The season's vaccine evidence lands, and sepsis algorithms look better on paper than in wards

The edition in brief

Two systematic reviews prepared for the 2026-2027 respiratory season summarise the evidence on COVID-19 and RSV immunisation. For COVID-19, 155 publications were eligible. Updated vaccines were associated with reduced hospitalisation in adults aged 65 and over (vaccine effectiveness 53.0%, 95% CI 37.0 to 65.0) and in those aged 18 to 64 (54.0%, 1.0 to 78.0). Maternal vaccination reduced COVID-19 emergency attendances in the vaccinated person (58.0%) and hospital contacts in infants in the first two months of life (50 to 54%), regardless of trimester. Paediatric emergency visits fell in children aged 9 months to 4 years (76.0%). No new safety signals were found. The RSV review covered 75 studies. Vaccination in older adults was associated with 83.3% effectiveness against RSV hospitalisation (95% CI 42.9 to 96.9), but one study found effectiveness significantly lower at 12 to 18 months than in the first season. Maternal vaccination at 32 to 36 weeks gave 51.0% to 70.0% against infant hospitalisation, and nirsevimab 63.6% to 93.0%. One self-controlled case series raised a possible Guillain-Barré signal in older adults; three randomised trials found none. A meta-analysis of 34 machine-learning sepsis prediction studies found a pooled AUROC of 0.913 but a 95% prediction interval of 0.660 to 0.983, with heavy reuse of the same public datasets. In Ethiopia, pooled good adherence to antiretroviral therapy was 79.4% and was strongly associated with viral suppression (odds ratio 6.30). The FDA recorded a supplement to an Alembic generic itraconazole application.