Mpox multi-antigen mRNA vaccine candidates by a simplified manufacturing strategy afford efficient protection against lethal orthopoxvirus challenge.

Current unprecedented mpox outbreaks in non-endemic regions represent a global public health concern. Although two live-attenuated vaccinia virus (VACV)-based vaccines have been urgently approved for people at high risk for mpox, a safer and more effective vaccine that can be available for the general public is desperately needed. By utilizing a simplified manufacturing strategy of mixing DNA plasmids before transcription, we developed two multi-antigen mRNA vaccine candidates, which encode four (M1, A29, B6, A35, termed as Rmix4) or six (M1, H3, A29, E8, B6, A35, termed as Rmix6) mpox virus antigens. We demonstrated that those mpox multi-antigen mRNA vaccine candidates elicited similar potent cross-neutralizing immune responses against VACV, and compared to Rmix4, Rmix6 elicited significantly stronger cellular immune responses. Moreover, immunization with both vaccine candidates protected mice from the lethal VACV challenge. Investigation of B-cell receptor (BCR) repertoire elicited by mpox individual antigen demonstrated that the M1 antigen efficiently induced neutralizing antibody responses, and all neutralizing antibodies among the top 20 frequent antibodies appeared to target the same conformational epitope as 7D11, revealing potential vulnerability to viral immune evasion. Our findings suggest that Rmix4 and Rmix6 from a simplified manufacturing process are promising candidates to combat mpox.

Design of a Virtual Reality Interactive Training System for Public Health Emergency Preparedness for Major Emerging Infectious Diseases: Theory and Framework.

BACKGROUND: Sufficient public health emergency preparedness (PHEP) is the key factor in effectively responding to and recovering from major emerging infectious diseases (MEIDs). However, in the face of MEIDs, PHEP is insufficient, so it is necessary to improve PHEP. The rapid development of virtual reality and human-computer interaction provides unprecedented opportunities for innovative educational methods. OBJECTIVE: This study designed a virtual reality interactive training system (VRITS) to provide an effective path for improving PHEP in the context of MEIDs so that the public can effectively respond to and recover from MEIDs. METHODS: This study used interactive narrative, situated learning and human-computer interaction theories as a theoretical framework to guide the design of the system. We used the literature research method and the Delphi method; consulted multidisciplinary experts, such as infectious diseases, disease control, psychology, and public health personnel, to determine the educational content framework; and set up an interdisciplinary team to construct an operating system framework for the VRITS. RESULTS: We named the VRITS "People's War Against Pandemic." The educational content framework includes 20 knowledge, emotion, and behavior skills in 5 aspects (cooperating with prevention and control work, improving emergency response ability, guaranteeing supplies and equipment, preparing economic resources, and maintaining physical and mental health). The operating system framework includes virtual interactive training, knowledge corner, intelligent evaluation, and community forum modules, and the core module is the virtual interactive training module. In this module, users control virtual characters to move in various scenes, and then identify and analyze the controllability and harmfulness of the evolving pandemic and select the correct prevention and control strategy to avoid infecting themselves and others. CONCLUSIONS: The development and sharing of the multidisciplinary theoretical framework adopted by People's War Against Pandemic can help us clarify the design ideas and assumptions of the VRITS; predict training results; understand the ability of training to change emergency knowledge, emergency emotion, and behavioral responses to MEIDs; and promote the development of more effective training systems based on virtual reality.

Hesitancy toward COVID-19 vaccines among medical students in Southwest China: a cross-sectional study.

Vaccine hesitancy is an obstacle to COVID-19 vaccination. This study aims to inform the vaccine hesitancy and analyze related factors toward COVID-19 vaccination among medical students in China, so as to provide suggestions for increasing vaccines uptake. An online cross-sectional survey was conducted among medical students in a medical university and a health school. A total of 2,196 valid questionnaires were received. 41.2% vaccine hesitancy was reported among medical students in total. Female (OR = 1.336) and individuals with higher education (OR = 1.724) reported slightly higher vaccine hesitancy. Being in low-risk areas and no need to get vaccinated (OR = 2.285), fear of serious consequences of vaccination (OR = 1.929), being in good health and no need to be vaccinated (OR = 1.891), being concerned about short-term side effects (OR = 1.793) and being concerned that the vaccine was ineffective (OR = 1.694) had higher prevalence of vaccine hesitancy. Those who were believing the specialty of study or work environment made vaccination necessary (OR = 0.378), believing they were susceptible to COVID-19 (OR = 0.411) and the vaccine was free (OR = 0.519) were more willing to get vaccinated. Confidence in vaccines and perceptions of benefits and risk are associated with vaccine hesitancy. It is important to strengthen vaccine health literacy education for medical students and enhance vaccine confidence. Countries need to supervise the public opinions in social media, television broadcasting and other media, so as to ensure the correct orientation of public opinion. Open and transparent evidence-based information is also needed which can help improve the vaccination coverage rate of the public.