Razzini JL, Palau J, Solovey G, Guinazu G, Sosa EM, Orta SR. Impact and effectiveness of RSV maternal immunization on infant hospitalizations in Buenos Aires: a hospital-based, multicentre, retrospective surveillance cohort study. The Lancet Regional Health – Americas 2025; 52: 101296.
doi: https://doi.org/10.1016/j.lana.2025.101296
Editorial comment: This excellent Argentinian study evaluated the impact of RSVpreF maternal immunization (MI) on RSV-related acute lower respiratory tract infection (ALRTI) hospitalizations using a hospital-based, multicenter retrospective cohort, with vaccine effectiveness (VE) estimated through a nested test-negative case–control analysis. A total of 3373 infants were included, 323 of whom were born during the vaccination period and eligible for VE assessment. The adjusted VE of RSVpreF MI against RSV-ALRTI hospitalization was 80.8% (95% CI: 62.8–90.5%) in infants <3 months and 66.1% (95% CI: 30.1–83.8) in infants <6 months. VE for PICU admission reached 87.2% (95% CI: 52.6–97.0), and 88.6% (95% CI: 62.3–97.1) for prolonged hospital stays among infants <6 months. Overall, RSV-ALRTI hospitalizations in infants <6 months decreased by 33.6% (95% CI: 29.5–37.2) in 2024 compared with expected levels from previous years. The number needed to immunize to prevent one RSV-related hospitalization was 83.9 (95% CI: 65.9–185.4).
Wang C, Lai X, Abbas K, Pouwels KB, Zhang H, Jit M, Fang H. Health impact and economic evaluation of the Expanded Program on Immunization in China from 1974 to 2024: a modelling study. Lancet Public Health. 2025 Dec;10(12):e1045-e1054.
doi: https://doi.org/10.1016/S2468-2667(25)00039-8
Editorial comment: This study used mathematical modelling to evaluate the impact of China’s EPI on eight high-burden vaccine-preventable diseases (measles, pertussis, hepatitis B, tuberculosis, hepatitis A, Japanese encephalitis, meningitis A, and poliomyelitis), accounting for non-linear vaccine effects. Based on the calendar year approach (1974–2024), the EPI was estimated to avert 703 million cases (95% CrI: 699.5–722.8), 2.48 million deaths (2.14–2.97), and 160 million DALYs (145–197). Using the birth cohort approach, the program was predicted to avert 707 million cases (703.9–727.0), 7.01 million deaths (6.95–7.87), and 279 million DALYs (266–316) over the lifetime of vaccinated cohorts.
Johansen ND, Modin D, Pardo-Seco J, Rodriguez-Tenreiro-Sánchez C, Loiacono MM, Harris RC, Dufournet M, van Aalst R, Chit A, Larsen CS, Larsen L, Wiese L, Dalager-Pedersen M, Claggett BL, Janstrup KH, Duran-Parrondo C, Piñeiro-Sotelo M, Cribeiro-González M, Conde-Pájaro M, Mirás-Carballal S, González-Pérez JM, Solomon SD, Sivapalan P, Martel CJ, Jensen JUS, Martinón-Torres F, Biering-Sørensen T; DANFLU-2 Study Group; GALFLU Trial Team. Effectiveness of high-dose influenza vaccine against hospitalisations in older adults (FLUNITY-HD): an individual-level pooled analysis. Lancet. 2025 Nov 22;406(10518):2425-2434.
doi: https://doi.org/10.1016/S0140-6736(25)01742-8
Editorial comment: FLUNITY-HD was a prespecified, individual-level pooled analysis of two harmonized pragmatic randomized trials comparing high-dose influenza vaccine (HD-IIV) with standard-dose influenza vaccine (SD-IIV) in older adults.
The primary outcome—hospitalization for influenza or pneumonia—occurred in 0.56% of HD-IIV recipients (1312/233,311) versus 0.62% of SD-IIV recipients (1437/233,009), yielding a relative vaccine effectiveness (rVE) of 8.8% (95% CI: 1.7–15.5; p=0.0082).
HD-IIV also significantly reduced: Cardiorespiratory hospitalizations: 2.02% vs 2.16% (rVE 6.3%; 95% CI: 2.5–10.0; p=0.0006); laboratory-confirmed influenza hospitalizations: 0.11% vs 0.16% (rVE 31.9%; 95% CI: 19.7–42.2; p<0.0001); all-cause hospitalizations: 8.54% vs 8.73% (rVE 2.2%; 95% CI: 0.3–4.1; p=0.012).
Cortes-Azuero O, O’Driscoll M, Ribeiro Dos Santos G, de Jesus R, de Lima STS, Scarponi D, Mukandavire C, Deol A, Kraemer MUG, de Souza WM, Salje H. The epidemiology of chikungunya virus in Brazil and the potential impact of vaccines: a mathematical modelling study. Lancet Infect Dis. 2025 Nov 27:S1473-3099(25)00605-X.
doi: https://doi.org/10.1016/S1473-3099(25)00605-X
Editorial comment: This study quantified annual CHIKV infection and disease burden across Brazil’s 27 federative units from 2014–2024 using a Bayesian mathematical model integrating 12 serosurveys, 488,234 confirmed cases, and 1,719 deaths. The authors then projected the impact of vaccination for 2025–2029 under several rollout strategies. They estimated that 18.3% (95% CrI: 16.5–20.3) of Brazil’s population has been infected since 2014, with highest risk in the northeast and southeast. Only 1.13% (1.07–1.19) of infections were detected by surveillance, with symptomatic illness more common with older age and in females. Vaccinating 40% of individuals ≥12 years (≈73 million doses) with a vaccine 70% effective against infection and 95% against disease could avert up to 1.6 million cases (0.5–3.0) and 198 deaths (61–359) over five years.
Jiao B, Sato R, Mak J, Patenaude B, de Villiers M, Deshpande A, Gamkrelidze I, Gaythorpe KAM, Hallett TB, Jit M, Li X, Lopman B, Nayagam S, Razavi-Shearer D, Tam Y, Woodruff KH, Hogan D, Mengistu T, Verguet S. Financial risk protection from vaccines in 52 Gavi-eligible low- and middle-income countries: A modeling study. PLoS Med. 2025 Nov 4;22(11):e1004764.
doi: https://doi.org/10.1371/journal.pmed.1004764
Editorial comment: In this study, the authors used a microsimulation model to estimate the number of catastrophic health expenditure (CHE) cases averted by a range of vaccines across 52 Gavi-eligible countries, stratified by wealth quintile. They evaluated vaccines against five pathogens—hepatitis B (routine and birth dose), H. influenzae type b, rotavirus, measles (routine and campaign doses), and S. pneumoniae. All vaccines, individually and combined, generated substantial financial risk protection (FRP), preventing an estimated ~200 million CHE cases from 2000 to 2030. Notably, about half of all averted CHE cases occurred among the poorest quintiles.Tthe first dose of measles vaccine had the greatest impact, averting approximately 1,400 CHE cases per 10,000 vaccinated. Overall, the findings highlight the powerful FRP benefits of vaccines, particularly for the most disadvantaged populations.
Sampri A, Shi W, Bolton T, Ip S, Knight R, Walker V, Denholm R, Raffetti E, Keene S, Allara E, Jiang X, Kontopantelis E, Denaxas S, Khunti K, Conrad N, Pagel C, Hardelid P, Sterne JAC, Brown KL, Whiteley WN, Cezard G, Wood AM; CVD-COVID-UK/COVID-IMPACT Consortium and the Longitudinal Health Wellbeing COVID-19 National Core Study. Vascular and inflammatory diseases after COVID-19 infection and vaccination in children and young people in England: a retrospective, population-based cohort study using linked electronic health records. Lancet Child Adolesc Health. 2025 Dec;9(12):837-847.
doi: https://doi.org/10.1016/S2352-4642(25)00247-0
Editorial comment: In this population-based retrospective study of nearly 14 million individuals under 18 years in England (2020–2022), 28% had a COVID-19 diagnosis. Infection was linked to markedly increased risks during the first week for arterial and venous thromboembolism, thrombocytopenia, myocarditis/pericarditis, and inflammatory conditions. Although risks declined after the first month, elevated rates of venous thromboembolism, thrombocytopenia, and myocarditis/pericarditis persisted for over 12 months. Among more than 9 million vaccine-eligible children (5–17 years), 37% received at least one BNT162b2 dose. Vaccination was associated with a small, short-term increase in myocarditis/pericarditis within four weeks, but the risk remained far lower than that observed after COVID-19 infection.
Walker RJ, Kingpriest PT, Gong J, Naisanga M, Ashraf MN, Roberti J, Lang T. Global perspectives on infectious diseases at risk of escalation and their drivers. Sci Rep. 2025 Nov 4;15(1):38630.
doi: https://doi.org/10.1038/s41598-025-22573-3
Editorial comment: A total of 3,752 globally diverse participants contributed to this two-step, mixed methods adapted Delphi study. First, an online survey of health workers and researchers (n=3,700) identified infectious diseases perceived to pose the greatest escalation risk and the factors driving them. Second, thematic workshops held in Africa, Asia, and Latin America (n=169) explored these drivers in depth. While survey respondents highlighted growing concern about tuberculosis, workshop participants underscored the rising threat of vector-borne diseases. Across regions, climate change, socioeconomic pressures, and increasing antimicrobial resistance were viewed as key forces accelerating these infection risks. This study offers valuable insight into global infectious disease priorities, distinguished by its large scale, diverse stakeholder input, and broad geographic representation.
Hills SL, Shlim DR, Schofield S, Wilson ME, Barnett ED, Chen LH, Christensen KJ, Staples JE. Chikungunya vaccination for travelers: Practical guidance for clinical decision-making. J Travel Med. 2025 Nov 20:taaf118.
doi: https://doi.org/10.1093/jtm/taaf118
Editorial comment: Two vaccines are now licensed for the prevention of chikungunya: IXCHIQ, a live-attenuated vaccine manufactured by Valneva, and VIMKUNYA, a virus-like particle vaccine produced by Bavarian Nordic. One or both products are already available in several countries, including Brazil, Canada, the United Kingdom, the United States, and multiple European nations and territories.
Although the lack of head-to-head studies limits direct comparison, the vaccines differ in ways that are important when advising travelers. The study summarizes key considerations—including immunogenicity and safety data, travel-related recommendations, and guidance for use during pregnancy and breastfeeding—to support informed decision-making.
Nowzari F, Nowzari F, Kian M, Zahedi M, Samimi K, Karimzadeh A, Tanideh N, Mussin NM, Tamadon A. Evolution and trends in non-viral mRNA Cancer vaccines: A scoping review from 2015 to 2025. Vaccine. 2025 Dec 5;71:128059.
doi: https://doi.org/10.1016/j.vaccine.2025.128059 Epub ahead of print. PMID: 41352221.
Editorial comment: This scoping review synthesizes clinical trials conducted between 2015 and 2025 evaluating non-viral mRNA-based cancer vaccines, with a focus on trends in delivery platforms—ex vivo dendritic-cell (DC) vaccines versus in vivo lipid-based systems—and their distribution across cancer types. Statistical analyses (linear regression and Fisher’s exact test) reveal a significant association between ex vivo DC platforms and brain/CNS cancers (p = 0.00042), with no meaningful correlation between DC vaccine administration routes and cancer type (p = 0.25). This review provides a data-driven overview of the evolving landscape, identifying key gaps in delivery optimization, reporting consistency, and methodological standardization. Two companion articles examine ex vivo DC vaccine approaches and advances in in vivo mRNA vaccine technologies in greater detail.
Gatwood J, Gomez-Espinosa E, Fusco N, Stempniewicz N, Singer D. Real-world utilization and potential clinical and economic value of recombinant zoster vaccine and select preventive services recommended for older adults in the United States. Vaccine. 2025 Dec 6;71:128015.
doi: https://doi.org/10.1016/j.vaccine.2025.128015
Editorial comment: In this targeted literature review, EMBASE, Medline, and Emcare were searched for publications from 2012–2022 reporting utilization, clinical outcomes, and economic data for the recombinant zoster vaccine (RZV) and five key comparator preventive services. Economic modeling studies reported the following estimated incremental cost-effectiveness ratios (ICERs) per quality-adjusted life-year (QALY):
- RZV vs no herpes zoster vaccination (≥50 years): $1,407–$91,156
- Influenza vaccination vs no vaccination (≥65 years): $8,833–$15,001
- Tdap vs Td vaccination (reflecting added pertussis protection; ≥65 years): $17,150–$336,108
- Hepatitis B vaccination vs no vaccination (≥50 years): $371,606–$541,461
- Pneumococcal vaccination vs no vaccination (≥50 years): $15,000–$38,000
Chang CY, Nasreen S, Sadarangani M, Cragg JJ, Marra F. Effect of pneumococcal conjugate vaccine booster dose on prevention of invasive pneumococcal disease in British Columbia, 2003-2018. Vaccine. 2025 Dec 3;71:128066.
doi: https://doi.org/10.1016/j.vaccine.2025.128066
Editorial comment: In this Canadian study, annual invasive pneumococcal disease (IPD) incidence was estimated using Poisson regression, with population at risk adjusted for immunization coverage. Adjusted incidence rate ratios (aIRRs) were calculated by serotype group, age, and vaccine schedule period. Among 598 IPD cases, 53.2% were unvaccinated, 31.8% received a full primary + booster schedule (2–3 primary doses plus 1 booster), and 15.1% received primary doses only (1–3 doses). Compared with unvaccinated children, the aIRR was 0.13 (95% CI: 0.10–0.17) for the primary + booster group and 0.32 (95% CI: 0.22–0.48) for the primary-only group. The primary + booster schedule showed a 61% lower incidence than primary-only (aIRR 0.39; 95% CI: 0.26–0.60). A schedule including a booster dose was associated with a significantly reduced IPD incidence, supporting the continued promotion of the full 2 + 1 (primary + booster) pneumococcal vaccine schedule to reduce disease burden in children.
Lu L, Lu X, Luo W. Personalized Cancer Vaccines: Current Advances and Emerging Horizons. Vaccines. 2025; 13(12):1231.
doi: https://doi.org/10.3390/vaccines13121231
Editorial comment: Personalized cancer vaccines represent a rapidly advancing frontier in oncology, leveraging the unique genetic and molecular features of each patient’s tumor to generate highly targeted immune responses. This review summarizes the current landscape and emerging directions of neoantigen-based personalized cancer vaccines, including peptide, mRNA, DNA, autologous dendritic-cell, and viral or bacterial vector platforms.
Valentini S, Sota J, Fineschi I, Conticini E, Garcia-Gonzalez E, D’Ignazio E, Bardelli M, Gentileschi S, Fabbroni M, Bellisai F, et al. Effectiveness and Safety of Recombinant Zoster Vaccine in Rheumatic Diseases: Real-World Evidence from a Single-Centre Italian Cohort. Vaccines. 2025; 13(12):1227.
doi: https://doi.org/10.3390/vaccines13121227
Editorial comment: Patients with rheumatic diseases (RMDs) are at increased risk of herpes zoster (HZ), particularly when receiving immunosuppressive therapy. Although the recombinant zoster vaccine (RZV) has demonstrated high effectiveness in the general population, data in rheumatologic patients remain limited due to their exclusion from pivotal trials. This retrospective study evaluated 179 adults who received two doses of RZV between January 2021 and June 2025, including 114 patients with RMDs and 65 individuals from the general population. Vaccine effectiveness was assessed by prevention of HZ reactivation, and safety outcomes included any adverse events temporally associated with vaccination.
A statistically significant reduction in varicella-zoster virus (VZV) reactivation was observed following vaccination (p < 0.001). Among RMD patients, only one case of HZ recurrence occurred 14 weeks post-vaccination, with no significant difference compared with the general population cohort. These findings support the broader use of RZV as a safe and effective preventive strategy in individuals with rheumatic diseases.
Myer L, Wasserman E, Tabasum S, Shittu E, Liu Y, Jose L, Horne E, Moraba RS, Wilhase A, Zar HJ, et al. Safety, Tolerability, and Immunogenicity of RSVpreF Vaccine in Pregnant Individuals Living with HIV. Vaccines. 2025; 13(12):1218.
doi: https://doi.org/10.3390/vaccines13121218
Editorial comment: HIV-exposed uninfected (HEU) infants have higher rates of severe RSV lower respiratory tract illness (RSV-LRTI) than HIV-unexposed infants, yet data on maternal RSV vaccination in this population are limited. This phase 3 randomized, double-blind trial evaluated the safety and immunogenicity of the bivalent RSVpreF vaccine in pregnant women with HIV in South Africa and their infants. A total of 343 participants received RSVpreF (n=172) or placebo (n=171). Reactogenicity was mostly mild to moderate, and adverse events—including hypertensive disorders—occurred at similar frequencies across groups. Infant safety outcomes were also comparable, with no differences in adverse events, serious adverse events, or preterm birth. RSVpreF induced strong maternal neutralizing antibody responses to RSV-A and RSV-B, with efficient transplacental antibody transfer (GMRs vs placebo at birth: 7.8 for RSV-A and 6.8 for RSV-B).
Millar JR, Anglemyer A, Werno A, Austin NC, Walls T. Epidemiology of Infant Group B Streptococcus Infection in New Zealand: A 10-Year Retrospective Study. Pediatr Infect Dis J. 2025 Dec 1;44(12):1209-1215.
doi: https://doi.org/10.1097/INF.0000000000004908
Editorial comment: This retrospective study (2012–2021) examined all infants under 180 days of age in New Zealand with invasive group B Streptococcus (GBS) infection. Clinical records from the National Collections dataset were linked to positive sterile-site GBS cultures or PCR results. Cases were classified as early-onset (≤2 days), late-onset (3–89 days), or ultra-late-onset (90–179 days), and incidence rates were estimated using Poisson regression.
Among 406 laboratory-confirmed and 224 clinically suspected cases, early-onset disease (EOGBS) incidence was higher than previously reported but showed no significant change over time (P = 0.4). Pacific infants had twice the EOGBS incidence of European infants, with elevated rates also observed among Māori infants. These findings underscore the urgent need for perinatal GBS vaccination to reduce disease burden and address inequities.
Saxena K, Dempsey A, Verma RP, Martinez R, Schmier JK, Zimet GD. Parental acceptance of HPV vaccinations at ages 9-10 in the United States. Hum Vaccin Immunother. 2025 Dec;21(1):2592432.
doi: https://doi.org/10.1080/21645515.2025.2592432
Editorial comment: This survey of 250 parents assessed attitudes toward HPV vaccination at ages 9–10. Most supported vaccination by age 10 (72% for boys; 77% for girls). Among parents whose children were vaccinated at 11–12 years, 90% said they would have accepted earlier vaccination.
Perceived benefits of starting at 9–10 included greater confidence in completing the series before sexual activity, fewer injections at later visits, and reduced concern about triggering sexual behavior. Reported barriers included separating HPV from other 11–12-year vaccines, challenges involving children in decision-making, and discomfort discussing sexuality at younger ages.
Overall, parental acceptance of HPV vaccination at ages 9–10 was high—both among those who had been offered early vaccination and those who had not.
Abbasi TN, Khan MS, Siddiqui E, Zaheer MA, Tabassum A, Zainab N, Waafira A. Exploring the safety and immunogenicity of the VLA15 vaccine among healthy or high-risk population: a systematic review and meta-analysis of randomized controlled trials. Ther Adv Vaccines Immunother. 2025 Oct 28;13:25151355251387927.
doi: https://doi.org/10.1177/25151355251387927
Editorial comment: This PROSPERO-registered systematic review and meta-analysis (CRD420251058818) included three RCTs with 5,907 participants (4,500 VLA15; 1,407 placebo). VLA15 was associated with higher rates of mild-to-moderate adverse events—fever, headache, fatigue, and arthralgia (all p < 0.0001), with a dose-response trend for arthralgia at higher doses. Nausea and severe unsolicited AEs did not differ significantly from placebo. Immunogenicity outcomes consistently favored VLA15, with higher IgG levels, GMTs, and seroconversion. Overall, VLA15 demonstrates strong immunogenicity and an acceptable safety profile despite increased reactogenicity.
Liedes O, Reinholm A, Ekström N, Haveri A, Solastie A, Vara S, Rijnink WF, Bestebroer TM, Richard M, de Vries RD, Jalkanen P, Lindh E, Ikonen N, Grifoni A, Sette A, Laaksonen T, Holopainen R, Kakkola L, Lappalainen M, Syrjänen RK, Kolehmainen P, Julkunen I, Nohynek H, Melin M. Influenza A(H5N8) vaccine induces humoral and cell-mediated immunity against highly pathogenic avian influenza clade 2.3.4.4b A(H5N1) viruses in at-risk individuals. Nat Microbiol. 2025 Dec 5.
doi: https://doi.org/10.1038/s41564-025-02183-5
Editorial comment: Finland’s 2023 outbreak of clade 2.3.4.4b A(H5N1) avian influenza prompted vaccination of high-risk workers in June 2024 with the MF59-adjuvanted A(H5N8) vaccine (Seqirus). In this observational phase IV study, researchers evaluated immune responses in at-risk individuals. Among those without prior avian influenza vaccination, two doses produced high seroprotection: 83% by microneutralization and 97% by haemagglutination inhibition. Previously vaccinated individuals achieved seroprotection after a single dose. The vaccine also generated measurable A(H5N8)-specific memory CD4+ T-cell responses, with ~5-fold increases in IFNγ after two doses. Overall, the findings indicate likely cross-protection against circulating clade 2.3.4.4b H5 viruses.
