The study aims to determine the seroprevalence of antibodies against tetanus among healthy people aged 1–59 years old in Shaanxi province. IgG against tetanus in serum samples were detected by ELISA. 6,439 subjects were enrolled. The positive rate (≥0.01 IU/mL) was 84.39% and GMC was 0.03 IU/mL. There were significant differences in positive rates (χ² = 308.944, p < 0.01) and GMC (Z = 5,200,000, p < 0.01) among different age groups. The positive rates (χ² = 304.3, p < 0.01) and GMCs (χ² = 146.417, p < 0.01) showed regional differences. Both full protection rate (≥0.1 IU/mL) (χ² = 36.834, p < 0.01) and GMC (Z = 688,000, p < 0.01) increased with the doses of tetanus-toxoid-containing vaccines (TTCVs) administered. The positive rate (χ² = 54.136, p < 0.01) and GMC (Z = 140,200, p < 0.01) decreased gradually with the time interval after full immunization with TTCVs. The full protection rate (≥0.1 IU/mL) (χ² = 176.201, p < 0.01) and GMC (Z = 629,900, p < 0.01) decreased with the interval (years) since the last dose of TTCVs. There were significant differences in the positive rates and GMCs for different ages, regions, immunization histories of TTCVs, and doses of TTCVs administered. The full protection rate and GMC decreased with the interval following full immunization with TTCVs and the interval since the last dose of TTCVs. The importance of using tetanus booster doses should be emphasized in adolescents and adults.

Backgrounds: The goal of this study is to explore the transmission dynamics for recent large-scale COVID-19 outbreaks in Shaanxi Province on the Chinese mainland. Furthermore, the potential effects of the Spring Festival travel rush on the ongoing COVID-19 pandemic were depicted. Methods: This study uses baseline data from a large cohort to investigate the characteristics of the recent COVID-19 epidemic in Shaanxi province. A cluster sampling method was used to recruit the study participants during the COVID-19 pandemic in Shaanxi province since Dec. 1 ^st , 2022. A total of 44 sampling cluster (11 village in rural areas and 33 residences in urban areas) were chosen for enrollment of study participants. A self-developed questionnaire was applied to data collection of socio-demographic and COVID-19 pandemic related information. Results: A total of 14,744 study participants were enrolled in the baseline survey and 12,111 completed survey data were extracted for analysis. The cumulative infection attack rate (IAR) of COVID-19 among the study participants was 84.7%. The cumulative IAR in urban and rural areas were 85.6% and 83.7%, respectively. A peak of COVID-19 self-reported diagnosis could be observed from Dec. 15 ^th , 2022 to Jan. 1 ^st , 2023 in the provincial level. Beside this major peak of the recent epidemic (around Dec.20 ^th , 2022), a small but steep rise could also be identified between Jan 13 ^th to 14 ^th , 2023. Individuals who escaped the first wave of COVID-19 outbreaks may face danger of infection from returnees during the 2023 Spring Festival. Conclusion: According to the COVID-19 cumulative IAR data, the herd community was primarily achieved in Shaanxi province’s urban and rural areas. The epidemic in Shaanxi province has been exacerbated by mass population movement during the Spring Festival travel rush in both urban and rural areas. Further surveillance should be performed to monitor the spread of SARS-CoV-2 infections.

Aim: We aimed to investigate the differences in clinical features (specifically, patterns of symptoms) of the COVID-19 patients in the early and late stage of this large scale COVID-19 outbreak in Shaanxi Province in China based on data from a large scale survey. Methods: This study used baseline data from a large survey to investigate the characteristics of the COVID-19 pandemic in Shaanxi province from Dec.2022 to Jan. 2021. A total of 44 sampling clusters (11 villages in rural areas and 33 residential urban areas) were chosen for enrollment of study participants. A self-developed questionnaire was applied to data collection. A total of 14,744 individuals were included, and data from 12,111 valid participants were collected for further analysis. The Patients infected before Dec. 15th 2022 were classified as early stage infects patients while those infected after Jan. 1st 2023 as late stage infects patients. Results: Information of 2,854 COVID-19 patients, comprising of 1,710 (16.7%) patients infected during the early stage and 1,144 (11.2%) during the late stage, were extracted from the background survey. Most of the COVID-19 typical symptoms (11 out of 12) were found to be more frequent in COVID-19 patients infected during the early stage compared to those infected during late stage. Nine of them showed statistical significance including fever (χ ² =93.42, P <0.001), cough (χ ² =8.97, P =0.003), muscle or body pain (χ ² =17.57, P<0.001), headache (χ ² =8.28, P =0.004), sore throat (χ ² =10.10, P =0.002), nausea or vomiting (χ ² =8.40, P =0.004), loss of taste or smell (χ ² =45.05, P <0.001) and chills (χ ² =8.17, P =0.004). The significance of most of these symptoms were kept after being adjusted for multiple variables. Conclusion: Individuals infected with the Omicron variant at an earlier stage of a COVID-19 outbreak are more prone to developing certain symptoms compared to those infected at late stage.

Objectives: Hepatitis E virus (HEV) infection is associated with severe hepatitis and high mortality rates, yet vaccination coverage remains suboptimal. Investigating public preferences for HEV vaccination is critical for developing targeted prevention strategies. This study employed a discrete choice experiment (DCE) to quantify attribute preferences and willingness-to-pay (WTP) for HEV vaccination among Chinese residents (in Shaanxi Province, for example), aiming to inform evidence-based immunization policy optimization. Methods: A cross-sectional survey recruited 3300 participants using stratified random sampling. The vaccine attributes—protective efficacy, duration of protection, and out-of-pocket cost—were identified using a systematic literature review and expert consultation. A comparative analysis of preference characteristics was conducted using conditional logit (Model 1) and mixed logit (Model 2) regression models. Population heterogeneity in vaccination preferences was further analyzed using the conditional logit framework, with marginal WTP estimated using parameter coefficients. Results: Among 3199 valid responses, duration of protection (Model 2: 10-years; β = 0.456, p < 0.001) and out-of-pocket cost (Model 2: 2000–3000 CNY; β = −0.179, p < 0.001) significantly influenced vaccination decisions. Preference heterogeneity was observed: women of childbearing age prioritized longer protection (10 years; β = 0.677, p < 0.001) and were sensitive to the cost of 1000–2000 CNY (β = 0.169, p = 0.011), while urban residents valued extended protection more than rural counterparts. Conclusions: Protection duration emerged as the primary determinant of HEV vaccination preference. Policy recommendations include implementing tiered pricing strategies and targeted health education campaigns emphasizing long-term protection benefits to enhance vaccine uptake and affordability.