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This report describes polio cases, vaccination uncertainty and challenges, and the way forward to eradicate polio from Pakistan. Numerous articles, government and non-government documents, and survey reports were studied and an online search was made to collect information on polio in Pakistan. Once again the polio vaccination program has been stopped and accused by the local community in Pakistan as a result an increase has been seen in polio cases in the last year. In 2019, a total of 117 wild poliovirus (WPV) and 18 circulating vaccine-derived poliovirus (cVDPV2) cases were reported from the country. The majority of cases were from the Khyber Pakhtunkhwa (KP) province as a result of polio vaccination uncertainty and many challenges faced by the vaccination program in the region. Pakistan reported their highest annual number of WPV cases as compared to last few years. This increase is not only an alarming threat for the country but also a key challenge for the global polio eradication movement. Increase awareness and raising immunization to over 100% in some areas especially in the remote area where every year many children missed vaccination to achieve global polio eradication goals.

The hepatitis E virus (HEV) is an important public health concern and a significant cause of enterically-transmitted viral hepatitis infections. HEV infection remains a serious threat to life, especially in immunocompromised individuals and pregnant women. Globally, vaccines have had a massive impact on public health and saved millions of lives. Vaccination can reduce the healthcare expenditure, decrease the mortality rate, and increase life expectancy. The availability of commercially effective vaccines is the most effective means for the prevention of HEV. However, the development of classic inactive or attenuated HEV vaccines is not feasible due to the lack of an efficient cell culture system for HEV. In recent years, recombinant HEV vaccine approaches have been explored. Many vaccine candidates have showed potential efficacy against HEV infection. Currently, the only licensed vaccine is Hecolin ® , a recombinant vaccine developed by Xiamen Innovax Biotech Co., Ltd. It is available in China. However, there are many hindrances when it comes to the acrossthe-board application of Hecolin ® and other vaccines worldwide. Large-scale efforts are needed to further evaluate the efficacy and safety of Hecolin ® in at-risk populations and to pass the World Health Organization prequalification for licensing outside of China.

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Background: Query fever (Q fever), caused by Coxiella burnetii, is a highly infectious zoonotic infection to humans and livestock. Despite extensive efforts to develop effective vaccines against this disease, only one vaccine is licensed and available. The aim of this study was to investigate the global research trends, keystone bibliometric parameters, and network visualization mapping in Q fever vaccine from 1941 to 2021.   Methods: A retrospective bibliometric followed by a visualized study was conducted. The searches were conducted in the Science Citation Index Expanded (SCI-E) Edition of Web of Science Core Collection (WoSCC). The following keywords were used: "Q fever" OR "Query fever" OR "Coxiella burnetii" OR "Coxiella-burnetii" OR "C. burnetii" (Topic) AND "Vaccin*" OR "Immuniz*" OR "Immunis*" (Topic) without any limitation. The data were plotted for co-authorship countries, co-occurrence keywords plus, and bibliographic coupling sources network visualization mapping. The VOSviewer version 1.6.17 was used for network visualization.   Results: The bibliographical search resulted in a total of 478 publications which were included in this study. The publications were mainly published in English (n=436), while the major document types were articles (n=391). The most productive year was 2014 (n=33), while the most cited year was 2020 (n=1026). The extensively studied research areas were immunology and veterinary science, and the most used keywords plus were Q-fever and Coxiella-burnetii. Kazar J (n=17) was the leading author, while the famous journal was Acta Virologica (n=23). The most active institution was the Slovak Academy of Sciences (n=32), and the leading country was the US (n=129).   Conclusion: A rapid increase has been observed in Q fever vaccine publications and citations in the past 20 years. This study might be of great interest to provide standard bibliographic information and keystones parameters in Q fever vaccine research.