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專家表態(tài),新冠疫苗接種者或仍具有傳染性

David Z. Morris
2020-12-23

我們?nèi)匀恍枰私庖呙缃臃N對(duì)傳染性的影響有多大。

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別不信,專家們已經(jīng)達(dá)成一致:成千上萬人接種了新冠疫苗,但他們?nèi)匀豢赡軘y帶病毒,并傳播給其他人。盡管這些人自己已經(jīng)得到了很好的保護(hù),但仍具有傳染性。這意味著,即使人們接種了疫苗,仍然需要戴上口罩,保持社交距離,以保護(hù)周圍的人。

華盛頓大學(xué)(University of Washington)的公共衛(wèi)生專家珍妮特?貝斯曼博士說:“我們?nèi)匀恍枰私庖呙缃臃N對(duì)傳染性的影響有多大,從而保護(hù)那些我接觸過的人,而不僅僅是我自己。”

疫苗開發(fā)進(jìn)展迅速,不確定性也隨之而來。通常情況下,在大批量投入使用之前,疫苗試驗(yàn)會(huì)對(duì)受試者進(jìn)行相當(dāng)長一段時(shí)間的觀察。這不僅可了解受試者的患病情況,還能夠得出傳染性的留存程度。可以肯定的是,各式各樣的候選新冠疫苗在一定程度上控制了病毒的傳播,但到底控制到了何種程度,現(xiàn)在還很難說。

這一矛盾背后的科學(xué)原理其實(shí)并不復(fù)雜。輝瑞(Pfizer)和Moderna公司的疫苗被注射到深層肌肉中,提供所謂的“全身免疫”。但仍然有部分區(qū)域會(huì)被遺漏(如鼻腔粘膜通道),病毒仍然能夠相對(duì)自由地繁殖。即使宿主未染病,新冠病毒也可能通過咳嗽、打噴嚏傳播,和染病者的傳播途徑并無區(qū)別。

KFF(前身為凱撒家庭基金會(huì))的流行病學(xué)家喬舒亞?米肖說:“全身免疫的作用和大樓安保類似。擁有粘膜免疫,就像雇傭了一位保鏢站在門口把守,隨時(shí)準(zhǔn)備對(duì)付病毒的進(jìn)攻。”

病毒“保鏢”的位置,研究人員可能要花幾個(gè)月的時(shí)間才可以確定。因?yàn)檫@一流程需要監(jiān)控已經(jīng)接種過疫苗的人,需要耗費(fèi)一段時(shí)間。貝斯曼說,針對(duì)“高混合程度和高傳播風(fēng)險(xiǎn)”的接種人群(如大學(xué)生)的研究能夠更快地提供疫苗接種后的傳播數(shù)據(jù)。米肖預(yù)計(jì),重點(diǎn)傳播研究將在“未來幾周和幾個(gè)月”進(jìn)行。

關(guān)于接種者傳播性的問題,通過正在進(jìn)行的疫苗試驗(yàn)也可以得到答案。盡管輝瑞和Moderna的疫苗都已經(jīng)獲得美國食品與藥品管理局(U.S. FDA)等衛(wèi)生部門的緊急使用批準(zhǔn),但制藥商仍然在繼續(xù)進(jìn)行標(biāo)準(zhǔn)試驗(yàn)。試驗(yàn)結(jié)束之后,永久性批準(zhǔn)才會(huì)下發(fā)。

輝瑞的發(fā)言人說:“我們的試驗(yàn)將繼續(xù)確定疫苗的全面保護(hù)能力?!币呙缃臃N后病毒傳播能力如何,也將包含在試驗(yàn)當(dāng)中。

但在長期試驗(yàn)數(shù)據(jù)及其他實(shí)驗(yàn)結(jié)果公布之前,只有通過測(cè)量高疫苗接種水平人群中新冠病毒的傳播情況,才能夠明確疫苗接種后的傳染性幾何。如果病毒傳播速度趨緩,則表明疫苗接種削弱了傳染性。但即便是在首發(fā)疫苗的發(fā)達(dá)國家,預(yù)計(jì)也要在2021年中下旬才可以達(dá)到高疫苗接種水平。這種方法花費(fèi)的時(shí)間,可能將占據(jù)大半年的時(shí)間。

根據(jù)美國食品與藥品管理局的說法,大多數(shù)疫苗在預(yù)防疾病的同時(shí),也減少了接種者的傳播能力。我們有理由持樂觀態(tài)度:當(dāng)前出爐的一波波新冠疫苗也將如此。最值得注意的是,Moderna的疫苗試驗(yàn)顯示,通過鼻拭子檢測(cè),無癥狀感染數(shù)量有所減少,這或?qū)⒈砻鹘臃N疫苗后傳播力降低了。斯克里普斯研究所(Scripps Research Translational Institute)的埃里克?托波爾博士稱,這些發(fā)現(xiàn)尚未定論,但就“疫苗接種后傳播力降低”這一點(diǎn),的確很有可能性。

不過,在更多確鑿的數(shù)據(jù)到來之前,來自衛(wèi)生部門的信息還是相當(dāng)明確:即使你已經(jīng)接種了疫苗,也請(qǐng)不要忘了戴口罩。(財(cái)富中文網(wǎng))

編譯:楊二一

別不信,專家們已經(jīng)達(dá)成一致:成千上萬人接種了新冠疫苗,但他們?nèi)匀豢赡軘y帶病毒,并傳播給其他人。盡管這些人自己已經(jīng)得到了很好的保護(hù),但仍具有傳染性。這意味著,即使人們接種了疫苗,仍然需要戴上口罩,保持社交距離,以保護(hù)周圍的人。

華盛頓大學(xué)(University of Washington)的公共衛(wèi)生專家珍妮特?貝斯曼博士說:“我們?nèi)匀恍枰私庖呙缃臃N對(duì)傳染性的影響有多大,從而保護(hù)那些我接觸過的人,而不僅僅是我自己?!?/p>

疫苗開發(fā)進(jìn)展迅速,不確定性也隨之而來。通常情況下,在大批量投入使用之前,疫苗試驗(yàn)會(huì)對(duì)受試者進(jìn)行相當(dāng)長一段時(shí)間的觀察。這不僅可了解受試者的患病情況,還能夠得出傳染性的留存程度??梢钥隙ǖ氖?,各式各樣的候選新冠疫苗在一定程度上控制了病毒的傳播,但到底控制到了何種程度,現(xiàn)在還很難說。

這一矛盾背后的科學(xué)原理其實(shí)并不復(fù)雜。輝瑞(Pfizer)和Moderna公司的疫苗被注射到深層肌肉中,提供所謂的“全身免疫”。但仍然有部分區(qū)域會(huì)被遺漏(如鼻腔粘膜通道),病毒仍然能夠相對(duì)自由地繁殖。即使宿主未染病,新冠病毒也可能通過咳嗽、打噴嚏傳播,和染病者的傳播途徑并無區(qū)別。

KFF(前身為凱撒家庭基金會(huì))的流行病學(xué)家喬舒亞?米肖說:“全身免疫的作用和大樓安保類似。擁有粘膜免疫,就像雇傭了一位保鏢站在門口把守,隨時(shí)準(zhǔn)備對(duì)付病毒的進(jìn)攻?!?/p>

病毒“保鏢”的位置,研究人員可能要花幾個(gè)月的時(shí)間才可以確定。因?yàn)檫@一流程需要監(jiān)控已經(jīng)接種過疫苗的人,需要耗費(fèi)一段時(shí)間。貝斯曼說,針對(duì)“高混合程度和高傳播風(fēng)險(xiǎn)”的接種人群(如大學(xué)生)的研究能夠更快地提供疫苗接種后的傳播數(shù)據(jù)。米肖預(yù)計(jì),重點(diǎn)傳播研究將在“未來幾周和幾個(gè)月”進(jìn)行。

關(guān)于接種者傳播性的問題,通過正在進(jìn)行的疫苗試驗(yàn)也可以得到答案。盡管輝瑞和Moderna的疫苗都已經(jīng)獲得美國食品與藥品管理局(U.S. FDA)等衛(wèi)生部門的緊急使用批準(zhǔn),但制藥商仍然在繼續(xù)進(jìn)行標(biāo)準(zhǔn)試驗(yàn)。試驗(yàn)結(jié)束之后,永久性批準(zhǔn)才會(huì)下發(fā)。

輝瑞的發(fā)言人說:“我們的試驗(yàn)將繼續(xù)確定疫苗的全面保護(hù)能力?!币呙缃臃N后病毒傳播能力如何,也將包含在試驗(yàn)當(dāng)中。

但在長期試驗(yàn)數(shù)據(jù)及其他實(shí)驗(yàn)結(jié)果公布之前,只有通過測(cè)量高疫苗接種水平人群中新冠病毒的傳播情況,才能夠明確疫苗接種后的傳染性幾何。如果病毒傳播速度趨緩,則表明疫苗接種削弱了傳染性。但即便是在首發(fā)疫苗的發(fā)達(dá)國家,預(yù)計(jì)也要在2021年中下旬才可以達(dá)到高疫苗接種水平。這種方法花費(fèi)的時(shí)間,可能將占據(jù)大半年的時(shí)間。

根據(jù)美國食品與藥品管理局的說法,大多數(shù)疫苗在預(yù)防疾病的同時(shí),也減少了接種者的傳播能力。我們有理由持樂觀態(tài)度:當(dāng)前出爐的一波波新冠疫苗也將如此。最值得注意的是,Moderna的疫苗試驗(yàn)顯示,通過鼻拭子檢測(cè),無癥狀感染數(shù)量有所減少,這或?qū)⒈砻鹘臃N疫苗后傳播力降低了。斯克里普斯研究所(Scripps Research Translational Institute)的埃里克?托波爾博士稱,這些發(fā)現(xiàn)尚未定論,但就“疫苗接種后傳播力降低”這一點(diǎn),的確很有可能性。

不過,在更多確鑿的數(shù)據(jù)到來之前,來自衛(wèi)生部門的信息還是相當(dāng)明確:即使你已經(jīng)接種了疫苗,也請(qǐng)不要忘了戴口罩。(財(cái)富中文網(wǎng))

編譯:楊二一

It’s surprising, but experts agree: The tens of thousands of people being vaccinated against the coronavirus right now may still be able to carry and transmit the SARS-CoV-2 virus to others, despite being well-protected against the symptoms of COVID-19 themselves. That means they must still wear masks and practice social distancing to protect those around them.

“We still have yet to learn how much infectivity is impacted by vaccination, thereby producing protection for those I am in contact with, not just for myself, when I receive a vaccine,” says Dr. Janet Baseman, a public health expert at the University of Washington.

This uncertainty is a consequence of the extremely rapid vaccine development process. Normally, a vaccine trial would observe recipients of a vaccine for a longer period of time, showing not just whether they became ill, but whether they spread contagion, before a vaccine entered wide use. While it’s likely that the various coronavirus vaccine candidates provide at least some reduction in transmission, it’s simply too soon to know for sure, or to what degree.

The science behind this seeming contradiction is relatively straightforward. Vaccines like Pfizer’s and Moderna’s are injected into deep muscle and provide so-called systemic immunity. But they may still leave areas, particularly nasal mucous passages, where the virus is relatively free to multiply. Even without making the host sick, that virus can then potentially spread through coughing or sneezing, just as it is spread by a person with a full-blown coronavirus infection.

“Having systemic immunity is like having a security guard that’s somewhere in the building,” says Joshua Michaud, an epidemiologist at KFF (formerly the Kaiser Family Foundation). “Having mucosal immunity is like having a security guard right at the door, ready to take on the incoming virus.”

It could take researchers months to determine just where that viral security guard is stationed, because it requires monitoring people who have already been vaccinated. According to Baseman, a study focusing on vaccinated people “with high levels of mixing and high risk of transmission,” such as college students, could provide faster data on post-vaccination transmission. Michaud expects focused transmission studies to be conducted in "the coming weeks and months."

Insight on the question will also come through ongoing vaccine trials. Though both Pfizer’s and Moderna’s vaccines have been approved for emergency use by health authorities such as the U.S. FDA, the drugmakers are continuing the standard trials that should lead to permanent approval.

“Our trial will continue to determine the full protection and potential of the vaccine,” including transmission after vaccination, according to a Pfizer spokesperson.

But until long-term trial data or other experimental results are released, post-vaccine infectivity will be made clear only by measuring the spread of the coronavirus through populations with high vaccination levels. If the spread slows, it will demonstrate that transmission is lowered by vaccination. But it is expected to take much of 2021 to reach high levels of vaccination even in countries at the front of the line, so that approach could take the better part of a year.

According to the FDA, most vaccines that protect from viral illnesses also reduce viral transmission by those who are vaccinated, and there is reason for optimism that the current wave of COVID vaccines will, as well. Most notably, Moderna’s vaccine trial showed some reduction in asymptomatic infections as measured through nasal swabs, which could suggest reduced transmission after vaccination. Dr. Eric Topol of the Scripps Research Translational Institute has described those findings as inconclusive, but promising on the question of post-vaccine transmission.

Until more conclusive data arrives, though, the message from health authorities is clear: Even after you've been vaccinated, don't toss that face mask.

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