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

IMPORTANCE: Dementia 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. OBJECTIVE: The aim of this systematic review is to evaluate whether common adult vaccinations are associated with a reduced risk of dementia. DATA SOURCES: PubMed, Embase and Web of Science were searched from inception to 1 January 2025. STUDY SELECTION: Observational studies comparing dementia and mild cognitive impairment incidence between vaccinated and unvaccinated adults aged ≥50 years. DATA EXTRACTION AND SYNTHESIS: Four 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 MEASURES: Incidence of dementia, including its subtypes. RESULTS: Twenty-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 RELEVANCE: Adult 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. REGISTRATION: https://osf.io/x3d4f/.

Abstract licence: CC BY

Background: Acute lymphoblastic leukemia is the most prevalent childhood cancer and the leading cause of cancer mortality before the age of 20. Although therapeutic advances have significantly improved survival, children and adolescents treated for acute lymphoblastic leukemia remain vulnerable to infections, largely preventable by vaccination, due to humoral and cellular immune dysfunction induced by disease and treatment. Materials and Methods: This systematic review, based on electronic databases, aims to evaluate antibody levels associated with potential protective immunity against vaccine antigens for diphtheria, pertussis, tetanus, poliomyelitis, Haemophilus influenzae type b, measles, mumps, rubella, influenza, varicella-zoster virus, yellow fever, pneumococcal, and meningococcal diseases in children and adolescents treated for acute lymphoblastic leukemia after completion of chemotherapy. Results: A total of twenty-four studies published between 1981 and 2023 were included, comprising 1110 children and adolescents. Protective antibody levels ranged from 11% to 97% for diphtheria, 0% to 90% for pertussis, 20% to 100% for tetanus, and 11% to 95% for poliomyelitis. Haemophilus influenzae type b, protection ranged from 16.7% to 100%. Viral vaccines also showed heterogeneous responses, with protection rates of 25–79% for mumps, 16–86% for measles, 35–98% for rubella, and 23–75% for varicella-zoster virus. Antibody responses to pneumococcal and meningococcal vaccines were consistently low, with protection rates of 5–38% for pneumococcal studies and 12% in a single meningococcal study. Conclusions: This review found a consistent and clinically relevant loss of vaccine-induced immunity in children and adolescents treated for acute lymphoblastic leukemia. The recommendation of vaccine booster doses for this vulnerable population, irrespective of serological status, may represent a more practical approach to ensuring adequate post-chemotherapy treatment protection.

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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. 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. 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. 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.

Abstract licence: CC BY-NC-ND

< 0.001) and comparable DT/TT responses. DTcP exhibited favourable safety and superior pertussis immunogenicity, particularly with the 2/4/6-month schedule. Its genetically engineered three-component design offers a promising strategy to combat pertussis amid global resurgence.

Abstract licence: CC BY

Vaccination represents one of the most effective public health interventions. However, a decrease in pediatric vaccination coverage has been observed in Italy, with an increase in vaccine-preventable infectious diseases. To counter this phenomenon, the Italian government approved a compulsory vaccination law in 2017, increasing the number of mandatory vaccinations from four to 10. This study analyzes the trends of vaccination coverages in Italy from 2000 to 2023, with a focus on the impact of the law. Vaccination coverage data were obtained from the Italian Ministry of Health, sorted by antigen. A linear regression and joinpoint regression analysis was performed for each antigen to identify a significant or non-significant change (increase or decrease) in the trend. Vaccination coverages declined steadily until 2015, but with the introduction of the law 119/2017, there was an increase for all antigens, ranging from 1.05% for tetanus to 5.30% for rubella. During the years of the COVID-19 pandemic, a decline in coverage was observed for all antigens, with values ranging from -0.24% for varicella to -2.39% for rubella. Implementing vaccine mandates seem to be useful for increasing vaccination coverages. Likewise, this study showed the negative impact of the COVID-19 pandemic on primary healthcare services, such as vaccination, contributing to a decline in coverage. Health systems should measure vaccination coverages and monitor changes and variations to be resilient toward external stressors and be proactive in tackling crises.

Abstract licence: CC BY-NC

The DTacP-sIPV/Hib combination vaccine is designed to replace the separate administration of diphtheria, tetanus, acellular pertussis, poliomyelitis, and Haemophilus influenzae type b vaccines. By incorporating Sabin strain inactivated poliovirus, DTacP-sIPV/Hib offers advantages in biosafety and manufacturing cost. This study provides a preliminary evaluation of the preclinical safety of a novel DTacP-sIPV/Hib combination vaccine in three animal models. Sprague-Dawley rats were randomly assigned to receive either DTacP-sIPV/Hib or saline by intramuscular injection and were monitored for 14 days for local reactions, body weight, and food intake, followed by necropsy and histopathological examination. Guinea pigs were allocated to negative control, positive control or vaccine groups and sensitized by three intramuscular injections on alternate days; animals were subsequently challenged and observed for allergic reactions. Japanese white rabbits were used in a bilateral self-controlled design, receiving vaccine in one quadriceps and saline in the contralateral side, with macroscopic and histopathological evaluation at 48 h and 16 days post-injection. The candidate DTacP-sIPV/Hib vaccine induced only mild, transient, and reversible local reactions in SD rats and rabbits, indicating acceptable local tolerability under the conditions tested. No detectable effects on body weight or food intake were observed in rats, and no allergic reactions were induced in guinea pigs, suggesting no apparent systemic safety signals in these models. Overall, these findings provide supportive nonclinical safety evidence for the candidate DTacP-sIPV/Hib vaccine and may inform the design and risk assessment of subsequent clinical studies.

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Addressing population health needs requires integrating indicators expressed on non-comparable scales, particularly for vaccination, a cornerstone of public health. OBJECTIVE: To propose and implement a Vaccination Needs Index based on national administrative data on tracer vaccines for children to support the prioritisation of Brazilian municipalities. METHODS: In this ecological study, we developed and applied a Vaccination Needs Index using national administrative data from 5570 Brazilian municipalities (2018-2022), integrating transformed and standardised indicators of vaccination coverage and the number of susceptible children for three tracer vaccines: diphtheria, tetanus, and polio (DTP) (third dose), polio (third dose), and measles, mumps, and rubella (MMR) (second dose). RESULTS: The estimated national coverages achieved in 2022 for the analysed vaccine doses were 79% for DTP, 67.7% for polio, and 46.1% for MMR. Consequently, approximately 3.0, 4.8 and 7.9 million children remained unvaccinated for these vaccines, respectively. When compared with criteria prioritising either unvaccinated children or low coverage alone, the top 5% of municipalities (n = 278) with the highest Vaccination Needs Index scores included a balanced mix of large, medium and small populations, with greater representation of the Legal Amazon region and Special Sanitary Indigenous Districts. These municipalities also had higher income inequality than the others, showing a mean difference in the Gini coefficient of 4.9 percentage points (95% CI: 4.2-5.7). CONCLUSIONS: The Vaccination Needs Index effectively integrated absolute and relative vaccination indicators, identifying populations with intersecting vulnerabilities and socioeconomic inequities. It provides a practical and scalable tool to guide tailored interventions and optimise resource allocation, thereby preventing the resurgence of vaccine-preventable diseases.

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This study analyzes vaccination coverage trends across 34 provinces in Afghanistan from 2000 to 2024, using data from the Institute for Health Metrics and Evaluation (IHME). Coverage rates for bacillus Calmette-Guérin (BCG), diphtheria-tetanus-pertussis third dose (DTP3), measles-containing vaccine first dose (MCV1), polio vaccine (three doses), pneumococcal conjugate vaccine third dose (PCV3), hepatitis B vaccine third dose (HepB3), Haemophilus influenzae type b vaccine third dose (Hib3), and rotavirus vaccine (RotaC) were assessed using the Kruskal-Wallis and Friedman tests. The Friedman test and Kruskal-Wallis H test were used to assess significant differences in vaccination coverage trends across the 34 provinces in Afghanistan from 2000 to 2024, enabling a comprehensive analysis of provincial and temporal trends. A downward trend in vaccination coverage was observed during the COVID-19 pandemic and after international aid limitations following the political change that occurred in Afghanistan in 2021. This decline in coverage may be associated with disruptions in vaccine distribution during these critical periods. Besides individual factors, vaccination adherence is influenced by health system factors, including vaccine availability and accessibility. The results of the Kruskal-Wallis and Friedman tests showed significant variability in vaccination coverage trends across the 34 provinces from 2000 to 2024. These findings highlight the need for intensive efforts to improve vaccination coverage in all 34 provinces to protect those most at risk.

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