Heine Gunnar H, Becker Sören L, Scheuer Anja L, Schirmer Stephan H
Medizinische Klinik II, AGAPLESION MARKUS KRANKENHAUS, Frankfurt.
Universität des Saarlandes, Homburg.
Dtsch Med Wochenschr. 2021 Apr;146(7):466-470. doi: 10.1055/a-1375-4471. Epub 2021 Mar 29.
Only fifteen months after the beginning of the COVID-19 pandemic, several vaccines are already available for clinical use. While the spike protein of SARS-CoV-2 constitutes the main target of all predominant SARS-CoV-2 vaccines, they work by different mechanisms (mRNA-based vaccines vs. vector-based vaccines vs. protein-based vaccines).Though there are slight differences regarding the level of protection against mild COVID-19, all five vaccines that have been through phase 3 trials were nearly 100 % effective in preventing severe or fatal cases of COVID-19. The side effects were of short duration.Patients with chronic kidney disease (or other significant comorbidities) were largely excluded from Phase 3 trials, which makes definite recommendations concerning their vaccination difficult. The vaccine's effectiveness may be reduced in that population due to a uremic immune defect and/or immunosuppressive medication. However, these patients have an increased risk for severe or fatal COVID-19, so that they may particularly benefit from the vaccine.
在新冠疫情开始仅15个月后，就已有几种疫苗可供临床使用。虽然严重急性呼吸综合征冠状病毒2（SARS-CoV-2）的刺突蛋白是所有主流SARS-CoV-2疫苗的主要靶点，但它们的作用机制不同（基于信使核糖核酸的疫苗与基于载体的疫苗与基于蛋白质的疫苗）。尽管在预防轻度新冠方面的保护水平存在细微差异，但所有已完成3期试验的五种疫苗在预防新冠严重或致命病例方面的有效性几乎达到100%。副作用持续时间较短。慢性肾病（或其他重大合并症）患者在很大程度上被排除在3期试验之外，这使得针对他们接种疫苗的明确建议变得困难。由于尿毒症免疫缺陷和/或免疫抑制药物治疗，该人群中疫苗的有效性可能会降低。然而，这些患者患新冠严重或致命疾病的风险增加，因此他们可能会特别受益于疫苗。
