Department of Immunobiology, New Haven, CT, USA; Yale University School of Medicine, New Haven, CT, USA.
Yale University School of Medicine, New Haven, CT, USA.
Lancet Infect Dis. 2022 Feb;22(2):e52-e58. doi: 10.1016/S1473-3099(21)00472-2. Epub 2021 Sep 14.
As the number of individuals vaccinated against SARS-CoV-2 rises worldwide, population-level data regarding the vaccines' ability to reduce infection are being generated. Randomised trials have shown that these vaccines dramatically reduce symptomatic COVID-19; however, less is known about their effects on transmission between individuals. The natural course of infection with SARS-CoV-2 involves infection of the respiratory epithelia and replication within the mucosa to sufficient viral titres for transmission via aerosol particles and droplets. Here we discuss the available data on the existing, approved SARS-CoV-2 vaccines' capacity to reduce transmissibility by reducing primary infection, viral replication, capacity for transmission, and symptomaticity. The potential for mucosal-targeted SARS-CoV-2 vaccine strategies to more effectively limit transmission than intramuscular vaccines is considered with regard to known immunological mechanisms. Finally, we enumerate the population-level effects of approved vaccines on transmission through observational studies following clinical trials and vaccine distribution in real-world settings.
随着全球接种 SARS-CoV-2 疫苗的人数增加,关于疫苗降低感染能力的人群水平数据正在产生。随机试验表明,这些疫苗显著降低了有症状的 COVID-19;然而,关于它们对个体之间传播的影响知之甚少。SARS-CoV-2 的自然感染过程涉及呼吸道上皮细胞的感染和粘膜内的复制,以产生足够的病毒载量,通过气溶胶颗粒和飞沫传播。在这里,我们讨论了关于现有、已批准的 SARS-CoV-2 疫苗通过减少原发性感染、病毒复制、传播能力和症状来降低传染性的能力的可用数据。考虑到已知的免疫机制,我们考虑了针对粘膜的 SARS-CoV-2 疫苗策略在限制传播方面是否比肌肉内疫苗更有效。最后,我们列举了临床试验后观察性研究和现实环境中疫苗分发对传播的人群水平影响。
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