Global Public Health Security Research Articles

Photochemical Strategies toward Precision Targeting against Multidrug-Resistant Bacterial Infections.

Infectious diseases pose a serious threat and a substantial economic burden on global human and public health security, especially with the frequent emergence of multidrug-resistant (MDR) bacteria in clinical settings. In response to this urgent need, various photobased anti-infectious therapies have been reported lately. This Review explores and discusses several photochemical targeted antibacterial therapeutic strategies for addressing bacterial infections regardless of their antibiotic susceptibility. In contrast to conventional photobased therapies, these approaches facilitate precise targeting of pathogenic bacteria and/or infectious microenvironments, effectively minimizing toxicity to mammalian cells and surrounding healthy tissues. The highlighted therapies include photodynamic therapy, photocatalytic therapy, photothermal therapy, endogenous pigments-based photobleaching therapy, and polyphenols-based photo-oxidation therapy. This comprehensive exploration aims to offer updated information to facilitate the development of effective, convenient, safe, and alternative strategies to counter the growing threat of MDR bacteria in the future.

Advances in Nucleic Acid Assays for Infectious Disease: The Role of Microfluidic Technology

Within the fields of infectious disease diagnostics, microfluidic-based integrated technology systems have become a vital technology in enhancing the rapidity, accuracy, and portability of pathogen detection. These systems synergize microfluidic techniques with advanced molecular biology methods, including reverse transcription polymerase chain reaction (RT-PCR), loop-mediated isothermal amplification (LAMP), and clustered regularly interspaced short palindromic repeats (CRISPR), have been successfully used to identify a diverse array of pathogens, including COVID-19, Ebola, Zika, and dengue fever. This review outlines the advances in pathogen detection, attributing them to the integration of microfluidic technology with traditional molecular biology methods and smartphone- and paper-based diagnostic assays. The cutting-edge diagnostic technologies are of critical importance for disease prevention and epidemic surveillance. Looking ahead, research is expected to focus on increasing detection sensitivity, streamlining testing processes, reducing costs, and enhancing the capability for remote data sharing. These improvements aim to achieve broader coverage and quicker response mechanisms, thereby constructing a more robust defense for global public health security.

Inhibitory interactions of the 2,3-dihydro-6,7-dihydroxy-1H-isoindol-1-one scaffold with Bunyavirales cap-snatching endonucleases expose relevant drug design features

The World Health Organization (WHO) identifies several bunyaviruses as significant threats to global public health security. Developing effective therapies against these viruses is crucial to combat future outbreaks and mitigate their impact on patient outcomes. Here, we report the synthesis of some isoindol-1-one derivatives and explore their inhibitory properties over an indispensable metal-dependent cap-snatching endonuclease (Cap-ENDO) shared among evolutionary divergent bunyaviruses. The compounds suppressed RNA hydrolysis by Cap-ENDOs, with IC50 values predominantly in the lower μM range. Molecular docking studies revealed the interactions with metal ions to be essential for the 2,3-dihydro-6,7-dihydroxy-1H-isoindol-1-one scaffold activity. Calorimetric analysis uncovered Mn2+ ions to have the highest affinity for sites within the targets, irrespective of aminoacidic variations influencing metal cofactor preferences. Interestingly, spectrophotometric findings unveiled sole dinuclear species formation between the scaffold and Mn2+. Moreover, the complexation of two Mn2+ ions within the viral enzymes appears to be favourable, as indicated by the binding of compound 11 to TOSV Cap-ENDO (Kd = 28 ± 3 μM). Additionally, the tendency of compound 11 to stabilize His+ more than His- Cap-ENDOs suggests exploitable differences in their catalytic pockets relevant to improving specificity. Collectively, our results underscore the isoindolinone scaffold's potential as a strategic starting point for the design of pan-antibunyavirus drugs.

HACD3 Prevents PB1 from Autophagic Degradation to Facilitate the Replication of Influenza A Virus.

Influenza A virus (IAV) continues to pose serious threats to the global animal industry and public health security. Identification of critical host factors engaged in the life cycle of IAV and elucidation of the underlying mechanisms of their action are particularly important for the discovery of potential new targets for the development of anti-influenza drugs. Herein, we identified Hydroxyacyl-CoA Dehydratase 3 (HACD3) as a new host factor that supports the replication of IAV. Downregulating the expression of HACD3 reduced the level of viral PB1 protein in IAV-infected cells and in cells that were transiently transfected to express PB1. Silencing HACD3 expression had no effect on the level of PB1 mRNA but could promote the lysosome-mediated autophagic degradation of PB1 protein. Further investigation revealed that HACD3 interacted with PB1 and selective autophagic receptor SQSTM1/p62, and HACD3 competed with SQSTM1/p62 for the interaction with PB1, which prevented PB1 from SQSTM1/p62-mediated autophagic degradation. Collectively, these findings establish that HACD3 plays a positive regulatory role in IAV replication by stabilizing the viral PB1 protein.

Mmu-miR-374b-5p modulated inflammatory factors via downregulation of C/EBP β/NF-κB signaling in Kupffer cells during Echinococcus multilocularis infection

BackgroundAlveolar echinococcosis (AE) is an important infectious disease caused by the metacestode larvae of Echinococcus multilocularis, seriously threatening global public health security. Kupffer cells (KCs) play important roles in liver inflammatory response. However, their role in hepatic alveolar echinococcosis has not yet been fully elucidated.MethodsIn this study, qRT-PCR was used to detect the expression level of miR-374b-5p in KCs. The target gene of miR-374b-5p was identified through luciferase reporter assays and loss of function and gains. Critical genes involved in NFκB signaling pathway were analyzed by qRT-PCR and western blot.ResultsThis study reported that miR-374b-5p was significantly upregulated in KCs during E. multilocularis infection and further showed that miR-374b-5p was able to bind to the 3'-UTR of the C/EBP β gene and suppressed its expression. The expression levels of NF-κBp65, p-NF-κBp65 and pro-inflammatory factors including iNOS, TNFα and IL6 were attenuated after overexpression of miR-374b-5p while enhanced after suppression of miR-374b-5p. However, the Arg1 expression level was promoted after overexpression of miR-374b-5p while suppressed after downregulation of miR-374b-5p. Additionally, increased protein levels of NF-κBp65 and p-NF-κBp65 were found in the C/EBP β-overexpressed KCs.ConclusionsThese results demonstrated that miR-374b-5p probably regulated the expression of inflammatory factors via C/EBP β/NF-κB signaling. This finding is helpful to explore the mechanism of inflammation regulation during E. multilocularis infection.Graphical

Spread and evolution of blaKPC-plasmid between Serratia marcescens and Klebsiella pneumoniae

ObjectivesblaKPC-carrying Enterobacterales have post great challenges to global healthcare systems. In this study, we reported the evolution and spread of blaKPC between Serratia marcescens and Klebsiella pneumoniae. MethodsFour S. marcescens and one K. pneumoniae strains were isolated from the sputum samples of the patient. Antimicrobial susceptibility tests and whole genome sequencing were performed to investigate the phenotype & genotype of strains. Conjugation assays, cloning experiment and kinetic parameters measuring were performed to explore the spread and antimicrobial resistance mechanisms. ResultsThe evolution and transmission of blaKPC-2 occurred during the treatment of ceftazidime-avibactam and trimethoprim-sulfamethoxazole. Analysis of the antimicrobial susceptibility and genetic profiles of the clinical strains showed that blaKPC-2 evolved into blaKPC-71 and blaKPC-44, together with resistance to ceftazidime-avibactam and carbapenems susceptibility recovery under antimicrobial pressure. Cloning and expression of blaKPC-44 & blaKPC-71 in E. coli DH5α showed that KPC-44 and KPC-71 resulted in a 64∼128-fold increase in the MIC value for ceftazidime-avibactam. Meanwhile, the kinetic assays also showed that the enzyme activity of KPC-44 and KPC-71 towards carbapenems was destroyed and couldn't be inhibited by avibactam. Based on the conjugation assay and whole genome sequence analyses, we provided evolutionary insights into the transmission pathway trace of blaKPC-bearing plasmids between S. marcescens and K. pneumoniae. ConclusionsMixed-species co-infection is one of the risk factors leading to the spread of plasmids carrying carbapenem-resistant genes, and increased surveillance of multidrug-resistant Enterobacterales is urgently needed.

Aptamers targeting SARS-CoV-2 nucleocapsid protein exhibit potential anti pan-coronavirus activity

Emerging and recurrent infectious diseases caused by human coronaviruses (HCoVs) continue to pose a significant threat to global public health security. In light of this ongoing threat, the development of a broad-spectrum drug to combat HCoVs is an urgently priority. Herein, we report a series of anti-pan-coronavirus ssDNA aptamers screened using Systematic Evolution of Ligands by Exponential Enrichment (SELEX). These aptamers have nanomolar affinity with the nucleocapsid protein (NP) of Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and also show excellent binding efficiency to the N proteins of both SARS, MERS, HCoV-OC43 and -NL63 with affinity KD values of 1.31 to 135.36 nM. Such aptamer-based therapeutics exhibited potent antiviral activity against both the authentic SARS-CoV-2 prototype strain and the Omicron variant (BA.5) with EC50 values at 2.00 nM and 41.08 nM, respectively. The protein docking analysis also evidenced that these aptamers exhibit strong affinities for N proteins of pan-coronavirus and other HCoVs (−229E and -HKU1). In conclusion, we have identified six aptamers with a high pan-coronavirus antiviral activity, which could potentially serve as an effective strategy for preventing infections by unknown coronaviruses and addressing the ongoing global health threat.

Transcriptome and proteomic analysis of mpox virus F3L-expressing cells.

Monkeypox or mpox virus (mpox) is a double-stranded DNA virus that poses a significant threat to global public health security. The F3 protein, encoded by mpox, is an apoenzyme believed to possess a double-stranded RNA-binding domain (dsRBD). However, limited research has been conducted on its function. In this study, we present data on the transcriptomics and proteomics of F3L-transfected HEK293T cells, aiming to enhance our comprehension of F3L. The gene expression profiles of pCAGGS-HA-F3L transfected HEK293T cells were analyzed using RNA-seq. Proteomics was used to identify and study proteins that interact with F3L. Real-time PCR was used to detect mRNA levels of several differentially expressed genes (DEGs) in HEK293T cells (or Vero cells) after the expression of F3 protein. A total of 14,822 genes were obtained in cells by RNA-Seq and 1,672 DEGs were identified, including 1,156 up-regulated genes and 516 down-regulated genes. A total of 27 cellular proteins interacting with F3 proteins were identified by liquid chromatography-tandem mass spectrometry (LC-MS/MS), and 19 cellular proteins with large differences in abundance ratios were considered to be candidate cellular proteins. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analyses showed that the DEGs were significantly enriched in immune-related pathways, including type I interferon signaling pathway, response to virus, RIG-I-like receptor signaling pathway, NOD-like receptor signaling pathway, etc. Moreover, some selected DEGs were further confirmed by real-time PCR and the results were consistent with the transcriptome data. Proteomics data show that cellular proteins interacting with F3 proteins are mainly related to RNA splicing and protein translation. Our analysis of transcriptomic and proteomic data showed that (1) F3L up-regulates the transcript levels of key genes in the innate immune signaling pathway, such as RIGI, MDA5, IRF5, IRF7, IRF9, ISG15, IFNA14, and elicits a broad spectrum of antiviral immune responses in the host. F3L also increases the expression of the FOS and JNK genes while decreasing the expression of TNFR2, these factors may ultimately induce apoptosis. (2) F3 protein interacts with host proteins involved in RNA splicing and protein translation, such as SNRNP70, POLR2H, HNRNPA1, DDX17, etc. The findings of this study shed light on the function of the F3 protein.

The impact of risk perception and institutional trust on COVID-19 vaccine hesitancy in China

ABSTRACT Vaccination has become the primary means for citizens to prevent severe morbidity and mortality during the pandemic. However, vaccine hesitancy poses a major threat to global public health security. Based on the data from Chinese General Social Survey in 2021, this study aims to explore the socio-political aspects of COVID-19 vaccine hesitancy, focusing on the relationship between COVID-19 risk perceptions, institutional trust and vaccine hesitancy. Among the samples, 39.8% of the respondents exhibited COVID-19 vaccine hesitancy, 48.9% had a high awareness of the risk of COVID-19, and 74.6% presented a high level of trust in institutions. The results showed that higher risk perception and institutional trust are negatively correlated with vaccine hesitancy (p < .001). Institutional trust had no statistically significant moderating effect on the association between risk perception and vaccine hesitancy, but the role of institutional trust in influencing vaccine hesitancy is more significant at a lower level of perceptions of COVID-19 risk. Furthermore, regional variations in the factors contributing to vaccine hesitancy were demonstrated in China. These findings have important implications for developing strategies to address vaccine hesitancy.

Online quantification of nicotine in e-cigarette aerosols by vacuum ultraviolet photoionization mass spectrometry.

The growing popularity of e-cigarettes and the associated risks of nicotine addiction present a new challenge to global public health security. Measuring the nicotine levels in e-cigarette aerosols is essential to assess the safety of e-cigarettes. In this study, a rapid in situ method was developed for online quantification of nicotine in e-cigarette aerosols by using a homemade vacuum ultraviolet photoionization aerosol mass spectrometer (VUV-AMS). E-cigarette liquids with different nicotine concentrations were prepared to generate aerosols containing different levels of nicotine, which were employed as the calibration sources for nicotine quantification by VUV-AMS. The results showed that the mass concentration of nicotine in e-cigarette aerosols has a good linear relationship with its signal intensity in the mass spectrum, and the limits of detection and quantitation of nicotine by VUV-AMS were found to be 2.0 and 6.2 μg per puff respectively. Then the online method was utilized to measure five commercial e-cigarettes, and their nicotine yields were determined to be between 31 and 188 μg per puff with the nicotine fluxes from 7.7 to 70 μg s-1, agreeing with the results of the gas chromatography with a flame ionization detector (GC-FID). This study demonstrated the feasibility and advantages of VUV-AMS for quick quantification of nicotine in e-cigarette aerosols within seconds.

UV-induced oxidase activity of carbon dots in visible UVA dosage, Escherichia coli quantification and bacterial typing

Ultraviolet (UV) light and foodborne pathogenic bacteriais are an important risk to the environment's safety. They endanger human health, and also lead to outbreaks of infectious disease, posing great threats to global public health security, national economy, and social stability. The appearance of carbon dot (CD) nanozymes offers a new perspective to solve the problems of detection of UV light and pathogenic bacteria in environment. This paper reports the preparation of CDs with dual enzyme-like activities (superoxide dismutase activity and UV-induced oxidase activity). The product can catalyze the oxidation of the substrate 3, 3′, 5, 5′-tetramethylbenzidine (TMB) under UV light (365 nm) to achieve rapid color development. Based on the excellent fluorescence properties of CDs, the colorimetric-fluorescence dual-channel real-time detection of UVA dose was realized, the mechanism underlying the catalytic oxidation of TMB by UV-induced oxidase CDs was also investigated. Furthermore, a portable CDs-TMB-PA hydrogel was prepared which could realize the real-time monitoring of UV in outdoor environment with the assistance of smartphone. Based on the pH dependency of the CD nanozymes and specific glycolytic response of the pathogenic bacteria Escherichia coli (E. coli) O157:H7, the direct, simple, quick, and sensitive typing and detection have been realized. This research offers new perspectives for studying CD nanozymes and their applications in UV and bacterial detection, demonstrating the remarkable potential of CD nanozymes in detecting environmental hazards.

Screening, Expression and Identification of Nanobody Against Monkeypox Virus A35R.

The monkeypox (Mpox) virus epidemic presents a significant risk to global public health security. A35R, a crucial constituent of EEV, plays a pivotal role in virus transmission, serves as a vital target for vaccine development, and has potential for serological detection. Currently, there is a dearth of research on nanobodies targeting A35R. The purpose of this study is to identify specific nanobodies target A35R, so as to provide new antibody candidates for Mpox vaccine development and diagnostic kit development. Three nanobodies specific to the monkeypox virus protein A35R were screened from a naïve phage display library. After four rounds of panning, positive phage clones were identified by enzyme-linked immunosorbent assay (ELISA). Further, the nanobody fusion protein was constructed in pNFCG1-IgG1-Fc vector and expressed in HEK293F cells and purified by affinity chromatography. The specificity and affinity of the nanobodies were identified by ELISA. The binding kinetics of the VHH antibody to A35R were assessed via employment of a bio-layer interferometry (BLI) apparatus, thereby determining the nanobodies affinity. The three purified nanobodies showed specific high-affinity binding MPXV A35R, of them, VHH-1 had the best antigen binding affinity (EC50 = 0.010 ug/mL). In addition, VHH-1 on Protein A biosensor can bind Mpox virus A35R, with an affinity constant of 54 nM as determined in BLI assay. In sum, we has obtained three nanobody strains against Mpox virus A35R with significant affinity and specificity, therefore laying an essential foundation for further research as well as the applications of diagnostic and therapeutic tools of Mpox virus.

SWOT Analysis of the Tourism Industry in Singapore

Singapore as a small city-country was ranked 36th in the worlds GDP with a GDP of USD396.99 billion, therefore, Studying the tourism development of Singapore is of great reference significance for its future development. This essay uses literature research methodology to analyze the SWOT of Singapore's tourist industry and to evaluate its status quo for future development. The tourism industry in Singapore has a decisive role in generating profit for economic growth. Research on Singapores tourism industry can assist future development planning. Based on SWOT analysis, Singapores tourism industry benefits from the improvement of tourism infrastructure and political stability, besides that, there is a new chance for the mitigation of the global public health security affair. However, the development of the tourism industry is also limited by its low tourism carrying capacity. Additionally, Singapores tourism industry also faces the threat from the surrounding same type of tourism cities. Therefore, Singapore can promote the tourism industry by adhering to sustainable development, building a convention tourism city and developing cultural tourism these three aspects.

Capture antibody imitator MnO2 nanozyme-based dual-signal immunochromatographic assay for rapid detection of Salmonella enteritidis

The sensitive and rapid detection of foodborne pathogens is of great significance to global public health security. Here, with two-dimensional nanomaterial MnO2 NSs as the capture antibody imitator and signal reporter molecules, based on its enzyme-catalyzed signal amplification capability, a label-free, dual-signal output immunochromatographic biosensor was constructed to achieve the sensitive detection of S. enteritidis. The capture antibody imitator of MnO2 capture probe shows an outstanding capture ability, forming a stable immune complex with S. enteritidis. As an in-situ catalytic amplification colorimetric signal trigger, MnO2 NSs exert oxidase-like enzyme activity and obtain satisfactory detection sensitivity. It is worth noting that the proposed dual-signal ICA has high analytical performances for S. enteritidis during the concentration range of 103-107 cfu mL−1 both in standard bacterial solutions and food matrixes.

China after COVID-19

Background:&#x0D; The COVID-19 pandemic has seriously affected global public health security and economic development, and is a huge test for China and other countries around the world. Among the factors affecting the outbreak of the epidemic, human abuse of wildlife appears to be the most important. Under the influence of relevant factors, China has formulated and implemented policies, laws and regulations on a comprehensive ban on wildlife.&#x0D; Objectives:&#x0D; Through the integration and impact analysis of China's comprehensive wildlife fasting policy and relevant laws and regulations, this paper aims to provide reference for other countries in epidemic prevention and control and the improvement of public health governance.&#x0D; Methods:&#x0D; Through the integration of relevant policies and regulations and detailed introduction, the author studied from three aspects: policies and regulations related to people's life, health and safety, improvement of public health and safety risk prevention and promotion of environmental protection and human civilization development, and analyzed its impact on all aspects of human society, especially public health safety and emergency management system and management capacity, to remind people to change the habit of over eating wild animals.&#x0D; Results:&#x0D; The article is of reference and guiding significance in promoting the global implementation of comprehensive fasting for wild animals, and in the current epidemic prevention and control of other countries, maintaining social public health and security governance, and safeguarding human health.&#x0D; Main Contribution to Evidence-Based Practice:&#x0D; The article demonstrates that the relevant policies, laws and regulations of China's comprehensive prohibition of wildlife have reference and guiding significance for epidemic prevention, maintenance of social public health and safety management, and protection of human health. In addition, it has promoted the global implementation of a comprehensive ban on wildlife.

SARS-CoV-2 Nsp15 suppresses type I interferon production by inhibiting IRF3 phosphorylation and nuclear translocation

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which causes 2019 coronavirus disease (COVID-19), poses a significant threat to global public health security. Like other coronaviruses, SARS-CoV-2 has developed various strategies to inhibit the production of interferon (IFN). Here, we have discovered that SARS-CoV-2 Nsp15 obviously reduces the expression of IFN-β and IFN-stimulated genes (ISG56, CXCL10), and also inhibits IRF3 phosphorylation and nuclear translocation by antagonizing the RLR-mediated antiviral signaling pathway. Mechanically, we found that the poly-U-specific endonuclease domain (EndoU) of Nsp15 directly associates with the kinase domain (KD) of TBK1 to interfere TBK1 interacting with IRF3 and the flowing TBK1-mediated IRF3 phosphorylation. Furthermore, Nsp15 also prevented nuclear translocation of phosphorylated IRF3 via binding to the nuclear import adaptor karyopherin α1 (KPNA1) and promoting it autophagy-dependent degradation. These findings collectively reveal a novel mechanism by which Nsp15 antagonizes host's innate immune response.

The potential role of plant secondary metabolites on antifungal and immunomodulatory effect.

With the widespread use of antibiotic drugs worldwide and the global increase in the number of immunodeficient patients, fungal infections have become a serious threat to global public health security. Moreover, the evolution of fungal resistance to existing antifungal drugs is on the rise. To address these issues, the development of new antifungal drugs or fungal inhibitors needs to be targeted urgently. Plant secondary metabolites are characterized by a wide variety of chemical structures, low price, high availability, high antimicrobial activity, and few side effects. Therefore, plant secondary metabolites may be important resources for the identification and development of novel antifungal drugs. However, there are few studies to summarize those contents. In this review, the antifungal modes of action of plant secondary metabolites toward different types of fungi and fungal infections are covered, as well as highlighting immunomodulatory effects on the human body. This review of the literature should lay the foundation for research into new antifungal drugs and the discovery of new targets. KEY POINTS: • Immunocompromised patients who are infected the drug-resistant fungi are increasing. • Plant secondary metabolites toward various fungal targets are covered. • Plant secondary metabolites with immunomodulatory effect are verified in vivo.

Editorial introductions.

Editorial introductions.

Prevalence of COVID-19 Pandemic Threat; Implications of Social Quarantine as Preventive Public Health Intervention

The emergence of coronavirus back in 2019 posed an epidemic threat to global public health security even after the execution of precautionary and control measures. The infectious disease was first identified in Wuhan, China and spread rapidly to multiple countries. Gradually, it caused casualties of people with a large number of coronavirus cases. Different countries implemented several interventions to mitigate the human-to-human transmission of this disease including travel restrictions, setting up isolation centers, lockdowns, and social quarantine. A systematic search was implemented through five electronic databases (PubMed, WHO, NIH, Scopus and Google Scholar). Research studies that were published until 30th May 2021 were included in this study, and eligibility criteria were selected for this review. The study shed light on the critical aspects of the implications of social quarantine preventive intervention to avoid the spread of COVID-19. The lessons learned from the pandemic can help the future preparedness and response plan to combat the progression of this disease. Yet limited studies have been conducted about the socio-economic impact of these social-distancing measures for most vulnerable populations. In this study, various research studies that have reported the positive and negative impact of physical distancing on the population were evaluated. In this situation, the Pakistani government must combat the coronavirus disease and take steps to improve the economic condition of the country. Special attention must be paid to the most disadvantaged and vulnerable populations such as the disabled, older population, homeless and poor populations to lessen the risks of coronavirus disease. Policymakers must ensure transparency in communication and provide evidence-based interventions to tackle the worse situation. The countries must coordinate their efforts to develop antivirals and vaccines for the treatment of infectious fatal diseases. Government must support the community through access to the use of technology, and home care to older residents, deliver health counseling services, and deliver home-based learning. All countries must use print, electronic and social media wisely and they must be coordinated, and provide education and social awareness among the citizenry regarding how to avoid being infected.

The COVID-19 vaccination decision-making preferences of elderly people: a discrete choice experiment

COVID-19 is a continuing threat to global public health security. For elderly people, timely and effective vaccination reduces infection rates in this group and safeguards their health. This paper adopted an offline Discrete Choice Experiment (DCE) to research the preference for COVID-19 vaccination amongst Chinese adults aged 50 years and above. Through multinomial logistic regression analysis, our DCE leverages five attributes—the risk of adverse reactions, protective duration, injection doses, injection period, and effectiveness—each of which is split into three to four levels. The risk of adverse reaction and the protective duration were demonstrated to be determinants of vaccination preference. Moreover, it was found that socio demographic factors like region, self-health assessment and the number of vaccinated household members can strengthen or weaken the effects of vaccine attributes. In conclusion, the preferences of the elderly population should be considered when developing COVID-19 vaccination programs for this population in China. Accordingly, the results may provide useful information for policymakers to develop tailored, effectively vaccination strategies.