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Vaccine. 2017 Dec 14;35(49 Pt B):6823-6827. doi: 10.1016/j.vaccine.2017.10.023. Epub 2017 Nov 6.
Global immunization efforts to date have heavily focused on infants and children, with noted success on public health. Healthy adolescents and adults contribute to the economic growth and development of countries but efforts to ensure vaccine coverage for these groups receive inadequate global attention and resources. Emerging epidemics for a number of infectious diseases including Ebola, Zika, dengue, malaria and the continuing epidemics of tuberculosis and several sexually transmitted infections, including HIV, HPV and Hepatitis B, have high incidence and prevalence in adolescents and adults. New vaccines under development for these diseases and under-used vaccines such as for human papilloma virus will have the greatest health and economic impact in these populations. Global consensus, political will, policies, global and country infrastructure, and financing mechanisms are needed to accelerate access for the billions of adolescents and adults living under the threat of devastating infectious disease outbreaks and epidemics, especially in lower income countries. The global health community and countries cannot afford to delay planning for implementation of adolescent and adult vaccine programs that will potentially save millions of lives and strengthen global and national economies. The article examines this next challenge and suggests a research agenda and a framework for action to galvanize global and national policy decision-makers to begin preparations for future immunization challenges.
迄今为止,全球免疫工作的重点主要放在婴幼儿上,在公共卫生方面取得了显著成就。健康的青少年和成年人是国家经济增长和发展的贡献者,但为这些人群确保疫苗接种的工作并未得到足够的全球关注和资源。包括埃博拉、寨卡、登革热、疟疾在内的一些传染病正在出现流行,结核病和若干性传播感染(包括艾滋病毒、人乳头瘤病毒和乙型肝炎)也持续流行,这些疾病在青少年和成年人中的发病率和流行率都很高。针对这些疾病的新疫苗正在开发中,而人乳头瘤病毒等使用率较低的疫苗将对这些人群产生最大的健康和经济效益。需要全球共识、政治意愿、政策、全球和国家基础设施以及融资机制,以加快为面临毁灭性传染病暴发和流行威胁的数十亿青少年和成年人提供疫苗,特别是在低收入国家。全球卫生界和各国都不能再拖延规划实施青少年和成人疫苗方案,因为这些方案有可能拯救数百万人的生命,并加强全球和国家经济。本文探讨了这一未来挑战,并提出了一个研究议程和行动框架,以激励全球和国家政策制定者开始为未来的免疫挑战做准备。