Parental awareness about immunization programs was found to be moderate, with a notable proportion of respondents lacking knowledge

The gap

Evidence profile

Sourced from the inline gaps and recommendations and future work of the source papers, classified as general, spanning 3 journals.

Supporting evidence — 3 representative gaps

• MEASLES VACCINATION EFFECTIVENESS AMONG CHILDREN UNDER FIVE YEARS OF AGE IN QASIMABAD (URBAN) HYDERABAD (2026) · Zenodo (CERN European Organization for Nuclear Research) · doi

  Parental awareness about immunization programs was found to be moderate, with a notable proportion of respondents lacking knowledge about the importance of complete vaccination. The persistence of gaps in immunization coverage indicates that current strategies are insufficient to achieve optimal protection against measles. The findings of this study indicate that the current level of vaccination coverage in the study area is insufficient to achieve herd immunity, thereby increasing the vulnerability of the population.

  generalinline gaps
  Keywords: immunization vaccination coverage current insufficient achieve parental awareness programs found moderate notable proportion respondents lacking
• Liver injury after COVID-19 vaccination: Current status and future perspectives (2026) · World Journal of Hepatology · doi

  According to the WHO, COVID-19 vaccination helps to reduce the number of deaths due to the disease, particularly in immunocompetent individuals. However, crucial knowl- edge gaps exist in evaluating the same in a heterogeneous population with a spectrum of host immune responses. Some of the challenges are discussed below: 1. At least one dose of the COVID-19 vaccine has been recommended for people who have never received any vaccine but are at high risk of getting COVID-19, including old age/sick, immunocompromised people, and healthcare workers. This concept poses the question, “Should people who are already affected by COVID-19 need a vaccine?”. Studies comparing natural infection and hybrid immunity show that the latter immunity is superior to the former and unvaccinated individuals in terms of humoral and cell-mediated immunity. Therefore, integration of the history of COVID- 19 before vaccination and the collection of more seroprevalence information on the conditions can help to devise effective immunization strategies. 3. 2. At least one dose of COVID-19 vaccine is recommended for pregnant women. As discussed in this review, studies show that pregnant women are at higher risk of hospitalization due to COVID-19. Furthermore, since pregnant women, particularly ones with low education and low income, show vaccine hesitancy, they were encour- aged to take the vaccine. However, vaccinated pregnant women have the same level of maternal and/or neonatal adverse events as compared to unvaccinated pregnant women. Thus, the benefit of vaccination in this population remains unclear and warrants more detailed clinical studies. Compared to healthy individuals, those with a higher risk were recommended for revaccination after 6 to 12 months of the most recent dose. Previous studies that assessed the safety, immunogenicity, and reactogenicity with booster doses after the primary vaccination with one, two, three, or more doses showed better protection and fewer systemic side effects than those that received only the primary dose. Addi- tionally, studies showed that homologous boosters had fewer systemic side effects than heterologous boosters. However, the impact of SARS-CoV-2 infection-induced immunity after the first or booster vaccination on potential side effects later remains unknown. The WHO considers healthy infants/children aged 6 months to 17 years as low priority group for COVID-19 vaccination. In addition, vaccine hesitancy is observed among the parents of infants compared to school-going children. Nonetheless, studies showed no adverse events except for pain at the injection site, malaise, and fever for vaccinated children. However, the long-term effect of vaccination in this group, with or without COVID-19, remains unknown. Since COVID-19 can cause anaphylaxis due to immediate-type hypersensitivity, and people with a previous history are at risk for anaphylaxis, vaccines are not recom- mended for this group of people with a history of severe

  generalrecommendations
  Keywords: covid vaccination vaccine people pregnant women dose risk immunity individuals recommended show history compared remains
• Navigating the Complexities of Vaccination in Immunocompromised Patients: Balancing Protection and Risk (2026) · INNOVAPATH · doi

  Immunocompromised individuals rely not only on direct vaccination but also on herd immunity for protection. High vaccination coverage among caregivers, household members, and the general population is critical in reducing the risk of exposure. This underscores the need for strong public health initiatives that promote widespread immunization, particularly during outbreaks of vaccine-preventable diseases such as influenza, measles, and COVID-19. protocols immunization Moving forward, continued research is necessary to optimize for immunocompromised individuals. Clinical trials should include more immunosuppressed participants to better understand vaccine efficacy and safety in these in immunology and vaccine technology, including next-generation vaccines designed to elicit stronger immune responses in immunocompromised patients, hold promise for improving protection. populations. Moreover, advances REFERENCES 1. Akkaya, M., Kwak, K., & Pierce, S. K. (2020). B cell memory and plasma cell formation in the context of chronic antigen stimulation: Lessons from autoimmunity and infection. Frontiers in Immunology, 11, 621222. 2. Apostolidis, S. A., Kakara, M., Painter, M. M., et al. (2021). Cellular and humoral immune responses following SARS-CoV-2 mRNA vaccination in patients with multiple sclerosis on anti-CD20 therapy. Nature Medicine, 27(11), 1990-2001. 3. Bastard, P., Rosen, L. B., Zhang, Q., et al. (2020). Auto-antibodies against type I IFNs in patients with Science, 370(6515), eabd4585. life-threatening COVID-19. 4. Boyarsky, B. J., Werbel, W. A., Avery, R. K., et al. (2021). Immunogenicity of a single dose of SARS- CoV-2 messenger RNA vaccine in solid organ transplant recipients. JAMA, 325(17), 1784-1786. 5. Centers for Disease Control and Prevention (CDC). (2022). Interim clinical considerations for use of COVID-19 vaccines currently approved or authorized in the United States. Retrieved from https://www.cdc.gov/coronavirus/2019- ncov/vaccines/recommendations/immuno.html 6. Diaz Granados, C. A., Dunning, A. J., Kimmel, M., et al. (2014). Efficacy of high-dose versus standard-dose influenza vaccine in older adults. New England Journal of Medicine, 371(7), 635- 645. 7. O’Brien, M. P., Forleo-Neto, E., Musser, B. J., et al. (2022). Subcutaneous REGEN-COV antibody combination to prevent COVID-19. New England Journal of Medicine, 385(13), 1184-1195. INNOVAPATHTM https://innovapath.us 3 Summer 2026 | Vol 2, Issue 2

  generalfuture work
  Keywords: vaccine covid immunocompromised vaccination vaccines patients medicine dose individuals protection high immunization influenza clinical efficacy

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