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抗 2019 年冠状病毒病疫苗:知情同意的必要性。

Anti-Coronavirus Disease 2019 Vaccines: Need for Informed Consent.

机构信息

From the International American University College of Medicine, Vieux Fort, Saint Lucia.

出版信息

Exp Clin Transplant. 2021 Aug;19(8):753-762. doi: 10.6002/ect.2021.0235.

Abstract

Vaccines are among some of the most efficacious medical and public health methods ever employed to contain a pandemic, in addition to providing protective and preventive measures. Evaluation of vaccineassociated adverse events through experimentation and empirical evidence is an integral part ofthoroughly assessing the safety of vaccines before authorization of their widespread use. History has highlighted the importance of continuous search for possible vaccine-related adverse effects and vaccine-induced immunogenicity long afterlicensure, suggesting that a primary concern with new vaccines is not only efficacy but also safety, particularly overthe long term. Many of the various anti-COVID-19 vaccines have used different types of technology, with some being introduced for the first time or rushed shortly into testing, bypassing animal experimentations. They have been adopted for use through emergency use authorizations, leading to a less than optimal collection of broad data on safety, immunogenicity, effectiveness, and time span of protection, as well as short follow-up of few months, despite many infectious disease experts arguing thatit takes 10 years to develop a vaccine. Given the valid concerns on well-recognized short-term and long-term safety issues, such as antibody-dependent enhancement and other processes like molecular mimicry and potential genomic transformation, the experimental nature of the vaccination process, the limited shortterm follow-up in the main trials, and the dismissal by law of pharma companies and health care providers from any medico-legal responsibilities, the application of an informed consent should become not only a necessity but also mandatory by law in accordance with all declarations on human rights. Such information should be provided to every potential recipient in the form of an official written digital consent prior to the registration for or the receipt of the vaccine.

摘要

疫苗是用于控制大流行的最有效医学和公共卫生方法之一,除了提供保护和预防措施外。通过实验和经验证据评估疫苗相关不良事件是在广泛使用疫苗之前全面评估其安全性的一个组成部分。历史强调了不断寻找可能的疫苗相关不良影响和疫苗诱导的免疫原性的重要性,即使在许可后很长时间也是如此,这表明新疫苗的主要关注点不仅是疗效,还有安全性,尤其是长期安全性。许多不同的抗 COVID-19 疫苗使用了不同类型的技术,其中一些是首次推出或在短时间内匆忙进入测试,绕过了动物实验。它们通过紧急使用授权被采用,导致对安全性、免疫原性、有效性和保护时间跨度以及仅数月的短期随访收集的数据不够理想,尽管许多传染病专家认为开发疫苗需要 10 年时间。鉴于对公认的短期和长期安全问题的合理担忧,例如抗体依赖性增强和其他过程,如分子模拟和潜在的基因组转化,疫苗接种过程的实验性质,主要试验中的短期随访有限,以及制药公司和医疗保健提供者被法律免除任何医疗法律责任,知情同意的应用不仅应该成为必要,而且应该根据所有关于人权的宣言成为法律规定。在登记或接种疫苗之前,应将此类信息以正式书面数字同意书的形式提供给每一位潜在的接受者。

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