Diphtheria (low dose) / Tetanus / Pertussis (acellular component) / Poliomyelitis (inactivated) vaccine (adsorbed) suspension for injection 0.5ml pre-filled syringes

ImportanceDementia is a highly prevalent issue in older people. Whilst the prevention of dementia is a public health priority, the role of vaccinations is still largely unexplored.ObjectiveThe aim of this systematic review is to evaluate whether common adult vaccinations are associated with a reduced risk of dementia.Data sourcesPubMed, Embase and Web of Science were searched from inception to 1 January 2025.Study selectionObservational studies comparing dementia and mild cognitive impairment incidence between vaccinated and unvaccinated adults aged ≥50 years.Data extraction and synthesisFour reviewers independently extracted data and assessed study quality using the Newcastle-Ottawa Scale. Risk ratios (RRs) and 95% confidence intervals (CIs) were pooled using a random-effects model.Main outcomes and measuresIncidence of dementia, including its subtypes.ResultsTwenty-one studies (n = 104 031 186 participants) were included. Vaccination against herpes zoster was associated with a reduced risk of any dementia (RR 0.76, 95% CI 0.69-0.83) and Alzheimer's disease (RR 0.53, 95% CI 0.44-0.64). Influenza vaccination was linked to a reduction in dementia risk (RR 0.87, 95% CI 0.77-0.99), as was pneumococcal vaccination (RR 0.64, 95% CI 0.47-0.87) for Alzheimer's disease. Tetanus, diphtheria, pertussis (Tdap) vaccination was also associated with a significant reduction for any dementia (RR 0.67, 95% CI 0.54-0.83).Conclusions and relevanceAdult vaccinations, particularly against herpes zoster, influenza, pneumococcus and Tdap, are associated with a lower risk of dementia. Vaccination strategies should be incorporated into public health initiatives for dementia prevention.Registrationhttps://osf.io/x3d4f/.

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This review aimed to characterize adolescent vaccination schedules in publicly funded national immunization programs in Latin America and the Caribbean. The initial review identified vaccine type, target age and gender, dose schedule, and vaccination coverage rate (VCR) across 50 countries/territories in the region. A systematic review from January 2010-October 2023 was then conducted to identify primary data collection studies reporting VCRs. Overall, 42 webpages and 23 primary studies were identified. Among 47 countries/territories with ≥1 vaccine for adolescent immunization, human papillomavirus (HPV) vaccine was included in 45, tetanus component vaccines in 43, and meningococcal vaccines in 10. Catch-up vaccination for hepatitis B in 17, and yellow fever in all 13 endemic countries/territories. VCRs were primarily available for HPV. The findings of this review underscore the need to prioritize adolescent vaccination, improve accessibility, and strengthen tracking infrastructure to ensure comprehensive protection of this age group across the region.

Abstract licence: Public domain

BackgroundMigrants in Europe often face barriers to vaccination, increasing their vulnerability to vaccine-preventable diseases (VPDs). Despite policies promoting catch-up immunisation on arrival, data on VPD burden and outcomes among migrants remain limited. This systematic review synthesises evidence on the prevalence, incidence, mortality, and outcomes of VPDs in migrants across EU/EEA countries, UK, and Switzerland.MethodsWe searched Medline, Embase, Global Health, and grey literature sources (including websites of national public health organisations and agencies) for primary studies and reports on VPD cases among migrants (foreign-born individuals) in 32 European countries, published between January 2010 and April 2024. Data on demographics, VPD type, vaccination status, and outcomes were extracted. We focused on diphtheria, measles, mumps, pertussis, rubella, and tetanus. Study quality was assessed using Joanna Briggs Institute tools.ResultsFifty-seven studies met inclusion criteria, reporting 1950 VPD cases in migrants across 16 countries (2010-2024). Most studies were in Germany (n = 12), Spain (n = 11), Switzerland (n = 8), Greece (n = 6), and the UK (n = 7). Reported cases included: measles (n = 992; 50.8 %), diphtheria (n = 546; 28.0 %), pertussis (n = 267; 13.7 %), and mumps (n = 137; 7.0 %). No cases of rubella or tetanus were reported. Migrants affected mainly included asylum seekers (n = 23 studies), refugees (n = 6), labour migrants (n = 2). Six studies from Greece, Germany, and Spain accounted for 1942 cases (99.6 %). Over half of diphtheria cases (n = 307; 55.4 %) occurred in reception centres. Diphtheria primarily affected adolescents and adults (n = 10 studies), while measles cases were mostly in children. Migrants from the Eastern Mediterranean and Africa were disproportionately affected by diphtheria. Non-EU/EEA European migrants (WHO EUR), mainly from Bosnia and Herzegovina and Serbia, accounted for most measles cases (87 %), and non-European migrants were from Somalia (n = 112), Afghanistan (n = 94), Eritrea (n = 76), and Syria (n = 64). Vaccination status was unknown or unreported in over 60 % of cases. Five VPD related deaths were reported of which 4/5 were due to measles.ConclusionMigrants are at increased risk of VPDs due to gaps in vaccination. Strengthening catch-up vaccination, particularly in adolescents and adults, and improving data collection are essential next steps.

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Poliomyelitis, preventable only through vaccination, remains a global health concern, with wild poliovirus transmission and the emergence of vaccine-derived polioviruses. The risk of further deterioration of the situation jeopardizes efforts to eradicate polio, which has been a long-term goal for the whole world. In this systematic review, an analysis of randomized clinical trials was carried out to comprehensively assess the immunogenicity and safety of various polio immunization methods in infants. Geometric mean neutralizing antibody titers (GMT) data collected after 28-31 days after immunization were used to calculate the geometric mean titer ratio (GMR), the analysis of which showed that both inactivated polio vaccine (IPV) and Sabin strain-based inactivated polio vaccine (sIPV) as primary vaccination induce high antibody rates. Average GMR rates (CI = 0.05) for the 3 types of polio were 83.08, 33.60, and 166.30 for IPV and 234.35, 44.04, and 163.13 for sIPV, with fractional IPV showing similar results. One or two doses of IPV were insufficient to induce protection levels of antibodies against type 2 poliovirus. The novel oral polio vaccine type 2 (nOPV2) and trivalent oral polio vaccine (tOPV) also demonstrated immunogenicity in establishing immunity comparable to the inactivated vaccine; the latter exhibited an average GMR of 50.75 for serotype 2. High antibody levels were also induced by combined vaccine schedules, with sIPV-sIPV-bOPV (GMR of 1,172.7 for type 1 and 887.6 for type 3) and IPV combinations with diphtheria-tetanus-whole-cell pertussis, hepatitis B and Haemophilus influenzae type b (351.2, 258.8, and 573.6 for the 3 types) or pentavalent rotavirus vaccine (354.6, 117.7, and 540.9 for the 3 types) establishing particularly high antibody levels. Analysis of adverse events presented all vaccines to be well-tolerated and safe, with a tendency for combination vaccines to have a higher frequency of local reactions and fever. While the studies presented a diverse landscape with some existing areas of concern, this review provides structured evidence supporting the safety and immunogenicity of existing polio vaccines, as well as highlighting the interchangeability of different vaccination approaches in infants. Future research should aim to provide detailed reporting of adverse events in order to facilitate more comprehensive assessment of vaccine immunogenicity and, therefore, efficacy.

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Background: Co-administration of vaccines can impact the immune response and safety. We aim to systematically review the current scientific literature and find evidence regarding the immunogenicity and safety of pneumococcal vaccines co-administered with common vaccines that are recommended for travelers, including hepatitis A, hepatitis B, yellow fever, tetanus, diphtheria, and acellular pertussis (Tdap), Japanese encephalitis, rabies, typhoid, or meningococcal (MCV) vaccine in adults (18 years or older). Methods: We followed the PRISMA 2020 guidelines and used the PICOS process to select the keywords. We searched PubMed, Web of Science, Scopus, EMBASE, and Google from 1 January 2000 to 30 June 2024. We included randomized controlled trials, non-randomized controlled trials, observational studies, case series, and case reports in adults, all published in English. Results: Out of 598 articles screened, 6 studies were included in our study. Three studies involved immunocompetent individuals, and three involved immunocompromised individuals. Co-administration of pneumococcal vaccine with Tdap or Hepatitis A in immunocompetent individuals was safe and immunogenic. Similar findings were reported for immunocompromised individuals when pneumococcal vaccines were co-administered with Tdap, hepatitis A, and hepatitis B. However, no reports investigated the co-administration of yellow fever, rabies, Japanese encephalitis, and typhoid. Two non-randomized studies in immunocompromised individuals had a high risk of bias. Conclusions: The studies collectively indicate that the co-administration of pneumococcal vaccines with Hepatitis A and Tdap vaccines in adult immunocompetent and immunocompromised individuals is safe and immunogenic. However, a knowledge gap remains, and further high-quality studies are needed, particularly due to the limited number of studies and the potential risk of bias.

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OBJECTIVE: This study aims to systematically review the published economic evaluations of vaccines included in China’s National Immunization Program (NIP), synthesise the current evidence base, and assess their cost-effectiveness. METHODS: A comprehensive search was conducted across PubMed, Web of Science, Embase, CNKI, CSTJ, and Wanfang Data for cost-benefit analyses (CBA), cost-effectiveness analyses (CEA), and cost-utility analyses (CUA) related to NIP vaccines in China, from database inception to 14 July 2025. Studies were screened following the PRISMA guidelines. The study’s reporting quality was assessed using the CHEERS 2022 checklist, while methodological quality was evaluated using the QHES instrument. RESULTS: A total of 41 studies were included and demonstrated an overall moderate methodological quality (mean CHEERS score: 66.42; mean QHES score: 70.63). The included studies covered a range of NIP-targeted vaccines, including hepatitis B, measles, tuberculosis, diphtheria-pertussis-tetanus, hepatitis A, and meningococcal vaccines, with hepatitis B receiving the greatest research focus (n = 32). Most evaluations were conducted from a societal or healthcare system perspective. The majority of studies reported benefit-cost ratios (BCR) greater than 1 or incremental cost-effectiveness ratios (ICER) below the per capita GDP threshold, indicating substantial economic value. Despite variations in model structures, baseline parameters, and assumptions, all studies consistently concluded that NIP vaccines are cost-effective compared with no vaccination. Hepatitis B vaccination, particularly when combined with maternal transmission prevention strategies, demonstrated exceptionally high net benefits at both national and subnational levels. CONCLUSION: NIP vaccines in China offer substantial economic value; however, interpretation of the findings may be influenced by methodological heterogeneity and the use of GDP per capita-based cost-effectiveness thresholds, and the adoption of standardised evaluation methods is essential to support policy optimisation and sustainability.

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Introduction: Inequities in access to medicines persist for asylum seekers, refugees, and undocumented migrants in Europe. For vaccines, access gaps not only exist for these groups in childhood routine immunization, but also for life-course and catch-up vaccinations. As part of a broader project examining access to medicines and vaccines for migrants across all stages of the migration cycle, this scoping review synthesizes evidence on the determinants of access to vaccines. Methods: We conducted a scoping review across PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Cochrane Database of Systematic Reviews, Scopus, and grey literature sources, covering the period 2000-2024. Sources were eligible if they addressed access to vaccines among migrants. We examined access to vaccines along the life course, and across phases of the migratory cycle, including departure, transit, reception and settlement, and return or deportation. Results: A total of 47 research studies and grey literature reports were included. Most studies focused on migrants in reception and settlement (destination) settings, with only twelve sources addressing other phases of the migratory cycle. Across European countries, migrants were frequently reported to have lower uptake of routine vaccines (e.g., measles-mumps-rubella (MMR), polio, diphtheria-tetanus-pertussis (DTP), and human papillomavirus (HPV)) and COVID-19 vaccines than host populations. The most frequently reported barriers were related to migrants' legal status, administrative requirements, and lack of documentation, alongside poor affordability of vaccination, limited awareness of their rights, and mistrust in the health system. Conclusions: Health systems need to adopt innovative approaches to expand vaccine access for migrant populations. Further, protecting confidentiality is essential for building trust and reducing ethical and legal risks. Flexible and coordinated vaccination strategies are required to address migrants' mobility across the different migration stages and settings. Our findings appeal for sustained improvements in access to vaccines among migrants in Europe, contingent on strong policy commitments to equity, data protection, and the adoption of life-course and catch-up vaccination strategies.

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