Frenck RW Jr, Naficy A, Feser J, Dickey MP, Leyva-Grado VH, Egan MA, Chen T, Eldridge JH, Sciotto-Brown S, Hermida L, Promeneur D, Luckay A, Medina H, Lazaro GA, Patel NR, Naqvi T, Broder CC, Dimitrov AS, Gast C, Mercer LD, Raine M, Andi-Lolo I, Innis BL, Aponte JJ, Hamm S, Rathi N. Safety and immunogenicity of a Nipah virus vaccine (HeV-sG-V) in adults: a single-centre, randomised, observer-blind, placebo-controlled, phase 1 study. Lancet. 2025 Dec 13;406(10521):2792-2803.
doi: https://doi.org/10.1016/S0140-6736(25)01390-X
Editorial comment: This phase 1, randomized, placebo-controlled study is the first to assess the safety and immunogenicity of a Nipah virus vaccine using the Hendra virus soluble G glycoprotein (HeV-sG-V), known to elicit cross-protective immunity due to strong structural similarity between NiV and HeV G proteins. Among healthy adults aged 18–49, immune responses were dose-dependent: one dose produced limited immunogenicity, while two doses—especially the 100 µg regimen given 28 days apart—generated robust antibody responses. All dosing regimens were well tolerated. The rapid antibody induction and enhanced persistence after two doses support the potential of HeV-sG-V for both outbreak response and preventive vaccination.
Zambon M, Hayden FG. Influenza A(H3N2) Subclade K Virus: Threat and Response. JAMA. 2025 Dec 18.
doi: https://doi.org/10.1001/jama.2025.25903
Editorial comment: This editorial provides a clear and timely overview of the growing number of patients infected and ill with the AH3N2 subclade 2 strain, detailing its clinical characteristics and the age groups most affected. Most importantly, it emphasizes that although the strain shows a reduced response to the current influenza vaccine, the vaccine still offers substantial protection—particularly against hospitalization.
Levrier A, Soudier P, Garenne D, Izri Z, Bowden S, Lindner AB, Noireaux V. A synthetic cell phage cycle. Nat Commun. 2025 Dec 15.
doi: https://doi.org/10.1038/s41467-025-67249-8
Editorial comment: In this in vitro study, the authors reconstructed an entirely cell-free viral cycle in which T7 phages infect synthetic cells engineered with lipopolysaccharides on the outer leaflet of their lipid membranes and containing a cell-free gene expression system. They quantified key parameters of this system—including multiplicity of infection, replication efficiency, liposome size limitations, and phage rebinding dynamics. This work establishes a versatile and fully defined platform for reconstructing and dissecting viral infections from their individual molecular components, offering valuable opportunities for vaccine epitope characterization and related applications.
Jabagi MJ, Bertrand M, Gabet A, Kolla E, Olié V, Zureik M. Nirsevimab vs RSVpreF Vaccine for Respiratory Syncytial Virus-Related Hospitalization in Newborns. JAMA. 2025 Dec 22:e2524082.
doi: https://doi.org/10.1001/jama.2025.24082
Editorial comment: This population-based cohort study used data from the French National Health Data System. Maternal vaccination with the RSVpreF vaccine occurred during 32 to 36 weeks’ gestation among infants born in mainland France between September 1 and December 31, 2024. Passive infant immunization with nirsevimab occurred prior to hospital discharge. Compared with the RSVpreF vaccine, passive infant immunization with nirsevimab was associated with a lower risk of hospitalization for RSV-associated lower respiratory tract infection (adjusted HR, 0.74 [95% CI, 0.61 to 0.88]). Compared with the RSVpreF vaccine, passive infant immunization with nirsevimab was associated with a lower risk of severe outcomes, including PICU admission (adjusted HR, 0.58 [95% CI, 0.42 to 0.80]), requiring ventilator support (adjusted HR, 0.57 [95% CI, 0.40 to 0.81]), or requiring oxygen therapy (adjusted HR, 0.56 [95% CI, 0.38 to 0.81]). The results were consistent across subgroups and in the sensitivity analyses.
Finn A, Guiso N, Wirsing von König CH, Martinón-Torres F, Palmu AA, Bonanni P, Bakhache P, Maltezou HC, Van Damme P. How to improve pertussis vaccination in pregnancy: a European expert review. Expert Rev Vaccines. 2025 Dec;24(1):175-182.
doi: https://doi.org/10.1080/14760584.2025.2473328
Editorial comment: In this publication, resulting from a European expert meeting, participants discussed optimal strategies for pertussis vaccination during pregnancy. The group concluded that, although current maternal immunization programs have been effective, the use of combined Tdap or Tdap-IPV vaccines is not ideal and reflects the absence of pertussis-only vaccines, which are currently unavailable in Europe. A pertussis-only vaccine could avoid repeated and unnecessary exposure of pregnant women to tetanus and diphtheria boosters with each pregnancy. Furthermore, recombinant pertussis vaccines with enhanced immunogenicity may offer prolonged passive protection against pertussis in young infants.
Semenzato L, Le Vu S, Botton J, Bertrand M, Jabagi MJ, Drouin J, Cuenot F, Olié V, Dray-Spira R, Weill A, Zureik M. COVID-19 mRNA Vaccination and 4-Year All-Cause Mortality Among Adults Aged 18 to 59 Years in France. JAMA Netw Open. 2025 Dec 1;8(12):e2546822.
doi: https://doi.org/10.1001/jamanetworkopen.2025.46822
Editorial comment: In this French study, Cox models weighted for sociodemographic characteristics and 41 comorbidities were used to estimate 4-year all-cause mortality. Time to event was censored at all-cause death, COVID-19 vaccination for unexposed individuals, or study termination on March 31, 2025. Vaccinated individuals had a 74% lower risk of death from severe COVID-19 (weighted hazard ratio [wHR], 0.26; 95% CI, 0.22–0.30) and a 25% lower risk of all-cause mortality (wHR, 0.75; 95% CI, 0.75–0.76), with similar associations observed after excluding deaths due to severe COVID-19. Sensitivity analyses consistently demonstrated a lower risk of death among vaccinated individuals, regardless of cause.
Meglic E, Ploner A, Clements M, Elfström M, Lei J. Herd effect of human papillomavirus vaccination on incidence of high-grade cervical lesions: a population-based cohort study in Sweden. Lancet Public Health. 2026 Jan;11(1):e35-e43.
doi: https://doi.org/10.1016/S2468-2667(25)00297-X
Editorial comment: The authors conducted a nationwide retrospective cohort study of 857,168 girls and women born between 1985 and 2000, using data from the Swedish National Cervical Screening Registry and other national health registries. Among unvaccinated women, High Grade Cervical Lesions (HSIL)+ incidence declined in the birth cohort eligible for the school-based HPV vaccination program, demonstrating that high vaccine coverage can generate a strong herd effect.
Gbesemete D, Ramasamy MN, Ibrahim M, Hill AR, Raud L, Ferreira DM, Guy J, Dale AP, Laver JR, Coutinho T, Faust SN, Reed TAN, Babbage G, Weissfeld L, Lang W, Locht C, Samal V, Goldstein P, Solovay K, Rubin K, Noviello S, Read RC. Efficacy, immunogenicity, and safety of the live attenuated nasal pertussis vaccine, BPZE1, in the UK: a randomised, placebo-controlled, phase 2b trial using a controlled human infection model with virulent Bordetella pertussis. Lancet Microbe. 2025 Dec;6(12):101211.
doi: https://doi.org/10.1016/j.lanmic.2025.101211
Editorial comment: The resurgence of pertussis is largely attributed to suboptimal vaccination coverage, particularly in countries that rely exclusively on acellular vaccines, which fail to induce mucosal immunity and generate minimal indirect (herd) protection. Consequently, sustained coverage levels above 95% are required to control transmission. BPZE1 is a live-attenuated Bordetella pertussis strain developed for intranasal administration, engineered through the genetic inactivation or deletion of three key virulence factors—pertussis toxin (PT), dermonecrotic toxin (DNT), and tracheal cytotoxin (TCT)—to safely prevent whooping cough while closely mimicking natural infection. This vaccine elicits robust Th1-biased cellular immunity alongside strong humoral responses. In a phase 2b human challenge study, intranasal BPZE1 vaccination prevented or markedly reduced infection following exposure to virulent B. pertussis, supporting its potential as a promising next-generation pertussis vaccine. Given its favorable safety profile, large-scale phase 3 clinical trials are warranted to confirm these findings and further assess its public health impact.
Moline HL, Tannis A, Goldstein L, Englund JA, Staat MA, Boom JA, Selvarangan R, Michaels MG, Weinberg GA, Halasa NB, Toepfer AP, Rutkowski RE, Salthouse A, Sahni LC, Schuster JE, Stewart LS, Williams JV, Payne DC, Klein EJ, Szilagyi PG, Dawood FS; New Vaccine Surveillance Network Collaborators. Effectiveness and Impact of Maternal RSV Immunization and Nirsevimab on Medically Attended RSV in US Children. JAMA Pediatr. 2025 Dec 22:e255778.
doi: https://doi.org/10.1001/jamapediatrics.2025.5778
Editorial comment: In this study, maternal RSV vaccine effectiveness was assessed by evaluating outcomes among newborns and infants younger than 6 months at the time of medical encounters. Nirsevimab effectiveness was estimated among newborns and infants younger than 8 months as of October 1, 2024, or born after that date. Among infants younger than 6 months, maternal RSV vaccination demonstrated 64% effectiveness (95% CI, 37%–79%) against medically attended RSV-associated acute respiratory illness (ARI) and 70% effectiveness (95% CI, 37%–86%) against RSV-associated hospitalization. Nirsevimab showed 81% effectiveness (95% CI, 71%–87%) against RSV-associated hospitalization, with sustained protection of 77% (95% CI, 42%–92%) at 130 to 210 days after receipt.
Dalisay SN, Landicho M, Lota MM, Fujimori Y, Acacio-Claro PJ, Roxas E, Abeleda A, Rosuello JZ, Dato M, Vogt F, Danchin M, Belizario V Jr, Kaufman J. Behavioural and social drivers of routine childhood immunization in selected low coverage areas in the Philippines. Glob Health Res Policy. 2025 Sep 29;10(1):48.
doi: https://doi.org/10.1186/s41256-025-00447-5
Editorial comment: This study focused on three low–vaccine-coverage regions in the Philippines. Focus groups were conducted with caregivers of vaccinated and unvaccinated children (0–11 years), and key informant interviews were held with immunization program managers and coordinators. Guides were based on the WHO Behavioural and Social Drivers (BeSD) of Vaccination framework. Perceived benefits and concerns about vaccine side effects emerged as key intrapersonal drivers. Social influences—including family members, barangay health workers, and community leaders—shaped decisions across socioecological levels. Practical barriers, such as vaccine availability and access to vaccination sites, continued to hinder uptake.
Shaaban FL, Groenendijk RW, Baral R, Caballero MT, Crowe JE Jr, Englund JA, Esteban I, Hirve S, Jit M, Kalergis AM, Karron RA, Lukacs N, Martinon-Torres F, Mejias A, Nair H, Nisar MI, Nyiro JU, Pecenka C, Sparrow E, Srikantiah P, Thwaites RS, Zar HJ, Bont LJ. The path to equitable respiratory syncytial virus prevention for infants: challenges and opportunities for global implementation. Lancet Glob Health. 2025 Dec;13(12):e2165-e2174.
doi: https://doi.org/10.1016/S2214-109X(25)00379-1
Editorial comment: This Review outlines the challenges and opportunities for expanding access to RSV prevention for infants in resource-restricted settings, guided by WHO’s Immunization Agenda 2030 and the UN’s Leave No One Behind framework for equitable, non-discriminatory development. Key domains discussed include disease burden, vaccine and monoclonal antibody development, health economics and impact modelling, policy and implementation considerations, programmatic delivery, surveillance, and public awareness. The Review synthesizes recent scientific advances and identifies the urgent actions required to achieve equitable global access to RSV prevention for all infants.
Capucetti A, Falivene J, Pizzichetti C, Latino I, Mazzucchelli L, Schacht V, Hauri U, Raimondi A, Virgilio T, Pulfer A, Mosole S, Grau-Roma L, Bäumler W, Palus M, Renner L, Ruzek D, Goldman Levy G, Foerster M, Chahine K, Gonzalez SF. Tattoo ink induces inflammation in the draining lymph node and alters the immune response to vaccination. Proc Natl Acad Sci U S A. 2025 Dec 2;122(48):e2510392122.
doi: https://doi.org/10.1073/pnas.2510392122
Editorial comment: In this study, the authors examined how different tattoo inks are transported and accumulate in the lymphatic system using a murine model. They observed rapid lymphatic drainage, followed by macrophage uptake of ink within the draining lymph nodes (LNs). This triggered an immediate local and systemic inflammatory response that persisted, with clear inflammation still present in LNs two months after tattooing. Ink-loaded macrophages were also associated with apoptosis in both human and mouse models. Importantly, ink accumulation in the LNs altered immune responses to two different vaccines. These findings highlight potential risks of tattooing related to immune modulation and provide valuable information for toxicology assessments, regulatory decision-making, and public awareness.
Carnalla-Barajas MN, Soto-Noguerón A, Solórzano-Santos F, Macías-Parra M, Díaz-Jiménez V, Sánchez-González G, Jiménez-Juárez R, Parra-Ortega I, Sánchez-Francia D, Luévanos-Velázquez A, Merlo-Palomera M, Flores-Santos A, Magaña-Aquino M, Tinoco-Favila JC, Corte-Rojas RE, Garza-González E, Guajardo-Lara CE, Vázquez-Narváez JA, Hernández-Magaña R, Sánchez-Reyes BA, Pacheco-Gil L, Monroy-Colín VA, Rincón-Zuno J, Feliciano-Guzmán JM, Echániz-Aviles G. Pneumococcal meningitis in Mexico. Serotype distribution and antimicrobial resistance before and after the introduction of pneumococcal conjugate vaccines in pediatric patients. Results from the GIVEBPVac group. J Infect Public Health. 2026 Jan;19(1):103030.
doi: https://doi.org/10.1016/j.jiph.2025.103030
Editorial comment: Using passive surveillance, the authors conducted a prospective analysis of pneumococcal isolates from children aged 0–17 years with meningitis between 1993 and 2024 through the GIVEBPVac network. A total of 575 isolates were examined. PCV13 serotypes declined from 77.2% in the pre-PCV period to 33.3% in the PCV13 era, while non-vaccine serotypes increased to 66.7%. Before PCV introduction, serotypes 14, 6B, 19F, and 23F predominated. In the PCV13 era, serotypes 19A and 15B became more common, and non-vaccine serotypes 23B and 6C emerged.
Kimathi, Derick et al. Low-dose yellow fever vaccination in infants: a randomised, double-blind, non-inferiority trial. The Lancet.
doi: https://doi.org/10.1016/S0140-6736(25)02069-0
Editorial comment: In Kenya, between Oct 7, 2021, and June 14, 2023, a total of 420 infants were enrolled and randomly assigned (210 per group). At day 28, seroconversion rates in the per-protocol population were 99% (95% CI 96–100; 177/179 infants) for the standard dose and 93% (95% CI 88–96; 166/179 infants) for the 500 IU dose. Compared with the standard yellow fever vaccine dose, the 500 IU dose did not meet the non-inferiority criterion, indicating that minimum dose requirements established for adults may not be directly generalizable to infants.
Saso A, Fröberg J, Jobe H, Eleveld M, Okoye M, Kanteh E, Arns A, van Opzeeland F, Kumado M, Faal A, Roberts E, Fofana ML, Baldeh AK, Conteh K, van Cranenbroek B, Roetynck S, de Jonge M, de Silva TI, Huynen M, Kampmann B, Diavatopoulos DA; GaPs Study Team. Mucosal immune responses to Bordetella pertussis in Gambian infants after maternal and primary vaccination: an immunological substudy of a single-centre, randomised, controlled, double-blind, phase 4 trial. Lancet Microbe. 2026 Aug 21:101219.
doi: https://doi.org/10.1016/j.lanmic.2025.101219
Editorial comment: This Gambian substudy included 160 infants from the GaPs trial (Feb 2019–May 2021). At 8 weeks of age—before primary vaccination—infants of mothers vaccinated with Tdap-IPV in pregnancy had significantly higher nasal anti-pertussis toxin IgG (GMR 3.84) and anti-B. pertussis IgG (GMR 6.45), but not IgA, compared with infants of mothers who received TT.
After primary vaccination, infants who received DTwP had substantially higher nasal anti-B. pertussis IgG GMCs than those vaccinated with DTaP, regardless of maternal vaccine group. Notably, DTaP-vaccinated infants born to Tdap-IPV-vaccinated mothers showed the lowest post-vaccination IgG levels, even when their baseline maternal antibody concentrations were low.
Sacchetto L, Marques BC, Banho CA, Bernardi V, Estofolete CF, Dos Santos CLS, Timenetsky MDCST, de Lacerda MVG, Freitas AC, Pereira DB, da Fonseca AJ, Gurgel RQ, Coelho IC, Fontes CJF, Marques Júnior ETA, Romero GAS, Teixeira MM, de Siqueira AM, Boaventura VS, Ramos F, Elias Júnior E, de Moraes JC, Vasilakis N, Miranda É, Moreira JAS, Boulos FC, Kallás EG, Nogueira ML. Dengue virus genetic diversity in unvaccinated and vaccinated dengue-infected individuals: an observational analysis of the Butantan-DV phase 3 trial in Brazil. Lancet Reg Health Am. 2025 Nov 29;53:101309.
doi: https://doi.org/10.1016/j.lana.2025.101309
Editorial comment: In this study, the authors analyzed 365 DENV-1 and DENV-2–positive samples from unvaccinated participants and vaccinated participants (28 days post-vaccination) enrolled in the Butantan-DV phase 3 trial in Brazil (2016–2021). Although sample numbers limited statistical power, vaccinated individuals—especially with DENV-1—showed significantly lower RT-qPCR Ct values, suggesting reduced viral replication. Breakthrough infections were not associated with any specific DENV-1 or DENV-2 lineage. Genetic analyses revealed no differences in intra-host mutation rates and no evidence of positive selection in viral coding regions. Breakthrough infections in Butantan-DV recipients were not linked to distinct viral lineages. Circulating DENV-1 and DENV-2 strains in both vaccinated and unvaccinated groups reflected normal transmission dynamics, including co-circulation and lineage replacement.
A, Hossain ME, Spiropoulou C, Shoemaker T, Rahman MZ, Banu S, Hensley L, Satter SM, Montgomery JM, Shirin T. P-586. 2025 Nipah Outbreaks in Bangladesh: Clinical Patterns, Emerging Risks, and Future Preparedness in an Expanding Epidemiologic Landscape. Open Forum Infect Dis. 2026 Jan 11;13(Suppl 1):ofaf695.800.
doi: https://doi.org/10.1093/ofid/ofaf695.800
Editorial comment: Nipah virus (NiV), a high-risk pathogen with pandemic potential, continues to cause near-annual outbreaks in Bangladesh. Since January 2025, IEDCR and icddr,b have investigated three sporadic outbreaks in urban or peri-urban areas of Pabna, Bhola (the first case reported there), and Faridpur. All primary cases were linked to consumption of raw date palm sap, with nearby bat roosts (2–13 km) housing 20–500 Pteropus medius bats. Patients tested NiV-positive within 4–11 days of symptom onset and 2–3 days after hospitalization. All presented with fever, neurological symptoms, respiratory distress, and died within 3–12 days. As in 2024, the 2025 cases showed 100% fatality, underscoring persistent NiV virulence. Continued raw sap consumption and delays in care-seeking highlight the urgent need for strengthened community awareness and surveillance.
Coelho LE, Goedert GT, Genari J, Luz PM, Carvalho LM, Santos CVBD, Csillag D, Konečný T, Campos Pellanda L, Struchiner CJ, Freitas da Silveira M, Hallal PC. COVID-19 vaccine trust and uptake: the role of media, interpersonal and institutional trust in a large population-based survey. Lancet Reg Health Am. 2025 Dec 8;53:101324.
doi: https://doi.org/10.1016/j.lana.2025.101324
Editorial comment: Among 29,281 participants (63.9% women; median age 51 years), 60% reported trusting the COVID-19 vaccine and 72% had received ≥3 doses. Vaccine uptake closely mirrored trust: 67% of unvaccinated or unsure individuals distrusted the vaccine, whereas trust rose progressively with the number of doses—62.6% among those with 3 doses, 73.8% with 4 doses, and 89.8% with ≥5 doses. Gen Z adults (18–30 years) were less likely to trust the vaccine (−0.07). Positive predictors of trust included higher education and reliance on television or nurses.
Lopatynsky-Reyes EZ, Rodriguez-Valencia JA, Chacon-Cruz E. Active Surveillance and Polymerase Chain Reaction (PCR) Between Two Passive Surveillance Periods Improve Detection and Characterization of Pleural Empyema: A 20-Year Study in Tijuana, Mexico. Cureus 2026 (January).
doi: https://doi.org/10.7759/cureus.101369
Editorial comment: To date, no published studies have systematically compared passive versus active surveillance for pleural empyema. The objective of this study was precisely to evaluate the impact of implementing active surveillance by comparing detection rates and the characterization of all variables associated with PE across passive and active surveillance periods, as well as after active surveillance was discontinued. The findings of this 20-YEAR study are truly remarkable and provide valuable insights into the importance of enhanced surveillance strategies for improving case detection, laboratory confirmation, and clinical understanding of pleural empyema—and to measure in detail the impacts of pneumococcal protein-conjugate vaccines (PCV7–PCV13) on reducing pneumococcal cases and the corresponding rise of methicillin-susceptible S. aureus cases.
Zhou D, Chan S, Zhong Y, Xu Z, Wang J, Wang Y, Gao Y, Xia Y, Zhang D, Tang W. Disease and Economic Burden Averted by Hib Vaccination in 160 Countries: A Machine-Learning Analysis. Vaccines. 2025 Nov 27;13(12):1197.
doi: https://doi.org/10.3390/vaccines13121197
Editorial comment: Between 1990 and 2021, Hib immunization prevented an estimated 1.32 million deaths (95% UI: 32,034–2.72 million) and 90.9 million disability-adjusted life-years (95% UI: 3.57–197.1 million) worldwide. The largest health and economic gains occurred in Africa and other LMICs. Deaths averted declined with later vaccine introduction (r = –0.56). Despite its impact, Hib vaccination has not improved health equity, as access remains limited in many LMICs. Overall, Hib immunization delivers substantial and highly cost-effective global benefits.
Gupta D, Kaur A, Verma V, Van Oorschot DAM, Penders Y, Guzman-Holst A. Prevalence of Respiratory Syncytial Virus in Adult Patients with Respiratory Illnesses in Low to Middle-Income Countries: A Systematic Review and Meta-Analyses. Infect Dis Ther. 2025 Dec 23.
doi: https://doi.org/10.1007/s40121-025-01265-5
Editorial comment: There remains a significant gap in understanding the burden of respiratory syncytial virus (RSV) among adults in low-, lower-middle-, and upper-middle–income countries. In this study, the authors used data identified through a previously described systematic literature review and applied a random-effects model to estimate pooled RSV prevalence across study populations. The findings show a substantial disease burden among high-risk adults aged 18–59 years and adults aged ≥50 years with respiratory illness in these settings, underscoring the need for strengthened RSV surveillance and improved prevention strategies for these populations.
Rahman MM, Sultana S, Dutta P, Hossain MS, Aquib WR, Sachi S, Prince KTP, Das R, Oyshee NT, Antara AJ, Choudhury SS, Farzin A, Karim MR, Khan AKMD, Sarkar T, Chowdhury NN, Khan MA, Malek FM, Fatema U, Parvin H, Habib MN, Hasan J, Chisty NN, Alam MR, Islam MA, Niloy N, Mahmood SJB, Siddika A, Rahman MM, Chowdhury M, Qayum MO, Islam Maerz MD, Makatsa MS, Bucsan AN, Sutton MS, Bishop E, Tian Z, Layton ED, Roederer M, Shalek AK, Seder RA, Scriba TJ, Wang C, Darrah PA, Seshadri C. BCG vaccination induces antibacterial effector functions among Vδ1/3 T cells that are associated with protection against tuberculosis. Cell Rep Med. 2026 Jan 12:102536.
doi: https://doi.org/10.1016/j.xcrm.2025.102536
Editorial comment: The authors used multimodal single-cell RNA sequencing, mass cytometry, and flow cytometry to characterize γδ T-cell responses in human infants and macaques following BCG vaccination. In BCG-vaccinated infants, a subset of Vδ1/3 T cells showed clonal expansion and differentiation into Mtb-reactive cytotoxic effector cells. In macaques, intravenous BCG similarly induced pro-inflammatory and cytotoxic Vδ1/3 T-cell responses, with these cells enriched in the airway compared with blood. Higher frequencies of cytokine-producing Vδ1/3 T cells in the airway correlated with protection against Mtb challenge. These findings suggest that BCG activates and recruits Vδ1/3 T cells to the lung, where they acquire functions that may contribute to protective immunity.
Vakaniaki EH, Barhishindi I, Mubiala A, Malembaka EB, Braunack-Mayer L, Nganga B, Sabiti Nundu S, Brosius I, Bracke S, Bangwen E, De Vos E, Colebunders R, Ngale M, Kayembe G, Tshongo C, Dilu A, Tshimanga C, Biampata JL, Bugeme PM, Ntamabyaliro N, Kirenga B, Wayengera M, Siewe Fodjo JN, Lupande Mwenebitu D, Rimoin AW, Wawina-Bokalanga T, Vercauteren K, Mukadi-Bamuleka D, Muyembe-Tamfum JJ, Krasemann S, Kindrachuk J, Azman AS, Nussenblatt V, Crozier I, Dodd LE, Tshiani-Mbaya O; MBOTE-SK Consortium; PREGMPOX Consortium; PALM007 Consortium; Uvira Study Group; Low N, Katoto PDMC, Mbala-Kingebeni P, Liesenborghs L. Maternal and neonatal outcomes after infection with monkeypox virus clade I during pregnancy in DR Congo: a pooled, prospective cohort study. Lancet. 2026 Jan 19:S0140-6736(25)02309-8.
doi: https://doi.org/10.1016/S0140-6736(25)02309-8
Editorial comment: Monkeypox virus (MPXV) has been associated with vertical transmission; however, systematic data remain limited. In this prospective cohort analysis, we pooled data from three cohort studies (MBOTE-SK, PREGMPOX, and Uvira mpox) and one randomized controlled trial (PALM007) conducted in the South Kivu, Maniema, and Sankuru provinces of the Democratic Republic of the Congo between Dec 29, 2022, and June 20, 2025. Pregnant women and adolescent girls with PCR-confirmed mpox were followed throughout hospitalization, delivery, and the postpartum period until discharge. Final pregnancy outcomes were available for 69 (78%) participants. Adverse pregnancy outcomes occurred in 35 women (51%; 95% CI 38–63), including fetal loss in 31 cases (45%; 95% CI 33–57), comprising 16 (52%) spontaneous abortions, four (13%) missed abortions, and 11 (35%) stillbirths. Among 38 live births, four neonates presented with congenital mpox-like lesions, and one neonate died within hours of birth. No preterm deliveries or structural congenital anomalies were observed. MPXV infection during the first trimester was associated with a significantly higher risk of adverse pregnancy outcomes compared with infection during the second (risk ratio [RR] 0.6; 95% CI 0.4–0.9) or third trimester (RR 0.2; 95% CI 0.1–0.4; p=0.0008). Overall, MPXV clade I infection during pregnancy was associated with a substantial risk of fetal loss and congenital infection, particularly when infection occurred during the first trimester.
