COVID-19 Vaccine Boosters: The Good, the Bad, and the Ugly.
COVID-19 Vaccine Boosters: The Good, the Bad, and the Ugly.
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DOI：
10.3390/vaccines9111299
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发表时间：
2021-11-09
期刊：
影响因子：
7.8
通讯作者：
Rezaei N
中科院分区：
文献类型：
--
作者：
Rzymski P;Camargo CA Jr;Fal A;Flisiak R;Gwenzi W;Kelishadi R;Leemans A;Nieto JJ;Ozen A;Perc M;Poniedziałek B;Sedikides C;Sellke F;Skirmuntt EC;Stashchak A;Rezaei N
接种 COVID-19 疫苗给限制 SARS-CoV-2 的传播带来了希望，并且在大流行情况下仍然是最理性的决定。然而，它并非没有挑战，包括疫苗剂量暂时短缺、疫苗严重不平等以及有关疫苗诱导免疫力的持久性的问题仍未得到解答。此外，SARS-CoV-2 随着其新变种的出现而经历了进化，其特点是传播性增强，并且至少能够部分逃避中和抗体。与此同时，血清抗体水平在疫苗接种后几个月内开始下降，最终增加了突破性感染的风险。本文讨论是否迫切需要注射加强剂量的 COVID-19 疫苗来控制大流行。我们的结论是，目前优化富裕人群的免疫水平不能以牺牲缺乏疫苗的低收入地区为代价。尽管疫苗接种预防感染的效率可能会随着时间的推移而下降，但目前的数据表明，其针对严重疾病、住院和死亡的功效仍然处于较高水平。如果包括非洲国家在内的各个地区的疫苗覆盖率继续保持在极低水平，SARS-CoV-2 迟早可能会演变成更适合逃避自然和疫苗诱导免疫的变种，最终带来全球威胁，当然也包括富裕人群。我们提供提高低收入国家疫苗接种率的重要建议。从定义上来说，这场大流行病是一次重大流行病学事件，需要超越个人眼前的自身利益；否则，遏制它的努力将是徒劳的。
Pursuing vaccinations against COVID-19 brings hope to limit the spread of SARS-CoV-2 and remains the most rational decision under pandemic conditions. However, it does not come without challenges, including temporary shortages in vaccine doses, significant vaccine inequity, and questions regarding the durability of vaccine-induced immunity that remain unanswered. Moreover, SARS-CoV-2 has undergone evolution with the emergence of its novel variants, characterized by enhanced transmissibility and ability to at least partially evade neutralizing antibodies. At the same time, serum antibody levels start to wane within a few months after vaccination, ultimately increasing the risk of breakthrough infections. This article discusses whether the administration of booster doses of COVID-19 vaccines is urgently needed to control the pandemic. We conclude that, at present, optimizing the immunity level of wealthy populations cannot come at the expense of low-income regions that suffer from vaccine unavailability. Although the efficiency of vaccination in protecting from infection may decrease over time, current data show that efficacy against severe disease, hospitalization, and death remains at a high level. If vaccine coverage continues at extremely low levels in various regions, including African countries, SARS-CoV-2 may sooner or later evolve into variants better adapted to evade natural and vaccine-induced immunity, ultimately bringing a global threat that, of course, includes wealthy populations. We offer key recommendations to increase vaccination rates in low-income countries. The pandemic is, by definition, a major epidemiological event and requires looking beyond one’s immediate self-interest; otherwise, efforts to contain it will be futile.