Technical and Implementation Guidelines forthe Introduction of Human Papillomavirus Vaccine into China’s NationalImmunization Program

FuzhenWang¹, Lei Cao¹, Keli Li¹, Guomin Zhang¹,Lixin Hao¹, Chao Ma¹, Ning Wen¹, Xiaoxue Liu¹,Jiakai Ye¹, Yan Li¹, Yudan Song¹, Zhijie An¹,Wenzhou Yu¹, Zundong Yin^1,#

1. National Immunization Program, Chinese Center for Disease Control andPrevention & Chinese Academy of Preventive Medicine, Beijing, China.

^# Corresponding author:Zundong Yin, yinzd@chinacdc.cn.

Humanpapillomavirus (HPV) vaccination administered before viral exposure (i.e.,prior to sexual debut) effectively prevents infection with vaccine-type HPVstrains and associated diseases, including cervical cancer. To advance HPVvaccination efforts and cervical cancer prevention, China has incorporated thebivalent HPV vaccine (types 16/18) into its National Immunization Program (NIP)as a program vaccine. This Policy Note presents comprehensive technical andimplementation guidelines for HPV vaccine deployment, encompassing guidancedevelopment methodology, target population definition, routine vaccinationschedules, catch-up vaccination protocols, implementation strategies, vaccinecoverage and adverse event monitoring plans, andanticipated implementation challenges with proposed mitigation measures. TheVaccine Technical Working Groups of the China CDC developed relevant technicalrecommendations and implementationguidelines, which were officially issued in November 2025.

《人乳头瘤病毒疫苗纳入国家免疫规划实施技术方案》政策解读

王富珍¹，曹雷¹，李克莉¹，张国民¹，郝利新¹，马超¹，温宁¹，刘晓雪¹，叶家楷¹，李燕¹，宋渝丹¹，安志杰¹，余文周¹，尹遵栋^1,#

1. 免疫规划中心，中国疾病预防控制中心（中国预防医学科学院），北京，中国。

^# 通信作者:尹遵栋，yinzd@chinacdc.cn。

HPV疫苗于暴露前（首次性行为之前）接种获得的效果最为理想，可预防疫苗覆盖型别的HPV感染及相关疾病（主要是宫颈癌）。为保护女性健康和推动子宫颈癌消除，中国将双价（16/18型）HPV疫苗纳入国家免疫规划。本政策解读提供了HPV疫苗纳入国家免疫规划的背景、纳入后的实施技术方案，包括目标人群、常规HPV疫苗接种程序、补种原则、接种组织实施、接种率监测和疑似预防接种异常反应监测处置要求，以及实施的挑战和措施建议等。纳入国家免疫规划后的实施技术方案由中国疾病预防控制中心国家免疫规划技术工作组制定，并于2025年11月印发实施。

For more information:https://weekly.chinacdc.cn/en/article/doi/10.46234/ccdcw2025.262

Progress and Challenges in theGlobal Elimination of Viral Hepatitis D

Minghui Li^1,2,3,#, QiWang¹, Weihua Cao¹, Yao Xie^1,2,3

1.Department of Hepatology Division 2, Beijing Ditan Hospital, Capital MedicalUniversity, Beijing, China;

2. HBVInfection, Clinical Cure and Immunology Joint Laboratory for Clinical Medicine,Capital Medical University, Beijing, China;

3. Department of HepatologyDivision 2, Peking University Ditan Teaching Hospital, Beijing, China.

^# Corresponding author:Minghui Li,liminghui0809@ccmu.edu.cn.

Hepatitis D virus (HDV) is adefective virus whose replication depends on hepatitis B virus (HBV) surfaceantigen (HBsAg). HBV/HDV coinfection represents the most severe form of viralhepatitis, substantially accelerating progression to liver fibrosis, cirrhosis,and hepatocellular carcinoma. In response to the World Health Organization's(WHO) 2030 elimination target for viral hepatitis as a major public healththreat, HDV elimination has emerged as one of the most formidable challenges,driven by its unique biological characteristics, widespread underdiagnosis, andhistorical absence of effective therapies. This article reviews key globaladvances in HDV epidemiology, screening and diagnosis, therapeutic development,and public health strategies. We provide an in-depth analysis of currentbarriers to elimination and offer strategic insights to guide future controlefforts.

全球消除丁型病毒肝炎的进展与挑战

李明慧^1,2,3,#，王琪¹，曹卫华¹，谢尧^1,2,3

1. 肝病二科，首都医科大学附属北京地坛医院，北京，中国；

2. 首都医科大学HBV感染、临床治愈与免疫联合实验室，北京，中国；

3. 肝病二科，北京大学地坛教学医院，北京，中国。

^# 通信作者：李明慧，liminghui0809@ccmu.edu.cn。

丁型肝炎病毒（HDV）是一种缺陷病毒，其复制依赖于乙型肝炎病毒（HBV）的表面抗原（HBsAg）。HBV/HDV共感染是病毒性肝炎中最严重的类型，会显著加速肝纤维化、肝硬化和肝细胞癌的进程。为响应世界卫生组织（WHO）提出的"2030年消除病毒性肝炎作为重大公共卫生威胁"的目标，HDV的消除因其独特的生物学特性、广泛的漏诊问题以及长期缺乏有效疗法，已成为最具挑战性的任务之一。本文概述了全球在HDV流行病学、筛查诊断、治疗研发和公共卫生策略方面的关键进展，深入分析了当前消除工作的主要障碍，并为未来防控措施提供战略洞见。

For more information:https://weekly.chinacdc.cn/en/article/doi/10.46234/ccdcw2025.263

Unmet Healthcare Needs Among People with Herpes Zoster — 25 PLADs,China, 2019--2024

Yanran Wang^1,2, Yiqi Xia^1,2, Xin Ye³,Wenhui Zhu^1,2, Jinxu Ai^1,2, Yang Shen^1,2,Chengsen Cui², Yemin Yuan², Dawei Zhu⁴,Zhenyu Shi^2,5,#, Ping He^2,#

1. School of Public Health, Peking University,Beijing, China;

2. China Center for Health Development Studies,Peking University, Beijing, China;

3. Institute forGlobal Public Policy, Fudan University, Shanghai, China;

4. InternationalResearch Center for Medicinal Administration, Peking University, Beijing, China;

5. School of Social Development, University ofHealth and Rehabilitation Sciences, Qingdao City, Shandong Province, China.

^# Corresponding authors: Zhenyu Shi, shizhenyu@bjmu.edu.cn; Ping He, phe@pku.edu.cn.

Addressing the healthcare needs of the growingnumber of patients with herpes zoster (HZ) presents significant challenges.This study examined the unmet healthcare needs and associated factors amongpeople with HZ across 25 provincial-level administrative divisions and cities(PLADs) in China from 2019-2024.We conducted anationwide population-based survey using probability-proportional-to-sizesampling. The structured questionnaire incorporated validated diagnosticcriteria for HZ, HZ health service utilization related questions, andsociodemographic information. Unmet healthcare needs were categorized as unmetoutpatient and hospitalization care needs. Odds ratio (OR) was estimated from multivariable logisticregression modeling to assess the associations between HZ unmet healthcareneeds and sociodemographic characteristics of individuals. This studyultimately completed 21,750 adult surveys (≥16 years old) in 25 PLADsacross the country. Among them, a healthcare utilization survey was conductedfor patients who had developed HZ in the past five years of the survey period,totaling 813 individuals.Among 813participants with HZ, 28.78% had unmet outpatient careneeds, and 36.36% of those who met the hospitalization criteria had unmetinpatient needs. Older adults had significantly lowerodds of unmet outpatient needs, with an OR of 0.57 (95% confidence interval: 0.40, 0.81), compared withyounger adults. In addition, urban residents had higherodds of unmet inpatient needs, with an ORof 2.18 (95% confidence interval: 1.00, 4.75).Our findings indicatesubstantial unmet healthcare needs among patients with HZ, with significantvariations observed across different age groups and residential regions. Thisstudy highlights the necessity of enhancing health literacy, with particular emphasison improving the standardized diagnosis of HZ in rural areas and thestandardized treatment among working-age residents with HZ.

带状疱疹患者未满足的医疗服务需要 — 25省份，中国，2019–2024年

王嫣然^1,2；夏祎琪^1,2；叶欣³；朱文辉^1,2；艾津旭^1,2；沈杨^1,2；崔成森²；袁叶敏²；朱大伟⁴；石振宇^2,5,#；何平^2,#

1. 公共卫生学院，北京大学，北京，中国

2. 中国卫生发展研究中心，北京大学，北京，中国

3. 全球公共政策研究院，复旦大学，上海，中国

4. 医药管理国际研究中心，北京大学，北京，中国

5. 社会发展学院，康复大学，青岛市，山东省，中国。

^# 通信作者：石振宇，shizhenyu@bjmu.edu.cn；何平，phe@pku.edu.cn。

随着带状疱疹患者的数量日益增多，其医疗服务需求的满足面临诸多挑战，本研究旨在探讨2019—2024年中国25个省份带状疱疹患者的未满足医疗服务需要及其影响因素。本研究采用按规模比例概率抽样法，开展全国性人群调查。所用结构化问卷包含经验证的带状疱疹诊断标准、带状疱疹医疗服务利用相关问题及社会人口学信息。未满足医疗服务需要分为未满足门诊和住院需要两类，通过多变量logistic模型计算比值比（OR），分析带状疱疹未满足医疗服务需要与个体社会人口学特征的关联。本研究最终在全国25个省份完成21750份成人调查（≥16岁），其中对调查时间五年内发病的带状疱疹患者开展医疗服务利用调查，共计 813 人。813名带疱患者中，28.78% 存在未满足门诊需要；而在符合住院指征的患者中，36.36% 存在未满足住院需要。与年轻患者相比，老年患者未满足门诊需求的比例显著更低（OR=0.57，95% CI：0.41~0.81）；此外，城市居民未满足住院服务需要的比例更高（OR=2.18，95% CI：1.00~4.75）。本研究表明，带状疱疹患者未满足的医疗服务需要较高，不同年龄组与居住地区的患者间未满足医疗服务需求具有显著差异。本研究结果提示应提升居民健康素养，尤其关注提高农村地区带状疱疹规范诊断和劳动年龄居民的规范治疗。

For more information:https://weekly.chinacdc.cn/en/article/doi/10.46234/ccdcw2025.265

Serological Survey of Lymphocytic Choriomeningitis Virus (LCMV)Infection — Gansu Province, China, 2023

Qian Ling^1,2,&;Haizhuo Wu^3,&; Xuelian Luo^2,4; Maoxing Dong³;Qianjin Fan^2,5; Hui Sun^2,4; Xiaoshu Zhang^3,#;Jianguo Xu^1,2,4,#

1. Department of Epidemiology andBiostatistics; Center for Infectious Diseases and Policy Research, PekingUniversity; Key Laboratory of Epidemiology of Major Diseases (PekingUniversity), Ministry of Education; Department of Laboratorial Science and Technology,School of Public Health, Peking University, Beijing, China

2. National Key Laboratory ofIntelligent Tracking and Forecasting for Infectious Diseases, NationalInstitute for Communicable Disease Control and Prevention, Chinese Center forDisease Control and Prevention & Chinese Academy of Preventive Medicine,Beijing, China

3. Gansu Provincial KeyLaboratory for Etiology of Infectious Disease, Gansu Provincial Center forDisease Control and Prevention, Lanzhou City, Gansu Province, China

4. Research Center for ReverseMicrobial Etiology, Workstation of Academician, Shanxi Medical University,Taiyuan City, Shanxi Province, China

5. Institute of Public Health,School of Medicine, Nankai University, Tianjin, China.

^& Joint first authors.

^# Corresponding authors: XiaoshuZhang, zhxs222@126.com; Jianguo Xu, xujianguo@icdc.cn.

Lymphocytic choriomeningitis virus (LCMV) is a globally distributedzoonotic pathogen transmitted primarily by rodents. Its nonspecific clinicalpresentation in the general population frequently results in underdiagnosis andunderreporting. To date, no large-scale seroprevalence surveys of LCMV havebeen conducted in China.During 2023, we collected 661 serum/plasma samplesfrom healthy individuals and tested them for anti-LCMV IgG antibodies using anenzyme-linked immunosorbent assay (ELISA). Samples testing positive by ELISAunderwent confirmatory testing via indirect immunofluorescence analysis (IFA)and neutralization assay (NTA). ELISA detectedanti-LCMV IgG antibodies in 18.31% (121/661) of samples, while IFA confirmedseropositivity in 1.97% (13/661). Four samples demonstrated neutralizingantibody activity with reduced viral infectivity. Seropositive cases weresporadically distributed across the study region, with farmers representing thepredominant occupational group. Key at-risk populations identified includedfarmers, rural residents, and individuals with lower educational attainment.This studyprovides the first serological evidence of past LCMV infections in humans inGansu Province. Targeted health education interventions tailored to high-riskpopulations are recommended to reduce future transmission.

淋巴细胞脉络丛脑膜炎病毒既往感染的血清学调查—甘肃省，中国，2023年

凌倩^1,2,&，武海卓^3,&，罗雪莲^2,4，董茂星³，范前进^2,5，孙晖^2,4，张晓曙^3,#，徐建国^1,2,4,#

1. 流行病与卫生统计学系；传染病防控技术和政策研究中心；重大疾病流行病学教育部重点实验室（北京大学）；检验学系，公共卫生学院，北京大学，北京，中国；

2. 传染病溯源预警与智能决策全国重点实验室，传染病预防控制所，中国疾病预防控制中心（预防医学科学院），北京，中国；

3. 甘肃省传染病病原学重点实验室，甘肃省疾病预防控制中心，兰州市，甘肃省，中国；

4. 山西医科大学院士工作站·反向病原学研究中心，太原市，山西省，中国；

5. 南开大学医学院公共卫生研究所，天津，中国。

^& 共同第一作者。

^# 通信作者：张晓曙, zhxs222@126.com; 徐建国, xujianguo@icdc.cn。

淋巴细胞脉络丛脑膜炎病毒（LCMV）是一种全球分布的由啮齿动物传播的人兽共患病原体。由于临床表现缺乏特异性，易被忽视。中国大陆此前尚无大规模人群既往感染情况的调查。在甘肃省地区于2023 年采集 661 份健康人血清/血浆，采用酶联免疫吸附试验（ELISA）检测特异性抗 LCMV IgG 抗体；判定的阳性样本再经间接免疫荧光试验（IFA）和中和试验（NTA）进一步检测。数据使用GraphPad Prism 10.1.2 与 SPSS 24 分析。ELISA 检测的LCMV IgG 抗体阳性率为 18.31%（121/661），IFA 阳性率为 1.97%（13/661）；其中 4 份样本检出中和抗体。感染呈散在分布，血清LCMV IgG抗体阳性者多为农民。需重点关注的人群包括农民、农村居住者及低教育水平者。本研究首次证实甘肃省存在 LCMV 既往感染情况，建议针对重点人群开展健康教育。

For more information:https://weekly.chinacdc.cn/en/article/doi/10.46234/ccdcw2025.266

Analysis of the Characteristics of Measles Virus D8 Genotype Basedon the Nucleoprotein (N-450) Gene Region — Gansu Province, China, 2024

Huan Wei¹; Hui Zhang¹; JianhuaChen¹; Shu Liang¹; Maoxing Dong¹; Biao Wang¹;Miao Wang¹; Xiaoshu Zhang^1,#

1. Lab for viruses, GansuProvincial Center for Disease Control and Prevention, Lanzhou City, GansuProvince, China.

^# Corresponding author: Xiaoshu Zhang, zhxs222@126.com.

Measles is the third most common infectious disease, after Smallpox and Polio, and the global health community has committed to eliminating it.Recently, measles recurrence and outbreakshave occurred in several countries, posing a significant challenge for China,which is on the brink of eliminating measles. This study aimed to analyze thegenetic characteristics of the D8 genotype of the measles virus (MeV) in GansuProvince in 2024 and provide a scientific basis for measles control andelimination efforts. Nucleic acid-positive throat swab specimens werecollected from measles cases confirmed in 14 municipal measles/rubella networklaboratories in the Gansu Province in2024.MeV RNA was directly extracted using a viralnucleic acid extraction kit, and 634 nucleotides at the 3'-terminal of thenucleoprotein gene were amplified using one-step reversetranscription-polymerase chain reaction (RT-PCR). The amplified products weresubjected to nucleotide sequencing to characterize the MeV gene. A total of 120sequences of a 450-nucleotide region within the nucleoprotein gene (N-450) ofMeV were obtained from the Measles and Rubella Network Laboratory of GansuProvince in 2024, of which 117 sequences were of the D8 genotype and 3sequences were of the A genotype. The similarities in nucleotide and amino acidsequences between the D8 genotype sequences were 96.4%–99.1% and 96.7%–98.0%,respectively. The Gansu D8 sequences belonged to the same major branch as theD8 reference strain identified by the World Health Organization (WHO), whichfurther divided into Cluster 1 and Cluster 2. By aligning oligonucleotidesequences using the rRT-PCR kit distributed by the Global Measles and Rubella LaboratoryNetwork (GMRLN) with sequences of the D8 genotype from the Gansu Province, thisstudy discovered that every sequence in Cluster 1 occurred at the reverseprimer annealing site, each containing three T-to-C transitions. The casesdetected in Gansu in 2024 were likely imported or linked to importation. It isrecommended to continue vaccination programs with measles-containing vaccinesin key areas and to carry out highly sensitive etiological monitoring anddetection to provide data support for subsequent measles elimination efforts.

基于核蛋白基因（N-450）区域麻疹病毒D8基因型特征分析 — 甘肃省，中国，2024年

魏欢¹，张慧¹，陈建华¹，梁舒¹，董茂星¹，王彪¹，王淼¹，张晓曙^1,#

1. 病毒实验室，甘肃省疾病预防控制中心，甘肃省传染病病原学重点实验室，兰州市，甘肃省，中国。

^# 通讯作者:张晓曙，zhxs222@126.com。

麻疹已成为继天花和脊髓灰质炎之后，全球公共卫生领域致力于消除的第三种病毒性传染病。近年来，全球多个国家发生了麻疹的复发和暴发，这为接近麻疹消除状态的中国带来巨大挑战。本研究旨在分析2024年甘肃省D8基因型麻疹病毒（Measles virus, MeV）的基因特征,为麻疹防控和消除工作提供科学依据。收集甘肃省2024年14个市级麻疹风疹网络实验室确诊的MeV核酸阳性咽拭子标本，直接用病毒核酸提取试剂盒提取样本RNA，采用一步法反转录-聚合酶链式反应（Reverse-transcript-polymerasechain reaction, RT-PCR）扩增MeV核蛋白基因羧基末端634个核苷酸片段，对扩增产物进行核苷酸序列测定并进一步分析MeV基因特征。2024年甘肃省麻疹风疹网络实验室共获得120株MeV 核蛋白基因450个核苷酸序列（a 450 nucleotide region withinthe nucleoprotein gene, N-450），其中有117株为D8基因型，3株为A基因型，117株D8基因型核苷酸序列相似度为97.3%–100.0%,氨基酸序列相似度为98.7%–100.0%。甘肃省D8株与世界卫生组织（World Health Organization，WHO）推荐的D8参考株同属于一个大分支，并进一步分成Cluster1和Cluster2两个分支。另外，将甘肃省D8株N-450区域与全球麻疹风疹网络实验室（Global Measles and Rubella Laboratory Network , GMRLN）下发的实时逆转录聚合酶链反应（real-time reverse-transcription，rRT-PCR）试剂盒的寡核苷酸序列比对，发现Cluster1的所有序列在反向引物结合位点发生3个T到C的同义转换。2024年甘肃省检测到的D8基因型很可能是输入或与输入相关。建议继续做好重点区域含麻疹成分疫苗（Measles containing vaccine，MCV）接种工作，并开展高敏感性病原学监测检测工作，为后续麻疹消除工作提供数据支撑。

For more information:https://weekly.chinacdc.cn/en/article/doi/10.46234/ccdcw2025.264