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AbstractBackground: College students have cited inconvenience, ease of forgetting, and lack of time as barriers to influenza (flu) vaccine receipt. We hypothesized that “pop-up” clinics and live-attenuated influenza vaccine (LAIV) would facilitate delivery and align with preferences of college students. Methods: During the 2023–2024 flu season, undergraduate participants were recruited to receive LAIV at 5 “pop-up” clinics across a large midwestern campus. Individuals who received LAIV were approached to complete a Likert-scale survey asking about their experience. Results: Across all clinics, 337 individuals received LAIV and 129 completed the survey. Respondents reported that “pop-up” clinics decreased barriers to vaccination. Regarding LAIV acceptance, 44.2% noted a preference for LAIV while 46.5% noted no preference between intranasal and injectable vaccines. Importantly, over 27% of students stated they would not have received vaccine without this “pop-up” clinic option. Conclusion(s): “Pop-up” clinics and LAIV effectively alleviate barriers to facilitate flu vaccination for college students. [ABSTRACT FROM AUTHOR]

Objective: This study examines Chinese international students' underlying beliefs and overall perception of the flu vaccination to inform effective health promotion efforts on U.S. college campuses. Participants: Data were collected in March 2020. Participants (N = 189) were recruited via email at a southeastern university in the U.S. Methods: Incorporating theory recommendations and recent vaccine-related research findings, this study designs a Four-Factor Measurement Model through confirmatory factor analysis (CFA) to examine Chinese international students' perception of flu vaccination. Results: Chinese international students' health beliefs, particularly their perceived susceptibility of the influenza virus, was the most important factor to explain their perception of flu vaccination. While normative beliefs were the least influential factor to account for Chinese international students' perception of flu vaccination, these students valued healthcare providers' opinions immensely. Conclusions: This study suggests the Four-Factor Measurement Model will help measure Chinese international students' perception of flu vaccination and can be applied to future vaccine-related research. [ABSTRACT FROM AUTHOR]

Madin–Darby canine kidney (MDCK) cells are commonly used to produce cell-based influenza vaccines. However, the role of the low-serum medium on the proliferation of MDCK cells and the propagation of the influenza virus has not been well studied. In the present study, we used 5 of 15 culture methods with different concentrations of a mixed medium and neonatal bovine serum (NBS) to determine the best culture medium. We found that a VP:M199 ratio of 1:2 (3% NBS) was suitable for culturing MDCK cells. Furthermore, the stable growth of MDCK cells and the production of the influenza virus were evaluated over long-term passaging. We found no significant difference in terms of cell growth and virus production between high and low passages of MDCK cells under low-serum culture conditions, regardless of influenza virus infection. Lastly, we performed a comparison of the transcriptomics and proteomics of MDCK cells cultured in VP:M199 = 1:2 (3% NBS) with those cultured in VP:M199 = 1:2 (5% NBS) before and after influenza virus infection. The transcriptome analysis showed that differentially expressed genes were predominantly enriched in the metabolic pathway and MAPK signaling pathway, indicating an activated state. This suggests that decreasing the concentration of serum in the medium from 5% to 3% may increase the metabolic activity of cells. Proteomics analysis showed that only a small number of differentially expressed proteins could not be enriched for analysis, indicating minimal difference in the protein levels of MDCK cells when the serum concentration in the medium was decreased from 5% to 3%. Altogether, our findings suggest that the screening and application of a low-serum medium provide a background for the development and optimization of cell-based influenza vaccines. [ABSTRACT FROM AUTHOR]

Resumen: La gripe es una amenaza constante que en ocasiones puede producir cuadros clínicos graves. Las mayores tasas de incidencia por grupos de edad ocurren en los menores de 15 años, especialmente en los menores de 5 años, en los que además las tasas de hospitalización son similares a las de las personas de 65 años en adelante. Además, los niños son los principales vectores de transmisión de la enfermedad. En España están autorizadas cinco vacunas antigripales en la edad pediátrica: tres inactivadas tetravalentes procedentes de cultivos en huevos embrionados, una inactivada tetravalente procedente de cultivos celulares, y una atenuada tetravalente de administración intranasal, que para la temporada 2024-2025 pasará a ser trivalente, al no incluir el linaje B Yamagata, como recomienda la OMS. El CAV-AEP recomienda la vacunación sistemática en: niños de 6 a 59 meses, niños y adolescentes pertenecientes a grupos de riesgo, personas que puedan transmitir la gripe a los grupos que tienen riesgo de gripe complicada, y convivientes o entorno familiar de menores de 6 meses. A partir de los 2 años de edad se recomienda preferentemente la vacuna atenuada intranasal por su mayor aceptabilidad y por facilitar la mejora de las coberturas. El CAV-AEP considera también que la vacunación antigripal de niños y adolescentes de 5-18 años sanos es una medida recomendable, por cuanto les proporciona protección individual y favorece la protección familiar y comunitaria. Es especialmente importante la vacunación antigripal de todos los profesionales sanitarios y la vacunación de las gestantes en cualquier momento del embarazo. Abstract: The flu is a constant threat that can sometimes cause severe forms of disease. The highest incidence rates by age group occur in children under 15 years of age, especially in those under 5 years, in whom the rate of hospitalization is also similar to the population aged 65 years and older. In addition, children are the main transmitters of the infection. In Spain, five influenza vaccines are authorized for the paediatric age group: three inactivated tetravalent vaccines harvested from fertilised eggs, one tetravalent inactivated vaccine obtained from cell cultures, and one attenuated tetravalent vaccine for intranasal administration, which will become trivalent in the 2024-2025 season by excluding the B Yamagata lineage as recommended by the WHO. The CAV-AEP recommends systematic vaccination in children aged 6 to 59 months, children and adolescents belonging to risk groups, people who can transmit the flu to groups at risk of complicated flu, and household contacts or close family of infants under 6 months. From 2 years of age, the intranasal attenuated vaccine is preferred due to its greater acceptability and thus contribution to greater vaccination coverage. The CAV-AEP also considers that vaccination against influenza of healthy children and adolescents aged 5 to 18 years is advisable, as it provides individual protection and promotes protection at the family and community levels. It is especially important to vaccinate all health care professionals against influenza as well as pregnant women at any time during the pregnancy.

Background: Vaccination of healthcare workers (HCWs) is pivotal in decreasing the incidence of contagious infections in hospital settings. In this study, we assessed the knowledge, attitude, and practice regarding HCWs' recommended vaccines among medical students and interns in Egypt. Methods: A multicenter, cross-sectional study was conducted using a structured, pilot-tested, and self-administered questionnaire among Egyptian medical students and interns. We invited 1332 participants to our survey using a systematic random sampling that included participants across nine medical schools in Egypt during the 2021–2022 academic year. Results: Out of 1332 participants, 1141 completed our questionnaire with a response rate of 85.7%. Overall, 43% of the participants had intermediate knowledge (knew 2–3 HCWs' recommended vaccines). Furthermore, 36.7% had received a booster dose of at least one of the HCWs' recommended vaccines over the last 10 years, with only 6.1% having received all recommended vaccines. Hepatitis B vaccine was the most widely known (71%) and received (66.7%). Interns were more likely to know, receive, and recommend HCWs' recommended vaccines. The majority (> 90%) agreed that vaccination is beneficial and safe, with a median score of eight (interquartile range [IQR: Q25-Q75]: 7–9) out of ten for vaccine efficacy and eight (IQR: 7–8) for safety. However, the median score for hesitancy was five (IQR: 2–7). The most common influential and limiting factors for vaccination were scientific facts (60.1%) and fear of vaccine side effects (44.9%). Conclusion: Although medical students in Egypt have good knowledge of and attitudes towards vaccination, there is a gap in their practices. Interventions are needed to improve vaccination uptake among medical students in Egypt. [ABSTRACT FROM AUTHOR]

There is limited literature regarding seasonal influenza vaccination (SIV) among those with a history of chronic obstructive pulmonary disease (HCOPD) prior to the COVID-19 pandemic, and no information on the topic assessing the years following the pandemic. This cross-sectional study used the Behavioral Risk Factor Surveillance Survey (BRFSS) data from the years 2017 to 2022 (n = 822,783 adults ages 50–79 years; 50.64% males). The exposure was a HCOPD, and the outcome was SIV within the past year. Weighted and adjusted logistic regression models were conducted overall and by the significant effect modifiers: smoking status, sex, and year. Having an HCOPD significantly increases the weighted adjusted odds (WAO) of SIV when compared to not having an HCOPD overall and by smoking status, sex, and year. For 2017 through 2022, among all current, former, and never smokers with an HCOPD, the WAO of SIV were: 1.36 (1.28, 1.45), 1.35 (1.27, 1.43), and 1.18 (1.09, 1.27), respectively. Among males with an HCOPD who were current, former, and never smokers, the WAO of SIV were: 1.35 (1.23, 1.48), 1.45 (1.33, 1.58), and 1.23 (1.05, 1.44), respectively. Among females with an HCOPD who were current, former, and never smokers, the WAO of SIV were: 1.31 (1.20, 1.43), 1.24 (1.15, 1.35), and 1.13 (1.04, 1.23), respectively. Study findings suggest males had significantly greater WAO ratios of receiving SIV than females in 2020 and 2022, during and after the COVID-19 pandemic. More specifically, males with an HCOPD who were former smokers had significantly greater WAOR of receiving SIV than females in 2020 and 2022. Understanding the potential barriers to SIV receipt by smoking status and sex, especially during a pandemic, and especially for individuals impacted by an HCOPD, is essential for better health interventions in times of a national crisis such as a pandemic. Additionally, SIV receipt is low among those with an HCOPD, and efforts should be made to improve this. [ABSTRACT FROM AUTHOR]

Despite the mass availability of COVID-19 vaccines in the United States, many Americans are still reluctant to take a vaccine as an outcome from exposure to misinformation. Additionally, while scholars have paid attention to COVID-19 vaccine hesitancy, the influence of general vaccine hesitancy for important viruses such as the flu has largely been ignored. Using nationally representative data from Pew Research Center's American Trends Panel survey (Wave 79), this study examined the relationship between perceived misinformation exposure, COVID-19 vaccine hesitancy, flu vaccine acceptance, political ideology, and demographic trends. The findings suggest that those who accepted the flu vaccine were less likely to be COVID-19 vaccine-hesitant. In addition, moderation analyses showed that perceived misinformation exposure increases COVID-19 vaccine hesitancy for conservatives and moderates but not for liberals. However, perceived misinformation exposure influences COVID-19 vaccine hesitancy among conservatives only if they are also flu vaccine-hesitant. Perceived misinformation exposure has no role in COVID-19 vaccine hesitancy if individuals (irrespective of political ideology) are regular with their flu vaccine. The results suggest that the effect of misinformation exposure on negative attitudes toward COVID-19 may be associated with generalized vaccine hesitancy (e.g., flu). The practical and theoretical implications are discussed.

The development of an effective combined vaccine represents a crucial strategy for preventing outbreaks of infectious diseases and reducing the burden on healthcare resources. Developing a combined vaccine against both influenza and the coronavirus is a promising approach, but it is still in the early stages of development. This paper reports on a novel combined pentavalent candidate vaccine that has shown promising results in mice, with statistically significant differences in mean antibody titer against the coronavirus and the influenza antigens compared to placebo. We have shown that the coronavirus antigen is capable of inducing an immune response autonomously, regardless of the presence of the influenza antigens in a combined vaccine. On the other hand, the presence of the coronavirus antigen in a combined vaccine showed to enhance the immune response against some of the studied influenza antigens, suggesting that these antigens may act in synergy and elicit an enhanced immune response. The absence of dose-dependent difference in mean antibody titer within the same antigenic groups of vaccine preparations suggested that even small amounts of the coronavirus and the influenza antigens could induce an immune response just as good as high-dose vaccine preparations, which certainly has important safety and cost implications. The vaccine is soon to be ready for clinical trials and mass production. [ABSTRACT FROM AUTHOR]

Toll-like receptors (TLRs) are well-known for their role in cancer development as well as in directing anti-tumor immunity. Because TLRs have also been implicated in the innate recognition of the influenza virus, itwas of great interest to investigate the potential TLRs' contribution to the reduction in tumor growth following intratumoral injection of an unadjuvanted influenza vaccine and the lack of antitumor response from an adjuvanted vaccine. In our previous publication, we showed that the unadjuvanted flu vaccine modulates TLR7 expression leading to anti-tumor response in a murine model of melanoma. Here, we show that the unadjuvanted and adjuvanted flu vaccines robustly stimulate different sets of TLRs, TLR3 and TLR7, and TLR4 and TLR9, respectively. In addition, the reduction in tumor growth and improved survival from intratumoral administration of the unadjuvanted vaccine was found to be diminished in TLR7-deficient mice. Finally, we observed that both vaccines have the capacity to modulate TLR expression on both innate and adaptive immune cells. Our findings add to the mechanistic understanding of the parameters that influence tumor outcomes in unadjuvanted and adjuvanted influenza vaccines. [ABSTRACT FROM AUTHOR]

There is a critical need to understand vaccine decision-making in high-risk groups. This study explored flu vaccine acceptance among Jordanian parents of diabetic children. Employing a cross-sectional approach, 405 parents from multiple healthcare centers across Jordan were recruited through stratified sampling, ensuring a broad representation of socioeconomic backgrounds. A structured questionnaire, distributed both in-person and online, evaluated their knowledge, attitudes, and acceptance of the flu vaccine for their diabetic children. The results indicated that only 6.4% of the study sample reported vaccinating their children against the flu annually, and only 23% are planning to vaccinate their children this year. A multinomial logistic regression analysis revealed notable variability in responses. Specifically, parents with a positive attitude towards the flu vaccine and those with older children had less odds to reject the vaccine (OR = 0.589, 95% CI (0.518–0.670), p < 0.001 and OR = 0.846, 95% CI (0.736–0.974), p = 0.02, respectively). Conversely, prevalent misconceptions regarding vaccine safety and efficacy emerged as significant barriers to acceptance. Our findings advocate for targeted educational programs that directly address and debunk these specific misconceptions. Additionally, strengthened healthcare communication to provide clear, consistent information about the flu vaccine's safety and benefits is vital to help enhance vaccine uptake among this vulnerable population, emphasizing the need to address specific concerns and misinformation directly. [ABSTRACT FROM AUTHOR]

Copyright of Ekonomik Yaklaşim is the property of Ekonomik Yaklasim Dernegi (Ekonomik Yaklasim Association) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Madin–Darby canine kidney (MDCK) cells are commonly used to produce cell-based influenza vaccines. However, the role of the low-serum medium on the proliferation of MDCK cells and the propagation of the influenza virus has not been well studied. In the present study, we used 5 of 15 culture methods with different concentrations of a mixed medium and neonatal bovine serum (NBS) to determine the best culture medium. We found that a VP:M199 ratio of 1:2 (3% NBS) was suitable for culturing MDCK cells. Furthermore, the stable growth of MDCK cells and the production of the influenza virus were evaluated over long-term passaging. We found no significant difference in terms of cell growth and virus production between high and low passages of MDCK cells under low-serum culture conditions, regardless of influenza virus infection. Lastly, we performed a comparison of the transcriptomics and proteomics of MDCK cells cultured in VP:M199 = 1:2 (3% NBS) with those cultured in VP:M199 = 1:2 (5% NBS) before and after influenza virus infection. The transcriptome analysis showed that differentially expressed genes were predominantly enriched in the metabolic pathway and MAPK signaling pathway, indicating an activated state. This suggests that decreasing the concentration of serum in the medium from 5% to 3% may increase the metabolic activity of cells. Proteomics analysis showed that only a small number of differentially expressed proteins could not be enriched for analysis, indicating minimal difference in the protein levels of MDCK cells when the serum concentration in the medium was decreased from 5% to 3%. Altogether, our findings suggest that the screening and application of a low-serum medium provide a background for the development and optimization of cell-based influenza vaccines.

Toll-like receptors (TLRs) are well-known for their role in cancer development as well as in directing anti-tumor immunity. Because TLRs have also been implicated in the innate recognition of the influenza virus, it was of great interest to investigate the potential TLRs’ contribution to the reduction in tumor growth following intratumoral injection of an unadjuvanted influenza vaccine and the lack of antitumor response from an adjuvanted vaccine. In our previous publication, we showed that the unadjuvanted flu vaccine modulates TLR7 expression leading to anti-tumor response in a murine model of melanoma. Here, we show that the unadjuvanted and adjuvanted flu vaccines robustly stimulate different sets of TLRs, TLR3 and TLR7, and TLR4 and TLR9, respectively. In addition, the reduction in tumor growth and improved survival from intratumoral administration of the unadjuvanted vaccine was found to be diminished in TLR7-deficient mice. Finally, we observed that both vaccines have the capacity to modulate TLR expression on both innate and adaptive immune cells. Our findings add to the mechanistic understanding of the parameters that influence tumor outcomes in unadjuvanted and adjuvanted influenza vaccines.

• The United States is not reaching the 70% national target rate for flu vaccination. • Flu vaccination varies greatly across race, socioeconomic status, and geography. • Rhode Island has implemented multiple strategies to promote flu vaccination. • Strategies include Medicaid expansion, Health Equity Zones, and state mandates. [ABSTRACT FROM AUTHOR]

Introduction. Influenza vaccination has been a concern for patients, healthcare professionals and decision-makers alike. This concern, in Romania, has materialized at the beginning of the cold season 2023-2024 by changing the legislative rules so that the purchase of the vaccine by patients is made on the basis of a compensated medical prescription, and not by its distribution through family medicine offices. Materials and method. On 29.09.2023, a survey based on 10 questions was carried out, to which 48 family doctors from Mures County responded. The survey was conducted before the legislative changes took effect, so the opinion expressed in the questionnaire has prospective value. Results. The 10 questions revealed respondents’ opinions on the optimal time to start a flu vaccination campaign, who should be the target group for such campaigns, the adverse reactions to immunization, attitudes of healthcare staff towards this type of vaccination and towards the advantages and vulnerabilities of the new legislation, and how the SARS-CoV-2 vaccination campaign might have influenced other vaccination campaigns. Conclusions. Respondents’ views on influenza vaccination were in line with literature data on the approach to immunizations in the cold season and the risks and benefits of such campaigns. Regarding the effects of the change in the regulations governing the flu vaccination campaign in Romania, a survey should also be conducted at the end of the 2023-2024 cold season. [ABSTRACT FROM AUTHOR]

Copyright of Saudi Medical Journal is the property of Saudi Medical Journal and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: The association between inactivated influenza vaccination and viral load in young children remains unclear. Methods: During the 2013/2014 to 2017/2018 influenza seasons in Japan, children under 6 years of age with pre‐defined influenza‐like illness and influenza‐positive status by real‐time RT‐PCR were recruited at pediatric clinics for this observational study. Influenza viral load was measured for the most predominant subtype/lineage in each season. Using median dichotomized viral load as an outcome, a multilevel logistic regression model was applied to estimate the multivariable adjusted odds ratio (MOR) and 95% confidence interval (CI) for higher viral load. Results: A total of 1,185 influenza‐positive children were analyzed. The median log10 viral load copy number (copies per milliliter) was 5.5 (interquartile range, 4.6 to 6.1) and did not differ by vaccination status: 5.5 for unvaccinated, 5.7 for one dose, and 5.5 for two doses (p = 0.67). The MOR of vaccinated (one or two doses) versus unvaccinated children was 1.19 (95% CI: 0.86–1.64). Other factors showing significant associations with higher viral load were positive results for A(H1N1)pdm09 and A(H3N2) in comparison with B/Yamagata. The respective MORs were 3.25 (95% CI: 2.28–4.64) and 1.81 (95% CI: 1.32–2.49). Significantly elevated MORs against higher viral load were also observed for higher body temperature at influenza diagnosis and shorter duration from fever onset to specimen collection. Conclusion: No association was observed between inactivated‐influenza vaccination and viral load at influenza‐positive diagnosis. Influenza subtype/lineage, body temperature, and time elapsed since fever onset were significantly associated with viral load. [ABSTRACT FROM AUTHOR]

Although influenza vaccines are safe and efficacious, vaccination rates have remained low globally. Today, with the advent of new media, many individuals turn to social media for personal health questions and information. However, misinformation may be rife, and health communications may be suboptimal. This study, therefore, aimed to investigate the public messaging related to influenza vaccines by organizations over Twitter, which may have a far-reaching influence. The theoretical framework of the COM-B (capacity, opportunity, and motivation component of behavior) model was used to interpret the findings to aid the design of messaging strategies. Employing search terms such as "flu jab", "flu vaccine", "influenza vaccine", and '" influenza jab", tweets posted in English and by organizations from 1 January 2017 to 1 March 2023 were extracted and analyzed. Using topic modeling, a total of 235,261 tweets by organizations over Twitter were grouped into four main topics: publicizing campaigns to encourage influenza vaccination, public education on the safety of influenza vaccine during pregnancy, public education on the appropriate age to receive influenza vaccine, and public education on the importance of influenza vaccine during pregnancy. Although there were no glaring pieces of misinformation or misconceptions, the current public messaging covered a rather limited scope. Further information could be provided about influenza and the benefits of vaccination (capability), promoting community, pharmacist-led influenza vaccination, and other avenues (opportunity), and providing greater incentivization and support for vaccination (motivation). [ABSTRACT FROM AUTHOR]

Abstract Age-related declines in immune response pose a challenge in combating diseases later in life. Influenza (flu) infection remains a significant burden on older populations and often results in catastrophic disability in those who survive infection. Despite having vaccines designed specifically for older adults, the burden of flu remains high and overall flu vaccine efficacy remains inadequate in this population. Recent geroscience research has highlighted the utility in targeting biological aging to improve multiple age-related declines. Indeed, the response to vaccination is highly coordinated, and diminished responses in older adults are likely not due to a singular deficit, but rather a multitude of age-related declines. In this review we highlight deficits in the aged vaccine responses and potential geroscience guided approaches to overcome these deficits. More specifically, we propose that alternative vaccine platforms and interventions that target the hallmarks of aging, including inflammation, cellular senescence, microbiome disturbances, and mitochondrial dysfunction, may improve vaccine responses and overall immunological resilience in older adults. Elucidating novel interventions and approaches that enhance immunological protection from vaccination is crucial to minimize the disproportionate effect of flu and other infectious diseases on older adults.

Objectives: We evaluated differences in vaccination rates of patients of teaching and private practices, and explored the rate of vaccine hesitancy in pregnant women. Methods: This was a cross-sectional study of a convenience sample of recently delivered women. Women completed a survey, which included a question about whether they received the influenza and/or Tdap vaccine, and a vaccine hesitancy scale for both influenza and Tdap vaccines. We also reviewed prenatal records to confirm vaccine administration and collected demographic data. Patients who received care on the teaching service (care by residents supervised by faculty) were compared with those who received care from 26 private practitioners in nine groups. The primary outcome was rate of vaccination. Fisher's exact test was performed to compare groups. Results: Of the 231 women approached, 208 (90.0%) agreed to participate. Of the 208 participants, 70 (33.7%) had prenatal care with a teaching practice, and 138 (66.3%) with a private practice. Patients of teaching practices had a higher influenza and Tdap vaccination rate compared with patients of private practices (Influenza: 70% versus 54.3%, p = 0.036; Tdap: 77.1% versus 58.4%, p = 0.009). Among the entire cohort, 55.3% had some degree of vaccine hesitancy. This did not differ between teaching and private practices (54.3% versus 55.8%, p = 0.883). Conclusions: In spite of similar prevalence of vaccine hesitancy, pregnant women cared for in teaching practices had higher vaccination rates than those cared for in private practices. Significance: What is Already Known on this Subject? Prior studies have assessed individual patient characteristics as predictors of influenza and tetanus, diphtheria, and pertussis (Tdap) vaccination in pregnancy, but little is published on the role of provider type. What this Study Adds? Teaching practices had higher vaccination rates in pregnancy than private practices despite similar prevalence of vaccine hesitancy between groups. Areas of future research should focus on incorporating evidence-based strategies in practices, particularly private practices, to improve vaccination rates in pregnancy. [ABSTRACT FROM AUTHOR]

There is a critical need to understand vaccine decision-making in high-risk groups. This study explored flu vaccine acceptance among Jordanian parents of diabetic children. Employing a cross-sectional approach, 405 parents from multiple healthcare centers across Jordan were recruited through stratified sampling, ensuring a broad representation of socioeconomic backgrounds. A structured questionnaire, distributed both in-person and online, evaluated their knowledge, attitudes, and acceptance of the flu vaccine for their diabetic children. The results indicated that only 6.4% of the study sample reported vaccinating their children against the flu annually, and only 23% are planning to vaccinate their children this year. A multinomial logistic regression analysis revealed notable variability in responses. Specifically, parents with a positive attitude towards the flu vaccine and those with older children had less odds to reject the vaccine (OR = 0.589, 95% CI (0.518–0.670), p < 0.001 and OR = 0.846, 95% CI (0.736–0.974), p = 0.02, respectively). Conversely, prevalent misconceptions regarding vaccine safety and efficacy emerged as significant barriers to acceptance. Our findings advocate for targeted educational programs that directly address and debunk these specific misconceptions. Additionally, strengthened healthcare communication to provide clear, consistent information about the flu vaccine’s safety and benefits is vital to help enhance vaccine uptake among this vulnerable population, emphasizing the need to address specific concerns and misinformation directly.

Relevance. Seasonal flu vaccination is still the most effective way to protect against flu viruses and help to reduce the burden of flu illnesses. Another possible benefit is the impact of yearly vaccines on severity of breakthrough infection. In this regard, the issue of choosing safe vaccine with high immunogenicity becomes relevant.Aims. To evaluate the prophylactic efficacy of inactivated seasonal flu vaccines (quadrivalent subunit vaccine with adjuvant and trivalent vaccine) and reactogenicity of quadrivalent vaccine.Materials and methods. 491 cases were included in our study: 152 cases received adjuvanted quadrivalent subunit flu vaccine «Grippol Quadrivalent», 118 cases received trivalent inactivated flu vaccine and 221 cases who have received no vaccinations during 2018–2019 epidemic season.Results. inactivated vaccines showed high prophylactic efficacy in preventing seasonal influenza. Incidence of influenza and other viral respiratory disease cases was lowest in «Grippol Quadrivalent» group. Breakthrough influenza cases in individuals vaccinated with inactivated vaccine were predominantly mild, no severe cases were reported. The early post-vaccination period in «Grippol Quadrivalent» group showed no variation in adverse events with other vaccines.Conclusion. Adjuvanted quadrivalent subunit flu vaccine was the most efficacious in preventing influenza in 2018–2019 epidemic season.

Summary: Background: The prospective multicentre observational INVIDIa-2 study investigated the clinical effectiveness of influenza vaccination in patients with advanced cancer receiving immune checkpoint inhibitors (ICI). In this secondary analysis of the original trial, we aimed to assess the outcomes of patients to immunotherapy based on vaccine administration. Methods: The original study enrolled patients with advanced solid tumours receiving ICI at 82 Italian Oncology Units from Oct 1, 2019, to Jan 31, 2020. The trial's primary endpoint was the time-adjusted incidence of influenza-like illness (ILI) until April 30, 2020, the results of which were reported previously. Secondary endpoints (data cut-off Jan 31, 2022) included the outcomes of patients to immunotherapy based on vaccine administration, for which the final results are reported herein. A propensity score matching by age, sex, performance status, primary tumour site, comorbidities, and smoking habits was planned for the present analysis. Only patients with available data for these variables were included. The outcomes of interest were overall survival (OS), progression-free survival (PFS), objective response rate (ORR), and disease-control rate (DCR). Findings: The original study population consisted of 1188 evaluable patients. After a propensity score matching, 1004 patients were considered (502 vaccinated and 502 unvaccinated), and 986 of them were evaluable for overall survival (OS). At the median follow-up of 20 months, the influenza vaccination demonstrated a favourable impact on the outcome receiving ICI in terms of median OS [27.0 months (CI 19.5–34.6) in vaccinated vs. 20.9 months (16.6–25.2) in unvaccinated, p = 0.003], median progression-free survival [12.5 months (CI 10.4–14.6) vs. 9.6 months (CI 7.9–11.4), p = 0.049], and disease-control rate (74.7% vs. 66.5%, p = 0.005). The multivariable analyses confirmed the favourable impact of influenza vaccination in terms of OS (HR 0.75, 95% C.I. 0.62–0.92; p = 0.005) and DCR (OR 1.47, 95% C.I. 1.11–1.96; p = 0.007). Interpretation: The INVIDIa-2 study results suggest a favourable immunological impact of influenza vaccination on the outcome of cancer patients receiving ICI immunotherapy, further encouraging the vaccine recommendation in this population and supporting translational investigations about the possible synergy between antiviral and antitumour immunity. Funding: The Federation of Italian Cooperative Oncology Groups (FICOG), Roche S.p.A., and Seqirus.

Age-related declines in immune response pose a challenge in combating diseases later in life. Influenza (flu) infection remains a significant burden on older populations and often results in catastrophic disability in those who survive infection. Despite having vaccines designed specifically for older adults, the burden of flu remains high and overall flu vaccine efficacy remains inadequate in this population. Recent geroscience research has highlighted the utility in targeting biological aging to improve multiple age-related declines. Indeed, the response to vaccination is highly coordinated, and diminished responses in older adults are likely not due to a singular deficit, but rather a multitude of age-related declines. In this review we highlight deficits in the aged vaccine responses and potential geroscience guided approaches to overcome these deficits. More specifically, we propose that alternative vaccine platforms and interventions that target the hallmarks of aging, including inflammation, cellular senescence, microbiome disturbances, and mitochondrial dysfunction, may improve vaccine responses and overall immunological resilience in older adults. Elucidating novel interventions and approaches that enhance immunological protection from vaccination is crucial to minimize the disproportionate effect of flu and other infectious diseases on older adults. [ABSTRACT FROM AUTHOR]

Influenza attack rates among college students are high. However, little is known about the determinants of students' flu vaccine adoption from their own perspectives. To fill this gap, this study aims to investigate barriers and facilitators to college students' flu vaccine adoption. A total of 545 students offered complete answers to an online survey. Thematic analysis was used for analyzing open-ended questions. Students' flu vaccine adoption was hindered by their fear associated with the flu vaccine, lack of pertinent knowledge, perceived lack of necessity, negative social influence, and time constraints and convenience concerns. Students were motivated to adopt the flu vaccine for their interest in self-care, positive experience with the flu vaccine adoption, good flu vaccine habits, and recommendations from trusted sources. Understanding determinants of students' flu vaccine adoption provides the first step in developing tailored health interventions that may increase students' flu vaccine adoption rates. [ABSTRACT FROM AUTHOR]

Background: Infections by Streptococcus pneumoniae and influenza viruses are vaccine-preventable diseases causing great morbidity and mortality. We evaluated pneumococcal and influenza vaccination practices during pre-international travel health consultations., Methods: We evaluated data on pretravel visits over a 10-year period (1 July 2012 through 31 June 2022) from 31 sites in Global TravEpiNet (GTEN), a consortium of US healthcare facilities providing pretravel health consultations. Data were collected using an online structured questionnaire utilized by GTEN providers. We obtained summary statistics and performed multivariable logistic regression models to identify characteristics associated with receiving the vaccinations., Results: At 116 865 pretravel visits, 28 754 (25%) travelers were eligible to receive pneumococcal vaccination and 56 150 (48%) travelers were eligible to receive influenza vaccination. A total of 19 557 (68%) pneumococcal vaccine-eligible travelers were not offered the vaccine at the pretravel visit. Among influenza vaccine-eligible travelers, 8592 (15%) were not offered the vaccine, and an additional 16 931 (30%) travelers declined the vaccine. Influenza vaccine was not available for 8014 (14%) eligible travelers. Nonadministration of the influenza vaccine was most frequent in the months of April through September. Compared to nonacademic centers or centers in the South or Midwest, travelers seen in academic centers or centers in the Northeast were more likely to receive either vaccine., Conclusions: Increasing awareness of global influenza transmission patterns and improving access to routine vaccines at the pretravel encounter may enhance vaccination for respiratory pathogens in departing US international travelers., Competing Interests: Potential conflicts of interest. The authors: No reported conflicts of interest. All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest., (© The Author(s) 2025. Published by Oxford University Press on behalf of Infectious Diseases Society of America.)

Background: Respiratory viral diseases have considerably declined since the COVID-19 outbreak, perhaps through influence by nonpharmaceutical interventions. We conducted a cross-sectional study using the CDC database to compare the pre- vs. post-pandemic flu activity (incidence) between the US states. Our secondary objectives were to estimate the association between flu activity and flu vaccination rates and compare the national trends of flu and RSV activities since the pandemic outbreak. Methods: We estimated the difference between pre-pandemic (April 2019–March 2020) and post-pandemic (April 2020–March 2021) flu activity between individual states using the Wilcoxon signed-rank test. The association between flu activity and immunization rates was also measured. Finally, parallel time trend graphs for flu and RSV activities were illustrated with a time series modeler. Results: The median (IQR) pre-pandemic flu activity was 4.10 (1.38), higher than the post-pandemic activity (1.38 (0.71)) (p-value < 0.001). There was no difference between pre-pandemic (45.50% (39.10%)) and post-pandemic (45.0% (19.84%)) flu vaccine acceptance (p-value > 0.05). Flu activity and vaccination rates were not associated (p-value > 0.05). Flu activity has declined since the COVID-19 outbreak, while RSV made a strong comeback in June 2021. Conclusion: Flu activity has significantly diminished throughout the pandemic while a sudden upsurge in RSV is a public health concern indicative of possible resurgence of other viruses. Flu vaccine acceptance neither changed during the pandemic nor influenced the diminished Flu activity.

Although influenza vaccines are safe and efficacious, vaccination rates have remained low globally. Today, with the advent of new media, many individuals turn to social media for personal health questions and information. However, misinformation may be rife, and health communications may be suboptimal. This study, therefore, aimed to investigate the public messaging related to influenza vaccines by organizations over Twitter, which may have a far-reaching influence. The theoretical framework of the COM-B (capacity, opportunity, and motivation component of behavior) model was used to interpret the findings to aid the design of messaging strategies. Employing search terms such as “flu jab”, “flu vaccine”, “influenza vaccine”, and ‘“ influenza jab”, tweets posted in English and by organizations from 1 January 2017 to 1 March 2023 were extracted and analyzed. Using topic modeling, a total of 235,261 tweets by organizations over Twitter were grouped into four main topics: publicizing campaigns to encourage influenza vaccination, public education on the safety of influenza vaccine during pregnancy, public education on the appropriate age to receive influenza vaccine, and public education on the importance of influenza vaccine during pregnancy. Although there were no glaring pieces of misinformation or misconceptions, the current public messaging covered a rather limited scope. Further information could be provided about influenza and the benefits of vaccination (capability), promoting community, pharmacist-led influenza vaccination, and other avenues (opportunity), and providing greater incentivization and support for vaccination (motivation).

(1) Background: vaccination is the most effective way to prevent influenza and reduce its complications. The main aim of the study is to assess a possible increase of parents'/caregivers' pediatric flu vaccination adherence due to a nasal administration as an alternative to injection in Bologna. (2) Methods: 169 parents/guardians of children who were joining the COVID-19 pediatric vaccination session in Bologna were interviewed. The results were summarized using descriptive statistics. A multiple logistic regression model was used to assess the determinants of the change in flu vaccine uptake if offered without injection administration. All analyses were conducted using STATA and R-Studio software. (3) Results: Only 29.0% of parents were informed about pediatric flu vaccination by pediatricians, and 32.5% heard about pediatric flu vaccination. Almost 72.2% of parents declared that they would not have their children vaccinated against influenza. Thus, 40.2% of them changed their opinion after being informed about the existence of a non-injective vaccine. Needle fear in children turned out to be a determinant of this opinion change (OR = 3.79; 95% CI = 1.63–9.43; p = 0.003). (4) Conclusions: the study has confirmed that needle fear is a determinant of vaccine hesitancy and that a different method of administration may increase parents'/guardians' adherence. [ABSTRACT FROM AUTHOR]

New influenza vaccines that provide effective and broad protection are desperately needed. Live attenuated viruses are attractive vaccine candidates because they can elicit both humoral and cellular immune responses. However, recent formulations of live attenuated influenza vaccines (LAIVs) have not been protective. We combined high-coverage transposon mutagenesis of influenza virus with a rapid high-throughput screening for attenuation to generate W7-791, a live attenuated mutant virus strain. W7-791 produced only a transient asymptomatic infection in adult and neonatal mice even at doses 100-fold higher than the LD50 of the parent strain. A single administration of W7-791 conferred full protection to mice against lethal challenge with H1N1, H3N2, and H5N1 strains, and improved viral clearance in ferrets. Adoptive transfer of T cells from W7-791-immunized mice conferred heterologous protection, indicating a role for T cell-mediated immunity. These studies present an LAIV development strategy to rapidly generate and screen entire libraries of viral clones.

• A global pandemic can create challenges in implementing mass vaccination. • Drive-thru point of distribution can be utilized strategically for health care employee vaccination. • A Drive-Thru "Flu-POD" was well received among employees in a Veterans Affairs Medical Center. The Advisory Committee on Immunization Practices recommends all healthcare practitioners and hospital staff receive an annual influenza vaccination. Many challenges were noted in achieving this goal; especially during the last 2 influenza seasons throughout the COVID-19 pandemic. Over the past 3 years our institution has implemented a Drive-Thru fixed Point of Distribution (POD) event for this purpose. Drive-Thru PODs can be a safe and effective strategy for employee vaccination during a pandemic. [ABSTRACT FROM AUTHOR]

Background: Countries launch vaccination programs to ensure vaccination coverage as part of the global health security. Special populations including patients with severe mental illness are under average vaccination rate. We aimed to improve the percentage of long-term patients in Qatar's mental health services who received their routine vaccination by the end of 2020 from a baseline rate of 10% to 90% from all vaccination types needed. Methods: This was an interrupted time series quality improvement project using two structured Plan-Do-Study-Act cycles to test the success of the outcome and process measures to reach the desired aim. Run charts were utilized to display the monthly vaccination rates as an outcome measure and the rate of vaccination refusals by the patients as a process measure. A multidisciplinary team was assembled. Root cause analysis was performed. Prioritizations for certain types of vaccines to be given were done. Results: We identified 50 eligible patients. Throughout 12 months, we reached a final vaccination rate of 92%. Number need to treat was used to express the effect size and was calculated as 1.2. Refusals to vaccinations by patients dropped from 41% at the start of the project to only 4% by the end. Conclusion: High vaccination rates over a 12-month period can serve as an indication for the success of the intervention. Sustainability of the results can be achieved by multiple strategies. These results may be useful to hospitals considering vaccine implementation or those currently struggling with implementation barriers.

(1) Background: The World Health Organization (WHO) and the Centers for Disease Control and Prevention (CDC) recommend that every person aged six months and over receive the influenza vaccine every year. Previous studies indicate that rural-area residents have less access to preventative health care services. This study aims to examine the variation in influenza vaccine use among rural and urban counties in Florida. (2) Methods: The study studied 24,116 participants from the Behavioral Risk Factor Surveillance System database. The study included only patients who live in Florida. We performed logistic regression analysis using survey procedures available in SAS®. Our regression model assessed the association between receiving the influenza vaccine and county status, age, income level, education level, and health coverage. We used ArcGIS software to create prevalence and vaccination maps. (3) Results: Of the total number of the study participants, 45.31% were residents of rural counties, and 54.69% were residents of urban counties. The logistic regression model showed no significant association between residing in rural counties and not receiving influenza vaccine in the past year (−0.05560, p-value = 0.0549). However, we found significant associations between not receiving influenza vaccine and age, high education level, and not having health care coverage (−0.0412, p-value < 0.0001; −0.04462, p-value = 0.0139; and 0.4956, p-value < 0.0001, respectively). (4)Conclusions: Our study did not find an association between influenza vaccine use among rural and urban residence. Increasing age, higher education, and having health care insurance had positive associations with influenza vaccine use. [ABSTRACT FROM AUTHOR]

• Antibody responses and protection to a cHA-based universal influenza virus vaccine declines with advanced age. • Age-associated decline in antibody responses and protection is more prominent in females than males. • Serum from vaccinated adult mice is not sufficient to protect naïve aged, sex-matched mice. • Age and sex should be considered in preclinical and clinical studies with universal influenza virus vaccines. To determine if biological sex and age intersect to affect universal influenza vaccine-induced immunity, adult and aged male and female C57BL/6 mice were sequentially immunized with a chimeric-hemagglutinin (cHA) stalk-based H1 vaccine. Adult mice developed greater quantity and quality of H1-stalk antibodies, that were more cross-reactive with other group 1, but not group 2, influenza viruses, than aged mice. The vaccine did not induce neutralizing or hemagglutination inhibition antibodies, but rather antibody-dependent cellular cytotoxicity, which was greater in adult than aged mice. Vaccinated adult mice were better protected than aged mice after challenge with 2009 H1N1 virus, experiencing less morbidity and having lower pulmonary virus titers. The age-associated decline in immunity and protection was consistently greater among females than males, with the reduction in immunity and protection for aged as compared with adult females often being the sole comparison driving the overall age-associated significant differences. The age-associated reduction in stalk-based immunity in females was not, however, associated with changes in estradiol. To determine if the better antibodies in adults could be utilized to protect aged mice, serum was passively transferred from vaccinated adult mice into naïve sex-matched aged mice. Even with transferred serum from young adult mice, aged females still suffered greater morbidity than aged males. These data suggest there are sex-dependent effects of aging on cHA-based universal influenza virus vaccine-induced immunity that cannot be reversed through transfer of serum from young animals. The lack of consideration of sex-specific effects of aging on immunity could hinder efforts toward universal vaccines. [ABSTRACT FROM AUTHOR]

Despite the mass availability of COVID-19 vaccines in the United States, many Americans are still reluctant to take a vaccine as an outcome from exposure to misinformation. Additionally, while scholars have paid attention to COVID-19 vaccine hesitancy, the influence of general vaccine hesitancy for important viruses such as the flu has largely been ignored. Using nationally representative data from Pew Research Center’s American Trends Panel survey (Wave 79), this study examined the relationship between perceived misinformation exposure, COVID-19 vaccine hesitancy, flu vaccine acceptance, political ideology, and demographic trends. The findings suggest that those who accepted the flu vaccine were less likely to be COVID-19 vaccine-hesitant. In addition, moderation analyses showed that perceived misinformation exposure increases COVID-19 vaccine hesitancy for conservatives and moderates but not for liberals. However, perceived misinformation exposure influences COVID-19 vaccine hesitancy among conservatives only if they are also flu vaccine-hesitant. Perceived misinformation exposure has no role in COVID-19 vaccine hesitancy if individuals (irrespective of political ideology) are regular with their flu vaccine. The results suggest that the effect of misinformation exposure on negative attitudes toward COVID-19 may be associated with generalized vaccine hesitancy (e.g., flu). The practical and theoretical implications are discussed.

The article addresses the challenges and interventions related to influenza vaccination in the Philippines, emphasizing the rising cases and vaccine hesitancy. It highlights barriers such as limited awareness, perceived low risk and the aftermath of the Dengvaxia controversy, proposing comprehensive awareness campaigns and budget allocation as interventions to improve vaccination rates.

Background: Respiratory viral diseases have considerably declined since the COVID-19 outbreak, perhaps through influence by nonpharmaceutical interventions. We conducted a cross-sectional study using the CDC database to compare the pre- vs. post-pandemic flu activity (incidence) between the US states. Our secondary objectives were to estimate the association between flu activity and flu vaccination rates and compare the national trends of flu and RSV activities since the pandemic outbreak. Methods: We estimated the difference between pre-pandemic (April 2019–March 2020) and post-pandemic (April 2020–March 2021) flu activity between individual states using the Wilcoxon signed-rank test. The association between flu activity and immunization rates was also measured. Finally, parallel time trend graphs for flu and RSV activities were illustrated with a time series modeler. Results: The median (IQR) pre-pandemic flu activity was 4.10 (1.38), higher than the post-pandemic activity (1.38 (0.71)) (p-value < 0.001). There was no difference between pre-pandemic (45.50% (39.10%)) and post-pandemic (45.0% (19.84%)) flu vaccine acceptance (p-value > 0.05). Flu activity and vaccination rates were not associated (p-value > 0.05). Flu activity has declined since the COVID-19 outbreak, while RSV made a strong comeback in June 2021. Conclusion: Flu activity has significantly diminished throughout the pandemic while a sudden upsurge in RSV is a public health concern indicative of possible resurgence of other viruses. Flu vaccine acceptance neither changed during the pandemic nor influenced the diminished Flu activity. [ABSTRACT FROM AUTHOR]

Developing influenza vaccines that protect against a broad range of viruses is a global health priority. Several conserved viral proteins or domains have been identified as promising targets for such vaccine development. However, none of the targets is sufficiently immunogenic to elicit complete protection, and vaccine platforms that can enhance immunogenicity and deliver multiple antigens are desperately needed. Here, we report proof-of-concept studies for the development of next-generation influenza vaccines using the bacteriophage T4 virus-like particle (VLP) platform. Using the extracellular domain of influenza matrix protein 2 (M2e) as a readout, we demonstrate that up to ~1,281 M2e molecules can be assembled on a 120 x 86 nanometer phage capsid to generate M2e-T4 VLPs. These M2e-decorated nanoparticles, without any adjuvant, are highly immunogenic, stimulate robust humoral as well as cellular immune responses, and conferred complete protection against lethal influenza virus challenge. Potentially, additional conserved antigens could be incorporated into the M2e-T4 VLPs and mass-produced in E. coli in a short amount of time to deal with an emerging influenza pandemic.

Developing influenza vaccines that protect against a broad range of viruses is a global health priority. Several conserved viral proteins or domains have been identified as promising targets for such vaccine development. However, none of the targets is sufficiently immunogenic to elicit complete protection, and vaccine platforms that can enhance immunogenicity and deliver multiple antigens are desperately needed. Here, we report proof-of-concept studies for the development of next-generation influenza vaccines using the bacteriophage T4 virus-like particle (VLP) platform. Using the extracellular domain of influenza matrix protein 2 (M2e) as a readout, we demonstrate that up to ~1,281 M2e molecules can be assembled on a 120 x 86 nanometer phage capsid to generate M2e-T4 VLPs. These M2e-decorated nanoparticles, without any adjuvant, are highly immunogenic, stimulate robust humoral as well as cellular immune responses, and conferred complete protection against lethal influenza virus challenge. Potentially, additional conserved antigens could be incorporated into the M2e-T4 VLPs and mass-produced in E. coli in a short amount of time to deal with an emerging influenza pandemic. [ABSTRACT FROM AUTHOR]

Background: In the United States, millions of people contract the flu each year. Immunization has been shown to provide the best protection against the flu. Increasing flu vaccination rates can reduce the number of patients who get the flu and seek care for non-specific symptoms thus making detection of the coronavirus more efficient. Method: A quality improvement project was implemented to increase the number of influenza vaccines received by employees at an onsite employer-based health clinic. Anonymous pre- and post-surveys were used to assess the flu knowledge of employees. Employees from a large financial group, who voluntarily participated, received an educational handout at the onsite health fair or at a lunch and learn. Full-time employees who carried their employer's health insurance were eligible to participate, whereas, dependents and contract employees were excluded. Findings: The number of employees who received the vaccination increased during the fall of 2019 (n = 406) when compared with the previous year (n = 337). Nineteen percent (n = 170) of employees completed surveys. There were statistically significantly more post- than pre-survey responses reflecting the participants' perceived knowledge of influenza and the flu vaccine. The majority of participants in both the pre- and post-surveys reported that they learned "a lot" about both influenza and the flu vaccine. Conclusion: Providing education and access to the vaccine in the workplace may improve flu knowledge, reduce barriers, and increase flu vaccine uptake among employees. [ABSTRACT FROM AUTHOR]

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Effective vaccination is based on three critical aspects of the B-cell response towards infectious agents: (i) that B-cells can generate specific antibodies towards a vast molecular diversity of antigens; proteins, sugars, DNA and lipids. There seems to be no limit to the ability to raise antibodies to everything. (ii) once stimulated, B-cells can perfect their antibodies through affinity maturation to complement every nook and cranny of the epitope and (iii) that the pathogen remains genetically stable and does not change to any great extent. Thus, antibodies produced against the vaccine and subsequent boosts recognize the viral virulent field isolates in future encounters and effectively knock them out. However, some vaccine targets, such as flu virus and HIV, are extremely genetically dynamic. The rapid genetic drift of these viruses renders them moving targets which assist in their ability to evade immune surveillance. Here we postulate that in the case of hyper-variable pathogens the B-cell response actually might be “too good”. We propose that restricting B-cell activities may prove effective in counteracting the genetic diversity of variant viruses such as flu and HIV. We suggest two levels of “B-cell restriction”: (i) to focus the B-cell response exclusively towards neutralizing epitopes by creating epitope-based immunogens; (ii) to restrict affinity maturation of B-cells to prevent the production of overly optimized exquisitely specific antibodies. Together, these “B-cell restrictions” provide a new modality for vaccine design.

(1) Background: vaccination is the most effective way to prevent influenza and reduce its complications. The main aim of the study is to assess a possible increase of parents’/caregivers’ pediatric flu vaccination adherence due to a nasal administration as an alternative to injection in Bologna. (2) Methods: 169 parents/guardians of children who were joining the COVID-19 pediatric vaccination session in Bologna were interviewed. The results were summarized using descriptive statistics. A multiple logistic regression model was used to assess the determinants of the change in flu vaccine uptake if offered without injection administration. All analyses were conducted using STATA and R-Studio software. (3) Results: Only 29.0% of parents were informed about pediatric flu vaccination by pediatricians, and 32.5% heard about pediatric flu vaccination. Almost 72.2% of parents declared that they would not have their children vaccinated against influenza. Thus, 40.2% of them changed their opinion after being informed about the existence of a non-injective vaccine. Needle fear in children turned out to be a determinant of this opinion change (OR = 3.79; 95% CI = 1.63–9.43; p = 0.003). (4) Conclusions: the study has confirmed that needle fear is a determinant of vaccine hesitancy and that a different method of administration may increase parents’/guardians’ adherence.

The flu is a constant threat that can sometimes cause severe forms of disease. The highest incidence rates by age group occur in children under 15 years of age, especially in those under 5 years, in whom the rate of hospitalization is also similar to the population aged 65 years and older. In addition, children are the main transmitters of the infection. In Spain, 5 influenza vaccines are authorized for the paediatric age group: three inactivated tetravalent vaccines harvested from fertilised eggs, one tetravalent inactivated vaccine obtained from cell cultures and one attenuated tetravalent vaccine for intranasal administration, which will become trivalent in the 2024-2025 season by excluding the B Yamagata lineage as recommended by the WHO. The CAV-AEP recommends systematic vaccination in children aged 6-59 months, children and adolescents belonging to risk groups, people who can transmit the flu to groups at risk of complicated flu, and household contacts or close family of infants under 6 months. From 2 years of age, the intranasal attenuated vaccine is preferred due to its greater acceptability and thus contribution to greater vaccination coverage. The CAV-AEP also considers that vaccination against influenza of healthy children and adolescents aged 5-18 years is advisable, as it provides individual protection and promotes protection at the family and community levels. It is especially important to vaccinate all health care professionals against influenza as well as pregnant women at any time during pregnancy., (Copyright © 2024 Asociación Española de Pediatría. Published by Elsevier España, S.L.U. All rights reserved.)

The aim of the study was to study the efficacy, safety and immunogenicity of trivalent split influenza vaccine in patients with rheumatoid arthritis (RA), ankylosing spondylitis (AS), systemic scleroderma (SSD). Material and methods. Ninety three patients were enrolled in the study, including 52 patients with RA, 34 with AS, 7 with SSD, and also 40 persons without rheumatic diseases (RD) (control group). At the time of enrolment, all patients received RD drug therapy. The duration of RD was from 2 months up to 46 years. Vaxigrip vaccine, which included the actual strains of influenza virus for the 2016-2017 or 2017-2018 seasons was administered subcutaneously in the amount of 1 dose (0.5 ml) against the backdrop of continuing RD therapy. The main stages of control were visits at 1-, 3- and 6-month intervals after vaccination. Standard clinical and laboratory tests, a clinical examination of the patient and assessment of disease activity were performed during the visits. Immunogenicity of the vaccine was evaluated at each stage of the control procedure using the commercial ELISA kits manufactured by PPDP LLC (St. Petersburg). Results. No cases of influenza or influenza-like illness were recorded during the entire period of observation. 81% of patients had no post-vaccination reactions in the RD group. Pain, swelling and hyperaemia of the skin with a diameter of up to 2 cm at the injection site were reported in 14% of cases and subfebrility, myalgia, malaise, headache in 5% of cases. The frequency of postvaccinal reactions among patients was not significantly different from that in the control group. There were no cases of exacerbation of RD or the occurrence of any new autoimmune disorders. The parameters of the humoral immune response in patients with RD did not significantly differ from those in the control group. Conclusion. The obtained data testify about good clinical efficacy and tolerability of trivalent split influenza vaccine in patients with RD.