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Vaccine policy and guideline recommendations require high quality evidence. A review of the evidence quality used to inform vaccine clinical practice guidelines could help guide researchers on how to improve the design of their clinical studies to produce evidence of greater value to decision-makers.

Understanding patterns of bacterial carriage and otitis media (OM) microbiology is crucial for assessing vaccine impact and informing policy. The microbiology of OM can vary with geography, time, and interventions like pneumococcal conjugate vaccines (PCVs). We evaluated the microbiology of nasopharyngeal and middle ear effusions in children living in Western Australia, 11 years following the introduction of PCV13.

Although uncommon, invasive meningococcal disease (IMD) results in death in 5%-10% of cases in healthy children and adolescents. This study aimed to examine demographics, clinical presentation, treatment and outcomes of Australian children hospitalized with IMD during the introduction of the meningococcal vaccine program, overall and by serogroup/disease severity. 

The pathogenesis of acute rheumatic fever (ARF) is poorly understood, limiting the development of immune-modulating therapies to treat disease and prevent progressive heart damage. Here, participants with definite ARF were compared to other severe acute paediatric conditions and matched healthy controls by profiling circulating immune molecules and cells to inform disease mechanisms and potential druggable pathways.

Intramuscular (IM) injection of benzathine benzylpenicillin G (BPG) forms the cornerstone of acute rheumatic fever (ARF) and rheumatic heart disease (RHD) secondary prophylaxis. BPG is available as either a low-cost powdered formulation or a costlier pre-filled suspension. Most of the global RHD burden lies in low- and middle-income countries, which rely on the powdered formulation. 

Rates of several vaccine preventable diseases, and associated hospitalisation, are higher among Aboriginal and/or Torres Strait Islander children than non-Indigenous children. Western Australia has among the lowest childhood vaccine coverage in Australia, particularly among Aboriginal and/or Torres Strait Islander children. Delayed vaccination is also more common in this population. This project aimed to understand the barriers and facilitators to vaccine uptake and timeliness among Aboriginal and/or Torres Strait Islander children aged under five years in Boorloo (Perth). 

Accumulating evidence indicates that antibiotic exposure may lead to impaired vaccine responses, however the mechanisms underlying this association remain poorly understood. Here we prospectively followed 191 healthy, vaginally born, term infants from birth to 15 months, using a systems vaccinology approach to assess the effects of antibiotic exposure on immune responses to vaccination.

As COVID-19 vaccinations rolled out globally from late 2020, rules and recommendations regarding vaccine use in pregnancy shifted rapidly. Pre-registration COVID-19 vaccine trials excluded those who were pregnant. Initial Australian medical advice did not routinely recommend COVID-19 vaccines in pregnancy, due to limited safety data and little perceived risk of local transmission.

Community perception of vaccine safety influences vaccine uptake. Our objective was to assess current vaccine safety monitoring by examining factors that may influence the availability of post-vaccination survey data, and thereby the specificity and sensitivity of existing signal detection methods.

Peter Richmond MBBS MRCP(UK) FRACP Head, Vaccine Trials Group Head, Vaccine Trials Group Professor Peter Richmond is Head of the Vaccine Trials Group