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新冠病毒疫苗接种是否需要遵循“经典原则”?

Does COVID-19 Vaccination Warrant the Classical Principle ""?

机构信息

Second Medical Clinic, School of Medicine, Aristotle University of Thessaloniki, Ippokration Hospital, 54652 Thessaloniki, Greece.

Department of Gastroenterology, University Hospital of Larisa, Mezourlo, 41110 Larisa, Greece.

出版信息

Medicina (Kaunas). 2021 Mar 9;57(3):253. doi: 10.3390/medicina57030253.

DOI:10.3390/medicina57030253
PMID:33803295
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7999356/
Abstract

The current severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic warrants an imperative necessity for effective and safe vaccination, to restrain Coronavirus disease 2019 (COVID-19) including transmissibility, morbidity, and mortality. In this regard, intensive medical and biological research leading to the development of an arsenal of vaccines, albeit incomplete preconditioned evaluation, due to emergency. The subsequent scientific gap raises some concerns in the medical community and the general public. More specifically, the accelerated vaccine development downgraded the value of necessary pre-clinical studies to elicit medium- and long-term beneficial or harmful consequences. Previous experience and pathophysiological background of coronaviruses' infections and vaccine technologies, combined with the global vaccines' application, underlined the obligation of a cautious and qualitative approach, to illuminate potential vaccination-related adverse events. Moreover, the high SARS-CoV-2 mutation potential and the already aggregated genetical alterations provoke a rational vagueness and uncertainty concerning vaccines' efficacy against dominant strains and the respective clinical immunity. This review critically summarizes existing evidence and queries regarding SARS-CoV-2 vaccines, to motivate scientists' and clinicians' interest for an optimal, individualized, and holistic management of this unprecedented pandemic.

摘要

当前严重急性呼吸综合征冠状病毒 2(SARS-CoV-2)大流行迫切需要有效的和安全的疫苗接种,以限制包括传染性、发病率和死亡率在内的 2019 年冠状病毒病(COVID-19)。在这方面,由于紧急情况,密集的医学和生物学研究导致了疫苗库的发展,尽管条件不完全成熟。随后的科学差距引起了医学界和公众的一些关注。更具体地说,加速的疫苗开发降低了必要的临床前研究的价值,以引出中-长期有益或有害的后果。以前的经验和冠状病毒感染的病理生理学背景以及疫苗技术,加上全球疫苗的应用,强调了谨慎和定性方法的义务,以阐明潜在的与疫苗接种有关的不良事件。此外,SARS-CoV-2 高的突变潜力和已经聚集的遗传改变引起了对疫苗对主要菌株的疗效以及各自的临床免疫的合理模糊性和不确定性。这篇综述批判性地总结了现有的关于 SARS-CoV-2 疫苗的证据和问题,以激发科学家和临床医生对这一前所未有的大流行进行最佳、个体化和整体管理的兴趣。