SHORT_COMMUNICATION Protracted conflicts and sanctions impose sustained constraints on health systems, particularly vaccine supply chains and routine immunization services. This commentary examines domestic vaccine production as a resilience strategy under such conditions, using Iran as a case study in the Eastern Mediterranean Region (EMR). Drawing on publicly available global and regional immunization data, policy reports, and institutional documentation, the analysis explores how domestic manufacturing can serve as a governance instrument in conflict-affected and sanction-constrained settings. Framed within health governance and system-resilience perspectives—particularly the adaptive resilience model (emphasizing flexibility and continuity under ongoing stress)—it highlights Iran's sustained production of essential childhood vaccines, which has supported national coverage despite external pressures. However, governance gaps—including regulatory alignment, limited regional integration, and restricted access to international quality-assurance mechanisms—limit its broader potential. Four policy considerations are proposed to enhance resilience: regulatory convergence, pharmacovigilance strengthening, health diplomacy, and integration into national/EMR planning.   http://vacres.pasteur.ac.ir/article-1-367-en.pdf 2024-06 1 2 10.52547/vacres.11.1.1 Health governance Health-system resilience Conflict and health Vaccine supply chains Eastern Mediterranean Region Vahid Marandi Vahid.marandi@gmail.com 1 Pasteur Institute of Iran, Technology Management Department, Tehran, Iran AUTHOR https://orcid.org/0000-0002-9209-7895

OTHERS_CITABLE Introduction: Pseudomonas aeruginosa is a major opportunistic pathogen causing urinary tract infections (UTIs), particularly in hospitalized or immunocompromised patients. Rising antibiotic resistance highlights the urgent need for effective vaccines. PcrV and OmpE as key virulence factors of P. aeruginosa are promising targets for vaccine development. In a previous study, a multi-epitope vaccine construct consisting B- and T-cell epitopes of PcrV and OmpE from P. aeruginosa was designed using immunoinformatics tools. In the present study, the immunogenicity of the recombinant protein was assessed in a murine model. Methods: After purification of the multi-epitope protein PcrV.OmpE using Nickel resin, different vaccine formulations including multi-epitope protein alone and admixed with alum were injected into mice through the subcutaneous route. Thereafter, the levels of systemic humoral and mucosal immune responses were investigated using ELISA method. Results: The multi-epitope vaccine construct alone elicited strong systemic IgG and IgA responses, as well as mucosal antibody in urine as compared to the control mice (p<0.05). The addition of alum significantly boosted systemic IgG and IgA, as well as mucosal IgG antibody response as compared to the multi-epitope alone (p<0.05). Conclusion: These results support the potential of a multi-epitope composed of PcrV and OmpE antigens for the prevention of P. aeruginosa-associated UTIs, warranting further studies on cellular immunity and protective efficacy. http://vacres.pasteur.ac.ir/article-1-369-en.pdf 2024-06 3 6 10.52547/vacres.11.1.3 Pseudomonas aeruginosa urinary tract infection multi-epitope vaccine PcrV OmpE Hamidreza Kalantari 1 Department of Microbiology, ShQ.C., Islamic Azad University, Shahr-e Qods, Iran. AUTHOR Mehri Habibi 2 Department of Medical Biotechnology, Biotechnology Research Center, Pasteur Institute of Iran, Tehran, Iran. AUTHOR Atosa Ferdousi 3 Department of Microbiology, ShQ.C., Islamic Azad University, Shahr-e Qods, Iran. AUTHOR Mohammad Reza Asadi Karam 4 Department of Molecular Biology, Pasteur Institute of Iran, Pasteur Ave., Tehran 1316943551, Iran. AUTHOR Taher Mohammadian 5 Department of Microbiology, ShQ.C., Islamic Azad University, Shahr-e Qods, Iran. AUTHOR

OTHERS_CITABLE Introduction: Rational vaccine design is a promising strategy for combating bacterial infections. Multi-epitope-based vaccines as a modern platform need to improvement by immunostimulants. Flagellin from Salmonella typhimurium acts as a potent Toll-like receptor 5 (TLR5) ligand. The incorporation of vaccine antigens into different sites, including the N- and C-terminal regions, as well as the hypervariable domains of FliC influences receptor docking and immune signaling. This study evaluates the effect of adjuvant positioning in a FliC-derived construct on TLR5 docking and epithelial IL-8 modulation. Methods: Variable D2 and D3 domains of FliC were substituted with antigenic regions of PapG II and FimH from Escherichia coli, connected via rigid and flexible linkers to generate three constructs differing in adjuvant position (N-terminal, central, and C-terminal). Computational analyses including 3D structure prediction and TLR5 docking were assessed. The optimal construct was expressed in E. coli, purified, and applied to HT-29 cells to measure IL-8 secretion using ELISA. Results: Docking analyses revealed that central placement of FliC in the multi-epitope construct (FlFPFl) provided the highest TLR5 binding affinity and stable interaction. Functional assays confirmed that FlFPFl significantly modulated IL-8 secretion compared to untreated cells (p < 0.05), demonstrating the critical role of adjuvant positioning in epithelial immune activation. Conclusion: This study highlights the importance of adjuvant topology in multi-epitope vaccine design. Based on in silico analyses, structural optimization of flagellin-based constructs derived from S. typhimurium improved receptor-accessible motif exposure and folding stability. Central adjuvant placement enhanced interaction with TLR5 and FlFPFl model showed the most favorable docking performance. http://vacres.pasteur.ac.ir/article-1-370-en.pdf 2024-06 7 14 10.52547/vacres.11.1.7 Salmonella typhimurium flagellin adjuvant vaccine docking Saeide Mirsharifi 1 Department of Microbiology, ShQ.C., Islamic Azad University, Shahr-e Qods, Iran AUTHOR Mohammad Reza Asadi Karam 2 Department of Molecular Biology, Pasteur Institute of Iran, Tehran, Iran AUTHOR Fatemeh Foroohi 3 Department of Microbiology, ShQ.C., Islamic Azad University, Shahr-e Qods, Iran AUTHOR Mehri Habibi 4 Department of Medical Biotechnology, Biotechnology Research Center, Pasteur Institute of Iran, Tehran, Iran. AUTHOR Touraj Rahimi 5 Department of Plant Production and Genetics, ShQ.C., Islamic Azad University, Shahr-e Qods, Iran AUTHOR