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March 26, 2026 Dear Reader, On paper, Clostridioides difficile looked like low-hanging fruit: two exotoxins, a well-defined high-risk population, and a simple premise, to neutralize toxins A and B before antibiotics disrupt the microbiome and prevent disease.Yet after more than a decade and multiple large programs, there is still no licensed vaccine, only a series of near misses. The rationale was sound. Toxoid vaccines work for tetanus and diphtheria, and early studies in C. difficile showed reassuring safety and strong antitoxin responses. However, phase 3 trials in older, comorbid populations proved far less predictable. CLOVER missed its primary endpoint, GSK has stepped back, and what seemed straightforward has turned into a lesson in the complexity of real-world efficacy in nosocomial disease. In this issue, we look at how Elaris is reviving Valneva’s toxoid candidate and Pfizer’s 32,000-participant BEETHOVEN trial, and why this still matters for high-risk patients in the coming decade. We also cover the extremely high incidence of TBEV infection vs. disease in Austria, myocarditis after mRNA COVID-19 vaccines, global and regional updates on COVID-19 vaccines, global polio eradication and current outbreaks, and this week’s evidence brief, along with fresh insights to support your vaccine counselling. The infographic shows the principles of mRNA vaccine production. Enjoy the reading! With all my best wishes – stay healthy and get the vaccine doses you need! Warm regards, Editor-in-Chief, Global Health Press |
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