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以色列78%新冠疫苗接种率，日新增高达6000例；mRNA疫苗真的有效吗？

2021-08-27 梅斯医学 MedSci原创

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以色列是全球新冠疫苗接种率最高的国家之一， 12岁以上的人口中有78%都接种了疫苗，主要为辉瑞mRNA疫苗。作为首批接种疫苗的国家，一向被寄予厚望的以色列却成为了全球感染率最高的国家之一！

以色列是全球新冠疫苗接种率最高的国家之一， 12岁以上的人口中有78%都接种了疫苗，主要为辉瑞mRNA疫苗。作为首批接种疫苗的国家，一向被寄予厚望的以色列却成为了全球感染率最高的国家之一！
 
                                                                             来源：dw.com
 
以色列的这波疫情风暴由Delta变异株所致，目前，每天每百万人中有约600多新增病例，增速十分迅猛。这让人对疫苗的效果充满疑问，在变异株面前，曾经被视作终极武器的疫苗和全民免疫屏障竟形同虚设？
 
毫无疑问，以色列的“失败”说明，突破性感染是在所难免的，甚至可以说是一定会发生的。而最初希望依靠疫苗和全民免疫屏障来终止疫情的愿望也已经破灭。
 
                                                                 来源：www.sciencemag.org
 
去年12月份，以色列成为了首批接种新冠疫苗的国家之一，并迅速覆盖了全国930万人口。首批接种疫苗者已经时逾8个月，疫苗的效果似乎随着时间的流逝在加快衰减，免疫力下降在初冬接种疫苗的以色列人身上已经显现出来。
 
据悉，今年6月和7月份的以色列感染病例研究显示，疫苗对新冠感染的保护作用与接种疫苗以来的时间成负相关。1月份接种疫苗的人发生突破性感染的风险比4月份接种的人高2.26倍。
 
这有力地说明了疫苗具有有限的时效性。正如以色列的生物信息学家乌里·沙利特所说的那样，以色列证明了疫苗有效，但还不够好。
 

                                                                     来源：www.sciencemag.org

不过这项研究也有争议，因为以色列的最初几批接种者包括了免疫力较弱的老年人，这批人发生突破性感染的概率本来就更高。截至8月15日，有514名以色列人因严重新冠病情住院，其中59%的人已足剂量接种了疫苗，这其中又有87%是60岁以上人群。
 
为了遏制疫情的蔓延，以色列政府从8月开始就对50岁及以上的人群进行了加强免疫。目前已经有100多万人接种了第三剂加强针。
 
                                       一位以色列老人在接种加强针。来源：www.haaretz.com
 
其实加强免疫是否有必要也存在争议。
 
美国的研究显示，在今年5月至7月期间，美国的三种疫苗对所有新冠感染的保护有效性从91.7%降至79.8%。
 
英国的研究也表明，在Delta变异株流行之后，英国使用的两款主要疫苗的保护效力也显著下降。
 
然而，实验室证据并不支持以上的结论。科研人员并未发现Delta变异株特别擅长于逃避疫苗产生的抗体。因此可能的解释是，疫苗诱导的免疫力在特定人群例如老年人中才会出现明显的降低，没必要对所有人都加强注射。
 
相反的研究结论在纽约出现。那里的数据显示疫苗的功效在18至49岁的人群中下降最多，在65岁以上的人群中反而下降最少。研究人员的解释是，上波疫情之后年轻人的风险行为更多，例如去酒吧和参与大型聚会，这增加了年轻人的感染风险。
 
                                                                         来源：quanjing.com
 
总体来说，2剂的标准疫苗接种方案仍然是有效的。以色列的数据表明，这一方案对50岁以下人群的重症保护率仍然接近92%，对50岁以上人群的重症保护率也有85%。美国和英国的数据则显示，2剂疫苗的住院保护率可以达到95%左右。
 
此前只有很有限的研究评估了第三针加强注射的效果。在器官移植患者的研究中发现，接种一剂mRNA疫苗后，只有17%的患者产生了保护性抗体，在标准的两剂后，这一比例只上升到54%，这可能是因为他们服用了免疫抑制剂。
 
而在接种第三剂加强针后，之前没有产生抗体的患者中有33.3%出现了抗体。之前抗体水平较弱的群体里抗体浓度也明显增加。这说明在免疫力低下的群体中，加强注射有一定的保护作用。
 
                                                                      来源：www.sciencemag.org
 
本月，以色列的最新报道显示，第三针疫苗在预防60岁以上人群感染方面的有效率为 86%。这也是全球第一项对加强针效果进行评价的大型研究。为此，以色列政府已经考虑向40岁以上人群开放加强针。
 
但这一措施却迎来了包括世卫组织总干事谭德塞在内的一些人士的反对，主要原因是全球很多地区还没有实现免疫覆盖，疫苗更需要留给一剂都没有注射过的人群。
 
                                                                      来源：www.haaretz.com
 
现在普遍认为，为医护人员和免疫系统较弱的人提供加强免疫很重要。但是否全人群都需要加强，这不单单是一个卫生问题，也是一个社会问题。如果号召全民加强免疫，可能会引起疫苗分配不均，富国富人对疫苗垄断的局面。
 
国产疫苗是否需要加强免疫，目前还缺乏研究数据的支持。以色列的经验告诉我们，或许加强免疫是遏制国内疫情蔓延的可行之路，但在目前国内接种率仍未达标的情况下，首要的任务依然是进一步扩大接种基数。
 
参考文献
1.https://www.sciencemag.org/news/2021/08/do-delta-breakthroughs-really-mean-vaccine-protection-waning-and-are-boosters-answer
2.https://www.sciencemag.org/news/2021/08/grim-warning-israel-vaccination-blunts-does-not-defeat-delta
3.https://www.sciencemag.org/news/2021/06/gives-hope-third-covid-19-vaccine-dose-can-boost-protection-organ-transplant-recipients
4.https://www.haaretz.com/israel-news/israel-booster-covid-86-effective-preventing-infection-elderly-data-shows-delta-1.10130185

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    2022-05-27 12498b3em08(暂无昵称)

    #RNA疫苗#

    0

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    2022-04-10 gous

    #接种率#

    0

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    2021-08-29 lishiwen

    #疫苗接种#

    0

  4. [GetPortalCommentsPageByObjectIdResponse(id=1947416, encodeId=4aba194e41633, content=<a href='/topic/show?id=88d81556543' target=_blank style='color:#2F92EE;'>#RNA疫苗#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=15565, encryptionId=88d81556543, topicName=RNA疫苗)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ce072500140, createdName=12498b3em08(暂无昵称), createdTime=Fri May 27 12:11:55 CST 2022, time=2022-05-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2078673, encodeId=5a8020e86736b, content=<a href='/topic/show?id=a34956696a7' target=_blank style='color:#2F92EE;'>#接种率#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=56696, encryptionId=a34956696a7, topicName=接种率)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7a9987, createdName=gous, createdTime=Sun Apr 10 18:11:55 CST 2022, time=2022-04-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1258083, encodeId=0e6a125808392, content=<a href='/topic/show?id=f538e0501e9' target=_blank style='color:#2F92EE;'>#疫苗接种#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=70501, encryptionId=f538e0501e9, topicName=疫苗接种)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=5c0050, createdName=lishiwen, createdTime=Sun Aug 29 00:11:55 CST 2021, time=2021-08-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1561651, encodeId=be8f156165119, content=<a href='/topic/show?id=118142341b1' target=_blank style='color:#2F92EE;'>#增高#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=42341, encryptionId=118142341b1, topicName=增高)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=af9415191444, createdName=liuxiaona, createdTime=Sun Aug 29 00:11:55 CST 2021, time=2021-08-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1567660, encodeId=3523156e660af, content=<a href='/topic/show?id=118142341b1' target=_blank style='color:#2F92EE;'>#增高#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=42341, encryptionId=118142341b1, topicName=增高)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=af9415191444, createdName=liuxiaona, createdTime=Sun Aug 29 00:11:55 CST 2021, time=2021-08-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1029905, encodeId=3083102990572, content=新冠肺炎，疫情何时才能消失, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=公卫新人, createdTime=Fri Aug 27 12:11:55 CST 2021, time=2021-08-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1011978, encodeId=cd9210119e8f3, content=以色列的这波疫情风暴由Delta变异株所致，疫苗效果值得怀疑。, beContent=null, objectType=article, channel=null, level=null, likeNumber=101, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTJlfgys76DEiaNtbYo2re3ibjrUPTRibEXRyFwAB4aAGiave842S0FQDf0wAoaH226NiaSoPPDzhndsf1g/132, createdBy=88b489038, createdName=yangchou, createdTime=Fri Aug 27 10:19:24 CST 2021, time=2021-08-27, status=1, ipAttribution=)]
    2021-08-29 liuxiaona

    #增高#

    0

  5. [GetPortalCommentsPageByObjectIdResponse(id=1947416, encodeId=4aba194e41633, content=<a href='/topic/show?id=88d81556543' target=_blank style='color:#2F92EE;'>#RNA疫苗#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=15565, encryptionId=88d81556543, topicName=RNA疫苗)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ce072500140, createdName=12498b3em08(暂无昵称), createdTime=Fri May 27 12:11:55 CST 2022, time=2022-05-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2078673, encodeId=5a8020e86736b, content=<a href='/topic/show?id=a34956696a7' target=_blank style='color:#2F92EE;'>#接种率#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=56696, encryptionId=a34956696a7, topicName=接种率)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7a9987, createdName=gous, createdTime=Sun Apr 10 18:11:55 CST 2022, time=2022-04-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1258083, encodeId=0e6a125808392, content=<a href='/topic/show?id=f538e0501e9' target=_blank style='color:#2F92EE;'>#疫苗接种#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=70501, encryptionId=f538e0501e9, topicName=疫苗接种)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=5c0050, createdName=lishiwen, createdTime=Sun Aug 29 00:11:55 CST 2021, time=2021-08-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1561651, encodeId=be8f156165119, content=<a href='/topic/show?id=118142341b1' target=_blank style='color:#2F92EE;'>#增高#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=42341, encryptionId=118142341b1, topicName=增高)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=af9415191444, createdName=liuxiaona, createdTime=Sun Aug 29 00:11:55 CST 2021, time=2021-08-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1567660, encodeId=3523156e660af, content=<a href='/topic/show?id=118142341b1' target=_blank style='color:#2F92EE;'>#增高#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=42341, encryptionId=118142341b1, topicName=增高)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=af9415191444, createdName=liuxiaona, createdTime=Sun Aug 29 00:11:55 CST 2021, time=2021-08-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1029905, encodeId=3083102990572, content=新冠肺炎，疫情何时才能消失, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=公卫新人, createdTime=Fri Aug 27 12:11:55 CST 2021, time=2021-08-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1011978, encodeId=cd9210119e8f3, content=以色列的这波疫情风暴由Delta变异株所致，疫苗效果值得怀疑。, beContent=null, objectType=article, channel=null, level=null, likeNumber=101, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTJlfgys76DEiaNtbYo2re3ibjrUPTRibEXRyFwAB4aAGiave842S0FQDf0wAoaH226NiaSoPPDzhndsf1g/132, createdBy=88b489038, createdName=yangchou, createdTime=Fri Aug 27 10:19:24 CST 2021, time=2021-08-27, status=1, ipAttribution=)]
    2021-08-29 liuxiaona

    #增高#

    0

  6. [GetPortalCommentsPageByObjectIdResponse(id=1947416, encodeId=4aba194e41633, content=<a href='/topic/show?id=88d81556543' target=_blank style='color:#2F92EE;'>#RNA疫苗#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=15565, encryptionId=88d81556543, topicName=RNA疫苗)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ce072500140, createdName=12498b3em08(暂无昵称), createdTime=Fri May 27 12:11:55 CST 2022, time=2022-05-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2078673, encodeId=5a8020e86736b, content=<a href='/topic/show?id=a34956696a7' target=_blank style='color:#2F92EE;'>#接种率#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=56696, encryptionId=a34956696a7, topicName=接种率)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7a9987, createdName=gous, createdTime=Sun Apr 10 18:11:55 CST 2022, time=2022-04-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1258083, encodeId=0e6a125808392, content=<a href='/topic/show?id=f538e0501e9' target=_blank style='color:#2F92EE;'>#疫苗接种#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=70501, encryptionId=f538e0501e9, topicName=疫苗接种)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=5c0050, createdName=lishiwen, createdTime=Sun Aug 29 00:11:55 CST 2021, time=2021-08-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1561651, encodeId=be8f156165119, content=<a href='/topic/show?id=118142341b1' target=_blank style='color:#2F92EE;'>#增高#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=42341, encryptionId=118142341b1, topicName=增高)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=af9415191444, createdName=liuxiaona, createdTime=Sun Aug 29 00:11:55 CST 2021, time=2021-08-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1567660, encodeId=3523156e660af, content=<a href='/topic/show?id=118142341b1' target=_blank style='color:#2F92EE;'>#增高#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=42341, encryptionId=118142341b1, topicName=增高)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=af9415191444, createdName=liuxiaona, createdTime=Sun Aug 29 00:11:55 CST 2021, time=2021-08-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1029905, encodeId=3083102990572, content=新冠肺炎，疫情何时才能消失, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=公卫新人, createdTime=Fri Aug 27 12:11:55 CST 2021, time=2021-08-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1011978, encodeId=cd9210119e8f3, content=以色列的这波疫情风暴由Delta变异株所致，疫苗效果值得怀疑。, beContent=null, objectType=article, channel=null, level=null, likeNumber=101, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTJlfgys76DEiaNtbYo2re3ibjrUPTRibEXRyFwAB4aAGiave842S0FQDf0wAoaH226NiaSoPPDzhndsf1g/132, createdBy=88b489038, createdName=yangchou, createdTime=Fri Aug 27 10:19:24 CST 2021, time=2021-08-27, status=1, ipAttribution=)]
    2021-08-27 公卫新人

    新冠肺炎，疫情何时才能消失

    0

  7. [GetPortalCommentsPageByObjectIdResponse(id=1947416, encodeId=4aba194e41633, content=<a href='/topic/show?id=88d81556543' target=_blank style='color:#2F92EE;'>#RNA疫苗#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=15565, encryptionId=88d81556543, topicName=RNA疫苗)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ce072500140, createdName=12498b3em08(暂无昵称), createdTime=Fri May 27 12:11:55 CST 2022, time=2022-05-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2078673, encodeId=5a8020e86736b, content=<a href='/topic/show?id=a34956696a7' target=_blank style='color:#2F92EE;'>#接种率#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=56696, encryptionId=a34956696a7, topicName=接种率)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7a9987, createdName=gous, createdTime=Sun Apr 10 18:11:55 CST 2022, time=2022-04-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1258083, encodeId=0e6a125808392, content=<a href='/topic/show?id=f538e0501e9' target=_blank style='color:#2F92EE;'>#疫苗接种#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=70501, encryptionId=f538e0501e9, topicName=疫苗接种)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=5c0050, createdName=lishiwen, createdTime=Sun Aug 29 00:11:55 CST 2021, time=2021-08-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1561651, encodeId=be8f156165119, content=<a href='/topic/show?id=118142341b1' target=_blank style='color:#2F92EE;'>#增高#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=42341, encryptionId=118142341b1, topicName=增高)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=af9415191444, createdName=liuxiaona, createdTime=Sun Aug 29 00:11:55 CST 2021, time=2021-08-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1567660, encodeId=3523156e660af, content=<a href='/topic/show?id=118142341b1' target=_blank style='color:#2F92EE;'>#增高#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=42341, encryptionId=118142341b1, topicName=增高)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=af9415191444, createdName=liuxiaona, createdTime=Sun Aug 29 00:11:55 CST 2021, time=2021-08-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1029905, encodeId=3083102990572, content=新冠肺炎，疫情何时才能消失, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=公卫新人, createdTime=Fri Aug 27 12:11:55 CST 2021, time=2021-08-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1011978, encodeId=cd9210119e8f3, content=以色列的这波疫情风暴由Delta变异株所致，疫苗效果值得怀疑。, beContent=null, objectType=article, channel=null, level=null, likeNumber=101, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTJlfgys76DEiaNtbYo2re3ibjrUPTRibEXRyFwAB4aAGiave842S0FQDf0wAoaH226NiaSoPPDzhndsf1g/132, createdBy=88b489038, createdName=yangchou, createdTime=Fri Aug 27 10:19:24 CST 2021, time=2021-08-27, status=1, ipAttribution=)]
    2021-08-27 yangchou

    以色列的这波疫情风暴由Delta变异株所致，疫苗效果值得怀疑。

    0

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