Background: A growing number of countries implement prenatal pertussis vaccination policies to safeguard unvaccinated infants. This meta-analysis aimed to evaluate the efficacy, immunogenicity, and safety of antenatal Tdap vaccination in pregnant individuals. Methods: We systematically searched PubMed, Embase, and Web of Science from their inception to 16 February 2025, rigorously screening studies and including seven randomized controlled trials and 10 case-control studies published between 2014 and 2024. For the test-negative design meta-analysis, odds ratios with 95% confidence intervals served as effect estimates, and vaccine efficacy was calculated accordingly. Standardized mean differences were used to assess geometric mean concentrations, while relative risks evaluated safety. Results: Maternal vaccination during pregnancy demonstrated 85% vaccine effectiveness (95% CI: 78–89%) in protecting infants under 3 months old. Pooled standardized mean differences for cord blood IgG antibodies against pertussis toxin, pertactin, and filamentous hemagglutinin were 1.57 (95% CI: 1.25–1.89), 2.15 (95% CI: 1.82–2.48), and 2.25 (95% CI: 1.81–2.68), respectively, indicating higher antibody levels in infants of vaccinated women before their first immunization. Safety analysis showed no significant association between Tdap vaccination during pregnancy and serious adverse events in infants (RR = 0.76, 95% CI: 0.46–1.24) and pregnant women (RR = 1.22, 95% CI: 0.83–1.81). Conclusion: Our findings support the implementation of pertussis vaccination during pregnancy.

Objectives: To investigate the acceptance and factors influencing acceptance of rubella-containing vaccine (RCV) among women of reproductive age in Guangdong, Henan, Hubei, Liaoning, Shanxi, Sichuan and Zhejiang provinces of China. Methods: Using a stratified sampling method, we selected one urban and one rural community health services center in each of two cities in seven provinces. From these centers, we recruited women 15–49 years of age to complete a questionnaire on their willingness to receive RCV and factors influencing willingness. The survey instrument was adapted from the behavioral and social drivers (BeSD) of vaccination survey tool developed by the World Health Organization. Results: Among 1286 participants, 981 (76.3%) were willing to receive RCV. Awareness of rubella ranged from 12.4% to 70.6%. Willingness to receive RCV differed significantly by region, occupation, vaccination history, and awareness. All latent variables of the structural equation model (SEM) were positively correlated with willingness, and all standardized paths were statistically significant (p < 0.001). Thinking and Feeling had direct positive effects on Social Processes (β = 0.789) and Practical Issues (β = 0.542), thereby indirectly affecting motivation. Conclusions: Women of reproductive age had high willingness to receive the rubella vaccination, but their general awareness of rubella was relatively low. It is necessary to strengthen the health education of women of reproductive age regarding rubella to improve RCV coverage.

Background: This study evaluated vaccine prescription conversion and identified associated factors in Henan Province, China, during 2025. Methods: The study was conducted in Lingbao City, Henan Province. All vaccine prescriptions issued in 2025 were collected, and vaccination status was linked through the Henan Provincial Immunization Information Management System. Subgroup analyses were stratified by vaccine type (NIP vs. non-NIP). Univariate analyses used χ², Mann–Whitney U, and Kruskal–Wallis H tests. Multivariable analyses employed Firth-corrected logistic regression for conversion behavior, and mixed-effects models with random intercepts for patient ID for conversion timeliness, analyzed using a two-part model. All analyses were performed using R software (version 4.5.3). Results: Among 50,887 prescriptions, the overall conversion rate was 13.8%. NIP vaccines had a higher conversion rate than non-NIP vaccines (76.8% vs. 12.5%, p < 0.001) and a higher same-day conversion rate (13.9% vs. 7.4%; χ² = 59.585, p < 0.001), but longer delays among non-same-day conversions (23 vs. 4 days). Manual prescriptions were associated with significantly higher conversion in both NIP (OR = 3.913) and non-NIP (OR = 37.720) subgroups. Vaccination clinics were associated with a nearly 20-fold higher odds (OR = 19.386). Interaction analyses showed manual prescriptions were more strongly associated with conversion and shorter delays in older adults, and had stronger associations with conversion for non-NIP vaccines (χ² = 22.275, p < 0.001). Vaccination clinics were most strongly associated with conversion in children (ΔP = 0.130); however, the improvement in same-day conversion among older adults was relatively smaller, suggesting additional barriers beyond clinic availability may exist in this population. Conclusions: Manual prescriptions and vaccination clinics were associated with higher vaccine prescription conversion, with particularly pronounced effects on non-NIP vaccines. Older adults exhibited the lowest conversion rates. In parallel with promoting electronic prescriptions, co-issuing paper prescriptions is recommended, particularly for non-NIP vaccines and older adults.

Background/Objectives: Dementia represents a major global health challenge, and preventive strategies remain limited. Observational studies have suggested a possible association between herpes zoster vaccination (HZV) and dementia risk, although the influence of vaccine type and dose regimen remains unclear. Methods: PubMed, Embase, and Web of Science were searched through January 2026. The primary random-effects meta-analysis included one adjusted estimate per independent study or data-source cluster. Quasi-experimental and correlated secondary estimates were reported separately, and alternative-estimate and leave-one-out analyses retained independent statistical units. The protocol was registered in PROSPERO (CRD420261326042). Results: Fourteen reports representing 13 studies were included. HZV was associated with a lower dementia risk in the primary analysis of five independent data sources (ratio estimate = 0.72; 95% CI: 0.65–0.81; I² = 97.1%), with similar sensitivity results (0.70–0.76). Two regression-discontinuity studies reported eligibility-associated absolute reductions in dementia diagnosis of 1.3 and 1.8 percentage points. Two direct vaccine comparisons favored the recombinant zoster vaccine (RZV; Shingrix) over the live attenuated vaccine (ZVL; Zostavax) (RMTL ratio = 0.83; 95% CI: 0.80–0.87; RR = 0.82; 95% CI: 0.69–0.98). The only direct dose comparison favored two or more RZV doses over one dose (RR = 0.81; 95% CI: 0.74–0.88). Active-comparator associations were generally attenuated, whereas age- and subtype-specific findings varied. These secondary findings were exploratory. Conclusions: HZV was associated with lower dementia risk in observational studies, with directionally consistent quasi-experimental findings. Direct evidence suggested potentially stronger inverse associations for RZV and complete vaccination, but was based on few independent data sources. Substantial heterogeneity and residual confounding preclude causal interpretation, and further prospective or randomized evidence is needed.

Objectives: To identify factors influencing influenza vaccination willingness and uptake among adults aged ≥60 years in Henan Province and to evaluate the effect of a brief educational intervention on vaccination willingness and behavior. Methods: In September 2024, a cross-sectional survey based on the Behavioral and Social Drivers (BeSD) framework was conducted among adults aged ≥60 years across five counties in Henan. For participants without baseline willingness, a 3 min one-on-one educational intervention was delivered. In May 2025, following the end of the 2024–2025 influenza vaccination season (which runs from 1 October to 31 March in Henan Province), we retrieved vaccination records for all participants from the Henan Provincial Immunization Information System. This system captures all influenza vaccinations administered at designated vaccination clinics across the province. To ensure completeness for doses administered outside the provincial system (e.g., in other provinces or at private healthcare facilities), we conducted telephone follow-up interviews with all participants whose baseline vaccination intention was inconsistent with their actual vaccination behavior (i.e., willing but unvaccinated or unwilling but vaccinated). During these interviews, for those who reported receiving the vaccine outside Henan Province or at private facilities, we inquired about the specific date and location of vaccination to supplement the registry data. We also explored the reasons behind the intention–behavior discrepancy. For these participants, we requested vaccination certificates or other supporting documentation to confirm their vaccination status. Results: Baseline vaccination willingness was 68.20% (1630/2390), whereas the actual vaccination rate was only 6.95% (166/2390), yielding a willingness-to-behavior conversion rate of 9.51% (155/1630) among those with baseline willingness. Of the 760 participants without baseline willingness, 543 (71.45%) completed the 3 min one-on-one instant educational intervention and the follow-up assessment; the remaining 217 were excluded due to refusal or loss to follow-up. Among these 543 completers, 46 (8.47%) became willing to vaccinate, and eight (1.47%) were subsequently vaccinated. Multivariate analysis identified the social processes dimension as the strongest correlate of both willingness (OR = 1.38 per 1-point increase, 95% CI: 1.33–1.44) and uptake (OR = 1.12, 95% CI: 1.03–1.22). Urban residence was associated with higher willingness (OR = 1.41, 95% CI: 1.12–1.78) and higher uptake (OR = 1.64, 95% CI: 1.11–2.42). Current smokers had a significantly lower uptake than never smokers (OR = 0.43, 95% CI: 0.22–0.85). Among the 11 participants without baseline willingness who were eventually vaccinated (eight from the intervention group and three from the non-intervention group), family/friend influence (63.64%, 7/11) and physician recommendation (36.36%, 4/11) were the primary drivers. For those with willingness but no action (n = 1475), the main barriers were perceived good health (33.29%), high vaccine cost (27.12%), and lack of time (26.31%). Conclusions: Influenza vaccination among older adults in Henan exhibits a “high willingness, low conversion” pattern, with social processes as the strongest driver bridging the intention–behavior gap. A brief educational intervention improved willingness but failed to translate into meaningful uptake, underscoring that knowledge transfer alone is insufficient. We recommend a multi-component strategy that (1) mobilizes family members and community doctors as trusted vaccine advocates; (2) leverages family and village doctor networks to reduce urban–rural disparities; (3) counters the “perceived good health” barrier with age-specific risk communication; and (4) integrates vaccine recommendations into routine care for high-risk groups, particularly frequent outpatient attendees and smokers.