Fuzhen Wang

Herpes zoster (HZ) and postherpetic neuralgia (PHN) cause substantial clinical and economic burdens, especially in older adults, yet real-world data from China are limited. Using the Jinan Regional Health Information Platform, we conducted a population-based retrospective cohort study (2018–2023) to estimate HZ and PHN incidence (per 1,000 person-years [PY]), recurrence rates, and direct medical costs and factors associated with costs. The study included 166,869 patients with HZ. The coverage-adjusted incidence of HZ was 6.80 per 1,000 person-years (PY) overall and ranged from 9.68 per 1,000 PY in the 50–59-year age group to a peak of 16.48 per 1,000 PY in the 70–79-year age group. PHN occurred in 14.2% of HZ patients. The overall coverage-adjusted incidence of PHN was 0.94 per 1,000 PY. HZ recurrence occurred in 0.87% of patients, corresponding to an incidence of 4.26 per 1,000 PY. A total of 72.9% of patients were included in the cost analyses. Median annual costs per patient were CNY 155.2 (interquartile range [IQR]: 50.3–533.1) overall, CNY 126.7 (IQR: 44.4–365.6) for outpatients and CNY 6,290.2 (IQR: 4,038.4–9,093.6) for inpatients. Higher costs were associated with older age, PHN, healthcare facility type, more frequent visits, and length of stay. HZ and PHN impose substantial epidemiological and economic burdens in Jinan, with incidence increasing with age, a persistent risk of recurrence, and costs influenced by demographic and healthcare-related factors. The online version contains supplementary material available at 10.1186/s12879-026-13245-2.

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.

DTaP-HBV-IPV-Hib hexavalent vaccine has been used in high-income countries for many years to prevent diphtheria, tetanus, pertussis, hepatitis B, poliomyelitis, and invasive Haemophilus influenzae type b disease. Currently, no hexavalent vaccines have been approved for use in China. Evidence of parental acceptance and interest in hexavalent vaccines can help policy makers and manufacturers make decisions about entering the vaccine market and the immunization program in China. We measured parental acceptance and willingness-to-pay (WTP) for a hexavalent vaccine to provide such evidence. We conducted a cross-sectional survey of children's caregivers in 16 vaccination clinics in seven cities in China and obtained information on socio-demographics, knowledge of disease, confidence in vaccines, previous vaccination experience, and acceptance of and WTP for hexavalent vaccine. Multivariate logistic regression was used to determine factors influencing acceptance, and multivariate tobit regression was used to identify factors impacting WTP. Between April 28 and June 30, 2023, a total of 581 parents of children aged 0-6 years participated in the survey; 435 (74.87%, 95% CI:71.3%-78.4%) parents indicated acceptance of hexavalent vaccine. Residence location, parents' education level, experience paying for vaccination, and disease knowledge scores were key factors affecting parents' choices for vaccination. Mean (SD) and median (IQR) willingness to pay for full 4-dose course vaccination were 2266.66 (1177.1) CNY and 2400 (1600-2800) CNY. Children's age (p < .001), parents' education level (p = .024), and perceived price barriers (p < .001) were significantly associated with WTP. Parents have high acceptance and willingness to pay for hexavalent vaccine. The less money parents have to pay out of pocket, the more willing they can be to accept the vaccine. Therefore, acceptance may increase even further if the vaccine is covered by medical insurance, provided free of charge by the government, or if its price is reduced. Our results provide reference for optimizing and adjusting immunization strategies in China.