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

Abstract Measles has re-emerged as a significant public health threat in Indonesia, signaling gaps in immunization coverage and systemic health inequities. Following the disruptions caused by the COVID-19 pandemic, the country has seen a troubling resurgence in cases. This editorial examines the current epidemiological situation, structural barriers to vaccination, and necessary strategies for elimination. In 2025, Indonesia recorded over 63,000 suspected cases, with the trend continuing into 2026. Current vaccination coverage for children aged 12–23 months stands at 73.46%, which is significantly below the 95% threshold required for herd immunity. Key barriers identified include maternal education levels, archipelagic geography, and sociocultural factors such as religious permissibility and safety concerns. Addressing the measles resurgence requires a multi-faceted approach: strengthening routine and catch-up immunization services, addressing social determinants of health, and rebuilding public trust through community engagement. Achieving high coverage is essential to prevent severe clinical complications and protect vulnerable populations.
Measles ; Measles resurgence ; Immunization coverage ; Indonesia ; Vaccine hesitancy ; Public health systems

Introduction: Effective vaccination campaigns have been instrumental in reducing COVID-19 transmission and severe disease outcomes. Despite efforts to improve vaccine accessibility, vaccine literacy and confidence remain important determinants of vaccine uptake. Rural and geographically isolated communities often experience barriers to healthcare access that may affect vaccination coverage. This study aimed to assess COVID-19 vaccination coverage, vaccine literacy, and vaccine confidence among residents of selected Geographically Isolated and Disadvantaged Areas (GIDAs) in Floridablanca, Pampanga. Methods: A descriptive cross-sectional study was conducted among 211 residents of Barangays San Ramon and Nabuclod. Data were collected through face-to-face interviews using a translated and pretested questionnaire on vaccine literacy and vaccine confidence. Vaccination records obtained from the Rural Health Unit were reviewed to determine COVID-19 vaccination coverage. Descriptive statistics, including frequencies and percentages, were used to summarize the data. Results: The majority of respondents demonstrated an average level of vaccine literacy (75.8%), while 17.5% exhibited high vaccine literacy. Most respondents also demonstrated positive to very positive vaccine confidence (71.6%). Among the eligible population, 80.5% had completed the primary COVID-19 vaccination series, whereas 19.5% remained unvaccinated. Among those who completed the primary series, only 24.2% had received at least one booster dose. Conclusion Residents of the selected GIDAs generally demonstrated average vaccine literacy, positive vaccine confidence, and relatively high primary COVID-19 vaccination coverage. However, low booster uptake and the persistence of unvaccinated individuals highlight the need for sustained health education, improved healthcare accessibility, and targeted community-based interventions. These findings underscore the importance of strengthening vaccine literacy and confidence to support future immunization programs in geographically isolated communities.
COVID-19 ; Rural Health ; Vaccination coverage

BACKGROUND

Cervical cancer, caused by human papillomavirus (HPV), is the second most common cancer among Filipino women. Despite vaccine availability, the Philippines has a low 60% immunization rate, driven by hesitancy and poor public awareness.

AIMS AND OBJECTIVES

This study assessed how 100 women (ages 18–45) in Quezon City understood HPV and their willingness to vaccinate.

MATERIALS AND METHODS

Researchers used a pre–post interventional study and purposive sampling and Cochran’s formula for size calculation. Participants completed a pretest, a Department of Health/World Health Organization/Centers for Disease Control and Prevention-based digital educational intervention, a posttest, and a satisfaction survey. Data were gathered confidentially under informed consent.

RESULTS

Results showed significant improvement in knowledge and willingness to vaccinate (P < 0.001), with almost all respondents expressing willingness. The intervention received high satisfaction ratings, proving the digital tool was effective and well-received.

CONCLUSION AND RECOMMENDATION

In conclusion, this study demonstrated that a structured digital educational tool effectively bridges knowledge gaps and addresses vaccine hesitancy in a community setting. Findings emphasize the importance of targeted, community-level initiatives to reduce cervical cancer risk. Future research should include teens and males and use a larger randomized sample for definitive evidence.

Human ; Female ; Adolescent: 13-18 Yrs Old ; Young Adult: 19-24 Yrs Old ; Adult: 25-44 Yrs Old ; Middle Aged: 45-64 Yrs Old ; Uterine Cervical Neoplasms ; Human Papillomavirus Viruses ; Vaccination ; Women

OBJECTIVES

Human papillomavirus (HPV) is a prevalent sexually transmitted infection linked to cervical and anal cancers. Although there are many studies worldwide on knowledge, attitudes, and practices (KAP) regarding HPV, research in the Philippines is still limited. This study assessed the knowledge, attitudes, and practices (KAP) of senior high school students in Manila regarding HPV infection and vaccination.

METHODS

A descriptive cross-sectional survey was conducted among 345 senior high school students from a private tertiary school in Manila using a self-administered questionnaire. Frequencies and percentages summarized demographic characteristics and KAP responses

RESULTS

Most respondents demonstrated good knowledge of HPV, with 86.4% recognizing its link to cervical and anal cancer and 86% identifying it as a common sexually transmitted infection. Attitudes toward vaccination were largely positive: 73% expressed willingness to be vaccinated, and 87.8% considered the vaccine safe. However, only 2.6% had been vaccinated. Limited discussions about HPV, misconceptions about gender susceptibility, and low awareness of local vaccine availability contributed to poor uptake. The internet was the primary information source (84.9%).

CONCLUSION

Most respondents demonstrated good knowledge of HPV, with 86.4% recognizing its link to cervical and anal cancer and 86% identifying it as a common sexually transmitted infection. Attitudes toward vaccination were largely positive: 73% expressed willingness to be vaccinated, and 87.8% considered the vaccine safe. However, only 2.6% had been vaccinated. Limited discussions about HPV, misconceptions about gender susceptibility, and low awareness of local vaccine availability contributed to poor uptake. The internet was the primary information source (84.9%).

Vaccination

Chimeric antigen receptor (CAR) T-cell therapy has shown remarkable efficacy in treating hematological malignancies and is expanding into other indications such as autoimmune diseases, fibrosis, aging and viral infection. However, clinical challenges persist in treating solid tumors, including physical barriers, tumor heterogeneity, poor in vivo persistence, and T-cell exhaustion, all of which hinder therapeutic efficacy. This review focuses on the critical role of tonic signaling in CAR-T therapy. Tonic signaling is a low-level constitutive signaling occurring in both natural and engineered antigen receptors without antigen stimulation. It plays a pivotal role in regulating immune cell homeostasis, exhaustion, persistence, and effector functions. The "Peak Theory" suggests an optimal level of tonic signaling for CAR-T function: while weak tonic signaling may result in poor proliferation and persistence, excessively strong signaling can cause T cell exhaustion. This review also summarizes the recent progress in mechanisms underlying the tonic signaling and strategies to fine-tune the CAR tonic signaling. By understanding and precisely modulating tonic signaling, the efficacy of CAR-T therapies can be further optimized, offering new avenues for treatment across a broader spectrum of diseases. These findings have implications beyond CAR-T cells, potentially impacting other engineered immune cell therapies such as CAR-NK and CAR-M.
Humans ; Immunotherapy, Adoptive/methods* ; Receptors, Chimeric Antigen/immunology* ; Signal Transduction/immunology* ; T-Lymphocytes/immunology* ; Neoplasms/immunology* ; Animals

The influenza virus is classified as a single-stranded negative-sense RNA virus in Orthomyxoviridae family, with epidemiological properties distinct from common cold. Previous studies have found that influenza infection can cause cardiac damage through various pathways, and patients with cardiovascular diseases are at relatively higher risk of adverse disease outcomes. Influenza vaccination has been proven to provide protective effect on patients with cardiovascular diseases. Currently, there is insufficient emphasis placed by cardiologists and cardiovascular disease patients on the prevention of influenza infection, leading to a low influenza vaccination rate in China. Therefore, based on the current clinical research progress and relevant guidelines, combined with the safety, feasibility and health economic benefits of influenza vaccinating in patients with cardiovascular diseases, as well as clinical experience from experts, this article proposes expert opinions on influenza vaccination in common cardiovascular diseases aiming to raise awareness of influenza prevention and benefiting patients.
Humans ; Cardiovascular Diseases/prevention & control* ; Influenza Vaccines/administration & dosage* ; Influenza, Human/prevention & control* ; Vaccination ; Expert Testimony

OBJECTIVE: Despite the global decrease in influenza infections during the coronavirus disease 2019 (COVID-19) pandemic, seasonal influenza remains a significant health issue. South Korea, known for its robust pandemic response and high influenza vaccination rates, offers a unique context for examining changes in vaccination trends during the pandemic. Using nationally representative data, we aimed to understand the impact of the pandemic on influenza vaccination behavior over a 12-year period and to identify vulnerable groups. METHODS: We analyzed influenza vaccination rates in South Korea between 2011-2022, focusing on pandemic-related impacts. The data of 2,426,139 adults (≥ 19 years) from the Korea Community Health Survey were used to assess demographic and sociological factors influencing vaccination behaviors. RESULTS: We observed an increase in influenza vaccination rates during the pre-COVID-19 period from 2011-2013 (weighted prevalence: 46.68% [95% confidence interval ( CI): 46.55-46.82]) to 2017-2019 (weighted prevalence: 52.50% [95% CI: 52.38-52.63]). However, a significant decline was observed in 2022, the late-COVID-19 pandemic period (weighted prevalence: 55.78% [95% CI: 55.56-56.01]), compared with the mid-pandemic period in 2021 (weighted prevalence: 59.12% [95% CI: 58.91-59.32]), particularly among populations traditionally prioritized for influenza vaccination, including older adults (≥ 65 years) and patients with chronic diseases and low educational and income levels. CONCLUSION The influenza vaccination rate in South Korea was significantly affected by the COVID-19 pandemic, showing a notable decrease among vulnerable demographic groups. This suggests the need for targeted public health strategies to address vaccine hesitancy and improve vaccination rates, particularly among high-risk populations.
Humans ; Republic of Korea/epidemiology* ; COVID-19/epidemiology* ; Adult ; Middle Aged ; Influenza Vaccines/administration & dosage* ; Male ; Female ; Influenza, Human/epidemiology* ; Aged ; Vaccination/statistics & numerical data* ; Young Adult ; Pandemics ; SARS-CoV-2

Colorectal cancer (CRC), a major global health concern, necessitates innovative treatments. Chimeric antigen receptor (CAR) T cells have shown promises, yet they grapple with challenges. The spotlight pivots to the rising heroes: CAR natural killer (NK) cells, offering advantages such as higher safety profiles, cost-effectiveness, and efficacy against solid tumors. Nevertheless, the specific mechanisms underlying CAR NK cell trafficking and their interplay within the complex tumor microenvironment require further in-depth exploration. Herein, we provide insights into the design and engineering of CAR NK cells, antigen targets in CRC, and success in overcoming resistance mechanisms with an emphasis on the potential for clinical trials.
Colorectal Neoplasms/immunology* ; Humans ; Killer Cells, Natural/metabolism* ; Receptors, Chimeric Antigen/genetics* ; Immunotherapy, Adoptive/methods* ; Tumor Microenvironment/immunology* ; Animals

The remarkable efficacy of chimeric antigen receptor (CAR) T cell therapy in hematological malignancies has provided a solid basis for the therapeutic concept, wherein specific pathogenic cell populations can be eradicated by means of targeted recognition. During the past few years, CAR-based cell therapies have been extensively investigated in preclinical and clinical research across various non-tumor diseases, with particular emphasis in the treatment of autoimmune diseases (ADs), yielding significant advancements. The recent deployment of CD19-directed CAR T cells has induced long-lasting, drug-free remission in patients with systemic lupus erythematosus (SLE) and other systemic ADs, alongside a more profound immune reconstruction of B cell repertoire compared with conventional immunosuppressive agents and B cell-targeting biologics. Despite the initial success achieved by CAR T cell therapy, it is critical to acknowledge the divergences in its application between cancer and ADs. Through examining recent clinical studies and ongoing research, we highlight the transformative potential of this therapeutic approach in the treatment of SLE, while also addressing the challenges and future directions necessary to enhance the long-term efficacy and safety of CAR-based cell therapies in clinical practice.
Humans ; Lupus Erythematosus, Systemic/immunology* ; Receptors, Chimeric Antigen/metabolism* ; Immunotherapy, Adoptive/methods* ; Cell- and Tissue-Based Therapy/methods* ; Animals ; T-Lymphocytes/immunology*