“Every time I had to pay $50, it was adding up, but there was no option”: A qualitative study with parents and primary caregivers in Australia on barriers to timely childhood vaccination

Limited data exist on seroconversion rates post-varicella vaccination in children with idiopathic nephrotic syndrome (NS). This cross-sectional study assessed anti-varicella IgG antibodies (VZV-IgG) in idiopathic NS children aged 1-18years who were previously vaccinated (2 doses at a minimum 8-week interval), at least 3 months prior to enrolment. Exclusion criteria included secondary NS and eGFR < 60mL/min/1.73m2 at the time of vaccination. Baseline characteristics and seroconversion titres (VZV-IgG ≥ 110IU/L) by enzyme-linked immunosorbent assay (ELISA) kit were assessed. Two-hundred children with idiopathic NS (55.5% males) received varicella vaccine. The median interval between doses was 3months [IQR 2, 7], with a median age at vaccination of 6.8years [3.8, 9.8], and a median illness duration of 4.1years [1.7, 6.6]. Overall seroconversion rate was 64.5% with median VZV-IgG titres of 179 [IQR 62, 452] IU/L. The seroconversion was significantly associated with clinical phenotype when unadjusted for confounders. On univariate analysis, each additional relapse, children on levamisole post-vaccination, those on one second-line immunosuppressive agent, on two second-line immunosuppressive agents, and each additional month after vaccination were associated with 16%, 88%, 66%, 77%, and 3% significantly lower odds of seroconversion. The seroconversion rates or titres among those vaccinated within 4weeks of discontinuation of steroids were however not significantly different. Breakthrough varicella occurred in 1.5%. To conclude, this study demonstrates that varicella vaccination confers seroprotection in approximately two-thirds of children with NS, with low rates of breakthrough varicella.

Active surveillance of adverse events following immunisation in children: pre, during and post COVID-19 pandemic

Exploring young fathers’ roles and decision-making regarding childhood vaccination in Tajikistan: A focus group study

Parental attitudes and factors associated with COVID-19 vaccination for toddlers in Japan: a questionnaire survey in Toyonaka city.

Mpox is a viral zoonotic disease that has gained global attention due to its recurrent outbreaks in endemic regions of Africa and beyond. The recent clade I outbreak in the Democratic Republic of the Congo (DRC) has been characterized by extensive transmission among children - particularly those under 15 years of age - and adults with elevated occupational risks, such as healthcare workers, sex workers, and hunters. Motivated by emerging evidence that vaccination alone may not explain the observed decline in mpox transmission across the DRC, and recognizing that behavioural modification is more feasible among adults, this study investigates the synergistic impact of vaccination and behaviour-driven contact reduction among high-risk adults within an age- and risk-structured modelling framework. The model stratifies the population into adults (high- and low-risk groups) and children. It incorporates vaccination for both adults and children, as well as behavioural adaptations (in the form of contact reduction) among high-risk adults. The model is calibrated to weekly reported mpox cases in the DRC from January 2024 to April 2025, from which key parameters are estimated. Scenario analyses reveal that among the adult population, behavioural change has a greater impact than vaccination in reducing mpox transmission. The model indicated that vaccination targeting children yielded the most significant effects, in comparison to either contact-reduction measures or immunization of adults. Moreover, our results indicate that initiating a 50% reduction in contact rates among high-risk adults approximately 20 weeks earlier yields an additional 20% decrease in the cumulative number of mpox cases, compared with implementing the same reduction concurrently with the vaccination intervention in the DRC. Given the current low vaccination coverage and supply constraints, our findings provide evidence-based guidance for optimizing vaccine allocation and prioritizing behavioural interventions among high-risk groups to prevent sustained transmission.

Prevalence estimates of sickle cell disease among children and adolescents in sub-Saharan Africa: a systematic review and modelling analysis.

Hepatitis A virus (HAV) is a leading cause of acute viral hepatitis worldwide, particularly in developing countries with poor sanitation, socio-demographic conditions including sexual transmitted diseases. Unlike HAV infection in children, which is generally asymptomatic, infections in adolescents and adults tend to present more severe symptoms. Indonesia is a country with intermediate HAV endemicity, with incidence rates increasing since 2007. Currently, hepatitis A vaccination is not included in the national routine immunisation program, despite the Indonesian Pediatric Society (IDAI) recommending vaccination for children starting at 12 months of age. Two types of HAV vaccines are used. Both show high efficacy in preventing HAV infection, with nearly 100% seroconversion after the second dose. Combined HAV and HBV vaccines also provide long-term protection against both viruses, maintaining high seropositivity rates up to 10 years post-vaccination. However, risks of antibody decline and local and systemic side effects remain, though these are generally well-tolerated.

Parental inquiry behavior and use of web-based information for childhood vaccination in Japan: Implications for communication quality and vaccination schedule adherence.

The dominant genres of the American healthcare system-electronic health records and research reports-are strategies for advancing commercial and empirical goals. These strategies have led us into an epistemic crisis in which clinicians and patients suffer from information overload, politicized health information, and conflicting narratives about medical practices across the lifespan, from vaccines in childhood to care at the end of life, resulting in a loss of trust between clinicians and patients. Two recent books offer insight into how previous epistemic crises were resolved by thepatterning of physicians' imaginations through genres now associated with health humanities. In her history of medicine in the early United States, the literary scholar Sari Altschuler shows how physicians used limericks, maps, and satires to address epistemic crises resulting from pandemics and the development of novel technologies. In her philosophy of art and imagination, the theologian Judith Wolfe shows how perceptual shifts can direct people and communities to new ends. When read in conversation, the works of Altschuler and Wolfe suggest the health humanities can provide novel strategies otherwise unavailable to physicians facing our current epistemic crisis.

Identification of best outreach strategies and delivery modalities for population subgroups for COVID-19 vaccination.

Racial disparities in coverage and determinants of childhood diphtheria, tetanus, and pertussis (DTaP) vaccination in Canada: a post-COVID-19 pandemic analysis.

Routine childhood immunization is still a critical topic to global public health, since it prevents an estimated 3.5 to 5 million deaths annually. However, its access remains uneven, especially in low-income countries, where structural inequalities limit the reach of immunization programs, and the Covid-19 pandemic disrupted routine services, worsening the existing disparities. This ecological study (2010–2023) examined associations between vaccine coverage and infant mortality using the WHO/UNICEF data for six childhood vaccines: BCG, DTP3, HepB3, Hib3, MCV2, and Pol3. Countries were stratified by income level using the World Bank World Development Indicators. Associations between vaccine coverage and infant mortality were evaluated using multivariable linear regression models adjusted for national income level. In addition, non-linear relationships and rank-based associations were explored using LOESS smoothing and Spearman correlation analyses. Results showed higher coverage and lower mortality in high-income countries; meanwhile, low-income countries faced both reduced coverage and higher mortality rates. A significant decline in coverage occurred in 2020, with only partial recovery by 2023. After adjusting for income, most vaccine coverage indicators lost statistical significance in relation to infant mortality. These findings highlight that income-related structural inequities determine immunization coverage and preventable child mortality, emphasizing the need for policies that simultaneously expand vaccine access, reduce structural barriers, and strengthen health systems.

SARS-CoV-2 Ancestral and Omicron variant immunity in Australian children in 2023, a seroprevalence study.

Instruments for measuring parents' vaccine hesitancy towards their children based on the COSMIN guidelines: A systematic review.

Immunization is one of the most impactful public health achievements, significantly reducing childhood morbidity and mortality worldwide. However, gender disparity and women's disempowerment constitute structural barriers in accessing vaccine services in low- and middle-income countries. In Nigeria, widespread differences in social norms and cultural values affect gender roles and influence women's ability to decide their own healthcare needs and participate in household decision-making. This leads to attitudinal differences in uptake of immunization depending on the child's location of residence. Using data from four waves of the Nigeria Demographic and Health Survey, we constructed two empowerment indices that determine whether caregivers participate in household decision-making and have the ability to decide on their healthcare needs. We used a structured spatiotemporal statistical model to determine whether a significant part of childhood vaccination coverage disparities can be attributed to these women's empowerment measures and predicted events at the third administrative level of the country. We considered five vaccination indicators: Bacillus Calmette-Guerin (BCG), zero-dose, receiving a complete dose of DPT, MCV-1 (first dose of measles-containing vaccine), and receipt of all basic vaccinations. The adopted model was validated by comparing the empirical estimates of vaccination coverage level from the data with model projections at the second administrative level. The findings indicate that although empowerment regarding participation in household decision-making and agency over healthcare access is generally associated with increased vaccine uptake, their effects vary considerably across locations and notably among the highly empowered category of women. Although there are efforts to bridge immunization gaps within the country, the study emphasizes the need for tailored strategies that target up-scaling the ability of women and the wider community to participate in the decision-making process and be able to decide on healthcare needs to address regional disparities and improve vaccination coverage.

Tuberculosis (TB) still threatens human life despite the availability of childhood vaccination and modern treatment regimens due to the emergence of tuberculosis with extended resistance profiles. The mouse active TB model remains the gold standard for evaluating anti-TB drugs and vaccines. However, in vivo experiments raise ethical concerns and are time-consuming. We established an Akaluc-based bioluminescence platform to enable rapid drug screening in culture media and THP‑1 cells. Codon-optimized Akaluc expression in mycobacteria was accomplished by assortment of vectors and promoters. Bioluminescence kinetics were evaluated in culture media and THP‑1 cells with or without drug treatment, and optimized by adjusting time points and substrate concentrations. TokeOni at a concentration of 10nM/100µL produced the highest bioluminescence compared to other tested concentrations and substrates. Among the tested promoter-plasmid constructs, the Ag85B promoter in pMV261 generated the strongest bioluminescence in Mycobacterium smegmatis and Mycobacterium bovis.Bioluminescence fluctuated with bacterial growth, peaking during the log phase and gradually declining during the stationary phase. A positive correlation was observed between bioluminescence and CFU reduction in vitro upon treatment with sensitive drugs.

Factors associated with intention to obtain HPV vaccination at ages 9-10 among parents with varied prior vaccine decision making experiences and choices.

Background: Autism spectrum disorder (ASD) now affects more than one in 31 children in the United States, with prevalence rising sharply over recent decades. ASD is recognized as a complex neurodevelopmental disorder shaped by genetic, environmental, and iatrogenic influences. Clarifying the contribution of these determinants is critical to addressing the escalating public health burden. Methods: We comprehensively examined epidemiologic, clinical, and mechanistic studies evaluating potential ASD risk factors, assessing outcomes, exposure quantification, strength and independence of associations, temporal relationships, internal and external validity, overall cohesiveness, and biological plausibility. Results: Key determinants of new-onset ASD before age nine include advanced parental age, premature delivery, genetic variants, sibling recurrence, maternal immune activation, in utero drug exposure, environmental toxicants, gut–brain axis disruption, and cumulative routine childhood vaccination. These factors may converge through pathways such as immune dysregulation, mitochondrial dysfunction, and neuroinflammation, which may contribute to neurodevelopmental injury in susceptible children. Of 136 studies examining childhood vaccines or their excipients, 29 found neutral risks or no association, while 107 inferred a possible link between immunization or vaccine components and ASD or other neurodevelopmental disorders (NDDs), based on findings spanning epidemiologic, clinical, mechanistic, neuropathologic, and case-report evidence of developmental regression. 12 studies comparing fully vaccinated and completely unvaccinated populations consistently showed superior overall health outcomes among the unvaccinated, including significantly lower risks of chronic disease and neuropsychiatric disorders such as ASD. The neutral association papers were undermined by absence of a genuinely unvaccinated control group, registry misclassification, ecological confounding, and averaged estimates that obscure effects within vulnerable subgroups. We observed strong, consistent increases in cumulative vaccine exposure during early childhood and the reported prevalence of autism across successive birth cohorts. To date, no study has evaluated the safety of the entire cumulative pediatric vaccine schedule for neurodevelopmental outcomes through age 9 or 18 years. Conclusion: The totality of evidence supports a multifactorial model of ASD in which genetic predisposition, neuroimmune biology, environmental toxicants, perinatal stressors, and iatrogenic exposures converge to produce the phenotype of a post-encephalitic state. Combination and early-timed routine childhood vaccination represents a significant modifiable risk factor for ASD within a broader multifactorial framework, supported by convergent mechanistic, clinical, and epidemiologic findings, and characterized by intensified use, the clustering of multiple doses during critical neurodevelopmental windows, and the lack of research on the cumulative safety of the full pediatric schedule. As ASD prevalence continues to rise at an unprecedented pace, clarifying the risks associated with cumulative vaccine dosing and timing remains an urgent public health priority. Keywords: Autism, autism spectrum disorder, neurodevelopmental disorder, vaccine, vaccination, determinants, risk factors

Timeliness and Dose-Dependent Protection of Pertussis Vaccination in Children under 5 years: Evidence from a Population-Based Cohort in Zhejiang Province, China.