Background: The adjuvanted recombinant zoster vaccine (RZV), consisting of varicella-zoster virus glycoprotein E (gE) and the AS01B adjuvant system, effectively prevents herpes zoster (HZ). In the absence of a well-defined correlate of protection, it is important to monitor the RZV immune response, as a proxy of clinical effectiveness. Methods: This systematic review examined post-vaccination parameters: humoral and cell-mediated immunity, avidity index, geometric mean concentration of antibody (GMC), and immunity persistence. The meta-analysis used a random-effects model, and subgroup and meta-regression analyses were conducted. Results: Among 37 included articles, after one month from RZV-dose 2, the pooled response rate for anti-gE humoral immunity was 95.2% (95%CI 91.9–97.2), dropping to 77.6% (95%CI 64.7–86.8) during immunosuppression. The anti-gE cell-mediated immunity-specific response reached 84.6% (95%CI 75.2–90.9). Varying factors, such as age, sex, coadministration with other vaccines, prior HZ, or live-attenuated zoster vaccine, did not significantly affect response rates. RZV induced a substantial increase in gE avidity. Immunity persistence was confirmed, with more rapid waning in the very elderly. Conclusions: This systematic review indicates that RZV elicits robust immunogenicity and overcomes immunocompromising conditions. The findings underscore the need for further research, particularly on long-term immunity, and have the potential to support HZ vaccination policies and programs.
The successful deployment of safe and effective vaccines against coronavirus disease 2019 (COVID-19) has been crucial in reducing the global disease burden. Owing to the need for vaccination series over time, continuous observational studies are needed to estimate the COVID-19 vaccine response in real-world conditions. In particular, the detection, assessment, and understanding of adverse effects following immunization (AEFI) with a COVID-19 vaccine are crucial to better address vaccination strategies. Therefore, this study aimed to investigate the risk of repeated AEFI post-administration of a booster dose of mRNA COVID-19 vaccine in a sample of healthcare workers (HCWs) in an Italian teaching hospital. The data on any local and systemic AEFI were studied in multivariate Poisson regression analyses to model the association between the incidence of each postvaccination symptom and its prior reporting after the administration of the previous doses. Overall, compared with the primary vaccination series, the majority of post-third dose AEFI were less reported. The results from multivariable models showed that the likelihood of reporting an AEFI after the third dose was higher in those who experienced the same postvaccination symptom after the second dose (all AEFI except for itch at injection site) and, although not significant for all AEFI, after the first dose. Any associations with age, gender, smoking habits, previous SARS-CoV-2 infection and other characteristics, as well as the health impact of AEFI were also assessed. Taken together, the results from this research support reframe AEFI symptoms as signals of a robust postvaccination reaction as well as of common vaccine response, and they add important data to inform booster vaccination strategies in HCWs and, extensively, in the adult population.
As respiratory syncytial virus (RSV) vaccine distribution gains traction in Europe and Italy, healthcare workers (HCWs) can strategize about vaccine promotion to increase uptake among patients at risk of RSV consequences, such cardiac patients. This cross-sectional survey investigated the knowledge about and attitude towards RSV and RSV vaccines, and the intention to recommend vaccination within a cardiological hospital in Italy. To explore factors associated with the outcomes of interest, multivariate logistic regression analyses were conducted. Of 197 invited HCWs, 78.2% returned the survey. The knowledge about market authorisation for new RSV vaccines for older adults (present in 46.9% of respondents) was significantly associated with the HCWs’ age, education, and previous update on vaccinations. HCWs with a higher educational level and those with a positive attitude towards RSV vaccines safety reported a higher attitude towards the importance of vaccinating people at risk. The willingness of recommending RSV vaccination to patients (70.5% of respondents) was more likely in HCWs who were knowledgeable about market authorisation for RSV vaccines and in physicians. This tempestive research sheds light on current factors influencing the strategies of cardiac HCWs regarding RSV vaccination. The results suggest the need for training events on the protective role of RSV vaccination in cardiac patients.
Background and Objectives: Cardiac patients are particularly at risk of herpes zoster (HZ), which is associated with a higher risk of major cardiovascular events. This research aimed to analyze the knowledge, attitudes and practices towards recombinant zoster vaccine (RZV) among cardiac healthcare professionals (HPs). Materials and Methods: A cross-sectional survey was conducted in a cardiological hospital in Italy. Multivariate regression models were built to identify factors associated with the outcomes of interest. Results: The response rate was 78.2% (154/197). Overall, age > 50 years and immunosuppression were recognized as risk factors for HZ by 38.3% and 75.3% of respondents, respectively. Regarding RZV, 29.1% of the HPs correctly responded about its schedule and 57.6% about the possibility of administration in immunocompromised individuals. This knowledge was significantly higher in HPs with a higher educational level (odds ratio (OR) = 4.42; 95%CI 1.70–11.47), in those who knew that HZ could cause postherpetic neuralgia (OR = 2.56; 95%CI 1.05–6.25) or major cardiovascular events (OR = 4.23; 95%CI 1.50–11.91), in those who had participated in professional updates on vaccinations (OR = 3.86; 95%CI 1.51–9.87) and in those who stated the need for further information about the RZV (OR = 6.43; 95%CI 1.42–29.98). Younger HPs (coefficient (β) = −0.02; 95%CI −0.04–−0.01), those with a positive attitude toward RZV safety (β = 2.92; 95%CI 2.49–3.36) and those who had previously cared for patients with HZ (β = 0.45; 95%CI 0.03–0.88) reported a more positive attitude toward RZV effectiveness. The practice of recommending vaccination was more prevalent in younger HPs (OR = 0.94; 95%CI 0.89–0.99), in those who had a master’s degree or higher education (OR = 7.21; 95%CI 1.44–36.08), in those with more positive attitudes toward RZV effectiveness (OR = 7.17; 95%CI 1.71–30.03) and in HPs who had already recommended the vaccine to patients in the past (OR = 4.03; 95%CI 1.08–14.96). Conclusions: Despite being a single-center study, our research brings attention to factors that currently impact cardiac HPs’ approaches to RZV. The findings indicate potential measures to enhance HPs’ awareness and practices, ultimately aiming to improve vaccination adherence and reduce the burden associated with HZ.
Greenhouse gas emissions and air pollution are closely interconnected environmental challenges with major implications for human health and global sustainability. Many of the activities that drive climate change also release pollutants such as nitrogen dioxide, sulphur dioxide, carbon monoxide, and particulate matter, which directly affect air quality and population health. This review synthesises current evidence on the main sources of greenhouse gas emissions and atmospheric pollutants, the atmospheric processes that influence air quality, and the epidemiological evidence linking air pollution exposure to adverse health outcomes. The paper also discusses the public health co-benefits of climate mitigation strategies, including the transition to cleaner energy systems, sustainable transport policies, and urban environmental interventions. Finally, the review places air pollution and climate change within the broader framework of human security, highlighting their implications for health security, environmental stability, food systems, and economic resilience. By integrating perspectives from environmental epidemiology, public health, and global environmental governance, this review provides a multidisciplinary overview of the links between greenhouse gas emissions, air quality, and human well-being, and underscores the importance of coordinated policy responses to address these interconnected challenges.