To evaluate the vaccine effectiveness (VE) of the adsorbed acellular diphtheria-tetanus-pertussis (DTaP) vaccine in infants and young children aged 2 years and under in Gansu province, thereby providing evidence for optimizing the immunization strategies for pertussis in underdeveloped western regions of China.

A retrospective cohort was established, including 176 688 resident children born in Gansu province from January 1 to December 31, 2023. The Poisson regression model was adopted to calculate the relative risk (RR) for evaluating the VE of 1–4 doses of DTaP vaccine against pertussis and pertussis-related hospitalization, after adjusting for factors such as region and sex.

The coverage rates of the 1st to 4th doses of DTaP vaccine among infants and young children aged 2 years and under in Gansu province were 92.88%, 91.15%, 89.22%, and 41.96%, respectively. The VE of the 1st to 4th doses against pertussis was 43.67% (95%CI: 39.60%–55.21%), 71.30% (95%CI: 50.13%–79.96%), 90.91% (95%CI: 88.82%–92.68%), and 99.20% (95%CI: 77.91%–99.80%), respectively. The VE of the 1st to 4th doses against pertussis-related hospitalization was 56.14% (95%CI: 18.13%–77.80%), 63.90% (95%CI: 22.71%–85.46%), 73.02% (95%CI: 58.10%–82.34%), and 94.40% (95%CI: 64.32%–98.70%), respectively.

The DTaP vaccine provides significant protection against pertussis and pertussis-related hospitalization in infants and young children aged 2 years and under in Gansu province in a dose-dependent manner. Efforts should focus on improving the timeliness of primary immunization and the coverage of booster doses.

To evaluate the vaccine effectiveness (VE) of trivalent inactivated influenza vaccine (TIV) against influenza among primary school students in Longgang district, Shenzhen city, Guangdong province during the 2024–2025 academic year, thus providing evidence for the cost-effectiveness evaluation of publicly funded influenza vaccine (InfV) programs.

Data on the roster of in-school primary school students in Longgang district from August 2024 to July 2025, together with their influenza incidence and InfV vaccination records, were extracted from the Longgang District Student Health Monitoring Information System, the China Information System for Disease Control and Prevention, and the Shenzhen Immunization Program Information Management System. According to class-level InfV vaccination coverage, students were stratified into four groups: <50.00%, 50.00%–74.99%, 75.00%–100%, and an overall group. Propensity score matching (PSM) was employed to balance covariates between the TIV-vaccinated and unvaccinated groups, forming a comparable real-world retrospective cohort. Multivariable Cox regression models were employed to estimate the adjusted vaccine effectiveness (aVE) of TIV against influenza.

After PSM, the overall group comprised 159 336 participants in both the TIV-vaccinated and unvaccinated groups, with influenza incidence densities of 1.40 and 2.35 per 100 person-years, respectively. The aVE (95%CI) of TIV against influenza by class-level vaccination coverage was 29.83% (21.00% to 37.67%) for the < 50.00% group, 37.84% (31.39% to 43.67%) for the 50.00%–74.99% group, 41.06% (36.23% to 45.53%) for the 75.00%–100% group, and 40.31% (36.44% to 43.95%) for the overall group. By age subgroups, the aVE (95%CI) was 46.75% (42.22% to 50.93%) for students of 6 to 8 years old and 28.76% (21.34% to 35.48%) for students of 9 to 12 years old. By vaccination history, the aVE (95%CI) was 46.52% (41.15% to 51.40%) for those unvaccinated the previous year and 35.78% (30.20% to 40.92%) for those vaccinated previously. Against influenza A, B, and mixed A+B, the aVE (95%CI) was 42.33% (37.48% to 46.80%), 35.64% (23.43% to 45.90%), and 21.00% (−22.46% to 49.04%), respectively.

TIV vaccination conferred substantial protective effects against influenza among primary school students in Longgang district during the 2024–2025 academic year. Annual timely administration of InfV before the influenza epidemic season and maintenance of high vaccination coverage are recommended.

To investigate the epidemiological characteristics of mumps breakthrough cases and evaluate vaccine effectiveness among children born in Shapingba district, Chongqing from 2008 to 2018, thus providing evidence for optimizing mumps immunization strategies and formulating precise prevention and control measures.

A retrospective cohort study was conducted among children born between January 1, 2008 and December 31, 2018 and residing in Shapingba district. Basic information and vaccination records for mumps-containing vaccine (MuCV) were obtained from the Chongqing Immunization Planning Information Management System. Mumps incidence data were retrieved from the China Information System for Disease Control and Prevention by matching child′s name, date of birth, gender, and current address. Participants were categorized into 1-dose, 2-dose, and 3-dose groups according to MuCV vaccination doses. Follow-up started from the completion date of each dose and ended at either mumps diagnosis or the study cutoff date (December 31, 2023). Person-years were calculated through the exact calculation method to determine incidence density. Univariate Poisson regression was employed to estimate disease risk across groups, while analyzing demographic characteristics, onset time, and time intervals from MuCV vaccination to mumps onset among breakthrough cases.

The total incidence density of mumps breakthrough cases among children born in Shapingba district, Chongqing from 2008 to 2018 was 21.16 per 10 000 person-years (1 149 cases). The overall incidence of breakthrough cases showed a bimodal distribution pattern, with peaks occurring from April to June and in September. The median intervals from MuCV vaccination to disease onset for breakthrough cases in the 1-dose, 2-dose, and 3-dose groups were 36.50 (24.02, 51.09) months, 59.60 (45.37, 74.00) months, and 80.40 (62.22, 97.49) months, respectively, with differences among the groups (H = 89.63, P < 0.001). The total incidence density of breakthrough cases among children who received 1, 2, and 3 doses of MuCV was 24.82, 16.60, and 10.05 per 10 000 person-years, respectively. Children receiving 2-dose MuCV had a 33% reduced risk of mumps breakthrough infection compared to those receiving 1-dose MuCV (VE = 33%, 95%CI: 24%–41%, P < 0.001).

The total incidence density of mumps breakthrough cases was relatively high among children born in Shapingba district, Chongqing from 2008 to 2018, with peak incidence occurring from April to June and in September. Two-dose MuCV vaccination can extend the duration of immune protection and significantly reduce the risk of breakthrough infection.

To evaluate the vaccine effectiveness (VE) of varicella vaccine (VarV) in individuals aged 2–17 years in a real-world setting.

On the basis of linked surveillance system data in 2024, a 1:3 individually matched case-control study design was adopted. Chi-square tests were conducted to compare distribution differences between groups. A conditional logistic regression model was employed to calculate the VE of VarV.

This study included 928 subjects (232 cases and 696 controls). There were differences (all P<0.001) between the case and control groups in terms of immunization history, number of doses, age at initial vaccination, and time since vaccination. The overall VE of VarV against varicella was 71.55% (95%CI: 60.26%–79.63%). The VE of one dose (VarV1) and two doses (VarV2) was 60.95% (95%CI: 41.85%–73.78%) and 76.73% (95%CI: 66.29%–83.93%), respectively. VE for initial vaccination at age of 1, 2, and ≥3 years was 71.13% (95%CI: 59.33%–79.51%), 82.15% (95%CI: 56.01%–92.76%), and 67.27% (95%CI: 37.07%–82.98%), respectively. The VE within ≤5 years, 6–10 years, and ≥11 years after the last dose was 80.93% (95%CI: 71.42%–87.28%), 66.20% (95%CI: 48.78%–77.69%), and 46.49% (95%CI: 12.57%–67.25%), respectively.

VarV demonstrates significant effectiveness in real-world settings, with two-dose vaccination providing superior protection. However, its VE notably wanes with time since vaccination.

To understand the degree of hesitancy among parents regarding their children′s vaccination with non-immunization program vaccines and its influencing factors, thus providing a basis for formulating targeted intervention measures.

A multi-stage stratified sampling method was used to select 4 182 parents of children aged 1-6 who accompanied their children to vaccination in 60 community health service centers in urban, suburban, and exurban areas of Beijing. The questionnaire survey was conducted with the Parent Attitudes about Childhood Vaccines (PACV) scale, and the score of the scale, the proportion of vaccine hesitancy and its influencing factors were analyzed.

The median (interquartile range) of the PACV scale score was 33.33 (20.00, 43.33). The proportion of vaccine hesitancy was 13.03% (545/4 182), and the hesitancy proportions for the 15 items in the scale ranged from 6.46% to 83.62%. Multivariate logistic regression analysis revealed that parents of children with non-local household registration (OR=1.313, 95%CI: 1.072–1.607) and male parents (OR = 1.487, 95%CI: 1.240–1.783) had a higher risk of vaccine hesitancy. In contrast, parents aged 30–39 years (OR = 0.668, 95%CI: 0.529–0.843), 40–49 years (OR = 0.690, 95%CI: 0.503-0.947), and ≥50 years (OR = 0.431, 95%CI: 0.267–0.696), as well as those with an annual household income of 100 000–190 000 yuan (OR = 0.644, 95%CI: 0.521–0.797), 200 000–490 000 yuan (OR = 0.567, 95%CI: 0.440–0.730), and ≥500 000 yuan (OR = 0.578, 95%CI: 0.393–0.849), and parents who were homemakers or unemployed (OR = 0.390, 95%CI: 0.232–0.656) had a lower risk of vaccine hesitancy. The top three items in terms of the proportion of parents′ hesitation were concern about children suffering severe adverse reactions after receiving paid vaccines (83.62%), the belief that children were vaccinated with more paid vaccines than needed (73.34%), and concerns about the safety of paid vaccines (70.30%).

The overall proportion of vaccine hesitancy among parents of children in Beijing regarding non-immunization program vaccines is relatively low, while the popularization and education of vaccine knowledge should still be strengthened to further reduce vaccine hesitancy.

To investigate public online attention, attitudes, and influencing factors regarding non-national immunization program vaccines (NIPVs) for infants and young children on social media platforms, thereby providing a reference for optimizing vaccine communication strategies.

Daily national Baidu index data for 10 topics related to the pentavalent vaccine, rotavirus vaccine, 13-valent pneumococcal conjugate vaccine (PCV13), and their corresponding diseases from July 2023 to June 2024 were collected. Additionally, 24 353 relevant notes were screened and included from five high-traffic maternal and infant topics—“Baby Vaccines,” “Self-paid Vaccines,” “Pertussis,” “New Moms,” and “Late Pregnancy”—on the Xiaohongshu platform between October 2023 and September 2024. Time-series analysis was conducted to describe trends in public attention. Content analysis was performed to classify attitudes in high-engagement Xiaohongshu notes and to identify the drivers and barriers influencing public vaccination decisions.

Baidu index analysis revealed a temporal association between public attention toward NIPVs and the epidemic trends of corresponding diseases. This was most notable during the peak search period for "Pertussis," which coincided with a significant rise in attention for the "Pentavalent vaccine." Content analysis of Xiaohongshu notes indicated that for polyvalent vaccines (represented by the pentavalent vaccine), positive attitudes accounted for 40.88%, driven primarily by the convenience of reduced injection frequency (45.91%). However, negative attitudes were also relatively prominent (12.57%), centering on high costs (16.98%) and the cost-effectiveness of alternative options (18.87%). Public concerns regarding PCV13 and the rotavirus vaccine focused mainly on adverse reactions following immunization, accounting for 20.99% and 21.12%, respectively.

Convenience, cost-effectiveness, and safety are the three core dimensions influencing parental decisions regarding NIPV vaccination for infants and young children. Vaccine communication strategies should be tailored to the specific public opinion foci of different vaccine types to break down information barriers and facilitate effective communication within broader maternal and infant communities.

To explore the factors influencing parents′ intention to vaccinate their daughters against HPV among primary and secondary school students based on the Information-Motivation-Behavioral Skills (IMB) model, thus providing evidence for improving the HPV vaccination rate among adolescent girls.

This cross-sectional study was conducted in November 2024. A multi-stage stratified cluster random sampling method was employed to select 1 276 parents with at least one daughter aged 9 to 14 from Xiangcheng district, Suzhou city. Data on parents′ intention to vaccinate their daughters against HPV and associated influencing factors were collected, with subgroup analyses performed according to parents′ gender.

Among the 1 276 participants, 89.0% were mothers. Although 64.42% of parents expressed intention to vaccinate their daughters against HPV, the actual vaccination rate was only 14.73%. Maternal own intention to be vaccinated emerged as the strongest associated factor of their daughters′ HPV vaccination across all models (total population: OR = 14.85, 95%CI: 9.95–22.16; mothers: OR = 14.22, 95%CI: 9.35–21.62; fathers: OR = 69.08, 95%CI: 9.78–488.01). Gender-stratified analyses revealed that HPV knowledge significantly influenced vaccination intention only among fathers (OR = 1.59, 95%CI: 1.08–2.32), while perceived susceptibility (OR = 1.31, 95%CI: 1.02–1.67), social norms (OR = 1.84, 95%CI: 1.28–2.66), anticipated regret (OR = 1.66, 95%CI: 1.26–2.18), and self-efficacy (OR = 2.86, 95%CI: 1.67–4.90) were significant predictors among mothers. Perceived barriers were a significant negative predictor across all groups (total population: OR = 0.41, 95%CI: 0.30–0.55; mothers: OR = 0.41, 95%CI: 0.30–0.57; fathers: OR = 0.23, 95%CI: 0.06–0.89). The IMB model demonstrated good explanatory power for parents′ intention of HPV vaccination for their daughters.

Parents′ intention to vaccinate their daughters against HPV is influenced by multiple factors and exhibits significant gender differences. The IMB model offers an effective theoretical framework for understanding the influencing factors in parents′ decision-making regarding HPV vaccination for their daughters.

To predict the risk of atherosclerotic cardiovascular disease (ASCVD) incidence in the elderly population based on a risk assessment model, thereby providing evidence for implementing risk factor interventions among high-risk older adults to delay or prevent the onset of ASCVD.

A random cluster sampling method was employed to select 47 community health service centers in Shenzhen. All older adults (aged ≥ 65 years) who received the health management services of the National Essential Public Health Services Program from January 1, 2018 to December 31, 2022 were included as participants. General information and physical examination results were collected. The China-PAR risk assessment model was used to calculate the 10-year risk scores and stratify the risk levels of ASCVD among the older adults.

This study included a total of 94 362 older adults (aged ≥ 65 years) from 2018 to 2022, comprising 41 552 males (44.03%) and 52 810 females (55.97%), with a mean age of (72.40 ± 5.42) years. Within the cohort, 14.68% were affected by diabetes, 34.59% by hypertension, and 8.11% by a combination of both diseases. The median 10-year ASCVD risk for the entire population during 2018–2022 was 11.46%, with females exhibiting a lower overall risk than males (9.57% vs. 13.50%). The median 10-year ASCVD risk exhibited an overall increasing trend among the older adults in Shenzhen from 2018 to 2022, with values of 11.20% in 2018, 11.40% in 2019, 11.55% in 2020, 11.51% in 2021, and 11.46% in 2022. Differences in ASCVD risk were identified across sex (χ² = 256.081), district (χ² = 258.537), and hypertension/diabetes status (χ² = 668.698) (all P < 0.001). Risk stratification revealed that low- and intermediate-risk individuals had higher proportions (1.30% and 37.36%, respectively) in 2018 and high-risk individuals had a higher proportion (64.61%) in 2020. Females predominated in the low- (95.40%) and intermediate-risk (86.04%) groups, whereas males constituted a majority (61.32%) in the high-risk group. High-risk individuals were the most prevalent across all chronic disease statuses. Geographical analysis showed that Longhua had the highest prevalence of low-risk individuals (22.18%), while Longgang led the moderate-risk group (23.69%). High-risk elderly individuals were primarily distributed across Longgang (25.59%) and Longhua (21.54%).

The 10-year ASCVD risk among the older adults in Shenzhen showed an increasing trend from 2018 to 2022. Essential public health services should strengthen the early identification of ASCVD risk factors and implement timely, risk-based stratified management, particularly targeting elderly males with chronic conditions or comorbidities.

To analyze national-level priority development policies in the education sector and thus provide references for implementing China′s strategy of priority development of health.

Official websites of the State Council and the National Health Commission were searched for the related documents during 1986–2025. The policy transfer theory, policy instrument theory, and literature review were employed to construct a policy analysis framework, which encompassed five first-level dimensions and 11 second-level dimensions. Content analysis was conducted in NVivo15 to code the policies for priority development of education, and a comparative study was carried out for selected outcome indicators to evaluate policy implementation effectiveness.

A total of 34 policies related to the priority development of education were included, which were issued between 1986 and 2025, with an average intensity score of 3.9. Policies were issued by the State Council (27 documents) or jointed by multiple departments such as the Ministry of Education (7 documents). The priority development of education was mainly reflected in resource investment and governance systems (accounting for 70.23% combined). China′s education expenditure remained at 4% or above of GDP since 2012, and student-teacher ratios (16.06:1 in 2024) were at an upper-middle level globally. Additionally, general public budget expenditure on education (reaching RMB 4 207.6 billion in 2024) and teacher compensation (ranking 5th in average annual growth rate among 19 industries from 2012 to 2024) ranked at upper-middle levels among various public service sectors in China. Although China′s average life expectancy surpassed that of upper-middle-income countries (reaching 79.25 years in 2025), its health expenditure and growth lagged behind the global average and other domestic public service sectors.

The notable outcomes in education demonstrate its priority development and leading position compared with the health sector. The health sector can learn from experience of education development by optimizing policy arrangements in resource allocation, organizational systems, and tilt in public policy to promote the priority development of health.

To understand the competitive risks of survival outcomes among patients with chronic obstructive pulmonary disease (COPD) in Zhejiang province, thereby providing evidence-based reference for formulating management and intervention programs for this population.

Incidence cases of COPD from January 1, 2014 to December 31, 2023 were collected from the COPD Surveillance Database of Zhejiang Provincial Center for Disease Control and Prevention, and death data from January 1, 2014 to December 31, 2024 were collected from the Death Surveillance Database. Death outcomes were matched for COPD patients. With death from respiratory diseases as the target event and malignant tumors, cerebrovascular diseases, heart disease, and other diseases as competing events, sex- and age-specific competing risk analyses were performed based on the time and underlying cause of death.

Among the 824 536 new COPD cases in Zhejiang province from 2014 to 2023, death outcome was observed in 211 586 cases. The 1-year, 5-year, and 10-year mortality probabilities were 0.089, 0.258, and 0.425, respectively. Respiratory diseases remained the primary risk of death (10-year cumulative risk: 0.150), followed by malignant tumors (10-year cumulative risk: 0.115, with lung cancer at 0.063 and other malignant tumors at 0.052). Cerebrovascular diseases had the lowest risk of death (10-year cumulative risk: 0.051). Stratified analysis showed that for male COPD patients, the malignant tumors had the highest cumulative risk within 3 years (3-year cumulative risk: 0.063), and respiratory diseases became the factor with the highest cumulative risk after 3 years (10-year cumulative risk: 0.162). For female patients, respiratory diseases consistently posed the highest cumulative risk (10-year cumulative risk: 0.120). For patients aged < 65 years, the risk of malignant tumors was the highest (10-year cumulative risk: 0.050); for those aged ≥65 years, the risk of respiratory diseases was the highest (10-year cumulative risk: 0.206). Other factors demonstrated similar risks, which were much lower than that of respiratory diseases.

COPD patients face complex mortality patterns, and their competitive risks show significant age and sex differences. This highlights the importance of developing personalized and multidisciplinary integrated intervention strategies for different patient subgroups to effectively improve the prognosis of COPD patients.