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不同人群的 COVID-19 疫苗更新信息。

COVID-19 vaccine updates for people under different conditions.

机构信息

National Center for Respiratory Medicine; State Key Laboratory of Respiratory Health and Multimorbidity; National Clinical Research Center for Respiratory Diseases; Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Beijing, 100029, China.

Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, 100029, China.

出版信息

Sci China Life Sci. 2024 Nov;67(11):2323-2343. doi: 10.1007/s11427-024-2643-1. Epub 2024 Jul 29.

Abstract

SARS-CoV-2 has caused global waves of infection since December 2019 and continues to persist today. The emergence of SARS-CoV-2 variants with strong immune evasion capabilities has compromised the effectiveness of existing vaccines against breakthrough infections. Therefore, it is important to determine the best utilization strategies for different demographic groups given the variety of vaccine options available. In this review, we will discuss the protective efficacy of vaccines during different stages of the epidemic and emphasize the importance of timely updates to target prevalent variants, which can significantly improve immune protection. While it is recognized that vaccine effectiveness may be lower in certain populations such as the elderly, individuals with chronic comorbidities (e.g., diabetes with poor blood glucose control, those on maintenance dialysis), or those who are immunocompromised compared to the general population, administering multiple doses can result in a strong protective immune response that outweighs potential risks. However, caution should be exercised when considering vaccines that might trigger an intense immune response in populations prone to inflammatory flare or other complications. In conclusion, individuals with special conditions require enhanced and more effective immunization strategies to prevent infection or reinfection, as well as to avoid the potential development of long COVID.

摘要

自 2019 年 12 月以来,SARS-CoV-2 已在全球范围内引发了感染浪潮,并持续至今。具有强大免疫逃逸能力的 SARS-CoV-2 变体的出现,削弱了现有疫苗对突破性感染的有效性。因此,鉴于现有疫苗种类繁多,确定不同人群的最佳利用策略非常重要。在这篇综述中,我们将讨论在疫情的不同阶段疫苗的保护效力,并强调及时更新以针对流行变体的重要性,这可以显著提高免疫保护效果。虽然人们认识到,与一般人群相比,某些人群(例如老年人、患有慢性合并症的人群[例如,血糖控制不佳的糖尿病患者、维持性透析患者]或免疫功能低下的人群)的疫苗有效性可能较低,但接种多剂疫苗可以产生强大的保护性免疫反应,超过潜在风险。然而,在考虑可能引发炎症爆发或其他并发症风险较高的人群产生强烈免疫反应的疫苗时,应谨慎行事。总之,特殊人群需要强化和更有效的免疫接种策略,以预防感染或再次感染,并避免长新冠的潜在发展。

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