COVID-19 vaccines in older adults with cancer: a Young International Society of Geriatric Oncology perspective.
COVID-19 vaccines in older adults with cancer: a Young International Society of Geriatric Oncology perspective.
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DOI：
10.1016/s2666-7568(21)00060-x
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发表时间：
2021-05
期刊：
影响因子：
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通讯作者：
Battisti NML
中科院分区：
文献类型：
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作者：
Loh KP;Soto-Perez-de-Celis E;Mislang AR;Chan WL;Battisti NML
截至2021年3月3日，已报告1. 15亿例COVID-19病例和260万例COVID-19相关死亡。尽管老年人（年龄≥ 65岁）并不比年轻人更容易感染SARS-CoV-2，但他们更有可能在感染后患上严重疾病并死亡。1除了年龄，癌症患者的预后也比非癌症患者差。2因此，理想情况下，这些患者群体应优先接受COVID-19疫苗接种。几种COVID-19疫苗的开发速度非常快，第一种疫苗在11个月内开发出来。然而，人们注意到，老年人在疫苗试验中的代表性仍然不足。例如，在对参加阿斯利康疫苗试验的11636名参与者进行的中期分析中，只有8.4%的参与者年龄在56-79岁之间，3.8%的参与者年龄在70岁或以上。在Moderna疫苗试验中招募的30351名患者中，25%的参与者年龄小于65岁。4大多数国家不排除老年人接种疫苗;但也有少数例外。在德国，疫苗接种常设委员会最初建议反对在65岁及以上的成年人中使用阿斯利康疫苗，因为该年龄组的数据缺乏。5然而，这一建议后来被修改为允许60岁以上的人常规使用。2021年3月30日，由于担心血栓风险，不再建议60岁以下人群常规使用。6在中国，建议推迟59岁以上人群的疫苗接种，以等待该年龄组的额外安全性和有效性数据。7针对老年人的疫苗试验正在进行中。8世卫组织免疫战略咨询专家组提供了一份优先次序路线图，指导各国根据疫苗供应情况（非常有限、有限、中等）和流行病学情况（广泛传播、局部或有限传播、没有报告病例但有爆发风险的国家）制定公共卫生和优先次序战略。9例如，新西兰在优先考虑接种疫苗的群体时采用了这一战略。在
As of March 3, 2021, 115 million COVID-19 cases and 2· 6 million COVID-19-related deaths had been reported. Although older adults (aged≥ 65 years) are no more susceptible to SARS-CoV-2 infection than younger adults, they are more likely to develop serious illness and die after they become infected. 1 In addition to age, patients with cancer also have worse outcomes compared with those without cancer. 2 Therefore, these groups of patients should ideally be prioritised for receipt of COVID-19 vaccines. Several COVID-19 vaccines have been developed extremely quickly, with the first vaccine developed in 11 months. However, it has been noted that older adults continue to be under-represented in vaccine trials. For example, in the interim analyses of 11 636 participants enrolled in the AstraZeneca vaccine trials, only 8· 4% of participants were aged 56–79 years and 3· 8% were aged 70 years or older. 3 Among the 30 351 patients enrolled in the Moderna vaccine trial, 25% of participants were younger than 65 years. 4 Most countries do not exclude older adults from receiving the vaccine; however, there are a few exceptions. In Germany, the Standing Committee on Vaccination initially recommended against the use of the AstraZeneca vaccine in adults aged 65 years and older due to paucity of data in this age group. 5 However, this recommendation was later changed to allow routine use in people aged older than 60 years. On March 30, 2021, routine use in people younger than 60 years was no longer recommended due to concerns about the risk of blood clots. 6 In China, it is recommended that vaccination is postponed for people older than 59 years pending additional safety and efficacy data in this age group. 7 Vaccine trials focusing on older adults are ongoing. 8The WHO Strategic Advisory Group of Experts on Immunization provided a prioritization roadmap to guide countries in developing public health and prioritisation strategies based on vaccine availability (very limited, limited, moderate) and epidemiological settings (widespread transmission, localised or limited transmission, countries with no reported cases but at risk for an outbreak). 9 New Zealand, for example, uses this strategy when prioritising groups for vaccine. In the