Debbag Roberto, Rudin Deborah, Ceddia Francesca, Watkins John
Latin American Vaccinology Society, Buenos Aires, Argentina.
Moderna, Inc., Cambridge, MA, USA.
Infect Dis Ther. 2025 Jan;14(Suppl 1):63-97. doi: 10.1007/s40121-024-01079-x. Epub 2024 Dec 30.
Vaccination represents a core preventive strategy for public health, with interrelated and multifaceted effects across health and socioeconomic domains. Beyond immediate disease prevention, immunization positively influences downstream health outcomes by mitigating complications of preexisting comorbidities and promoting healthy aging. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), influenza virus, and respiratory syncytial virus (RSV) are common respiratory viruses responsible for broad societal cost and substantial morbidity and mortality, particularly among at-risk individuals, including older adults and people with frailty or certain comorbid conditions. In this narrative review, we summarize the overall impact of vaccination for these 3 viruses, focusing on mRNA vaccines, each of which exhibits unique patterns of infection, risk, and transmission dynamics, but collectively represent a target for preventive strategies. Vaccines for COVID-19 (caused by SARS-CoV-2) and influenza are effective against the most severe outcomes, such as hospitalization and death; these vaccines represent the most potent and cost-effective interventions for the protection of population and individual health against COVID-19 and influenza, particularly for older adults and those with comorbid conditions. Based on promising results of efficacy for the prevention of RSV-associated lower respiratory tract disease, the first RSV vaccines were approved in 2023. Immunization strategies should account for various factors leading to poor uptake, including vaccine hesitancy, socioeconomic barriers to access, cultural beliefs, and lack of knowledge of vaccines and disease states. Coadministration of vaccines and combination vaccines, such as multicomponent mRNA vaccines, offer potential advantages in logistics and delivery, thus improving uptake and reducing barriers to adoption of new vaccines. The success of the mRNA vaccine platform was powerfully demonstrated during the COVID-19 pandemic; these and other new approaches show promise as a means to overcome existing challenges in vaccine development and to sustain protection against viral changes over time.A graphical abstract and video abstract is available with this article.
疫苗接种是公共卫生的核心预防策略，在健康和社会经济领域具有相互关联且多方面的影响。除了直接预防疾病外，免疫接种通过减轻既往合并症的并发症和促进健康老龄化，对下游健康结果产生积极影响。严重急性呼吸综合征冠状病毒2（SARS-CoV-2）、流感病毒和呼吸道合胞病毒（RSV）是常见的呼吸道病毒，会造成广泛的社会成本以及大量发病和死亡，尤其是在包括老年人、体弱或患有某些合并症的高危人群中。在这篇叙述性综述中，我们总结了针对这三种病毒的疫苗接种的总体影响，重点关注mRNA疫苗，每种疫苗都表现出独特的感染、风险和传播动态模式，但总体上是预防策略的目标。针对由SARS-CoV-2引起的新冠肺炎和流感的疫苗对最严重的后果，如住院和死亡有效；这些疫苗是保护人群和个人健康免受新冠肺炎和流感影响，特别是对老年人和合并症患者最有效和最具成本效益的干预措施。基于预防RSV相关下呼吸道疾病的疗效的 promising 结果，首批RSV疫苗于2023年获批。免疫接种策略应考虑导致接种率低的各种因素，包括疫苗犹豫、获取的社会经济障碍、文化信仰以及对疫苗和疾病状态的知识缺乏。疫苗的联合接种以及联合疫苗，如多组分mRNA疫苗，在物流和接种方面具有潜在优势，从而提高接种率并减少采用新疫苗的障碍。mRNA疫苗平台在新冠肺炎大流行期间得到了有力证明；这些以及其他新方法有望成为克服疫苗开发中现有挑战并随着时间推移维持对病毒变化的保护的一种手段。本文配有图形摘要和视频摘要。
