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地方性、流行性和大流行性感染:自然和后天群体免疫的作用。

Endemic, epidemic and pandemic infections: the roles of natural and acquired herd immunity.

作者信息

Stevens Dennis L, Bryant Amy E

机构信息

University of Washington School of Medicine, Seattle, Washington.

Department of Biomedical and Pharmaceutical Sciences, Idaho State University College of Pharmacy, Meridian, Idaho, USA.

出版信息

Curr Opin Infect Dis. 2023 Jun 1;36(3):171-176. doi: 10.1097/QCO.0000000000000916. Epub 2023 Mar 20.

Abstract

PURPOSE OF REVIEW

This review summarizes the general concepts of innate and acquired immunity, including vaccine use and hesitancy, as they relate to reduction of the global burden of highly communicable infectious diseases.

RECENT FINDINGS

Vaccination to increase herd immunity remains the cornerstone of disease prevention worldwide yet global vaccination goals are not being met. Modern obstacles to vaccine acceptance include hesitancy, reduced altruistic intentions, impact of COVID-19, distrust of science and governmental agencies as well as recent geopolitical and environmental disasters. Together, such barriers have negatively impacted immunization rates worldwide, resulting in epidemics and pandemics of serious life-threatening infections from vaccine-preventable diseases, especially those affecting children. In addition, pathogens thought to be controlled or eradicated are reemerging with new genetic traits, making them more able to evade natural and acquired immunity, including that induced by available vaccines. Lastly, many serious and widespread infectious diseases await development and utilization of efficacious vaccines.

SUMMARY

The global burden of communicable diseases remains high, necessitating continued pathogen surveillance as well as vaccine development, deployment and continued efficacy testing. Equally important is the need to educate aggressively the people and their leaders on the benefits of vaccination to the individual, local community and the human population as a whole.

摘要

综述目的

本综述总结了先天免疫和后天免疫的一般概念,包括疫苗的使用和犹豫态度,因为它们与减轻全球高度传染性传染病负担相关。

最新发现

通过接种疫苗提高群体免疫力仍然是全球疾病预防的基石,但全球疫苗接种目标尚未实现。疫苗接受度面临的现代障碍包括犹豫态度、利他意愿降低、新冠疫情的影响、对科学和政府机构的不信任以及近期的地缘政治和环境灾难。这些障碍共同对全球免疫接种率产生了负面影响,导致疫苗可预防疾病引发严重威胁生命的感染的流行和大流行,尤其是那些影响儿童的疾病。此外,被认为已得到控制或根除的病原体正带着新的基因特征重新出现,使其更有能力逃避天然免疫和后天免疫,包括现有疫苗诱导的免疫。最后,许多严重且广泛传播的传染病等待有效疫苗的研发和使用。

总结

传染病的全球负担仍然很高,因此需要持续进行病原体监测以及疫苗研发、部署和持续的有效性测试。同样重要的是,需要大力教育民众及其领导人,让他们了解接种疫苗对个人、当地社区和整个人类群体的益处。

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