Background: A certain percentage of the vaccinated population initially did not want to get vaccinated but changed their minds (from 30% to 70%). By October 2022, World Bank reported that the Philippines had 77.8% COVID-19 vaccination rate. Knowing the factors that changed their decision can help improve the vaccination rate. Objective: This survey aimed to identify the factors that influence positive change in vaccination decisions. Methods: This survey was conducted in the Philippines among Filipinos aged 18-80 years old between March to April 2022. The dependent variable in the study was decision change, a binary variable coded as 1 for a vaccinated person who changed their decision from no to yes and 0 for an unvaccinated person who did not change their decision from yes to no. Results: Age (adjusted odds ratio [aOR] = 0.92, 95% CI = 0.89-0.96) and having a college degree (aOR=11.707, 95% CI=3.23-42.41) are related to changing decisions. Young and college degree holders are likely to change their decisions positively about getting vaccinated. Employer requirement also influences decision change because it affects a person's livelihood. High scores on vaccine confidence (aOR = 1.181, 95% CI = 1.12-1.25) and awareness (aOR = 1.318, 95% CI = 1.08-1.61) are associated with decision change. Conclusion Being young, educated, employed with a requirement to vaccinate, and having high vaccine awareness and confidence are strongly associated with a positive change in the decision to get vaccinated.
Vaccines ; Vaccination ; Philippines ; Awareness ; Covid-19

Objective The prevalence of drug-resistant Mycobacterium tuberculosis (Mtb) strains is exacerbating the global burden of tuberculosis (TB), highlighting the urgent need for new treatment strategies for TB. Methods The recombinant adenovirus vaccine expressing cyclic di-adenosine monophosphate (c-di-AMP) phosphodiesterase B (CnpB) (rAd-CnpB), was administered to normal mice via mucosal immunization, either alone or in combination with drug therapy, to treat Mtb respiratory infections in mice.Enzyme-linked immunosorbent assay (ELISA) was used to detect the levels of antibodies in serum and bronchoalveolar lavage fluid (BALF). Real-time quantitative PCR was performed to assess the transcription levels of cytokines interferon γ(IFN-γ) and interleukin 10(IL-10) in mouse lungs. Flow cytometry was used to determine the proportions of CD4⁺ and CD8⁺ T cell subsets in the lungs and spleens. ELISA was employed to measure the levels of cytokines IFN-γ, IL-2, IL-10, inflammatory factors IL-6, and tumor necrosis factor α (TNF-α) secreted by spleen cells following antigen stimulation. The bacteria loads in the lungs and spleens of Mtb-infected mice were enumerated by plate counting methods. Resluts Intranasal immunization with rAd-CnpB induced high titers of IgG in mouse serum and the production of IgG and IgA in BALF, along with alterations in T lymphocyte subsets in the lungs and spleens. Administration of rAd-CnpB, either alone or in combination with drugs, to Mtb-infected mice significantly increased serum IgG levels as well as IgA and IgG levels in BALF. rAd-CnpB immunization promoted the secretion of CnpB-specific cytokines and inflammatory factors by splenocytes in Mtb-infected mice. However, rAd-CnpB immunotherapy, either alone or combined with drugs, did not significantly affect the bacterial loads in the lungs and spleens of mice with Mtb respiratory infections. Conclusion Mucosal immunization with rAd-CnpB induced significant mucosal, humoral and cellular immune responses in mice, and significantly enhanced CnpB-specific cellular immune responses in Mtb-infected mice.
Animals ; Adenoviridae/immunology* ; Mycobacterium tuberculosis/genetics* ; Mice ; Female ; Phosphoric Diester Hydrolases/genetics* ; Tuberculosis Vaccines/administration & dosage* ; Tuberculosis/prevention & control* ; Mice, Inbred BALB C ; Cytokines ; Lung/microbiology* ; Immunization ; Bronchoalveolar Lavage Fluid/immunology* ; Immunity, Mucosal

Tumor immunotherapy has revolutionized the treatment prospects for various malignant tumors. Immune checkpoint inhibitors (ICIs) and chimeric antigen receptor T-cell therapy (CAR-T) , as representative of tumor immunotherapy, have achieved tremendous success in clinical practice and have become the first-line clinical treatment options for certain tumors. This article summarizes the progress and challenges of immune checkpoint inhibitors and CAR-T therapy in tumor treatment, and discusses the future direction of tumor therapeutic vaccines development. Identifying novel therapeutic targets within the realm of tumor immunology, engineering innovative drug delivery systems, and employing combinatorial therapeutic strategies are poised to enhance therapeutic efficacy and patient outcomes in oncology, thereby extending benefits to a broader patient population.
Humans ; Neoplasms/immunology* ; Immune Checkpoint Inhibitors/therapeutic use* ; Receptors, Chimeric Antigen/genetics* ; Immunotherapy/methods* ; Immunotherapy, Adoptive/methods* ; Animals ; Cancer Vaccines/therapeutic use*

Objective To characterize the properties of Hepa1-6-derived microparticles (Hepa1-6-MPs), investigate their stimulatory effects on dendritic cells (DCs) and their cellular uptake pathways, and explore the specific cytotoxic effects of CD8⁺ T cells induced by Hepa1-6-MP-loaded DCs on hepatoma cell lines, with the aim of developing a novel immunotherapeutic model for hepatocellular carcinoma (HCC). Methods The isolated Hepa1-6-MPs were identified using Western blotting, transmission electron microscopy (TEM) and dynamic light scattering (DLS). Flow cytometry was used to assess the uptake pathways of Hepa1-6-MPs by DCs. Subsequently, enzyme-linked immunosorbent assay (ELISA) was used to measure the effects of Hepa1-6-MP-loaded DCs on the release levels of tumor necrosis factor α(TNF-α) and interferon γ(IFN-γ) into the supernatant of CD8⁺ T cells. Lactate dehydrogenase (LDH) tests were conducted to evaluate the cytotoxic effects of CD8⁺ T cells stimulated by Hepa1-6-MP-loaded DCs on hepatoma cells. Results The morphology, size and protein markers of Hepa1-6-MPs met the established criteria. Hepa1-6-MPs enhanced the expression of DC maturation markers CD80 and CD86, and were internalized by DCs via clathrin-mediated endocytosis and phagocytosis pathways. Subsequently, Hepa1-6-MP-loaded DCs stimulated CD8⁺ T cells to release high levels of TNF-α and IFN-γ, which induced their specific cytotoxicity against HCC cells. Conclusion These findings suggest that Hepa1-6-MP-loaded DCs may be a promising HCC immunotherapeutic tool.
Carcinoma, Hepatocellular/therapy* ; Liver Neoplasms/therapy* ; Dendritic Cells/immunology* ; Humans ; Cancer Vaccines/immunology* ; CD8-Positive T-Lymphocytes/immunology* ; Cell Line, Tumor ; Tumor Necrosis Factor-alpha/immunology* ; Interferon-gamma/immunology* ; Cell-Derived Microparticles/immunology* ; Animals

BACKGROUND: Japan lacks comprehensive reports on the nationwide voluntary vaccine coverage. The effectiveness of public subsidies in promoting vaccination has not been fully investigated. Therefore, we aimed to estimate the nationwide coverage of voluntary vaccines, compare it with that of national immunization program (NIP)-included vaccines, and investigate the effectiveness of public subsidies. METHODS: We obtained nationwide monthly vaccine market data for rotavirus, Haemophilus influenzae type b (Hib), diphtheria, tetanus toxoid, acellular pertussis, inactivated poliovirus (DTaP-IPV), and mumps vaccines; estimated recipient numbers; and calculated coverage as the proportion of children from October 2011 to March 2022. Regarding the NIP-included vaccine, we compared vaccine coverage calculated from nationwide annual market data with that estimated by World Health Organization (WHO)/United Nations Children's Fund (UNICEF), using Bland-Altman analysis. RESULTS: The estimates of Hib and DTaP-IPV vaccine coverage derived from market data were slightly higher than the WHO/UNICEF estimates, with mean differences of 0.05 (95% CI: 0.02-0.07) for Hib and 0.03 (95% CI: 0.01-0.05) for DTaP-IPV. The coverage of the rotavirus vaccine gradually increased long before the implementation of national subsidies, reaching 0.9 in 2020. Hib vaccine coverage had already achieved 1.0 by January 2012. The coverage of the DTaP-IPV vaccine was approximately 0.6-0.8 in 2013, reaching 1.0 in 2014. The coverage of mumps vaccine increased gradually from 2011 to 2021. CONCLUSIONS Despite the possibility of overestimation, our estimates may serve as a valuable surrogate for actual vaccine coverage in Japan. An increasing trend in rotavirus and mumps vaccine coverage was observed when these vaccines were categorized as voluntary. Although vaccination policies differ from country to country, it would be beneficial to share findings on the impact of subsidies in Japan with other countries.
Japan ; Humans ; Vaccination Coverage/statistics & numerical data* ; Infant ; Immunization Programs/statistics & numerical data* ; Rotavirus Vaccines ; Haemophilus Vaccines ; Child, Preschool ; Poliovirus Vaccine, Inactivated ; Vaccines

Immunomodulatory cancer therapy is witnessing the rise of viral immunotherapy. The oncolytic influenza A virus, although promising in preclinical investigations, remains to be implemented in clinical practice. Recent progress in genetic engineering, coupled with experiential insights, offers opportunities to enhance the therapeutic efficacy of the influenza A virus. This review explores the use of the influenza virus, its attenuated forms, and associated vaccines in cancer immunotherapy, highlighting their respective advantages and challenges. We further elucidate methods for engineering influenza viruses and innovative approaches to augment them with cytokines or immune checkpoint inhibitors, aiming to maximize their clinical impact. Our goal is to provide insights essential for refining influenza A virus-based viral tumor immunotherapies.
Humans ; Neoplasms/immunology* ; Immunotherapy/trends* ; Influenza A virus/immunology* ; Oncolytic Virotherapy/trends* ; Animals ; Cancer Vaccines/therapeutic use* ; Oncolytic Viruses ; Genetic Engineering ; Immune Checkpoint Inhibitors/therapeutic use*

BACKGROUND

The COVID-19 pandemic significantly impacted global health, especially among older adults at higher risk for severe illness. Despite the benefits of vaccination, booster vaccine hesitancy posed a barrier to optimal protection in the elderly population.

This study aimed to identify factors associated with COVID-19 booster vaccine hesitancy among geriatric patients at the Family Medicine Outpatient Clinic of Region 1 Medical Center.

An analytic, cross-sectional study was conducted with 183 geriatric patients aged 60 and above who had received the primary COVID-19 vaccine series. Data were collected using a 25-item questionnaire addressing sociodemographic information, medical history, COVID-19 knowledge, and vaccine attitudes. Statistical analyses, including chi-square tests and logistic regression, identified factors influencing booster vaccine hesitancy.

The majority of participants were between the ages of 60-69 (66.7%, n=122) and predominantly female (69.4%, n=127). High hesitancy rates were notably observed among elderly females (75.6%), individuals with lower educational attainment (79.7%), and single individuals (93.3%). Other significant factors included hypertension (76.5%) and the absence of prior influenza (81.5%) or pneumococcal (75.9%) vaccinations.

These findings highlight the critical need for targeted educational efforts to mitigate COVID-19 vaccine hesitancy within specific subgroups, particularly elderly females, those with lower education levels, and individuals with certain health conditions. By implementing personalized outreach and emphasizing the advantages of vaccination, stakeholders can enhance vaccine uptake and improve health outcomes for this vulnerable segment of the population.

BACKGROUND

Coronavirus disease 2019 (COVID-19) infection is still a problem in our country for the past 2 years. The pandemic severely affected the immunocompromised and high-risk group of patients, such as the pregnant and lactating women. Research shows that this group has higher risk of being critically ill as well as dying. However, there are only a few studies on how COVID-19 vaccine is perceived among this vulnerable group. Hence, this study aims to assess the knowledge, attitude, and practices on COVID-19 vaccine among high-risk pregnant and lactating women. Moreover, the results will be used in crafting health policies that affect this specific group of patients.

A prospective cross-sectional study was conducted on high-risk pregnant and lactating women who sought antenatal consults at the High-Risk Clinic in a tertiary training hospital for a 1-month period. Participants were asked to answer a validated questionnaire assessing their knowledge, attitudes, and practices on COVID-19 vaccine. They were also asked about their sociodemographic characteristics, co-morbidities, history of COVID-19 infection, and vaccination status, as well as the source of their information regarding the vaccine. Descriptive statistics was used to summarize in this study. In addition, frequency and proportion were used for nominal variables, median and range for ordinal variables, and mean and standard deviation for interval or ratio variables. MINITAB 20 was used for data analysis.

A total of 323 high-risk pregnant and lactating women were enrolled in the study with an average age of 29 years old. Socio-demographic characteristics of the participants showed that they were high-school graduate, single, mostly financially disadvantaged, and resides in Cavite, Laguna, Batangas, Rizal and Quezon area. The majority have diabetes mellitus as their co-morbidity, were not infected with COVID-19 and had already been vaccinated. The significant source of information of vaccine information was mainly from social media. The study presented that more than 90% were aware that COVID-19 vaccine was recommended by professional organizations, however, only 55%–59% only agree that it is safe during pregnancy and breastfeeding. The result also conveyed a positive attitude toward vaccination as the pregnancy progresses, as well as during lactation. As to practices, 80% of the participants were told by their health care providers to get vaccinated and 72% of them reported vaccine side effects. Furthermore, 58% of the participants would recommend vaccination during pregnancy while only 54% will recommend it while breastfeeding.

Assessment of knowledge, attitudes, and practices of COVID-19 vaccine among high-risk pregnant and lactating women gave an understanding on how a vulnerable population perceives vaccination. In general, this research study presented high percentage COVID-19 vaccine awareness and acceptance; however, it can also be seen that there is a mixed perception regarding vaccine safety during pregnancy and lactation. Strategies to improve health literacy which are evidenced based that can be carried out by a health care provider could be established to achieve maximum vaccination coverage among high-risk group of patients.

OBJECTIVES

During the early COVID-19 pandemic (2020 to mid-2021), the Philippine government relied on nonpharmaceutical interventions such as lockdowns and Enhanced Community Quarantine (ECQ). With the emergency use authorization of vaccines, assessing their potential impact became essential. This study develops a Philippine model to evaluate the epidemiologic and economic effects of COVID-19 vaccination, estimating its impact on mortality, hospitalization, and mild/asymptomatic cases under various prioritization strategies, including booster doses and the presence of variants of concern.

A dynamic transmission model (DTM) with an SEIR (Susceptible-Exposed-Infected-Recovered) structure was calibrated using local data, including case numbers, deaths, seroprevalence, vaccination coverage, and intervention costs. The model’s outputs informed a cost-effectiveness analysis (CEA) from health system and societal perspectives over a two-year horizon. Incremental Cost-Effectiveness Ratios (ICERs) were calculated, with costs adjusted to 2020 prices and discount rates of 3%-10% applied. Sensitivity analyses, including one-way and probabilistic approaches, assessed robustness, while a budget impact analysis (BIA) estimated government expenditures in 2020 and 2021.

Without vaccination, daily cases could have peaked at 400,000 between February and May 2021. A vaccination campaign was projected to reduce cases to around 20,000, significantly lowering mortality.  

From the health system perspective, the estimated cost without vaccination was PhP 14.46 trillion, with 93.83 million QALYs. With vaccination, costs dropped to PhP 2.36 trillion, while QALYs increased to 101.79 million. From the societal perspective, costs were PhP 14.68 trillion without vaccination and PhP 2.38 trillion with vaccination, with the same QALY outcomes.

CEA results confirmed that vaccination was cost-saving, with ICERs of -PhP 1,520,727.28 per QALY (health system) and -PhP 1,546,171.63 per QALY (societal). Sensitivity analyses supported these findings, with oneway sensitivity analysis showing minimal impact from parameter changes and probabilistic sensitivity analysis confirming cost-saving outcomes. The BIA estimated government expenditures of PhP 983.45 billion in 2020 and PhP 1.47 trillion in 2021 for the vaccine scenario, lower than the no-vaccine scenario.

Indeed, our modeling has shown that COVID-19 vaccines could mitigate the spread of COVID-19 and provide good value for money.

INTRODUCTION: A successful vaccination programme forms the cornerstone of controlling coronavirus disease 2019 (COVID-19). The unprecedented speed of COVID-19 vaccine development and lack of long-term data have raised fears regarding its safety and efficacy. Vaccine hesitancy can undermine the uptake, and hence success of the vaccination programme. Given the high complication rates of COVID-19 infections in kidney transplant recipients, it is particularly important to identify and address vaccine hesitancy in this population. METHODS: We conducted a cross-sectional survey among kidney transplant recipients attending transplant clinic between 5 April and 5 May 2021. The survey assessed attitudes towards COVID-19, willingness/hesitancy towards COVID-19 vaccination, vaccination concerns and prompts to vaccination. This was scored on a Likert scale with scores ranging from 'strongly disagree' - 1 point to 'strongly agree' - 5 points. RESULTS: One hundred and one completed responses were captured. Of these, 86% respondents reported to agree or strongly agree to vaccination. This was despite significant concerns of allograft rejection (mean score 4.12, standard deviation [SD] 0.97) and decreased immunosuppressant efficacy (mean score 4.14, SD 0.96) with vaccination. Multivariable model showed a positive association with transplant vintage of ≥ 5 years (median 2.41), lower educational levels of secondary school or less (median 5.82) and healthcare provider advocacy (median 1.88) in predicting vaccine acceptance. CONCLUSIONS Vaccine acceptance rate was high among kidney transplant recipients. Vaccine hesitancy remains a concern in those with a transplant vintage of less than 5 years and those with tertiary educational level. Healthcare provider advocacy is important in improving vaccine acceptance rates.
Humans ; Kidney Transplantation ; Singapore/epidemiology* ; Male ; Cross-Sectional Studies ; Female ; COVID-19 Vaccines ; COVID-19/epidemiology* ; Middle Aged ; Adult ; Transplant Recipients/psychology* ; Patient Acceptance of Health Care/statistics & numerical data* ; Vaccination Hesitancy/psychology* ; Surveys and Questionnaires ; Vaccination/psychology* ; Aged ; SARS-CoV-2