November 27, 2025

HPV

Effects of Human Papillomavirus (HPV) Vaccination Programmes on Community Rates of HPV‐Related Disease and Harms from Vaccination
This review included 225 studies from 347 records, evaluating over 132 million people. They included 86 cohort studies, four case‐control studies, 46 cross‐sectional studies, 69 pre‐post vaccine introduction studies, five RCT extensions and two self‐controlled case series. Thirteen additional studies reported on more than one type of analysis. Of the included studies, 177 reported only on females, 11 only males and 37 a combination of males and females. Review concludes there are now long‐term outcome data from different countries and from different study designs that consistently report a reduction in the development of high‐grade CIN and cervical cancer in females vaccinated against HPV in early adolescence. Data show that there is greater benefit to vaccinating younger adolescents prior to becoming sexually active. There is evidence that HPV vaccination does not increase the risk of the most common adverse events reported on social media.

Polio

Polio Safety and Immunogenicity of Novel Live Attenuated Type 1 and Type 3 Oral Poliomyelitis Vaccines in Healthy Adults in the USA: A First-in-human, Observer-masked, Multicentre, Phase 1 Randomised Controlled Trial
The risks of vaccine-derived polioviruses and vaccine-associated paralytic poliomyelitis motivated the development of novel types 1, 2 and 3 oral poliovirus vaccines (nOPV1 and nOPV3, respectively). These vaccines are designed to have similar immunogenicity but improved genetic stability (to reduce risk of being able to neuroinvade and cause paralytic disease) relative to Sabin-strain OPVs. This study aimed to assess the safety and immunogenicity of nOPV1 and nOPV3 in healthy adults. Participants were block randomised, stratified by site and according to polio vaccination history (inactivated poliovirus vaccine [IPV] only [hereafter IPV participants] or regimens including OPV [hereafter OPV participants]), and randomly assigned to receive either nOPV or homotypic Sabin-strain monovalent OPV (mOPV). Both vaccine candidates are safe and well tolerated in healthy adults and can elicit neutralizing antibody responses similar to those elicited by mOPV1 and mOPV3, respectively. In addition, the profile of viral shedding was similar to that of the corresponding mOPV, with shedding in most vaccine recipients limited to the first two weeks after the first vaccination, with subsequent rapid decline to largely undetectable levels by four to six weeks after vaccination.

Influenza

Superior Effectiveness and Estimated Public Health Impact of Cell- Versus Egg-Based Influenza Vaccines in Children and Adults During the U.S. 2023–2024 Season
These are the results from a test-negative design study applied to a large, linked, real-world dataset to assess the rVE of cell based versus egg-based flu vaccines in preventing confirmed influenza during the 2023-2024 season. The analysis included 2,119 QIVc-cases, 14,750 QIVc-controls, 14,559 QIVe-cases, and 75,351 QIVe-controls. QIVc was superior to QIVe in preventing test-confirmed influenza with an rVE of 19.8% (95% CI 15.7–23.8%) in the full population, and with rVEs of 19.6% (13.6–25.3%) in the pediatric population aged 6 months–17 years and 18.5% (12.1–24.5%) in adults aged 18–64 years. Consistent results were observed for all sensitivity and subgroup analyses against any influenza. They estimate that if all vaccinated individuals aged 6 months–64 years in the U.S. received QIVc over QIVe, an estimated 2,379,395 additional symptomatic illnesses would have been prevented, with proportionate reductions in related complications.

Efficacy, Immunogenicity, and Safety of Modified mRNA Influenza Vaccine
These are results of a phase 3 trial, where they randomly assigned healthy adults between the ages of 18 and 64 years to receive either a quadrivalent modRNA influenza vaccine (modRNA group) or a licensed inactivated quadrivalent influenza vaccine (control group) during the 2022–2023 influenza season in the United States, South Africa, and the Philippines. The primary end point was relative efficacy, defined by the reduction in the percentage of participants with laboratory-confirmed influenza associated with influenza-like illness at least 14 days after vaccination with the modRNA vaccine, as compared with the control vaccine. When they looked at 18,476 participants who underwent randomization: 9,225 assigned to receive the modRNA vaccine and 9,251 to receive the control vaccine, the relative efficacy of the modRNA vaccine as compared with the control vaccine against influenza-like illness was 34.5% (95% confidence interval [CI], 7.4 to 53.9) on the basis of 57 cases in the modRNA group and 87 cases in the control group. Primarily mild or moderate reactogenicity was observed in both vaccine groups but was reported more frequently in the modRNA group (overall local reactions, 70.1% vs. 43.1%; overall systemic events, 65.8% vs. 48.7%). Fever occurred in 5.6% of the participants in the modRNA group and in 1.7% of those in the control group.

RSV

Estimating Risk of Guillain-Barré Syndrome in US Medicare-Enrolled Older Adults Following Medically Attended Respiratory Syncytial Virus Disease: A Self-Controlled Case Series Analysis
The risk of Guillain-Barré Syndrome goes up two-to-fourfold with RSV infection compared to the two cases per every 1 million shots seen with RSV vaccination. In this analysis, among 452,471 eligible patients with RSV disease, <11 incident GBS cases occurred in the risk period and 34 during the control period. The adjusted IRR for GBS post RSV disease was 2.11 (95% CI: 1.01–4.37), consistent across sensitivity analyses of alternative risk/control periods and after excluding coinfections. The IRR increased to 2.59 (1.17–5.73) after ICD-10 code adoption, with a marked rise among patients aged ≥75 years (3.98 [1.45–10.91]). Conclusion: GBS risk increases after RSV disease compared to control periods not temporally adjacent to RSV disease, with an effect particularly evident among patients aged ≥75 years. RSV should be recognized as one of the pathogens that may rarely lead to GBS.

COVID: Active Vaccination

Effectiveness of the BNT162b2 and mRNA-1273 JN.1-adapted Vaccines against COVID-19-associated Hospitalisation and Death: A Danish, Nationwide, Register-based, Cohort Study
This cohort study included all Danish residents older than 65 years on Oct 1, 2024. A total of 1,247,315 were older than 65 years and 894,560 met inclusion criteria and were included in the study. Among those without JN.1 vaccination, 278 COVID-19 hospitalisations and 84 deaths were observed. Vaccine effectiveness for BNT162b2 JN.1 was 70·2% (95% CI 62·0–76·6) against hospitalisation and 76·2% (63·4–84·5) against death. For mRNA-1273 JN.1, vaccine effectiveness was 84·9% (70·9–92·2%) against hospitalisation and 95·8% (69·2–99·4%) against death. They looked at infection with KP.3.3.3 and XEC and found: The BNT162b2 JN.1 vaccine effectiveness against hospitalisation was 71·7% (44·4–85·6) after infection with KP.3.1.1 and 76·8% (59·0–86·9) after infection with XEC. BNT162b2 JN.1 vaccine effectiveness against death from these variants was 90·9% (67·4–97·5) for KP.3.1.1 and 76·3% (24·7–92·6) for XEC. So no discernible issue with these variants for protection with the JN.1 vaccines.

SARS-CoV-2 vaccination and myositis in Norway and Sweden
Investigators conducted a population-based cohort study in Norway and Sweden of 13 million persons who turned 12 years or older in 2021 and were residents at start of follow-up on December 27, 2020. Persons were followed until incident diagnosis of myositis, censoring, or end of study (May 21, 2023). They observed 101 myositis events in 7,002 398 unvaccinated person-years and 99 myositis events within 180 days of any combination of mRNA vaccines (6,241 529 person-years), and 13 with the adenoviral vector vaccine (445 256 person-years). Adjusted IRRs for the 180-day risk periods following any combination of mRNA vaccines and the adenoviral vector vaccine were 0.84 (95% confidence interval, 0.63–1.11) and 1.31 (0.72–2.36) respectively, compared with unvaccinated periods. The estimates for each specific first, second and third dose of mRNA were similar to the estimate of all doses combined. They conclude that “In this nationwide study of > 13.6 million person-years in two countries there were no signs of an increased risk of myositis after SARS-CoV-2 vaccination, neither after the mRNA vaccines nor after the adenoviral vector vaccine.”

COVID: The Late Phase/PASC/Long COVID

Digitally Assessed Long COVID Symptomatology Is Associated With Lymphocyte Mitochondrial Dysfunction and Altered Immune Potential
This is a detailed clinical, immunologic, and mitochondrial analysis on 27 patients with LC and 27 who recovered from COVID-19 and were healthy. Symptom burden and severity were assessed and quantified via a digital platform with the modified COVID-19 Yorkshire Rehabilitation Scale. Mitochondrial function of circulating immune cell populations (lymphocytes and monocytes) was analyzed by measuring mitochondrial mass and mitochondrial membrane potential. Production of 11 cytokines after whole blood stimulation with bacterial and viral agonists was measured by multiplex immunoassay. Relationships between mitochondrial and immune parameters with LC symptoms were investigated. Patients with LC had a decreased mitochondrial membrane potential of CD56bright natural killer cells, particularly in patients experiencing dizziness, whereas reduced mitochondrial membrane potential in CD4+ lymphocytes was found in patients with worsening breathlessness. Upon LPS stimulation, patients with LC demonstrated significantly lower IFN-γ production. In response to viral ligand R848, impaired IFN-β and IL-10 responses were associated with worsening cough and executive functions.

Long COVID Trajectories in the Prospectively Followed RECOVER-Adult U.S. Cohort
In this study, Long COVID trajectories were determined prospectively among 3,659 participants (69% female; 99.6% Omicron era) in the National Institutes of Health Researching COVID to Enhance Recovery (RECOVER) Adult Cohort. They report identifying eight distinct longitudinal profiles based on a Long COVID research index measured three to 15 months after infection. Overall, 195 (5%) had persistently high Long COVID symptom burden, 443 (12%) had non-resolving, intermittently high symptom burden.