{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,14]],"date-time":"2026-05-14T06:33:43Z","timestamp":1778740423706,"version":"3.51.4"},"reference-count":47,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2025,8,8]],"date-time":"2025-08-08T00:00:00Z","timestamp":1754611200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Vaccines"],"abstract":"<jats:p>Background: Immunocompromised and clinically fragile individuals are at increased risk of herpes zoster (HZ), but vaccine uptake remains low due to organizational barriers and vaccine hesitancy (VH). This study aimed to evaluate the impact of a multidisciplinary hospital-based counseling model on attitudes toward the recombinant adjuvanted zoster vaccine (RZV). The primary objective was to assess changes in VH over time using the Vaccination Attitudes Examination (VAX) scale; secondary objectives included identifying factors associated with VH, evaluating vaccine safety, and monitoring post-vaccination HZ incidence. Methods: A prospective cohort study was conducted in a large research hospital in Rome, in collaboration with the Local Health Authority. Eligible patients were offered individualized counseling and administered two doses of the RZV. VH was assessed using the 12-item VAX scale at baseline and at one-year follow-up. Multivariable linear regression analysis was performed to investigate associations between baseline characteristics and VH scores. Results: Between July 2022 and July 2023, 178 patients were enrolled, of whom 90 completed the one-year follow-up. Baseline VH was moderate (mean VAX: 2.291\/6.000); higher scores were significantly associated with younger age, female sex, and rheumatologic disease (p &lt; 0.05). After the intervention, VAX scores improved significantly across all subscales, particularly in trust in vaccine safety and benefits (p &lt; 0.001). RZV was well tolerated; adverse events were mild and transient. Breakthrough HZ occurred in 3.33% of cases during follow-up. Conclusions: A multidisciplinary hospital-based model effectively improved vaccine attitudes and acceptance in fragile patients. Tracking VH over time with validated tools offers insights for scaling targeted interventions in high-risk groups.<\/jats:p>","DOI":"10.3390\/vaccines13080843","type":"journal-article","created":{"date-parts":[[2025,8,8]],"date-time":"2025-08-08T09:56:42Z","timestamp":1754647002000},"page":"843","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Understanding Attitudes Toward Zoster Vaccination in the Hospital Setting: A Multidisciplinary Model to Contrast Vaccine Hesitancy in Fragile Patients\u2014A Prospective Longitudinal Observational Study"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0189-7687","authenticated-orcid":false,"given":"Luca","family":"Regazzi","sequence":"first","affiliation":[{"name":"Hygiene Unit, Department of Life Sciences and Public Health, Universit\u00e0 Cattolica del Sacro Cuore, 00168 Roma, Italy"},{"name":"Department of Biomedicine and Prevention, Tor Vergata University of Rome, 00133 Roma, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Silvia","family":"Martinelli","sequence":"additional","affiliation":[{"name":"Hygiene Unit, Department of Life Sciences and Public Health, Universit\u00e0 Cattolica del Sacro Cuore, 00168 Roma, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Federica","family":"Rizzo","sequence":"additional","affiliation":[{"name":"Hygiene Unit, Department of Life Sciences and Public Health, Universit\u00e0 Cattolica del Sacro Cuore, 00168 Roma, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Enrica","family":"Tamburrini","sequence":"additional","affiliation":[{"name":"Infectious Diseases Unit, Department of Safety and Bioethics, Universit\u00e0 Cattolica del Sacro Cuore, 00168 Roma, Italy"},{"name":"Infection Disease Unit, Department of Medical and Surgery Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Roma, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7559-7364","authenticated-orcid":false,"given":"Pierluigi Francesco","family":"Salvo","sequence":"additional","affiliation":[{"name":"Infectious Diseases Unit, Department of Safety and Bioethics, Universit\u00e0 Cattolica del Sacro Cuore, 00168 Roma, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Silvia Laura","family":"Bosello","sequence":"additional","affiliation":[{"name":"Rheumatology Unit, Department of Geriatric and Orthopaedic Sciences, Universit\u00e0 Cattolica del Sacro Cuore, 00168 Roma, Italy"},{"name":"Rheumatology Unit, Department of Ageing, Neurosciences, Head-Neck and Orthopaedics Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Roma, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francesco","family":"Landi","sequence":"additional","affiliation":[{"name":"Geriatrics Unit, Department of Geriatric and Orthopaedic Sciences, Universit\u00e0 Cattolica del Sacro Cuore, 00168 Roma, Italy"},{"name":"Geriatrics Unit, Department of Ageing, Neurosciences, Head-Neck and Orthopaedics Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Roma, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2426-3465","authenticated-orcid":false,"given":"Simona","family":"Sica","sequence":"additional","affiliation":[{"name":"Hematology Unit, Department of Radiological and Haematological Sciences, Universit\u00e0 Cattolica del Sacro Cuore, 00168 Roma, Italy"},{"name":"Haematology Unit, Department of Laboratory and Hematology Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Roma, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-2054-5155","authenticated-orcid":false,"given":"Antonietta","family":"Spadea","sequence":"additional","affiliation":[{"name":"ASL Roma 1\u2014Local Health Authority, 00193 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5804-2284","authenticated-orcid":false,"given":"Domenico","family":"Pascucci","sequence":"additional","affiliation":[{"name":"Hygiene Unit, Department of Life Sciences and Public Health, Universit\u00e0 Cattolica del Sacro Cuore, 00168 Roma, Italy"},{"name":"Health Management, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Roma, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8532-0593","authenticated-orcid":false,"given":"Patrizia","family":"Laurenti","sequence":"additional","affiliation":[{"name":"Hygiene Unit, Department of Life Sciences and Public Health, Universit\u00e0 Cattolica del Sacro Cuore, 00168 Roma, Italy"},{"name":"Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Roma, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,8,8]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Oleszko, M., Zapolnik, P., Kmiecik, W., and Czajka, H. (2025). Herpes Zoster: Risk Factors for Occurrence, Complications, and Recurrence with a Focus on Immunocompromised Patients. Diseases, 13.","DOI":"10.3390\/diseases13030071"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1714","DOI":"10.1080\/21645515.2020.1847582","article-title":"A systematic literature review of herpes zoster incidence worldwide","volume":"17","author":"Vroling","year":"2021","journal-title":"Hum. Vaccines Immunother."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1293","DOI":"10.1111\/ced.14650","article-title":"Cigarette smoking and risk of herpes zoster: A population-based cohort study in Taiwan","volume":"46","author":"Dai","year":"2021","journal-title":"Clin. Exp. Dermatol."},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Patil, A., Goldust, M., and Wollina, U. (2022). Herpes zoster: A Review of Clinical Manifestations and Management. Viruses, 14.","DOI":"10.3390\/v14020192"},{"key":"ref_5","unstructured":"CDC (2024, November 16). Clinical Considerations for Shingrix Use in Immunocompromised Adults Aged \u226519 Years, Available online: https:\/\/www.cdc.gov\/shingles\/hcp\/vaccine-considerations\/immunocompromised-adults.html."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"3735","DOI":"10.1080\/21645515.2021.1932216","article-title":"Potential public health impact of the adjuvanted recombinant zoster vaccine among people aged 50 years and older in Beijing","volume":"17","author":"Lee","year":"2021","journal-title":"Hum. Vaccines Immunother."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"949","DOI":"10.1093\/cid\/ciab121","article-title":"Effectiveness of the Recombinant Zoster Vaccine in Adults Aged 50 and Older in the United States: A Claims-Based Cohort Study","volume":"73","author":"Sun","year":"2021","journal-title":"Clin. Infect. Dis."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"S429","DOI":"10.1093\/infdis\/jiab387","article-title":"Herpes Zoster Vaccines","volume":"224","author":"Harbecke","year":"2021","journal-title":"J. Infect. Dis."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"e528","DOI":"10.1097\/RHU.0000000000001790","article-title":"A Medical Records Review Study Assessing Safety of Zoster Vaccine Recombinant, Adjuvanted in Patients With Rheumatic Disease","volume":"28","author":"Gupta","year":"2022","journal-title":"J. Clin. Rheumatol."},{"key":"ref_10","unstructured":"WHO (2024, November 16). The European Immunization Agenda 2030 (EIA2030). Available online: https:\/\/www.who.int\/europe\/publications\/i\/item\/9789289056052."},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Calabr\u00f2, G.E., Tognetto, A., Carini, E., Mancinelli, S., Sarnari, L., Colamesta, V., Ricciardi, W., and de Waure, C. (2020). Strategies to Improve Vaccination among At-Risk Adults and the Elderly in Italy. Vaccines, 8.","DOI":"10.3390\/vaccines8030358"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"3541","DOI":"10.1016\/j.vaccine.2018.01.061","article-title":"Vaccination in immunocompromised host: Recommendations of Italian Primary Immunodeficiency Network Centers (IPINET)","volume":"36","author":"Martire","year":"2018","journal-title":"Vaccine"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"652","DOI":"10.1007\/s12160-017-9888-y","article-title":"Understanding the Dimensions of Anti-Vaccination Attitudes: The Vaccination Attitudes Examination (VAX) Scale","volume":"51","author":"Martin","year":"2017","journal-title":"Ann. Behav. Med."},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Taylor, S., Landry, C.A., Paluszek, M.M., Groenewoud, R., Rachor, G.S., and Asmundson, G.J.G. (2020). A Proactive Approach for Managing COVID-19: The Importance of Understanding the Motivational Roots of Vaccination Hesitancy for SARS-CoV-2. Front. Psychol., 11.","DOI":"10.3389\/fpsyg.2020.575950"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"2055422","DOI":"10.1080\/21645515.2022.2055422","article-title":"Vaccine uptake and barriers to vaccination among at-risk adult populations in the US","volume":"18","author":"Kolobova","year":"2022","journal-title":"Hum. Vaccines Immunother."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"2411821","DOI":"10.1080\/21645515.2024.2411821","article-title":"Overview of adult immunization in Italy: Successes, lessons learned and the way forward","volume":"20","author":"Bechini","year":"2024","journal-title":"Hum. Vaccines Immunother."},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Cesaroni, G., Calandrini, E., Balducci, M., Cappai, G., Di Martino, M., Sorge, C., Nicastri, E., Agabiti, N., and Davoli, M. (2022). Educational Inequalities in COVID-19 Vaccination: A Cross-Sectional Study of the Adult Population in the Lazio Region, Italy. Vaccines, 10.","DOI":"10.3390\/vaccines10030364"},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Salussolia, A., Capodici, A., Scognamiglio, F., La Fauci, G., Sold\u00e0, G., Montalti, M., Di Valerio, Z., Pia Fantini, M., Odone, A., and Costantino, C. (2024). Herpes zoster (HZ) vaccine coverage and confidence in Italy: A Nationwide cross-sectional study, the OBVIOUS project. BMC Infect. Dis., 24.","DOI":"10.1186\/s12879-024-09344-7"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"ckae144.1257","DOI":"10.1093\/eurpub\/ckae144.1257","article-title":"The role of sociodemographic factors on herpes zoster vaccine uptake among hard-to-reach populations","volume":"34","author":"Diedenhofen","year":"2024","journal-title":"Eur. J. Public Health"},{"key":"ref_20","unstructured":"Gazzetta Ufficiale (2024, February 02). Ministero della Salute Piano Nazionale Prevenzione Vaccinale 2023\u20132025. Available online: https:\/\/www.gazzettaufficiale.it\/eli\/id\/2023\/08\/21\/23A04685\/sg."},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Czajka, H., Czajka, S., Bi\u0142as, P., Pa\u0142ka, P., J\u0119drusik, S., and Czapkiewicz, A. (2020). Who or What Influences the Individuals\u2019 Decision-Making Process Regarding Vaccinations?. Int. J. Environ. Res. Public Health, 17.","DOI":"10.3390\/ijerph17124461"},{"key":"ref_22","unstructured":"Regione Lazio (2024, November 16). Available online: https:\/\/www.regione.lazio.it."},{"key":"ref_23","unstructured":"EMA (2025, July 31). Shingrix: Summary of Product Characteristics. Available online: https:\/\/www.ema.europa.eu\/en\/documents\/product-information\/shingrix-epar-product-information_en.pdf."},{"key":"ref_24","unstructured":"Regione Lazio (2025, July 01). Programma di Immunizzazione Contro Herpes Zoster. Revisione della Strategia Generale. Available online: https:\/\/www.vaccinarsinlazio.org\/assets\/uploads\/files\/215\/20-revisione-strategia-regionale-anti-hz-1536968-13dic24.pdf."},{"key":"ref_25","unstructured":"(2025, July 31). Bilancio di Missione Fondazione Policlinico Universitario Agostino Gemelli IRCCS\u2014Universit\u00e0 Cattolica del Sacro Cuore. Available online: https:\/\/www.policlinicogemelli.it\/informazioni\/bilancio-missione\/."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"21287","DOI":"10.1007\/s12144-022-03209-5","article-title":"Validation and psychometric properties of the Italian Vaccination Attitudes Examination (VAX-I) scale","volume":"42","author":"Bruno","year":"2022","journal-title":"Curr. Psychol."},{"key":"ref_27","first-page":"155","article-title":"Adherence to Current Vaccination Recommendations for Patients With Rheumatoid Arthritis in Mexico","volume":"17","year":"2021","journal-title":"Reumatol. Clin. Engl. Ed."},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Al-Omar, H.A., Sherif, H.M., and Mayet, A.Y. (2019). Vaccination status of patients using anti-TNF therapy and the physicians\u2019 behavior shaping the phenomenon: Mixed-methods approach. PLoS ONE, 14.","DOI":"10.1371\/journal.pone.0223594"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"511","DOI":"10.1016\/j.jadohealth.2021.06.003","article-title":"Young Adult Perspectives on COVID-19 Vaccinations","volume":"69","author":"Adams","year":"2021","journal-title":"J. Adolesc. Health"},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"Zhang, P., Li, Y., Wang, H., Luo, L., Wang, P., Wang, H., Li, Q., Meng, Z., Yang, H., and Liu, Y. (2022). COVID-19 Vaccine Hesitancy Among Older Adolescents and Young Adults: A National Cross-Sectional Study in China. Front. Public Health, 10.","DOI":"10.3389\/fpubh.2022.877668"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"e080707","DOI":"10.1136\/bmjopen-2023-080707","article-title":"Understanding attitudes and beliefs regarding COVID-19 vaccines among transitional-aged youth with mental health concerns: A youth-led qualitative study","volume":"14","author":"Artna","year":"2024","journal-title":"BMJ Open"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"e2251833","DOI":"10.1001\/jamanetworkopen.2022.51833","article-title":"Analysis of mRNA COVID-19 Vaccine Uptake Among Immunocompromised Individuals in a Large US Health System","volume":"6","author":"Tartof","year":"2023","journal-title":"JAMA Netw. Open"},{"key":"ref_33","doi-asserted-by":"crossref","unstructured":"Cummings, P.E., Lakoh, S., Yendewa, S.A., Massaquoi, S.P.E., James, P.B., Sahr, F., Deen, G.F., Salata, R.A., Gevao, P., and Yendewa, G.A. (2023). Understanding COVID-19 Vaccine Uptake and Hesitancy among People with HIV in Freetown, Sierra Leone: A Cross-Sectional Study. Vaccines, 11.","DOI":"10.1101\/2023.05.11.23289882"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"28812","DOI":"10.1007\/s12144-022-03660-4","article-title":"Examining four types of anti-vaccination attitudes prior to and during the COVID-19 pandemic","volume":"42","author":"Huynh","year":"2022","journal-title":"Curr. Psychol."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"168","DOI":"10.4314\/ahs.v23i4.19","article-title":"Bolstering the willingness to uptake COVID-19 vaccination through multidisciplinary health communication intervention: A cue for reaching herd immunity in Nigeria","volume":"23","author":"Ibenyenwa","year":"2023","journal-title":"Afr. Health Sci."},{"key":"ref_36","doi-asserted-by":"crossref","unstructured":"David, S.S.B., Shamai-Lubovitz, O., Mourad, V., Goren, I., Iunger, E.C., Alcalay, T., Irony, A., Greenfeld, S., Adler, L., and Cahan, A. (2023). A Nationwide Digital Multidisciplinary Intervention Aimed at Promoting Pneumococcal Vaccination in Immunocompromised Patients. Vaccines, 11.","DOI":"10.3390\/vaccines11081355"},{"key":"ref_37","doi-asserted-by":"crossref","unstructured":"Moosa, A.S., Wee, Y.M.S., Jaw, M.H., Tan, Q.F., Tse, W.L.D., Loke, C.Y., Ee, G.L.A., Ng, C.C.D., Aau, W.K., and Koh, Y.L.E. (2022). A multidisciplinary effort to increase COVID-19 vaccination among the older adults. Front. Public Health, 10.","DOI":"10.3389\/fpubh.2022.904161"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"178","DOI":"10.1097\/JHQ.0000000000000337","article-title":"Mitigating COVID-19 Vaccine Waste Through a Multidisciplinary Inpatient Vaccination Initiative","volume":"44","author":"Baumann","year":"2022","journal-title":"J. Healthc. Qual."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"e22072","DOI":"10.1097\/MD.0000000000022072","article-title":"Effects of a multidisciplinary team-led school-based human papillomavirus vaccination health-promotion programme on improving vaccine acceptance and uptake among female adolescents: A cluster randomized controlled trial","volume":"99","author":"Chau","year":"2020","journal-title":"Medicine"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"189","DOI":"10.7326\/M23-2023","article-title":"Effectiveness of Recombinant Zoster Vaccine Against Herpes Zoster in a Real-World Setting","volume":"177","author":"Zerbo","year":"2024","journal-title":"Ann. Intern. Med."},{"key":"ref_41","doi-asserted-by":"crossref","unstructured":"Larson, H., Leask, J., Aggett, S., Sevdalis, N., and Thomson, A. (2013). A Multidisciplinary Research Agenda for Understanding Vaccine-Related Decisions. Vaccines, 1.","DOI":"10.3390\/vaccines1030293"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"149","DOI":"10.1007\/s10354-022-00946-x","article-title":"Multidisciplinary expert group: Communication measures to increase vaccine compliance in adults","volume":"174","author":"Hastall","year":"2024","journal-title":"Wien. Med. Wochenschr."},{"key":"ref_43","doi-asserted-by":"crossref","unstructured":"Sansone, V., Giudice, G.M.d, Polla, G.D., and Angelillo, I.F. (2024). Knowledge, Attitudes, and Coverage of Recommended Vaccinations in Individuals with Chronic Medical Conditions: A Cross-Sectional Telephone Survey in Italy. Vaccines, 12.","DOI":"10.3390\/vaccines12030336"},{"key":"ref_44","doi-asserted-by":"crossref","unstructured":"Napolitano, F., Polla, G.D., Capano, M.S., Augimeri, M., and Angelillo, I.F. (2020). Vaccinations and Chronic Diseases: Knowledge, Attitudes, and Self-Reported Adherence among Patients in Italy. Vaccines, 8.","DOI":"10.3390\/vaccines8040560"},{"key":"ref_45","unstructured":"Istituto Superiore di Sanit\u00e0 (2025, July 31). Guida alle Controindicazioni alle Vaccinazioni. Available online: https:\/\/www.epicentro.iss.it\/vaccini\/pdf\/19_3_web.pdf."},{"key":"ref_46","unstructured":"Regione Piemonte (2024, November 16). Direzione Sanit\u00e0 e Welfare SPeV-AcdLFSAA, Franco Giovanetti (SISP\u2013ASL CN2). La Vaccinazione dei Soggetti Che Pre-Sentano un Rischio Aumentato di Infezione Invasiva da Batteri Capsulati (Streptococcus Pneumoniae, Neisseria Meningi-Tidis, Haemophilus Influenzae). Available online: https:\/\/www.regione.piemonte.it\/web\/temi\/cultura-turismo-sport\/cultura\/archivi-biblioteche-istituti-culturali\/archivi."},{"key":"ref_47","unstructured":"Kroger, A., Bahta, L., Long, S., and Sanchez, P. (2024, November 16). General Best Practice Guidelines for Immunization. Vaccine Recommendations and Guidelines of the ACIP. CDC, Available online: https:\/\/www.cdc.gov\/vaccines\/hcp\/acip-recs\/general-recs\/downloads\/general-recs.pdf."}],"container-title":["Vaccines"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2076-393X\/13\/8\/843\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T18:26:16Z","timestamp":1760034376000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2076-393X\/13\/8\/843"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8,8]]},"references-count":47,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2025,8]]}},"alternative-id":["vaccines13080843"],"URL":"https:\/\/doi.org\/10.3390\/vaccines13080843","relation":{},"ISSN":["2076-393X"],"issn-type":[{"value":"2076-393X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,8,8]]}}}