Teo Shyh Poh
Department of Internal Medicine, Raja Isteri Pengiran Anak Saleha (RIPAS) Hospital, Brunei Darussalam.
Ann Geriatr Med Res. 2021 Mar;25(1):4-9. doi: 10.4235/agmr.21.0011. Epub 2021 Feb 4.
Coronavirus disease 2019 (COVID-19) caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has resulted in a global pandemic and significant loss of life. Older people are vulnerable to SARS-CoV-2 infections and complications; thus, they are a priority group to receive COVID-19 vaccines. This review discusses considerations for COVID-19 vaccines for older adults. The general concepts of vaccine effectiveness in older adults are described, particularly immune senescence and vaccine development approaches to improve immunogenicity. The types of COVID-19 vaccine platforms are also described before reviewing the available, although limited, evidence from phase 3 COVID-19 vaccine trials relevant to older adults. The BNT162b2 vaccine by Pfizer-BioNTech and mRNA-1273 vaccine from Moderna demonstrated high efficacy and immunogenicity, which were also observed in older people. While the ChAdOx1 nCoV-19 vaccine (AZD1222) by AstraZeneca demonstrated some efficacy in older people, the vaccine dose requires clarification through further studies. Finally, the Ad26.COV2.S vaccine by Janssen Pharmaceuticals shows promise as a single-dose vaccine with a potential durability of response.
由严重急性呼吸综合征冠状病毒2（SARS-CoV-2）引起的2019冠状病毒病（COVID-19）已导致全球大流行和大量生命损失。老年人易受SARS-CoV-2感染及并发症影响；因此，他们是接种COVID-19疫苗的优先群体。本综述讨论了针对老年人的COVID-19疫苗的相关考量。描述了老年人疫苗有效性的一般概念，特别是免疫衰老以及提高免疫原性的疫苗开发方法。在回顾与老年人相关的3期COVID-19疫苗试验中现有的（尽管有限）证据之前，还介绍了COVID-19疫苗平台的类型。辉瑞-生物科技公司的BNT162b2疫苗和莫德纳公司的mRNA-1273疫苗显示出高疗效和免疫原性，在老年人中也观察到了这一点。虽然阿斯利康公司的ChAdOx1 nCoV-19疫苗（AZD1222）在老年人中显示出一定疗效，但疫苗剂量需要通过进一步研究加以明确。最后，杨森制药公司的Ad26.COV2.S疫苗作为一种单剂量疫苗显示出前景，且反应可能具有持久性。
