Pittet LF, Casalaz D, Donath S, Gardiner K, Goodall C, Flanagan KL, Robins-Browne R, Shann F, Curtis N, Messina NL; Melbourne Infant Study: BCG for Allergy and Infection Reduction (MIS BAIR) Group. Effect of neonatal BCG vaccination on oral herpes in early childhood: A nested study within a randomised controlled trial. Vaccine. 2026 Apr 15;81:128577.
doi: https://doi.org/10.1016/j.vaccine.2026.128577
Editorial comment: Emerging evidence continues to highlight the non-specific (off-target) benefits of BCG vaccination, extending beyond tuberculosis. In this exploratory analysis, neonatal BCG was associated with a reduced risk and recurrence of herpes labialis in early childhood, suggesting a potential role in modulating HSV-related disease. While these findings are promising—particularly given the lack of effective preventive strategies for recurrent HSV—they must be interpreted with caution due to methodological limitations, including sample size and incomplete follow-up. Nonetheless, this study reinforces the broader concept that vaccines may confer unexpected, clinically meaningful protection beyond their primary targets, warranting further rigorous investigation.
Clark AD, Feikin DR, Danovaro-Holliday MC, Sanderson CFB. Timeliness of children’s vaccinations in 91 low-income and middle-income countries: an analysis of survey data. Lancet Glob Health. 2026 May;14(5):e714-e722.
doi: https://doi.org/10.1016/S2214-109X(25)00554-6
Editorial comment: Despite steady improvements in overall vaccine coverage across LMICs, timeliness remains a critical and underrecognized gap. This large, multi-country analysis shows that many children receive vaccines weeks later than recommended, with delays increasing across multi-dose series (notably DTP and measles vaccines), and only about half of doses administered on time for several key antigens. While coverage eventually rises with age, this “late protection” leaves children vulnerable during their highest-risk periods, undermining the full impact of immunization programs. The findings reinforce a crucial message: coverage alone is not enough—timeliness must become a central performance metric. Strengthening delivery systems, improving birth-dose implementation, and prioritizing early-life vaccination are essential to close this gap and maximize the life-saving potential of vaccines.
Steinhardt LC, Kwambai TK, Oneko M, Ouma E, Njoroge R, Callier V, Hu Z, Gutman JR, Yego R, Otieno K, Onoka K, Otieno L, Oduol K, Serebryannyy L, Lin BC, Adams W, Hickman S, Preston AC, Carlton K, Holdsworth M, Xiao Y, O Ter Kuile F, Odongo W, Murphy SC, Tran TM, Kariuki S, Crompton PD, Seder RA; Kenya Malaria mAb Trials Team. Safety and efficacy of the monoclonal antibody L9LS for malaria prevention in children exposed to perennial malaria transmission in Kenya: a randomised, double-blind, placebo-controlled, phase 2 trial. Lancet. 2026 Apr 25;407(10539):1614-1625.
doi: https://doi.org/10.1016/S0140-6736(26)00258-8
Editorial comment: This phase 2 trial adds to the growing momentum around monoclonal antibodies as a new tool for malaria prevention, particularly in high-burden settings. In young children exposed to intense perennial transmission, L9LS demonstrated a favorable safety profile and moderate protective efficacy (~43%), marking an important step beyond seasonal malaria strategies. While efficacy did not reach the high levels seen in older children or seasonal settings, these findings are encouraging. They suggest that long-acting antibodies could complement existing malaria interventions, especially for the most vulnerable age groups. However, optimization of dosing and durability of protection will be critical to unlock their full public health potential in endemic regions.
Heath PT, Zuma-Gwala N, Helmig RB, Horne E, Kjærbye-Thygesen A, Crusell MKW, Nchabeleng M, Strehlau R, Khalil MR, Jones CE, Biccler J, Dimsits J, Johansson-Lindbom B, Fischer PB, Oostvogels L, Madhi SA; MVX0004 study group. Immunogenicity and safety of a group B Streptococcus vaccine (GBS-AlpN) in pregnant women and their infants: a phase 2, multicentre, observer-blind, randomised, placebo-controlled study. Lancet Infect Dis. 2026 May;26(5):486-496. doi: 10.1016/S1473-3099(25)00659-0. Epub 2025 Dec 9. Erratum in: Lancet Infect Dis. 2026 Mar;26(3):e146.
doi: https://doi.org/10.1016/S1473-3099(26)00048-4
Editorial comment: This phase 2 study advances the promise of maternal immunization against group B streptococcus (GBS), a leading cause of neonatal sepsis and mortality. The novel GBS-AlpN vaccine demonstrated a favorable safety profile and robust immunogenicity, with high levels of transplacentally transferred antibodies in newborns—particularly with two-dose regimens. Importantly, the vaccine targets proteins covering the vast majority of invasive GBS strains, supporting its potential for broad protection. While clinical efficacy remains to be confirmed, these results represent a significant step toward a long-awaited maternal GBS vaccine, with the flexibility of dosing schedules adding practical value for real-world implementation.
Kareus E, Levenson D, Lee S, Gomez-Lopez N. The maternal-fetal interface as an immunological barrier: Structure, regulation, and breakdown. Cell Rep. 2026 Mar 26;45(4):117164.
doi: https://doi.org/10.1016/j.celrep.2026.117164
Editorial comment: The maternal–fetal interface represents a highly specialized and dynamic immunological environment, balancing tolerance to the fetus with protection against infection and the inflammatory signals required for labor. Across pregnancy, tightly regulated immune populations—ranging from regulatory T cells and macrophages to uterine NK cells—maintain this equilibrium, with a programmed shift toward inflammation at term to enable parturition. Importantly, disruption of this balance, as seen in chronic placental inflammation, can lead to harmful immune activation within fetal tissues. These insights underscore a critical message: maternal immunization is not only safe when appropriately implemented, but essential. By enhancing protective immunity without compromising this delicate balance, maternal vaccines play a key role in safeguarding both mother and infant during a uniquely vulnerable window of life—reinforcing their value as a cornerstone of early life disease prevention.
Sauré D, Zgheib A, Torres JP, Goic M, Thraves C, Pacheco J, Burgos J, Del Solar F, Neira I, O’Ryan M, Basso LJ. Health care utilization and cost implications of Chile’s 2024 nirsevimab strategy for RSV prevention: a counterfactual analysis. Lancet Reg Health Am. 2026 Apr 20;59:101475.
doi: https://doi.org/10.1016/j.lana.2026.101475
Editorial comment: In 2024, Chile became the first country in the Southern Hemisphere to implement universal immunization with nirsevimab against Respiratory Syncytial Virus (RSV)—and the results are striking. Using nationwide data, this real-world analysis shows substantial reductions in infant disease burden, including tens of thousands fewer medical visits, hospital bed-days, ICU stays, and parental work-loss days. Importantly, the program was not only clinically impactful but also economically favorable, generating a net benefit of approximately $23.5 million USD, with both seasonal and catch-up cohorts contributing significantly to cost savings. These findings reinforce the transformative potential of long-acting monoclonal antibodies as a population-level prevention strategy, particularly when implemented universally and extended to infants born before the RSV season.
Singh T, Sinjana Y, Kapoor AP. Aerial innovations in healthcare: A systematic review of drone-based logistics and regulatory barriers. Sustainable Futures 2026 June;11:101758.
doi: https://doi.org/10.1016/j.sftr.2026.101758
Editorial comment: A PRISMA-guided review of 54 studies (2018–2025) highlights the growing role of unmanned aerial vehicles (UAVs) in healthcare logistics—particularly for improving timeliness and last-mile delivery of critical, lightweight medical products in resource-limited settings. When effectively integrated into health systems and supported by validated cold-chain processes, drones can enhance access during routine care and emergencies. However, scalability remains constrained by persistent challenges: limited battery life and payload capacity, weather sensitivity, cold-chain risks, fragmented regulatory frameworks (especially beyond visual line-of-sight approvals), and concerns around cybersecurity, privacy, and liability. While emerging technologies—AI-driven routing, IoT monitoring, blockchain traceability, and 5G connectivity—offer potential solutions, real-world, system-level validation is still limited. Notably, the evidence base remains heavily focused on technical performance, with insufficient attention to governance, ethics, and implementation readiness. Overall, UAVs represent a promising but still maturing tool for resilient and equitable healthcare delivery—requiring regulatory harmonization, stronger institutional capacity, and interoperable standards to achieve sustainable scale.
Stacey HD, Garin-Ortega L, Lopez PG, Ramezani-Rad P, Ramirez SI, Faraji F, Bhavsar D, Levi G, Krammer F, Crotty S. Local B cell immunity and durable memory after live-attenuated influenza intranasal vaccination of humans. Sci Transl Med. 2026 Apr 29;18(847):eadz8439.
doi: https://doi.org/10.1126/scitranslmed.adz8439
Editorial comment: Seasonal influenza vaccines are traditionally delivered intramuscularly, generating strong systemic antibody responses—primarily targeting the hemagglutinin (HA) head. However, this study highlights a critical gap in how we evaluate protection: circulating immunity does not fully capture mucosal immune responses, where respiratory viruses initiate infection.
Using longitudinal sampling of the upper airway, investigators show that the intranasal live-attenuated vaccine (FluMist) induces robust, durable mucosal immunity, characterized by sustained HA-specific IgA+ and IgG+ memory B cells with an activated phenotype, persisting up to six months post-vaccination. These local responses were observed across influenza A (H1, H3) and B strains and were associated with circulating T follicular helper cells. In contrast, intramuscular vaccination—while generating strong systemic antibodies—failed to elicit comparable local memory B cell responses in the upper respiratory tract. These findings underscore a paradigm shift: effective protection against respiratory pathogens may depend as much on mucosal immunity as on systemic responses. Intranasal platforms, despite lower measured systemic immunogenicity, may offer critical advantages by targeting the site of viral entry—supporting their broader role in next-generation influenza vaccines and other respiratory pathogens.
Brisson M, Drolet M, Gingras G et al. Substantial increases in cervical cancer inequalities worldwide without enhanced human papillomavirus vaccination and screening efforts: a global modelling study. Lancet. 2026; May 2;407:1726-1737.
doi: https://doi.org/10.1016/S0140-6736(26)00410-1
Editorial comment: Despite the World Health Organization call to eliminate cervical cancer, global progress remains deeply unequal. Modeling across 67 LMICs and 42 HICs shows that, under current strategies, high-income countries are on track to eliminate cervical cancer by mid-century—while low- and middle-income countries will see only modest reductions, with inequalities projected to increase dramatically. The analysis is clear: status quo approaches will fail LMICs. Achieving high HPV vaccination coverage in girls alone can reduce disparities, but true global equity—and elimination—requires full implementation of WHO targets, including vaccination, screening, and treatment, alongside expanded strategies such as gender-neutral and multi-age cohort vaccination. The message is unequivocal: cervical cancer elimination is scientifically within reach—but without accelerated, equitable prevention, it risks becoming a success story for some—and a failure for many.
Hoxie I, Vasilev K, Clark J, Amin H, Peña Alzua G, Bhavsar D, Puente-Massaguer E, Siram K, Short K, Tee R, Burkhart D, Evans JT, Krammer F. A TRAC-478-adjuvanted recombinant N1 neuraminidase influenza virus vaccine induces balanced and broadly protective immune responses. NPJ Vaccines. 2026 May 2.
doi: https://doi.org/10.1038/s41541-026-01456-2
Editorial comment: Current influenza vaccines, focused on hemagglutinin, offer limited protection against drifted strains. This study highlights a promising shift: targeting neuraminidase with a recombinant vaccine enhanced by combined TLR agonists. The result is a broader, more functional immune response—including cross-reactive antibodies with strong ADCC activity and robust Th1-biased cellular immunity—translating into protection against diverse H1N1 and H5N1 strains in preclinical models. These findings support neuraminidase-based strategies, particularly with optimized adjuvant systems, as a viable path toward broader and potentially pandemic-resilient influenza vaccines.
Miles AC, Vojicic J, Peyrani P, Rosenstock S, Li H, Vietri JT, Yan Q, Randall AE, Zhao X, Zhu W, Zhao B, Zhou A, Jodar L, Gessner BD, Theilacker C, Moïsi JC, Balmer P, Grant LR, Cane A. Real-world effectiveness of 20-valent pneumococcal conjugate vaccine against all-cause outcomes among Medicare beneficiaries aged 65 years and older in the USA: a retrospective cohort study. Lancet Infect Dis. 2026 Apr 30:S1473-3099(26)00115-5.
doi: https://doi.org/10.1016/S1473-3099(26)00115-5
Editorial comment: First real-world data following licensure show that PCV20 provides meaningful protection in adults ≥65 years, reducing invasive pneumococcal disease, pneumococcal pneumonia, and—most notably—all-cause pneumonia and LRTIs within the first year. While relative effectiveness is modest, the absolute public health impact is substantial, driven by large reductions in respiratory illness burden. These findings reinforce the value of adult pneumococcal vaccination and support broader implementation of PCV20 in aging populations.
Shapiro IE, Bassani-Sternberg M. From prediction to precision: how immunopeptidomics advances neoantigen discovery. Trends Cancer. 2026 Apr 1:S2405-8033(26)00034-8.
doi: https://doi.org/10.1016/j.trecan.2026.02.003
Editorial comment: Immunopeptidomics is transforming personalized cancer immunotherapy by directly identifying tumor-specific neoantigens presented by HLA molecules. Unlike traditional prediction-based approaches, this technology uses mass spectrometry to detect naturally presented peptides on tumor cells, improving neoantigen selection and immunogenicity assessment. Combined with AI and machine learning, immunopeptidomics has the potential to significantly advance precision cancer vaccines and T-cell–based therapies.
Leroux-Roels I, Huang G, Ferguson M, Kohli A, Clark R, Bickel M, Soens M, Du E, Pucci A, Hicks B, Eschen C, Das R, Wilson E; Fluent Trial Investigators. Efficacy and Safety of an mRNA Seasonal Influenza Vaccine in Adults. N Engl J Med. 2026 May 7;394(18):1803-1813.
doi: https://doi.org/10.1056/NEJMoa2516491
Editorial comment: The phase 3 trial of the investigational mRNA-based influenza vaccine mRNA-1010 marks an important milestone in the evolution of next-generation influenza vaccines. In adults ≥50 years of age, mRNA-1010 demonstrated superior protection compared with licensed standard-dose influenza vaccines, reducing RT-PCR-confirmed influenza-like illness by 26.6%. These findings reinforce the potential of mRNA technology beyond COVID-19, particularly for pathogens such as influenza where vaccine effectiveness has historically been suboptimal. Although local and systemic reactogenicity was more frequent with mRNA-1010, most adverse events were mild to moderate and transient, while serious vaccine-related events remained rare. If confirmed across multiple influenza seasons and populations, mRNA influenza vaccines could significantly reshape seasonal influenza prevention strategies, especially for older adults who remain at highest risk of severe disease and death.
Yalemwork Ewnetu, Tolulope Adeyemi Kayode, Colins O Oduma, Temitope M Adeyemi-Kayode, Aragaw Zemene, Wossenseged Lemma, Nega Berhane, Cristian Koepfli. High-altitude Plasmodium falciparum and Plasmodium vivax reservoirs in Ethiopia are not linked to recent travel. Open Forum Infectious Diseases, 2026;, ofag247,
doi: https://doi.org/10.1093/ofid/ofag247
Editorial comment: This study challenges the long-standing assumption that the Ethiopian highlands are largely protected from malaria transmission because of their altitude. Investigators identified substantial subclinical and clinical malaria prevalence at elevations up to 2800 meters, suggesting that local transmission may be more sustained than previously recognized. Importantly, only a minority of infected individuals reported recent travel to endemic lowland areas, indicating that imported infections alone cannot explain the observed burden. These findings raise important concerns regarding the potential impact of climate change, ecological shifts, and vector adaptation in expanding malaria transmission into traditionally low-risk regions. The study also highlights diagnostic implications, as LDH-based rapid tests detected significantly more subclinical P. falciparum infections than HRP2-based assays. Together, these data support intensified surveillance and malaria control interventions in highland regions now increasingly vulnerable to endemic transmission.
Mwapasa V, Asante K, Milligan P et al. Impact of introducing RTS,S/AS01E malaria vaccine on mortality in young children in Ghana, Kenya, and Malawi: an observational evaluation of a cluster-randomised implementation programme. The Lancet. 2026, May;407:1796-1808.
doi: https://doi.org/10.1016/S0140-6736(26)00248-5
Editorial comment: The 46-month evaluation of the RTS,S/AS01E malaria vaccine in Ghana, Kenya, and Malawi provides compelling real-world evidence that malaria vaccination can significantly reduce childhood mortality in sub-Saharan Africa. Despite only moderate uptake of the three-dose schedule and low coverage of the fourth dose, implementation of RTS,S was associated with a 13% reduction in all-cause mortality among vaccine-eligible children, preventing approximately one in eight deaths. These findings represent a major milestone for malaria prevention and reinforce the urgent need to accelerate the large-scale deployment of malaria vaccines in regions where malaria remains a leading cause of childhood death.
Ayesa Syenina, Christine Y.L. Tham, Danny J.H. Tng, Valerie S.Y. Chew, Jia Xin Yee, Yan Shan Leong, Noor Zayanah Hamis, Hwee Cheng Tan, Han Yi Joon, Jing Ti Chan, Yuchen Yang, Yin Bun Cheung, Eugenia Z. Ong, Jenny G. Low, Eng Eong Ooi. Influence of obesity on susceptibility to systemic symptoms and host responses to orthoflaviviral infection: a prospective observational study using yellow fever vaccine to simulate acute infection. eBioMedicine 2026;128:106290.
doi: https://doi.org/10.1016/j.ebiom.2026.106290
Editorial comment: This study highlights obesity as a potentially underestimated risk factor for severe orthoflaviviral diseases, including yellow fever and other flavivirus infections of growing global concern. Using the live attenuated yellow fever vaccine as a model of acute orthoflaviviral infection, investigators demonstrated that individuals with obesity experienced more systemic symptoms and inflammatory responses despite similar viral RNA levels compared with individuals without obesity. These findings suggest that the chronic pro-inflammatory state associated with obesity may amplify disease manifestations and potentially contribute to worse outcomes during flaviviral infections. In the context of the parallel global epidemics of climate change and obesity, this research raises important questions regarding host susceptibility, vaccine responses, and future prevention strategies against emerging arboviral threats.
Kumaresan V, Palanisamy R, Sivaperumal P, Bhatt P. Editorial: Exploring immune evasion and vaccine strategies in host-pathogen interactions. Front Immunol. 2026 Apr 14;17:1828398.
doi: https://doi.org/10.3389/fimmu.2026.1828398
Editorial comment: This editorial highlights the growing importance of understanding host–pathogen interactions to develop next-generation vaccines and immunotherapies. Advances in immunoinformatics, epitope design, host-targeted therapies, and mucosal adjuvants are transforming vaccinology by enabling more precise, scalable, and potentially broader protection against evolving infectious threats. Together, these innovations may play a critical role in improving pandemic preparedness and combating emerging infectious diseases in the future.
Williams JTB, Cruz H, Stein A, Breslin K, Brtnikova M, Crane B, Irving SA, Glenn S, Kenigsberg T, Lewin B, Tartof S, Sundaram ME, Fuller S, Schmidt T, O’Leary S, Canedo D, Glanz JM, DeSilva M, Fuller CC, Zerbo O, Hambidge SJ. Hepatitis B Vaccine Series Completion by 18 Months in Infants Without a Birth Dose. JAMA Netw Open. 2026 Apr 1;9(4):e269962.
doi: https://doi.org/10.1001/jamanetworkopen.2026.9962
Editorial comment: This large U.S. cohort study reinforces the critical importance of administering the hepatitis B vaccine at birth. Children who received the birth dose achieved exceptionally high completion rates of the hepatitis B vaccine series by 18 months (>97%), whereas vaccine completion among those who missed the birth dose declined substantially over time, falling to nearly 55% in recent birth cohorts. These findings highlight the birth dose not only as protection against perinatal hepatitis B transmission, but also as a powerful predictor of long-term adherence to routine immunization schedules. In an era of growing vaccine hesitancy and declining pediatric vaccine uptake, strengthening universal newborn hepatitis B vaccination policies remains essential for sustaining childhood immunization coverage and preventing future gaps in protection.
Tejada R, Baena A, Trujillo L, et al. Impact of switching from a quadrivalent to a nonavalent HPV vaccine on HPV infections and cervical cancer in Colombia: a mathematical modelling study. The Lancet Regional Health – Americas. 2026 May 5;58.
doi: https://doi.org/10.1016/j.lana.2026.101483
Editorial comment: This modeling study from Colombia highlights the substantial potential impact of transitioning from quadrivalent to nonavalent HPV vaccination strategies. While increasing vaccine coverage remains essential, the findings suggest that switching to the nonavalent vaccine could dramatically accelerate reductions in HPV prevalence and cervical cancer incidence, particularly under gender-neutral vaccination programs. Importantly, only the nonavalent strategy achieved projections consistent with cervical cancer elimination thresholds. In countries where HPV vaccine uptake remains suboptimal, these data reinforce that broader-valency vaccines, combined with high coverage, may play a decisive role in achieving the WHO goal of cervical cancer elimination.
Lahat A, Sharif K. Vaccination in Immune-Mediated Intestinal Diseases: Efficacy, Safety, and Future Directions. Vaccines. 2026; 14(5):426.
doi: https://doi.org/10.3390/vaccines14050426
Editorial comment: This special issue highlights that vaccination should be considered a core component of care for patients with immune-mediated intestinal diseases, including inflammatory bowel disease and celiac disease. Although non-live vaccines are generally safe and effective in these populations, immunosuppressive therapies—particularly anti-TNF agents—can significantly reduce vaccine immunogenicity and durability. Emerging evidence also suggests that systemic antibody responses alone may not fully reflect protection, as mucosal immunity often remains suboptimal despite vaccination. Together, these findings support a more personalized “precision vaccination” approach integrating disease type, immunosuppressive therapy, booster strategies, and future development of mucosal vaccine platforms for vulnerable patients.
Dhuri K, Ubhe A. Emerging lipids-based adjuvant delivery technologies for vaccines. Vaccine. 2026 May 6;84:128662.
doi: https://doi.org/10.1016/j.vaccine.2026.128662
Editorial comment: This review highlights the growing importance of lipid-based adjuvant delivery systems in the development of next-generation vaccines. As vaccine platforms evolve toward recombinant proteins, DNA, and mRNA technologies, more sophisticated delivery systems are required to enhance immune responses, stability, and safety. Lipid-based platforms—including emulsions, liposomes, and nano/microparticles—have emerged as highly versatile tools capable of efficiently delivering vaccine antigens and nucleic acids to antigen-presenting cells. The success of these technologies during recent pandemics underscores their central role in the future of vaccinology, pandemic preparedness, and the development of more effective and adaptable vaccines for both human and animal health.
Sreekanth S, Lahon A. Strategies to enhance DNA vaccine efficacy against emerging arboviruses: lessons from ZIKA and Chikungunya viruses. Vaccine. 2026 May 12;85:128680.
doi: https://doi.org/10.1016/j.vaccine.2026.128680
Editorial comment: This review highlights the growing potential of DNA vaccines as a promising strategy against emerging arboviral threats such as Zika and chikungunya viruses, which frequently co-circulate in Aedes-endemic regions. While chikungunya vaccines have recently achieved regulatory approval in some countries, Zika vaccine development continues to face major challenges because of its neurotropism, congenital complications, and potential for sexual and vertical transmission. The authors emphasize that advances in adjuvants and delivery technologies—including Toll-like receptor agonists and molecular adjuvants—may significantly enhance the immunogenicity of DNA vaccine platforms. The review also underscores the importance of multivalent vaccine strategies capable of targeting multiple arboviruses simultaneously, an increasingly relevant approach in the era of climate change, expanding vector distribution, and overlapping arboviral epidemics.
Homaira N, Qian J, Scaria A, Stepien S, Macartney K, Liu B. Effectiveness of Maternal Influenza Vaccination on Influenza and Acute Respiratory Infection in Infants. Pediatr Infect Dis J. 2026 Jun 1;45(6):554-560.
doi: https://doi.org/10.1097/INF.0000000000005111
Editorial comment: This large population-based study reinforces the value of maternal influenza vaccination in protecting young infants during the first six months of life—a period when they remain highly vulnerable and are too young to receive influenza vaccines themselves. Although vaccine effectiveness against infant influenza hospitalization was modest overall, maternal immunization still provided meaningful protection and supports current recommendations for influenza vaccination during pregnancy. These findings further highlight the critical role of maternal immunization strategies in reducing the burden of vaccine-preventable respiratory infections in early infancy.
