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移植项目面临缺乏 SARS-CoV-2 疫苗接种经验证据的问题:社会建议共识更新。

Transplantation programs facing lack of empirical evidence on SARS-CoV-2 vaccination: A society recommendation consensus update.

机构信息

Department of Surgery, Charité - Universitätsmedizin Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.

Department for Shoulder and Elbow Surgery, Center for Musculoskeletal Surgery, Charité - Universitätsmedizin Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.

出版信息

Transpl Infect Dis. 2021 Aug;23(4):e13696. doi: 10.1111/tid.13696. Epub 2021 Jul 28.

DOI:10.1111/tid.13696
PMID:34288294
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8420432/
Abstract

BACKGROUND

Since phase III trials for the most prominent vaccines excluded immunocompromised or immunosuppressed patients, data on safety and efficacy of SARS-CoV-2 vaccines for recipients of solid organ transplantations are scarce.

AIMS

Our study offers a synthesis of expert opinions aligned with available data addressing key questions of the clinical management of SARS-CoV-2 vaccinations for transplant patients.

METHOD

An online research was performed retrieving available recommendations by national and international transplantation organizations and state institutions on SARS-CoV2 vaccination management for transplant recipients.

RESULTS

Eleven key statements were identified from recommendations by 18 national and international societies, and consensus for the individual statements was evaluated by means of the Society Recommendation Consensus score. The highest consensus level (SRC A) was found for prioritized access to vaccination for transplant patients despite anticipation of a weakened immune response. All currently authorized vaccines can be considered safe for transplant patients (SRC A). The handling of immunosuppressive medication, the timely management of vaccines, and other aspects were aligned with available expert opinions.

CONCLUSION

Expert consensus can be determined for crucial aspects of the implementation of SARS-CoV-2 vaccination programs. We hereby offer a tool for immediate decision-making until empirical data becomes available.

摘要

背景

由于最著名的疫苗的三期临床试验排除了免疫功能低下或免疫抑制患者,因此关于 SARS-CoV-2 疫苗在实体器官移植受者中的安全性和有效性的数据很少。

目的

我们的研究综合了专家意见,并结合现有数据,针对 SARS-CoV-2 疫苗接种管理的关键问题提出了针对移植患者的临床管理建议。

方法

通过检索国家和国际移植组织以及国家机构关于 SARS-CoV2 疫苗接种管理的建议,进行了在线研究。

结果

从 18 个国家和国际协会的建议中确定了 11 项关键陈述,并通过社会推荐共识评分评估了对个别陈述的共识程度。尽管预期免疫反应减弱,但为移植患者优先接种疫苗获得了最高共识水平(SRC A)。所有目前授权的疫苗均可被认为对移植患者是安全的(SRC A)。免疫抑制药物的处理、疫苗的及时管理以及其他方面与现有专家意见一致。

结论

可以确定实施 SARS-CoV-2 疫苗接种计划的关键方面的专家共识。在获得经验数据之前,我们特此提供一个用于即时决策的工具。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d7f7/8420432/2aef4cd3a815/TID-23-0-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d7f7/8420432/2aef4cd3a815/TID-23-0-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d7f7/8420432/2aef4cd3a815/TID-23-0-g001.jpg

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本文引用的文献

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Transpl Int. 2021 Oct;34(10):1770-1775. doi: 10.1111/tri.13979. Epub 2021 Sep 19.
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两剂抗 SARS-CoV-2 疫苗接种后医护人员体液免疫反应的随访 - Delta 变异突破感染的有效性。
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严重急性呼吸综合征冠状病毒2(SARS-CoV-2)BNT162b2疫苗在实体器官移植受者中的免疫原性。
Am J Transplant. 2021 Aug;21(8):2913-2915. doi: 10.1111/ajt.16607. Epub 2021 May 7.
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Weak anti-SARS-CoV-2 antibody response after the first injection of an mRNA COVID-19 vaccine in kidney transplant recipients.肾移植受者首次接种mRNA新冠疫苗后抗SARS-CoV-2抗体反应较弱。
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SARS-CoV-2 Infection after Vaccination in Health Care Workers in California.加利福尼亚州医护人员接种疫苗后感染新冠病毒
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Immunogenicity of a Single Dose of SARS-CoV-2 Messenger RNA Vaccine in Solid Organ Transplant Recipients.mRNA 疫苗在实体器官移植受者中的单剂免疫原性。
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