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大流行疫苗研发到推出的漫漫长路:从 2009 年 H1N1 流感大流行中吸取的经验教训的系统评价。

The long road of pandemic vaccine development to rollout: A systematic review on the lessons learnt from the 2009 H1N1 influenza pandemic.

机构信息

School of Population Health, University of New South Wales, Sydney, New South Wales, Australia.

Biosecurity Program, Kirby Institute, University of New South Wales, Sydney, New South Wales, Australia.

出版信息

Am J Infect Control. 2022 Jul;50(7):735-742. doi: 10.1016/j.ajic.2022.01.026. Epub 2022 Feb 4.

Abstract

BACKGROUND

The 2009 Influenza A(H1N1) pandemic prompted one of the largest public health responses in history. The continuous emergence of new and deadly pathogens has highlighted the need to reflect upon past experiences to improve pandemic preparedness. The aim of this study was to examine the development and rollout of 2009 influenza A(H1N1) pandemic vaccine and knowledge challenges for the effective implementation of vaccination programs for COVID-19 and future influenza pandemics.

METHODS

A systematic review was conducted searching EMBASE (inception to current date) and PUBMED (from January 2009 to current date) databases for relevant published studies about influenza A(H1N1) pandemic vaccines. A Google search was conducted to identify relevant documents from gray literature. Selected Studies were reviewed and summarized.

RESULTS

A total of 22, comprising of 12 original studies and 10 relevant documents met the inclusion criteria. Fourteen papers reported an initial high demand that outweighed production capacity and caused vaccine shortages. Vaccine procurement and supply were skewed toward high-income countries. Low vaccination rates of about 5%-50% were reported in all studies mainly due to a low-risk perception of getting infected, safety concerns, and the fear of adverse effects.

CONCLUSIONS

Safety concerns about the approved H1N1 vaccines resulted in many unsuccessful vaccination campaigns worldwide. Understanding the factors that influence people's decision to accept or refuse vaccination, effective risk communication strategies, adequate resources for vaccine deployment initiatives and building local capacities through shared knowledge and technology transfer may help to improve COVID-19 vaccine uptake and accelerate pandemic control.

摘要

背景

2009 年甲型 H1N1 流感大流行促使人们采取了历史上最大规模的公共卫生措施之一。新出现的致命病原体不断出现,凸显了人们需要反思过去的经验,以改善大流行防范工作。本研究旨在考察 2009 年甲型 H1N1 流感大流行疫苗的研发和推广情况,以及为有效实施 COVID-19 和未来流感大流行疫苗接种计划而面临的知识挑战。

方法

系统检索了 EMBASE(从建库到当前日期)和 PUBMED(从 2009 年 1 月到当前日期)数据库中关于甲型 H1N1 流感大流行疫苗的相关研究,还通过谷歌搜索确定了灰色文献中的相关文件。对入选的研究进行了评估和总结。

结果

共纳入 22 篇文献,其中包括 12 篇原始研究和 10 篇相关文献。14 篇论文报道称,最初的需求量很大,超过了生产能力,导致疫苗短缺。疫苗采购和供应偏向高收入国家。所有研究报告的疫苗接种率均较低,约为 5%-50%,主要原因是人们对感染风险的认识较低、安全性问题以及对不良反应的担忧。

结论

人们对已批准的 H1N1 疫苗的安全性问题表示担忧,导致全球许多疫苗接种运动失败。了解影响人们接受或拒绝接种疫苗的因素、有效的风险沟通策略、为疫苗部署计划提供充足资源以及通过共享知识和技术转让建立地方能力,可能有助于提高 COVID-19 疫苗接种率并加速大流行控制。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b365/8815192/40d452d93447/gr1_lrg.jpg

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