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专家表态,新冠疫苗接种者或仍具有传染性

David Z. Morris
2020-12-23

我们仍然需要了解疫苗接种对传染性的影响有多大。

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别不信,专家们已经达成一致:成千上万人接种了新冠疫苗,但他们仍然可能携带病毒,并传播给其他人。尽管这些人自己已经得到了很好的保护,但仍具有传染性。这意味着,即使人们接种了疫苗,仍然需要戴上口罩,保持社交距离,以保护周围的人。

华盛顿大学(University of Washington)的公共卫生专家珍妮特•贝斯曼博士说:“我们仍然需要了解疫苗接种对传染性的影响有多大,从而保护那些我接触过的人,而不仅仅是我自己。”

疫苗开发进展迅速,不确定性也随之而来。通常情况下,在大批量投入使用之前,疫苗试验会对受试者进行相当长一段时间的观察。这不仅可了解受试者的患病情况,还能够得出传染性的留存程度。可以肯定的是,各式各样的候选新冠疫苗在一定程度上控制了病毒的传播,但到底控制到了何种程度,现在还很难说。

这一矛盾背后的科学原理其实并不复杂。辉瑞(Pfizer)和Moderna公司的疫苗被注射到深层肌肉中,提供所谓的“全身免疫”。但仍然有部分区域会被遗漏(如鼻腔粘膜通道),病毒仍然能够相对自由地繁殖。即使宿主未染病,新冠病毒也可能通过咳嗽、打喷嚏传播,和染病者的传播途径并无区别。

KFF(前身为凯撒家庭基金会)的流行病学家乔舒亚•米肖说:“全身免疫的作用和大楼安保类似。拥有粘膜免疫,就像雇佣了一位保镖站在门口把守,随时准备对付病毒的进攻。”

病毒“保镖”的位置,研究人员可能要花几个月的时间才可以确定。因为这一流程需要监控已经接种过疫苗的人,需要耗费一段时间。贝斯曼说,针对“高混合程度和高传播风险”的接种人群(如大学生)的研究能够更快地提供疫苗接种后的传播数据。米肖预计,重点传播研究将在“未来几周和几个月”进行。

关于接种者传播性的问题,通过正在进行的疫苗试验也可以得到答案。尽管辉瑞和Moderna的疫苗都已经获得美国食品与药品管理局(U.S. FDA)等卫生部门的紧急使用批准,但制药商仍然在继续进行标准试验。试验结束之后,永久性批准才会下发。

辉瑞的发言人说:“我们的试验将继续确定疫苗的全面保护能力。”疫苗接种后病毒传播能力如何,也将包含在试验当中。

但在长期试验数据及其他实验结果公布之前,只有通过测量高疫苗接种水平人群中新冠病毒的传播情况,才能够明确疫苗接种后的传染性几何。如果病毒传播速度趋缓,则表明疫苗接种削弱了传染性。但即便是在首发疫苗的发达国家,预计也要在2021年中下旬才可以达到高疫苗接种水平。这种方法花费的时间,可能将占据大半年的时间。

根据美国食品与药品管理局的说法,大多数疫苗在预防疾病的同时,也减少了接种者的传播能力。我们有理由持乐观态度:当前出炉的一波波新冠疫苗也将如此。最值得注意的是,Moderna的疫苗试验显示,通过鼻拭子检测,无症状感染数量有所减少,这或将表明接种疫苗后传播力降低了。斯克里普斯研究所(Scripps Research Translational Institute)的埃里克•托波尔博士称,这些发现尚未定论,但就“疫苗接种后传播力降低”这一点,的确很有可能性。

不过,在更多确凿的数据到来之前,来自卫生部门的信息还是相当明确:即使你已经接种了疫苗,也请不要忘了戴口罩。(财富中文网)

编译:杨二一

别不信,专家们已经达成一致:成千上万人接种了新冠疫苗,但他们仍然可能携带病毒,并传播给其他人。尽管这些人自己已经得到了很好的保护,但仍具有传染性。这意味着,即使人们接种了疫苗,仍然需要戴上口罩,保持社交距离,以保护周围的人。

华盛顿大学(University of Washington)的公共卫生专家珍妮特•贝斯曼博士说:“我们仍然需要了解疫苗接种对传染性的影响有多大,从而保护那些我接触过的人,而不仅仅是我自己。”

疫苗开发进展迅速,不确定性也随之而来。通常情况下,在大批量投入使用之前,疫苗试验会对受试者进行相当长一段时间的观察。这不仅可了解受试者的患病情况,还能够得出传染性的留存程度。可以肯定的是,各式各样的候选新冠疫苗在一定程度上控制了病毒的传播,但到底控制到了何种程度,现在还很难说。

这一矛盾背后的科学原理其实并不复杂。辉瑞(Pfizer)和Moderna公司的疫苗被注射到深层肌肉中,提供所谓的“全身免疫”。但仍然有部分区域会被遗漏(如鼻腔粘膜通道),病毒仍然能够相对自由地繁殖。即使宿主未染病,新冠病毒也可能通过咳嗽、打喷嚏传播,和染病者的传播途径并无区别。

KFF(前身为凯撒家庭基金会)的流行病学家乔舒亚•米肖说:“全身免疫的作用和大楼安保类似。拥有粘膜免疫,就像雇佣了一位保镖站在门口把守,随时准备对付病毒的进攻。”

病毒“保镖”的位置,研究人员可能要花几个月的时间才可以确定。因为这一流程需要监控已经接种过疫苗的人,需要耗费一段时间。贝斯曼说,针对“高混合程度和高传播风险”的接种人群(如大学生)的研究能够更快地提供疫苗接种后的传播数据。米肖预计,重点传播研究将在“未来几周和几个月”进行。

关于接种者传播性的问题,通过正在进行的疫苗试验也可以得到答案。尽管辉瑞和Moderna的疫苗都已经获得美国食品与药品管理局(U.S. FDA)等卫生部门的紧急使用批准,但制药商仍然在继续进行标准试验。试验结束之后,永久性批准才会下发。

辉瑞的发言人说:“我们的试验将继续确定疫苗的全面保护能力。”疫苗接种后病毒传播能力如何,也将包含在试验当中。

但在长期试验数据及其他实验结果公布之前,只有通过测量高疫苗接种水平人群中新冠病毒的传播情况,才能够明确疫苗接种后的传染性几何。如果病毒传播速度趋缓,则表明疫苗接种削弱了传染性。但即便是在首发疫苗的发达国家,预计也要在2021年中下旬才可以达到高疫苗接种水平。这种方法花费的时间,可能将占据大半年的时间。

根据美国食品与药品管理局的说法,大多数疫苗在预防疾病的同时,也减少了接种者的传播能力。我们有理由持乐观态度:当前出炉的一波波新冠疫苗也将如此。最值得注意的是,Moderna的疫苗试验显示,通过鼻拭子检测,无症状感染数量有所减少,这或将表明接种疫苗后传播力降低了。斯克里普斯研究所(Scripps Research Translational Institute)的埃里克•托波尔博士称,这些发现尚未定论,但就“疫苗接种后传播力降低”这一点,的确很有可能性。

不过,在更多确凿的数据到来之前,来自卫生部门的信息还是相当明确:即使你已经接种了疫苗,也请不要忘了戴口罩。(财富中文网)

编译:杨二一

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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