新型冠状病毒疫苗免疫策略的强化和优化

doi:10.3969/j.issn.1674-8115.2021.12.001

摘要/Abstract

摘要：

新中国成立之初，政府通过推行一系列卫生政策和措施，快速提升了人民健康水平。疫苗研发生产和公共卫生机构建设是落实“预防为主”政策的重要支撑，在控制各类传染病流行中发挥了重要作用。新型冠状病毒肺炎（简称新冠肺炎）疫情发生以来，中国快速部署5条新型冠状病毒疫苗（简称新冠疫苗）研发技术路线。通过社会防控举措的实施和疫苗接种，疫情得到快速和持续的控制。但由于全球疫情的反复，中国“外防输入、内防反弹”的压力持续增加，如何调整疫情防控策略备受关注。该文从新冠疫苗研发、疫苗接种、免疫策略动态调整、加强免疫、新冠疫苗老年人群接种、免疫规划等方面进行了综述，并通过对当前全球疫情整体走势的判断，对中国新冠疫苗免疫策略整体实施的分析，为中国后续新冠疫苗接种策略和疫情防控策略的调整提出了建议。

关键词: 新型冠状病毒肺炎, 疫苗, 加强免疫, 老年人, 免疫规划, 免疫策略

Abstract:

At the beginning of the founding of New China, the government implemented a series of health policies and measures to quickly improve the people's health. The development of vaccine and the construction of public health facilities work together to provide important support for the implementation of the ??prevention first'' policy, and have played an important role in preventing the spread of various infectious diseases. Since the outbreak of COVID-19, China has rapidly deployed five technical routes to accelerate vaccine research and development. Combining vaccination with public health emergency measures, Chinese government stopped the spread of COVID-19 scientifically and effectively. Due to the rebounded global epidemic, the pressure of ??external defense input, internal defense rebound'' keeps increasing. How to adjust the strategies for epidemic prevention and control has become an important issue. This article reviews the vaccine research and development, vaccine administration, dynamic adjustment of immunization strategies, booster immunization, immunization for the elderly, and the immunization plan. With predicting the trend of global epidemic and analyzing China's COVID-19 vaccination strategy, it provides new thoughts for the next strategic adjustment of China's COVID-19 vaccination as well as the epidemic prevention and control.

Key words: COVID-19, vaccine, booster immunization, the elderly, immunization program, immunization strategy

中图分类号:

R186

吕晓亚, 宋磊, 马昭, 王曙光, 马豪, 邵一鸣, 武治印. 新型冠状病毒疫苗免疫策略的强化和优化[J]. 上海交通大学学报(医学版), 2021, 41(12): 1545-1550.

Xiao-ya LÜ, Lei SONG, Zhao MA, Shu-guang WANG, Hao MA, Yi-ming SHAO, Zhi-yin WU. Strengthening and optimization of immunization strategy for COVID-19 vaccines[J]. JOURNAL OF SHANGHAI JIAOTONG UNIVERSITY (MEDICAL SCIENCE), 2021, 41(12): 1545-1550.

参考文献 33

1	余文周, 温宁, 汪海波, 等. 我国现阶段维持无脊髓灰质炎状态面临的挑战和对策[J]. 中国疫苗和免疫, 2013, 19(5): 468-472.
2	中国疾病预防控制中心. 免疫规划[EB/OL]. (2021-09-13) [2021-11-20]. .
3	国家统计局. 人口总量平稳增长人口素质显著提升: 新中国成立70周年经济社会发展成就系列报告之二十[R/OL]. (2019-09-12) [2021-11-20]. .
4	WHO. The COVID-19 vaccine tracker and landscape compiles detailed information of each COVID-19 vaccine candidate in development by closely monitoring their progress through the pipeline[R/OL]. (2021-12-03) [2021-12-07]. .
5	WHO. Status of COVID-19 Vaccines within WHO EUL/PQ evaluation process[R/OL]. (2021-11-11)[2021-12-07]. .
6	全国人民代表大会常务委员会. 中华人民共和国疫苗管理法[EB/OL]. (2019-06-29) [2021-11-20]. .
7	全国人民代表大会常务委员会. 中华人民共和国药品管理法[EB/OL]. (1984-09-20) [2021-11-20]. .
8	WHO. WHO coronavirus (COVID-19) dashboard[EB/OL]. [2021-11-20]. .
9	WHO. Update on Omicron[EB/OL]. [2021-11-29]. .
10	Tartof SY, Slezak JM, Fischer H, et al. Effectiveness of mRNA BNT162b2 COVID-19 vaccine up to 6 months in a large integrated health system in the USA: a retrospective cohort study[J]. Lancet, 2021, 398(10309): 1407-1416.
11	Cao Y, Yisimayi A, Bai Y, et al. Humoral immune response to circulating SARS-CoV-2 variants elicited by inactivated and RBD-subunit vaccines[J]. Cell Res, 31(7): 732-741.
12	Cohn BA, Cirillo PM, Murphy CC, et al. SARS-CoV-2 vaccine protection and deaths among US veterans during 2021[J]. Science, 2021. DOI: 10.1126/science.abm0620.
13	Tang P, Hasan MR, Chemaitelly H, et al. BNT162b2 and mRNA-1273 COVID-19 vaccine effectiveness against the SARS-CoV-2 Delta variant in Qatar[J]. Nat Med, 2021. DOI: 10.1038/s41591-021-01583-4.
14	Liu Y, Rocklöv J. The reproductive number of the Delta variant of SARS-CoV-2 is far higher compared to the ancestral SARS-CoV-2 virus[J]. J Travel Med, 2021, 28(7): taab124.
15	McMorrow M. Improving communications around vaccine breakthrough and vaccine effectiveness[R/OL]. (2021-07-29) [2021-11-20]. .
16	Delamater PL, Street EJ, Leslie TF, et al. Complexity of the basic reproduction number (R₀)[J]. Emerg Infect Dis, 2019, 25(1): 1-4.
17	Israel says Pfizer vaccine effectiveness down to 39 pct amid spread of Delta variant[N/OL]. (2021-07-23) [2021-11-20]. .
18	Jara A, Undurraga EA, González C, et al. Effectiveness of an inactivated SARS-CoV-2 vaccine in Chile[J]. N Engl J Med, 2021, 385(10): 875-884.
19	Ministry of Health, Chile. Immunization campaign against SARS-CoV-2: early estimates of the effectiveness of booster shots in Chile[R/OL]. [2021-11-20]. .
20	Pan H, Wu Q, Zeng G, et al. Immunogenicity and safety of a third dose, and immune persistence of CoronaVac vaccine in healthy adults aged 18-59 years: interim results from a double-blind, randomized, placebo-controlled phase 2 clinical trial[Z/OL]. [2021-11-20]. .
21	Wang K, Cao Y, Zhou Y, et al. A third dose of inactivated vaccine augments the potency, breadth, and duration of anamnestic responses against SARS-CoV-2[Z/OL]. [2021-12-07]. .
22	U.S. Food & Drug Administration. FDA authorizes booster dose of Pfizer-BioNTech COVID-19 vaccine for certain populations[R/OL]. [2021-12-07]. .
23	U.S. Food & Drug Administration. Moderna COVID-19 vaccine application for emergency use authorization of a booster dose[R/OL]. [2021-12-07]. .
24	Vaccines and Related Biological Products Advisory Committee. DMID21-0012-heterologous platform boost study: mix and match[R/OL]. [2021-12-07]. .
25	Mok CKP, Cheng SMS, Chen C, et al. A RCT of a third dose CoronaVac or BNT162b2 vaccine in adults with two doses of CoronaVac[Z/OL]. [2021-11-20]. .
26	Cao Y, Hao X, Wang X, et al. Humoral immunogenicity and reactogenicity of CoronaVac or ZF2001 booster after two doses of inactivated vaccine[J]. Cell Res, 2021. DOI: 10.1038/s41422-021-00596-5.
27	Wu S, Huang J, Zhang Z, et al. Safety, tolerability, and immunogenicity of an aerosolised adenovirus type-5 vector-based COVID-19 vaccine (Ad5-nCoV) in adults: preliminary report of an open-label and randomised phase 1 clinical trial[J]. Lancet Infect Dis, 2021, 21(12): 1654-1664.
28	Li XN, Huang Y, Wang W, et al. Efficacy of inactivated SARS-CoV-2 vaccines against the Delta variant infection in Guangzhou: a test-negative case-control real-world study[J]. Emerg Microbes Infect, 2021, 10(1): 1751-1732.
29	National Center for Immunization and Respiratory Diseases (NCIRD), Division of Viral Diseases. Risk for COVID-19 infection, hospitalization, and death by age group[R/OL]. [2021-11-29]. .
30	Ministerio de Salud, Argentina. ESTUDIO efectividad de campaña nacional de vacunación en reducción de la mortalidad por COVID-19 en personas de 60 años y mayores[R/OL]. [2021-11-20]. .
31	全国人民代表大会常务委员会. 中华人民共和国基本医疗卫生与健康促进法[EB/OL]. (2020-01-02) [2021-11-20]. .
32	全国人民代表大会常务委员会. 中华人民共和国传染病防治法[EB/OL]. (2020-01-22) [2021-11-20]. .
33	谭敦民. ̒̒疫苗犹豫''成为世卫组织难题?[J]. 家庭医药: 就医选药, 2020(2): 2.

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