effective only in individuals who are infected with M tuberculosis was rolled out exclusively to young adolescents, the projected low population impact could take many years to detect. We propose that challenges to the inclusion of young adolescents should be considered explicitly in the development of tuberculosis vaccine policy, so that they do not risk exclusion from the direct benefits of vaccination. We describe an alternative efficacy trial design, which would leverage higher rates of tuberculosis case accrual after recent household tuberculosis exposure, to deliver both vaccine efficacy data and validation of an immune correlate of protection. This novel strategy, together with licensure data from older populations, might support rapid implementation of new, effective tuberculosis vaccines for young adolescents.

How CEPI can enhance global vaccine equity and transparency.

Whiteman Megan M, Tundang Ronald R, Maybarduk Peter P, Abdullah Hisham H et al.