What will it take? Perspectives from five low- and middle-income countries on opportunities and challenges of introducing new maternal vaccines.

Background: New vaccines for pregnant women have recently been introduced in some high-income countries to protect infants in early life. Implementing maternal immunisation (MI) successfully in low- and middle-income countries will require planning and adaptations to immunisation and maternal health programs. To inform cost of MI delivery studies, we gathered perspectives from key stakeholders in five countries (Bangladesh, Ghana, Kenya, Mozambique, and Nepal) regarding health system requirements, opportunities, and challenges to introducing new maternal vaccines into routine health programs.

Gathering information on maternal immunization readiness in Bangladesh, Ghana, Kenya, Mozambique, and Nepal: Applying a WHO checklist.

New respiratory syncytial virus (RSV) maternal vaccines have begun roll out in some countries, with efforts in progress to broaden access worldwide and shorten the timeline to access for low- and middle-income countries (LMICs). Prior to new maternal immunization (MI) introductions, countries will need to evaluate their capacity and readiness for successful introduction. The World Health Organization's Maternal Immunization and Antenatal Care Situation Analysis (MIACSA) project (2016-2019) developed a checklist for countries to self-evaluate their capacity to introduce new maternal vaccines.

Hybrid immunity to SARS-CoV-2 arises from serological recall of IgG antibodies distinctly imprinted by infection or vaccination.

Unlabelled: We used plasma IgG proteomics to study the molecular composition and temporal durability of polyclonal IgG antibodies triggered by ancestral SARS-CoV-2 infection, vaccination, or their combination ("hybrid immunity"). Infection, whether primary or post-vaccination, mainly triggered an anti-spike antibody response to the S2 domain, while vaccination predominantly induced anti-RBD antibodies. Immunological imprinting persisted after a secondary (hybrid) exposure, with >60% of the ensuing serological response originating from the initial antibodies generated during the first exposure.

Evidence to support health system prioritization of health behaviors in the COVID-19 era.

Background: Since the COVID-19 pandemic health systems have shifted necessarily from chronic to infectious disease treatment, but chronic disease remains critical. One large health system uniquely tracks member health behaviors. This analysis compares data from select months of an ongoing monthly cross-sectional survey before and during the pandemic.