Emergency response capacity of primary healthcare institutions in epidemic prevention and control greatly practiced and improved during the prevention and control of COVID-19 epidemic, and in this context, the construction of a more targeted and practical emergency response capacity evaluation indicators system for major infectious diseases in primary medical institutions is necessary.

To construct an emergency response capacity evaluation indicators system for major infectious diseases in primary medical institutions in Beijing, based on the theory of emergency management and resilience.

From October to November in 2022, a preliminary emergency response capacity evaluation indicators system for major infectious diseases in primary medical institutions in Beijing, was constructed by literature analysis method, policy induction method, and focus group discussion method. From March to May in 2023, two rounds of correspondence were conducted using the modified delphi method, and the emergency response capacity evaluation indicators system for major infectious diseases in primary medical institutions in Beijing, was determined according to the results of modified Delphi method, and the weights of all of the evaluation indicators were determined by analytic hierarchy process.

The effective recovery rates of the questionnaires in the two rounds of modified Delphi method was 94.4% (17/18) and 100.0% (17/17), respectively, and the expert authority coefficient was 0.84. The coordination coefficients of the importance and operability of the indicators was 0.144 (P<0.05), 0.190 (P<0.05), respectively, in the first round of modified Delphi method; was 0.104 (P<0.05), 0.155 (P<0.05), respectively, in the second round of modified Delphi method. In the eventually formed emergency response capacity evaluation indicators system for major infectious diseases in primary medical institutions in Beijing, there were 3 first-level indicators (preparedness capacity, disposal capacity, and assessment and recovery capacity), 18 second-level indicators, and 56 third-level indicators, and the weight of the 3 first-level indicator was 0.528, 0.333 and 0.140, respectively.

Based on the theoretical framework of emergency management and the concept of resilience, we constructed the emergency response capacity evaluation indicators system for major infectious diseases in primary medical institutions in Beijing, in which the indicators can be dynamically adjusted according to the actual situation, so as to more truly reflect the emergency response capacity for major infectious diseases, and to provide a reference for the evaluation of emergency response capacity for major infectious diseases in primary healthcare institutions.

Community health service institutions are the bottom of the infectious disease prevention and control system, and it's crucial to the control of urban epidemic situations. After the COVID-19, the prevention and control capacity of community health service institutions in Beijing has been improved, but there is a lack of evaluation, and the direction of future improvement is not clear.

To evaluate the changes in the infectious disease prevention and control capacity of community health service institutions in Beijing during the COVID-19 period, analyze the influencing factors, and put forward suggestions for improvement measures, so as to provide a scientific basis for further enhancing the prevention and control capacity of infectious diseases at the grass-roots level.

From 2019 to 2022, questionnaires were conducted on 334, 354, 405 and 405 community health service centers and independent community health service stations willing to cooperate with the survey in Beijing. The quantitative scoring method was used to measure the comprehensive capacity of infectious disease prevention and control of various institutions from the sentinel setting (20 points), pathogen detection of common infectious diseases (30 points), and the emergency capacity of responding to infectious diseases and public health emergencies (50 points). Linear mixed model is used to compare the changes in the prevention and control capacity of various institutions from 2019 to 2022, and the factors affecting the improvement of the prevention and control capacity of infectious diseases are analyzed.

The median scores of comprehensive capacity for infectious disease prevention and control in 2019-2022 were 50 (43, 60), 63 (43, 70), 70 (50, 80) and 70 (50, 80), respectively. The differences between each year were statistically significant (P<0.05) .Linear mixed model showed that, organization category, whether to set up preventive health care department, whether to have P2 laboratory, the actual number of employees have an impact on the comprehensive ability of infectious disease prevention and control (P<0.05). The comprehensive capacity of infectious disease prevention and control in community health service centers was 18.94 (95%CI=15.73-22.15, P<0.05) higher than that of independent community health service stations, and the comprehensive capacity of the prevention and health care department was 6.50 (95%CI=4.00-9.01, P<0.05) higher than those without, the institution of infectious disease prevention and control with P2 laboratories was 2.59 (95%CI=0.62-4.55, P<0.05) higher than those without, and the capacity for infectious disease prevention and control of institutions with a larger number of on-the-job staff was increased by 0.05 (95%CI=0.03-0.07, P<0.05) .

During the period of COVID-19 disease, the prevention and control capacity of the community health service institutions in Beijing has been improved year by year, mainly influenced by factors such as the type of institutions, the setting of prevention and health care departments, the setting of P2 laboratories and the actual number of people on duty. It is suggested to invest continuously, rationally allocate resources, strengthen personnel training, and establish a sound working mechanism.

China is not only a high-burden country for tuberculosis (TB) but also bears the largest global burden of hepatitis B. The dual prevalence of TB and hepatitis B poses significant challenges, as co-infected patients face higher risks of treatment failure and relapse. A key clinical challenge lies in ensuring the effective implementation of anti-tuberculosis regimens while minimizing the incidence of liver injury and avoiding treatment interruptions caused by hepatic complications. Due to limited clinical research data in this area in China, comprehensive diagnostic and treatment guidelines for pulmonary TB complicated by chronic hepatitis B virus (HBV) infection have yet to be established. Based on this, and referencing relevant domestic and international guidelines and consensus documents, the National Clinical Research Center for Infectious Diseases Jiangxi Branch, Jiangxi Provincial Key Laboratory of Tuberculosis organized a panel of experts from various fields including tuberculosis, infectious diseases, hepatology, and pathology to conduct intensive discussions and develop 11 expert consensus recommendations. This consensus aims to provide guidance for standardized diagnosis and treatment as well as scientific management of tuberculosis patients co-infected with HBV.

The epidemic of multidrug-resistant tuberculosis (MDR-TB) is a serious public health hazard. China is one of the countries with high MDR-TB disease burden.

To analyze the current status and changing trends of MDR-TB disease burden in China from 1992 to 2021, and to provide a reference for the development of prevention and control strategies.

Disease burden data of MDR-TB of China, the global and different socio-demographic index (SDI) regions from 1992-2021 were extracted from the Global Burden of Disease database 2021 (GBD 2021), and the Joinpoint regression model was used to calculate the annual percentage change (APC) and average annual percentage change (AAPC) to describe changing trends. Age-period-cohort model was used to analyze the age, period and cohort effects of MDR-TB incidence and mortality in China.

From 1992 to 2021, the standardized incidence rate and standardized mortality rate of MDR-TB in China decreased from 7.72/100 000 and 2.21/100 000 to 1.49/100 000 and 0.15/100 000, respectively, with decreases of 80.70% and 93.21%, respectively. In 2021, China's MDR-TB standardized incidence rate and standardized mortality rate were in the lower middle level among the global and different SDI regions, but the burden was still heavier compared with that in high SDI regions. The results of the Joinpoint analysis showed that, in terms of regional differences, the AAPC of MDR-TB standardized incidence rate and standardized mortality rate in China from 1992 to 2021 were -5.51% and -9.06%, respectively, which were on decreasing trends (P<0.05). In terms of gender differences, both the standardized incidence rate and standardized mortality rate of MDR-TB decreased more rapidly in females (AAPC was -5.91% and -10.08%, respectively, P<0.05) than in males (AAPC was -5.26% and -8.51%, respectively, P<0.05), and the disease burden was higher in males than in females. In terms of age differences, the fastest decrease of the incidence rate of MDR-TB occurred at 85-89 years old (AAPC=-6.04%, P<0.05), and the fastest decrease of the mortality rate was occurred at 15-19 years old (AAPC=-9.88%, P<0.05). The results of the APC analysis showed that the net shift values of the incidence rate of MDR-TB and the mortality rate in China from 1992 to 2021 were -7.78% and -11.07%, respectively. The age effect showed that the incidence rate fluctuated and increased with age increase, and the mortality rate showed a monotonous increment, both of which reached their maximum values at 85-89 years old, with 22.10/100 000 and 16.58/100 000, respectively. The period effect showed that the risk of incidence and mortality decreased with the passage of years, and the risk ratio (RR) of incidence and mortality decreased from 1.55 and 1.87 to 0.26 and 0.13, respectively. The cohort effect showed that the risk of incidence and mortality decreased with the backward movement of birth cohort, and the RR of incidence and mortality decreased from 44.01 and 185.33 to 0.02 and 0.01, respectively.

The disease burden of MDR-TB in China showed a decreasing trend overall from 1992 to 2021, but the speed of decrease gradually slowed down, and the disease burden was still heavier compared with that in high SDI regions. Males and the elderly are high disease burden groups, and the popularisation of MDR-TB health education and early diagnosis and treatment should be strengthened.

Pneumonia in children poses a serious disease burden globally, and pneumococcal conjugate vaccination is the most direct and effective preventive measure against pneumococcal disease, while there is a lack of information on the coverage of 13-valent pneumococcal conjugate vaccine (PCV13) in children.

To analyze the vaccination rate of PCV13 in children born from 2017 to 2022 in Jiangsu Province, find the difference and reasons under different circumstances, and provide reference on improvement of PCV13 vaccination rate for future.

Through the Jiangsu provincial vaccination management information system, the basic information and vaccination information of PCV13 (as of 2023-12-31) were collected, including the date of birth, gender, household registration attributes, date of vaccination, and the number of doses of vaccination and other basic information, and the data were descriptive analyzed.

There were 4 537 123 children registered in the Jiangsu provincial vaccination management information system from 2017 to 2022, of which 784 220 children were vaccinated with 2 406 974 doses of PCV13, with a vaccination rate of 17.28%. In Jiangsu Province, there were 697 698 children given the first dose of vaccination, of which 82 503 (11.83%) were given the first dose at <2 months of age, 511 273 (73.28%) at 2-6 months of age, 26 106 (3.74%) at 7-11 months of age, 38 530 (5.52%) at 12-24 months of age, and 39 286 (5.63%) at 2-5 years of age. The rate of 1, 2, 3, and 4 doses of vaccination was higher among resident children (16.11%, 14.71%, 13.43%, and 11.50%) than among migrant children (13.87%, 12.70%, 11.42%, and 9.52%) (P<0.05). In terms of regional distribution, the vaccination rate of each dose was in the order of South Jiangsu, Central Jiangsu and North Jiangsu from high to low, and the difference was statistically significant (P<0.05). In terms of gender, there was no statistically significant difference in the rates of the first dose and the second doses of vaccination between boys and girls (P>0.05) ; but the rates of the 3rd and 4th doses of vaccination were lower in boys than in girls (P<0.05). Among children born in 2017-2022, the rate of 1, 2, 3, and 4 doses of vaccination increased with the year of birth (P<0.05). The proportion of children aged 2-6 months who received the first dose of PCV13 was the highest among children of different household registration, gender, year of birth and region, and significant differences were also observed in the ages at the first vaccination of the children from various household registration, of both genders, with various regions, and in various years of birth (P<0.05) .

The vaccination rate of PCV13 among children in Jiangsu Province is 17.28%, which is at a relatively low level. The age of the first dose of vaccination is the highest in the age of 2-6 months, and the vaccination rate of each dose increases with the year of birth, so in order to improve the coverage level of PCV13 in the target population, it is recommended that PCV13 be included in the National Immunization Program.

The prevalence and epidemiology of pre-treatment drug resistance (PDR) and acquired drug resistance (ADR) among HIV-infected individuals vary considerably in different regions of China. Both types of drug resistance have adverse effects on the antiviral treatment outcomes for patients, potentially exacerbating their poor prognosis. Currently, there is a paucity of research on the prevalence and epidemiology of PDR and ADR among HIV-infected individuals in Southwest China.

This study investigated the prevalence and epidemiology of pre-treatment drug resistance and acquired drug resistance among people living with HIV (PLWH) in Southwest China.

This was a large cross-sectional study that enrolled PLWH who visited Guiyang Public Health Clinical Center between January 1, 2021, and June 30, 2023, and underwent drug resistance gene testing. HIV-1 genotype and drug resistance were analyzed using HIV-1 pol sequence. The Stanford University HIV Drug Resistance Database was used to analyze major drug resistance mutations in the reverse transcriptase and protease Sanger sequences. Risk factors associated with pre-treatment drug resistance were evaluated using a Logistic regression model.

A total of 1 613 individuals were included in the study, with 824 ART-naive and 789 ART-experienced. The most common genotype among ART-naive patients was B+C (47.0%), and the drug resistance rate was 18.7% (154/824) with non-nucleoside reverse transcriptase inhibitors (NNRTIs) accounting for 14.9% (123/824), nucleoside reverse transcriptase inhibitors (NRTIs) accounting for 1.7% (14/824), protease inhibitors (PIs) accounting for 2.7% (22/824), and integrase strand transfer inhibitors (INSTIs) accounting for 1.9% (16/824). Among the ART-experienced patients, the most common genotype was CRF01-AE (37.4%), with a drug resistance rate of 27.8% (219/789). The mutation rates for NNRTIs, NRTIs, PIs, and INSTIs were 7.7% (61/789), 19.3% (152/789), 2.7% (21/789), and 1.1% (9/789), respectively. Furthermore, multivariate Logistic regression modeling revealed that transmission route, CD₄⁺ T-cell count, viral load, and the time interval between diagnosis and ART initiation were associated with an increased risk of pre-treatment drug resistance (P<0.05) .

The incidence of pre-treatment drug resistance and acquired drug resistance mutations among PLWH in Southwest China is relatively high, 18.7% and 27.8% respectively. Transmission route, CD₄⁺ T-cell count, viral load, and the time interval between diagnosis and ART initiation are associated with an increased risk of pretreatment drug resistance. Therefore, to prevent the development of resistance, there is an urgent need for routine baseline genotypic resistance testing and adequate intervals for viral load monitoring.

Intestinal infectious diseases are one of the common infectious diseases. Analysis and prediction of their epidemic status can provide certain reference for the prevention and treatment of intestinal infectious diseases.

To understand the incidence and mortality of three enteric infectious diseases, including diarrheal diseases, typhoid fever and paratyphoid fever, and invasive non-typhoidal Salmonella intestinal infections in China from 1990 to 2019, and to predict their morbidity and mortality from 2020 to 2030, so as to provide reference for the prevention and control of intestinal infectious diseases.

Based on the 2019 Global Burden of Disease Database (GBD), the incidence and mortality data of three enteric infectious diseases, including diarrheal diseases, typhoid fever and paratyphoid fever, and invasive non-typhoidal Salmonella intestinal infections in China from 1990 to 2019 were collected. The change rate (%) and estimated annual percentage change (EAPC) were used to describe the changing trends of the above three intestinal infectious diseases. The autoregressive integrated moving average model (ARIMA) was used to predict the morbidity and mortality of the above three enteric infectious diseases in China from 2020 to 2030.

There was no statistically significant change in the incidence of diarrheal diseases from 1990 to 2019 (EAPC=0.09, P>0.05), while the incidence of typhoid fever, paratyphoid fever and invasive non-typhoid salmonella intestinal infections showed a downward trend (EAPC were -4.0% and -0.64% respectively, P<0.05). The mortality rates of diarrheal diseases, typhoid fever and paratyphoid fever, and invasive non-typhoidal Salmonella intestinal infections all showed a downward trend from 1990 to 2019 (EAPC were -8.39%, -3.38%, and -1.87%, respectively, P<0.05). Among all age groups, the incidence of diarrheal disease among people aged ≥70 years in 2019 was the highest among all age groups, and it was on the rise (EAPC=0.27, P<0.05). The mortality rates of the above three intestinal infectious diseases in all age groups from 1990 to 2019 showed a downward trend (P<0.05). The ARIMA model prediction results show that the incidence of diarrheal diseases in China will be on an upward trend from 2020 to 2030, while the incidence of typhoid and paratyphoid fever and invasive non-typhoid Salmonella will be on a downward trend. The estimated incidence of the above three diseases was 58 793.04/10⁵, 5.26/10⁵, 0.447/10⁵, respectively. In addition, the mortality rates of diarrheal diseases, typhoid fever and paratyphoid fever, and invasive non-typhoid Salmonella in our country will all show a downward trend from 2020 to 2030. The mortality rates of the above three diseases in 2030 were expected to be 0.214/10⁵ and 0.039/10⁵, 0.026/10⁵, respectively.

The mortality rates of diarrheal diseases, typhoid fever and paratyphoid fever, and invasive non-typhoidal Salmonella intestinal infections in China will show a downward trend in 2030. Except for the incidence of diarrheal diseases, which will show an upward trend, the incidence of the other two diseases will show a downward trend. It reminds the government and relevant health departments to pay attention to diarrheal diseases and adopt different prevention and control measures for different groups of people.

Surge hospitals play an important role in combating a major infectious disease outbreak. Compared with other situations, the management and operation of surge hospitals amid the outbreak of major infectious diseases are specific, and serious consequences will be caused if there is a loophole in the hospital management model. However, there is no research that reviews and summarizes relevant studies.

To perform a scoping review of the research on surge hospital management during a major infectious disease outbreak, so as to understand the elements of hospital management and research status, providing guidance for future research in this field.

This review used a methodological framework developed based on Arksey & O'Malley's framework and principles as well as recommendations from related scholars and colleagues' guiding principles. Studies on the management of surge hospitals amid the outbreak of major infectious diseases were searched in electronic databases of PubMed, Embase, Cochrane Library and SinoMed from inception to June 17, 2022. Then the included studies were summarized and analyzed.

Twenty-five studies were included. All studies were about the management of mobile cabin hospitals and designated hospitals for treating COVID-19 in China during the COVID-19 pandemic. The elements of surge hospital management included emergency preparedness, personnel management, operation management and service management.

The number of studies on surge hospital management has increased, with an extensive scope of research, but the quality of them is unsatisfactory, and there is a lack of unified evaluation indicators and feedback tools. In the future, efforts should be made to improve the quality of relevant studies, formulate a standardized surge hospital management process, increase the construction and implementation of evaluation indicators, so as to provide more guidance for clinical nursing practice.

Post-COVID-19 condition is defined as the presence of symptoms that cannot be explained by other diagnoses, lasting for at least 2 months, occurring three months after a possible or confirmed SARS-CoV-2 infection. It is the result of a complex interplay of biological, psychological, and sociocultural factors, characterized by a high number of affected individuals, complex pathogenesis, diverse symptoms, and a significant need for long-term care. The diagnosis is considered exclusionary and can be classified into six subtypes, including non-severe COVID-19 multiorgan sequelae, pulmonary fibrosis sequelae, myalgic encephalomyelitis or chronic fatigue syndrome, postural orthostatic tachycardia syndrome, post-intensive care syndrome, and medical or clinical sequelae. Based on comprehensive evaluation, treatment and care can be provided through a multidisciplinary approach involving medication, diet, exercise, psychological interventions, patient education, and other methods.

Hepatocellular carcinoma (HCC) is the main pathological type of primary liver cancer (PLC) and is closely associated with Hepatitis B virus (HBV) infection. HCC in its early stages often presents no significant symptoms and is usually discovered at an advanced stage with liver, portal vein, or other site metastases, leading to a poor prognosis. Regular screening and early diagnosis in high-risk populations in the early stages of the disease are of great significance for clinical treatment and prognosis.

To explore the application value of oligosaccharides and alpha-fetoprotein (AFP) in the risk population and patients of HBV-related HCC, providing a reference for clinical diagnosis.

The study included 165 chronic HBV infection patients treated at the First Affiliated Hospital of Soochow University from January to November 2022, comprising 123 non-HCC and 42 HCC patients. Patient data (age, gender, cirrhosis status), laboratory indices[total bilirubin (TB), albumin (ALB), platelet count (PLT), AFP]were collected through electronic medical records, and a liver cancer risk prediction model score for chronic liver disease patients (aMAP score) was calculated, along with oligosaccharide marker test results (G-Test). HCC patients were classified as the HCC group (42 cases), and non-HCC patients were divided based on aMAP scores into low-risk (<50 points, 40 cases), medium-risk (50-60 points, 44 cases), and high-risk (>60 points, 39 cases) groups. Receiver operating characteristic (ROC) curves were plotted to analyze the efficacy of AFP, G-Test, and their combined diagnosis of HCC, calculating the area under the ROC curve (AUC), and the DeLong test was used to compare the differences between combined and single indicator AUCs. Kappa consistency tests were used to analyze the consistency of AFP and G-Test with clinical diagnostic results.

In patients with HCC, levels of AFP and G-Test were higher compared to those in the low-risk, medium-risk, and high-risk groups (P<0.05). Additionally, age and the proportion of liver cirrhosis were higher than those in the low-risk and medium-risk groups, ALB levels was lower than that of low risk group and medium risk group and TB levels were lower than those in the high-risk group, while PLT was lower than that in the low-risk group (P<0.05). In the high-risk group, patients exhibited higher age, TB, and G-Test levels compared to the low-risk and medium-risk groups, whereas ALB and PLT levels were lower than those in the low-risk and medium-risk groups, and the proportion of liver cirrhosis was higher than that in the low-risk group (P<0.05). Patients in the medium-risk group showed higher age and liver cirrhosis proportion compared to the low-risk group, and PLT was lower than that in the low-risk group (P<0.05). The AUCs for diagnosing HCC using AFP and G-Test were 0.796 (95%CI=0.706-0.886, P<0.001) and 0.878 (95%CI=0.813-0.943, P<0.001), respectively. The AUC for the combined diagnosis was 0.901 (95%CI=0.844-0.957, P<0.001). DeLong test results showed that the AUC for combined diagnosis was higher than AFP alone (Z=2.104, P=0.035). Consistency analysis showed that the concordance rate of AFP with clinical diagnosis was 84.8% (140/165), with moderate consistency (Kappa=0.539, P<0.001), and for G-Test, it was 89.5% (145/165), indicating higher consistency (Kappa=0.704, P<0.001). The AUC of G-Test in diagnosing AFP-negative HCC was 0.895 (95%CI=0.839-0.952, P<0.001) .

Oligosaccharide chain markers can be used as a complementary detection marker for AFP-negative HCC patients as a potential serum biomarker with better diagnostic efficacy than AFP in patients with HBV-related HCC.

After infection with SARS-CoV-2, the body will experience symptoms such as hyposthenia, fatigue, and accelerated heart rate for a period of time. Current research institutions do not have a clear description of the persistent symptoms and causes of corona virus disease 2019 (COVID-19) .

To explore the correlation between the characteristics of fatigue and its related symptoms during the recovery period of COVID-19, and provide data reference for the scientific control of COVID-19.

The survey of COVID-19 was conducted in urban and rural areas of Guangzhou, Wuhan and Zhengzhou from December 2022 to February 2023, a total of 750 questionnaires were distributed and 732 questionnaires were recovered, with an effective rate of 97.6%. Among the 732 respondents, 356 were males (48.63%) and 376 were females (51.37%) ; the average age was (35.2±16.0) years. There were 526 infected individuals and 206 uninfected individuals. The infections and clinical symptoms of the respondents were statistically analyzed by using questionnaires, and the subjective fatigue level was measured using the Fatigue Scale-14 (FS-14), and the measurement results were analyzed for differences. Pearson correlation analysis was used to explore the correlation between clinical characteristics and fatigue levels in COVID-19, and binary Logistic regression analysis was used to explore the risk factors for fatigue in COVID-19.

Fever was the most common symptom of COVID-19, accounting for 88.97% (468/526), the average maximum fever temperature in febrile patients was (38.96±1.35) ℃. The physical fatigue and overall fatigue scores of infected individuals were higher than those of uninfected individuals (P<0.05). The scores of physical fatigue, mental fatigue and overall fatigue of female infected individuals were higher than those of male infected individuals (P<0.05). Pearson correlation analysis showed that the total fatigue score of FS-14 was positively correlated with the maximum fever temperature (r=0.192, P<0.001), fever duration (r=0.299, P<0.001) and physical recovery time (r=0.358, P<0.001). The results of binary Logistic regression analysis showed that fever (OR=1.215, 95%CI=1.029-1.434, P=0.022), the accelerated heart rate (OR=7.325, 95%CI=1.671-32.114, P=0.008), and ocular pain (OR=3.298, 95%CI=1.251-8.696, P=0.016) were risk factors for fatigue above moderate in COVID-19 during recovery period.

The fatigue symptoms of COVID-19 are obvious during the recovery period, with females had higher levels of fatigue than males. Accelerated heart rate, ocular pain, and elevated maximum fever temperature may be risk factors for fatigue above moderate in COVID-19 during recovery period.

The COVID-19 pandemic has devastated human health and global economy. Diminished immune function of health-related vulnerable populations leads to insufficient protective effect of the vaccine with a higher risk of severe illness and death following infection, and there is a lack of adequate targeted drugs for the prevention and treatment of COVID-19. In the context that COVID-19 treated as a Category B disease in China, vulnerable populations have become the priority populations for epidemic prevention and control. Therefore, the strategies of individual immunization and prevention should be further optimized for vulnerable populations. In addition to vaccines, other prevention strategies should be supplemented, such as long-acting neutralizing antibodies. Based on this, this paper reviews the identification, immune function characteristics and prevention strategies of COVID-19 in vulnerable populations, to provide a reference for the prevention and control strategies for health-related vulnerable populations in China, expecting that more suitable preventive drugs for vulnerable populations can be developed in the future to reduce the risk of COVID-19 in vulnerable populations.

Inhaled recombinant COVID-19 vaccine (type 5 adenoviral vector) (hereinafter referred to as the inhaled COVID-19 vaccine) is the first approved inhaled COVID-19 vaccine in China, with the advantages of good immunity, painlessness, and higher accessibility, which has been included in the WHO Emergency Use Listing and China's list of second-dose booster immunization vaccines. The real-world application of this vaccine deserves more attention due to the poor understanding of it by the public.

To understand the real experience in depth of first-line medical staff in epidemic prevention aged≥18 years in Guiyang city who received inhaled COVID-19 vaccine, so as to provide a reference for the promotion of this type of vaccine.

The recipients who completed the emergency vaccination with inhaled COVID-19 vaccine at a vaccination site of Guiyang city in October 2022 were selected as research subjects based on the the principle of booster immunization by using purposive sampling method. The sample size was determined by interviewing until no new case emerged which was data saturation. A total of 17 recipients were interviewed in this study. Semi-structured interviews were conducted with the research subjects, face-to-face interviews were conducted to understand the vaccination experience at that time firstly, and telephone interviews were conducted 5-7 days after vaccination. The Colaizzi seven-step analysis method was used for the data collection and analysis.

A total of five themes were summarized including the convenience of vaccination, good vaccination experience, light psychological burden, low vaccine hesitancy and uncertain protective effect. The convenience of vaccination includes simple and time-saving vaccination process, fast vaccination speed, low cost, and no interruption of nucleic acid testing; the good vaccination experience includes comfortable feeling of vaccination, harmonious observation atmosphere, fewer adverse reactions, and no interference with daily life; light psychological burden includes reduction of tension and anxiety of vaccination, better mental health maintenance, non-invasive vaccination and elimination of vaccination fears; low vaccine hesitancy includes high vaccination accessibility, increase of vaccine acceptance, increase of public perception of epidemic outbreak risk; uncertain protective effect includes uncertain which vaccination method provides better protection between injection and inhalation, whether inhaled COVID-19 vaccine has a good protective effect against variant strains.

Inhaled COVID-19 vaccine is convenient to administer with fewer adverse reactions, which is highly accepted by first-line medical staff in epidemic prevention aged≥18 years in Guiyang city with good experience.

The elderly are a priority population for COVID-19 vaccination. COVID-19 vaccination can effectively reduce the risk of developing severe and critically ill patients or even death in COVID-19 patients. However, the current vaccination rate of the elderly in China is relatively low, and the COVID-19 vaccination behavior among the elderly has been rarely reported in current studies.

To investigate COVID-19 vaccination behavior and its influencing factors among the elderly in China, and to provide a reference for improving the COVID-19 vaccination rate of the elderly.

A total of 1 323 older adults aged 60 years and above in Wujin District of Changzhou City, Zhongmu County of Zhengzhou City, Chengzhong District of Xining City and Linkou County of Mudanjiang City were selected as research subjects from August 3 to August 14 in 2022 by using a stratified random sampling method and investigated by self-designed questionnaires. Binary Logistic regression analysis was used to explore the influencing factors of the first dose of COVID-19 vaccination, full course of COVID-19 vaccination, and booster dose of COVID-19 vaccination.

96.60% (1 278/1 323) of the elderly received the first dose of COVID-19 vaccine, 91.76% (1 214/1 323) completed the full course of COVID-19 vaccination, and 79.67% (1 054/1 323) received the booster dose of COVID-19 vaccine. The results of binary Logistic regression analysis showed that compared with the older adults aged 60-64 years, the older adults aged 75 years and above were less likely to receive the first dose of the COVID-19 vaccine〔OR (95%CI) =0.27 (0.11, 0.62), P<0.05〕; compared with the older adults with chronic disease, the older adults without chronic disease were more likely to receive the first dose of COVID-19 vaccine〔OR (95%CI) =2.07 (1.12, 3.84), P<0.05〕; the older adults with higher levels of perceived benefit were more likely to receive the first dose of COVID-19 vaccine〔OR (95%CI) =1.39 (1.07, 1.79), P<0.05〕. Compared with the older adults aged 60-64 years, who maintained regular physical exercise, those aged 75 years and above〔OR (95%CI) =0.34 (0.19, 0.59), P<0.05〕, who did not maintain regular physical exercise〔OR (95%CI) =0.64 (0.42, 0.96), P<0.05〕were less likely to complete the full course of vaccination; compared with the older adults with chronic diseases, the older adults without chronic diseases were more likely to complete the full course of the COVID-19 vaccination〔OR (95%CI) =1.59 (1.05, 2.40), P<0.05〕. Compared with older adults aged 60-64 years and from the central region, the older adults aged 75 years and above〔OR (95%CI) =0.55 (0.36, 0.86), P<0.05〕and from the eastern region〔OR (95%CI) =0.47 (0.34, 0.64), P<0.05〕were less likely to receive the booster dose of COVID-19 vaccine; compared with the older adults with chronic diseases, the older adults without chronic diseases were more likely to receive the booster dose of COVID-19 vaccine〔OR (95%CI) =1.54 (1.15, 2.06), P<0.05〕; older adults with higher levels of perceived severity were more likely to receive the booster dose of COVID-19 vaccine〔OR (95%CI) =1.06 (1.00, 1.11), P<0.05〕. Subgroup analysis showed that compared with the older adults with chronic diseases aged 60-64 years, from the central region, older adults with chronic diseases aged 75 years and above〔OR (95%CI) =0.35 (0.19, 0.65), P<0.05〕, from the eastern region〔OR (95%CI) =0.49 (0.29, 0.83), P<0.05〕were less likely to receive the booster dose of COVID-19 vaccine; older adults with chronic diseases who had higher levels of perceived severity were more likely to receive the booster dose of COVID-19 vaccine〔OR (95%CI) =1.09 (1.01, 1.18), P<0.05〕. Compared with the older adults from the central region without chronic diseases, the older adults from the eastern region without chronic diseases were less likely to receive the booster dose of COVID-19 vaccine〔OR (95%CI) =0.44 (0.29, 0.68), P<0.05〕.

More attention should be paid to the elderly who are senior and with chronic diseases in the process of COVID-19 vaccination. The vaccination rate of the elderly should be further increased by strengthening the publicity of COVID-19 vaccine knowledge.