新冠病毒仍在肆虐，那么新冠增强疫苗效果如何?免疫功能低下人群是否能够接种?
咨询委员会建议，新冠增强疫苗对免疫功能低下的人“将是有帮助的”
Karen Weintraub《今日美国》
周四，一个联邦咨询委员会的几名成员表示，免疫严重受损的人应该考虑接种第三剂COVID-19疫苗，而且绝对应该采取其他预防措施，比如戴口罩，确保周围的人接种疫苗。
免疫实践咨询委员会没有正式推荐第三针的监管权力，在周四的会议上公布的数据表明，加强注射不太可能造成伤害，而可能对那些因癌症而免疫功能严重受损或正在服用强效药物以防止自身免疫反应或器官排斥的人有益。
“有足够的数据表明，额外的剂量是有帮助的，”委员会成员、加州斯坦福大学医学院儿科教授格蕾丝·李博士说。
在四项小型的移植和透析患者的研究中，33%到50%的患者在注射了两针后出现了抗体。李说，她希望联邦机构能监督接受第三针的人，以确保这些注射是安全的。
美国疾病控制与预防中心表示，普通公众还不需要注射加强针，因为人们仍然可以通过最初的注射得到很好的保护。根据美国疾病控制与预防中心的数据，目前97%的COVID-19住院患者没有接种疫苗。
虽然疫苗可以保护90%以上的健康人群不出现COVID-19症状，甚至更能保护他们不患重病，但疫苗对癌症患者、服用免疫抑制药物的患者和移植患者的保护作用较弱。
美国疾病控制与预防中心的萨拉·奥利弗博士告诉委员会，免疫功能低下的人如果感染COVID-19，变得严重疾病的风险高于平均水平。他们也更有可能将病毒传染给与其一起生活的人。在接种疫苗后因COVID-19住院的患者中，有超过40%的人免疫功能低下。
她说，大约2.7%的人口，即90万美国人免疫功能低下。
约翰斯·霍普金斯医学院的移植外科医生、研究员多里·塞格夫在会后表示，一些免疫功能低下的患者已经在自己接受加强注射，而没有经过研究或观察以确保他们的安全。塞格夫与该委员会没有联系。
塞格夫在接受采访时说:“任何时候你给别人注射疫苗，都是在试图激活他们的免疫系统。”在接受移植的病人中，激活免疫系统可能会损害他们捐赠的器官，尽管药物旨在防止身体排斥它。前两剂COVID-19疫苗似乎对移植患者是安全的，但到目前为止，只有几十名患者接受了第三剂疫苗的跟踪治疗。
研究和支持组织白血病和淋巴瘤协会的首席医疗官格温·尼科尔斯博士说，血癌患者似乎也能够安全地服用前两剂COVID-19疫苗。
但她说，目前还不清楚加强注射是否对白血病、淋巴瘤或多发性骨髓瘤患者安全有效。
“我们都应该采取未接种疫苗的行动，尤其是血癌患者，”她说。继续避开那些你无法控制环境的地方。不要让人们因为你戴口罩而羞辱你。”
在周四发表在网上的一项针对1500名血癌患者的研究中，75%的人在接种两剂疫苗后产生了明显的免疫反应，但25%的人没有。
尼科尔斯说，许多没有产生抗体的患者没有得到积极治疗，这表明是他们的疾病，而不是治疗，破坏了他们的免疫反应。尼科尔斯的组织仍在为接种疫苗患者的登记寻找志愿者。
目前还不清楚什么水平的抗体能预防感染或严重疾病。除了抗体，免疫系统还有其他防御手段，所以仅仅因为一个人没有抗体，并不意味着他们是完全不安全的。
此外，抗体水平会随着时间的推移而下降，而接种疫苗的保护似乎会保持强劲，至少6-12个月。不同的测试记录的抗体水平也不同。
这就是为什么CDC不鼓励人们检查自己的抗体水平，以确定自己是否得到了充分的保护。
但塞格夫说，他在研究试验中使用抗体测试来筛选参试者，希望能确定哪些人最需要兴奋剂。要加入他的一项试验，患者必须在注射两针辉瑞或Moderna的疫苗后一个多月没有可检测到的抗体，或测量值低于50单位/毫升，使用罗氏Elecsys抗受体结合域分析。
塞格夫最近从美国国家卫生研究院获得了4000万美元的拨款，用于研究更好地保护肾移植受者的方法。
他希望下个月在约翰霍普金斯大学的一项试点研究中招募首批患者，然后将其扩展到全国。
比较COVID-19疫苗:以下是我们目前所知的情况
更多COVID-19新闻:全球可能有100多万儿童因疫情成为孤儿
塞格夫说，当病人尝试不同的保护方法时，跟踪他们是至关重要的，以确保他们是安全的，其他人可以从他们的经验中学习。
代表美国医师学会参加周四会议的杰森·戈德曼博士说，他周三在自己的诊所看到了6名COVID-19患者，他们都接种了疫苗，还有一名新生儿，他是由未接种疫苗的家庭成员感染的。
“我担心，在免疫功能低下的患者中，增强剂的效果不会比最初系列更有效，”在佛罗里达州珊瑚泉练习的戈德曼说。“我们需要强调，通过确保每个人都接种疫苗，为我们自己、我们的家人、朋友和爱人创建一个保护圈的重要性。”
请通过[email protected]联系Karen Weintraub。
《今日美国》的健康和患者安全覆盖部分得益于Masimo医疗保健伦理、创新和竞争基金会的拨款。Masimo基金会不提供编辑输入
附上原文，以供参考，拒绝转载，侵权必删：
COVID booster shot 'would be helpful' for immunocompromised people, advisory committee recommends
Karen Weintraub USA TODAY
People who are severely immune-compromised should consider getting a third dose of a COVID-19 vaccine, several members of a federal advisory committee said Thursday, and should definitely take other precautions like wearing masks and making sure those around them are vaccinated.
The Advisory Committee on Immunization Practices , which doesn't have the regulatory authority to officially recommend a third shot, presented data at its meeting Thursday that suggested a booster shot was unlikely to cause harm and might benefit someone who is significantly immunocompromised because of cancer or on powerful medication to prevent autoimmune reactions or organ rejection.
"There is sufficient data to suggest that an additional dose would be helpful," said Dr. Grace Lee, a committee member and professor of pediatrics at Stanford University School of Medicine in California.
In four small studies of transplant and dialysis patients who did not develop antibodies in response to two shots, 33% to 50% developed them after a third.Lee said she hoped federal agencies would monitor people who receive a third dose to ensure these shots are safe.
The Centers for Disease Control and Prevention has said that booster shots are not yet needed by the general public, because people continue to be well protected by their initial shots. Currently, 97% of those hospitalized with COVID-19 were not vaccinated, according to the CDC.
While vaccines protect more than 90% of healthy people from getting symptoms of COVID-19 and even more from getting seriously ill, the shots are less protective for those with cancer, particularly blood cancers, people taking immunosuppressive medication and transplant patients.
People who are immunocompromised are at above-average risk for becoming severely ill if they catch COVID-19, Dr. Sara Oliver, with the CDC, told the committee. They are also more likely to transmit the virus to people they live with. And more than 40% of those hospitalized with COVID-19 after being vaccinated are immune-compromised.
About 2.7% of the population — or 900,000 Americans — are immunocompromised, she said.
Some immune-compromised patients are already getting booster shots on their own, without being studied or watched to make sure they are safe, Dr. Dorry Segev, a transplant surgeon and researcher at Johns Hopkins Medicine,who is not connected with the committee said after the meeting.
"Anytime you give someone a vaccine, you are trying to activate their immune system," Segev said in an interview. In a transplant patient, activating the immune system could damage their donated organ, despite drugs aimed at keeping the body from rejecting it. The first two COVID-19 vaccine doses appear to be safe for transplant patients, but only a few dozen patients have been followed so far after a third.
Blood cancer patients also appear to be able to take the first two COVID-19 vaccine doses safely, said Dr. Gwen Nichols, chief medical officer of the Leukemia and Lymphoma Society, a research and support group.
But it's not yet clear whether a booster shot will be safe and effective for those with leukemia, lymphoma or multiple myeloma, she said.
"We all ought to act unvaccinated, especially blood cancer patients," she said. "Continue to avoid places where you can't control your environment. Don't let people shame you from wearing a mask."
In a study of 1,500 blood cancer patients published online Thursday, 75% mounted a measurable immune response after getting both doses of the vaccine, but 25% did not.
Many of the patients who did not make antibodies were not in active treatment, suggesting their disease, not their treatment, undermines their immune response, said Nichols, whose organization is still seeking volunteers for its registry of vaccinated patients.
It's not clear what level of antibody is protective against infection or severe disease. The immune system has other means of defense in addition to antibodies, so just because someone doesn't have antibodies doesn't mean they are completely unsafe.
Plus, antibody levels decline over time, while protection from vaccination seems to remain strong at least for 6-12 months. And antibody levels are recorded differently by different tests.
That's why the CDC discourages people from checking their antibody levels to decide if they are adequately protected.
But Segev said he uses antibody tests to screen enrollees in his research trials, hoping to identify those who most need a boost. To join one of his trials, a patient has to have no detectable antibodies or measure fewer than 50 units per milliliter more than a month after two shots of Pfizer or Moderna's vaccine, using the Roche Elecsys anti-Receptor Binding Domain assay.
Segev recently received a $40 million grant from the National Institutes of Health to study ways to better protect kidney transplant recipients.
He expects to enroll the first patients next month in a pilot study at Johns Hopkins and then expand it nationwide.
Comparing the COVID-19 vaccines:Here is a closer look at what we know so far
More COVID-19 news:More than a million children around the world may have been orphaned by the pandemic
It's crucial, Segev said, to track patients as they try different protective approaches to ensure that they are safe and that others can learn from their experiences.
Dr. Jason Goldman, who represented the American College of Physicians at Thursday's meeting, said he saw six COVID-19 patients in his clinic Wednesday, all vaccinated, as well as a newborn, who had been infected by an unvaccinated family member.
"I worry that boosters will not be any more effective in the immunocompromised than in the initial series ," said Goldman, who practices in Coral Springs, Florida. "We need to stress the importance of creating a circle of protection for ourselves and our family, friends and loved ones… by making sure everyone gets vaccinated."
Contact Karen Weintraub at [email protected].
Health and patient safety coverage at USA TODAY is made possible in part by a grant from the Masimo Foundation for Ethics, Innovation and Competition in Healthcare. The Masimo Foundation does not provide editorial input
Source of articles：https://www.usatoday.com/
Author：Karen Weintraub
咨询委员会建议，新冠增强疫苗对免疫功能低下的人“将是有帮助的”
Karen Weintraub《今日美国》
周四，一个联邦咨询委员会的几名成员表示，免疫严重受损的人应该考虑接种第三剂COVID-19疫苗，而且绝对应该采取其他预防措施，比如戴口罩，确保周围的人接种疫苗。
免疫实践咨询委员会没有正式推荐第三针的监管权力，在周四的会议上公布的数据表明，加强注射不太可能造成伤害，而可能对那些因癌症而免疫功能严重受损或正在服用强效药物以防止自身免疫反应或器官排斥的人有益。
“有足够的数据表明，额外的剂量是有帮助的，”委员会成员、加州斯坦福大学医学院儿科教授格蕾丝·李博士说。
在四项小型的移植和透析患者的研究中，33%到50%的患者在注射了两针后出现了抗体。李说，她希望联邦机构能监督接受第三针的人，以确保这些注射是安全的。
美国疾病控制与预防中心表示，普通公众还不需要注射加强针，因为人们仍然可以通过最初的注射得到很好的保护。根据美国疾病控制与预防中心的数据，目前97%的COVID-19住院患者没有接种疫苗。
虽然疫苗可以保护90%以上的健康人群不出现COVID-19症状，甚至更能保护他们不患重病，但疫苗对癌症患者、服用免疫抑制药物的患者和移植患者的保护作用较弱。
美国疾病控制与预防中心的萨拉·奥利弗博士告诉委员会，免疫功能低下的人如果感染COVID-19，变得严重疾病的风险高于平均水平。他们也更有可能将病毒传染给与其一起生活的人。在接种疫苗后因COVID-19住院的患者中，有超过40%的人免疫功能低下。
她说，大约2.7%的人口，即90万美国人免疫功能低下。
约翰斯·霍普金斯医学院的移植外科医生、研究员多里·塞格夫在会后表示，一些免疫功能低下的患者已经在自己接受加强注射，而没有经过研究或观察以确保他们的安全。塞格夫与该委员会没有联系。
塞格夫在接受采访时说:“任何时候你给别人注射疫苗，都是在试图激活他们的免疫系统。”在接受移植的病人中，激活免疫系统可能会损害他们捐赠的器官，尽管药物旨在防止身体排斥它。前两剂COVID-19疫苗似乎对移植患者是安全的，但到目前为止，只有几十名患者接受了第三剂疫苗的跟踪治疗。
研究和支持组织白血病和淋巴瘤协会的首席医疗官格温·尼科尔斯博士说，血癌患者似乎也能够安全地服用前两剂COVID-19疫苗。
但她说，目前还不清楚加强注射是否对白血病、淋巴瘤或多发性骨髓瘤患者安全有效。
“我们都应该采取未接种疫苗的行动，尤其是血癌患者，”她说。继续避开那些你无法控制环境的地方。不要让人们因为你戴口罩而羞辱你。”
在周四发表在网上的一项针对1500名血癌患者的研究中，75%的人在接种两剂疫苗后产生了明显的免疫反应，但25%的人没有。
尼科尔斯说，许多没有产生抗体的患者没有得到积极治疗，这表明是他们的疾病，而不是治疗，破坏了他们的免疫反应。尼科尔斯的组织仍在为接种疫苗患者的登记寻找志愿者。
目前还不清楚什么水平的抗体能预防感染或严重疾病。除了抗体，免疫系统还有其他防御手段，所以仅仅因为一个人没有抗体，并不意味着他们是完全不安全的。
此外，抗体水平会随着时间的推移而下降，而接种疫苗的保护似乎会保持强劲，至少6-12个月。不同的测试记录的抗体水平也不同。
这就是为什么CDC不鼓励人们检查自己的抗体水平，以确定自己是否得到了充分的保护。
但塞格夫说，他在研究试验中使用抗体测试来筛选参试者，希望能确定哪些人最需要兴奋剂。要加入他的一项试验，患者必须在注射两针辉瑞或Moderna的疫苗后一个多月没有可检测到的抗体，或测量值低于50单位/毫升，使用罗氏Elecsys抗受体结合域分析。
塞格夫最近从美国国家卫生研究院获得了4000万美元的拨款，用于研究更好地保护肾移植受者的方法。
他希望下个月在约翰霍普金斯大学的一项试点研究中招募首批患者，然后将其扩展到全国。
比较COVID-19疫苗:以下是我们目前所知的情况
更多COVID-19新闻:全球可能有100多万儿童因疫情成为孤儿
塞格夫说，当病人尝试不同的保护方法时，跟踪他们是至关重要的，以确保他们是安全的，其他人可以从他们的经验中学习。
代表美国医师学会参加周四会议的杰森·戈德曼博士说，他周三在自己的诊所看到了6名COVID-19患者，他们都接种了疫苗，还有一名新生儿，他是由未接种疫苗的家庭成员感染的。
“我担心，在免疫功能低下的患者中，增强剂的效果不会比最初系列更有效，”在佛罗里达州珊瑚泉练习的戈德曼说。“我们需要强调，通过确保每个人都接种疫苗，为我们自己、我们的家人、朋友和爱人创建一个保护圈的重要性。”
请通过[email protected]联系Karen Weintraub。
《今日美国》的健康和患者安全覆盖部分得益于Masimo医疗保健伦理、创新和竞争基金会的拨款。Masimo基金会不提供编辑输入
附上原文，以供参考，拒绝转载，侵权必删：
COVID booster shot 'would be helpful' for immunocompromised people, advisory committee recommends
Karen Weintraub USA TODAY
People who are severely immune-compromised should consider getting a third dose of a COVID-19 vaccine, several members of a federal advisory committee said Thursday, and should definitely take other precautions like wearing masks and making sure those around them are vaccinated.
The Advisory Committee on Immunization Practices , which doesn't have the regulatory authority to officially recommend a third shot, presented data at its meeting Thursday that suggested a booster shot was unlikely to cause harm and might benefit someone who is significantly immunocompromised because of cancer or on powerful medication to prevent autoimmune reactions or organ rejection.
"There is sufficient data to suggest that an additional dose would be helpful," said Dr. Grace Lee, a committee member and professor of pediatrics at Stanford University School of Medicine in California.
In four small studies of transplant and dialysis patients who did not develop antibodies in response to two shots, 33% to 50% developed them after a third.Lee said she hoped federal agencies would monitor people who receive a third dose to ensure these shots are safe.
The Centers for Disease Control and Prevention has said that booster shots are not yet needed by the general public, because people continue to be well protected by their initial shots. Currently, 97% of those hospitalized with COVID-19 were not vaccinated, according to the CDC.
While vaccines protect more than 90% of healthy people from getting symptoms of COVID-19 and even more from getting seriously ill, the shots are less protective for those with cancer, particularly blood cancers, people taking immunosuppressive medication and transplant patients.
People who are immunocompromised are at above-average risk for becoming severely ill if they catch COVID-19, Dr. Sara Oliver, with the CDC, told the committee. They are also more likely to transmit the virus to people they live with. And more than 40% of those hospitalized with COVID-19 after being vaccinated are immune-compromised.
About 2.7% of the population — or 900,000 Americans — are immunocompromised, she said.
Some immune-compromised patients are already getting booster shots on their own, without being studied or watched to make sure they are safe, Dr. Dorry Segev, a transplant surgeon and researcher at Johns Hopkins Medicine,who is not connected with the committee said after the meeting.
"Anytime you give someone a vaccine, you are trying to activate their immune system," Segev said in an interview. In a transplant patient, activating the immune system could damage their donated organ, despite drugs aimed at keeping the body from rejecting it. The first two COVID-19 vaccine doses appear to be safe for transplant patients, but only a few dozen patients have been followed so far after a third.
Blood cancer patients also appear to be able to take the first two COVID-19 vaccine doses safely, said Dr. Gwen Nichols, chief medical officer of the Leukemia and Lymphoma Society, a research and support group.
But it's not yet clear whether a booster shot will be safe and effective for those with leukemia, lymphoma or multiple myeloma, she said.
"We all ought to act unvaccinated, especially blood cancer patients," she said. "Continue to avoid places where you can't control your environment. Don't let people shame you from wearing a mask."
In a study of 1,500 blood cancer patients published online Thursday, 75% mounted a measurable immune response after getting both doses of the vaccine, but 25% did not.
Many of the patients who did not make antibodies were not in active treatment, suggesting their disease, not their treatment, undermines their immune response, said Nichols, whose organization is still seeking volunteers for its registry of vaccinated patients.
It's not clear what level of antibody is protective against infection or severe disease. The immune system has other means of defense in addition to antibodies, so just because someone doesn't have antibodies doesn't mean they are completely unsafe.
Plus, antibody levels decline over time, while protection from vaccination seems to remain strong at least for 6-12 months. And antibody levels are recorded differently by different tests.
That's why the CDC discourages people from checking their antibody levels to decide if they are adequately protected.
But Segev said he uses antibody tests to screen enrollees in his research trials, hoping to identify those who most need a boost. To join one of his trials, a patient has to have no detectable antibodies or measure fewer than 50 units per milliliter more than a month after two shots of Pfizer or Moderna's vaccine, using the Roche Elecsys anti-Receptor Binding Domain assay.
Segev recently received a $40 million grant from the National Institutes of Health to study ways to better protect kidney transplant recipients.
He expects to enroll the first patients next month in a pilot study at Johns Hopkins and then expand it nationwide.
Comparing the COVID-19 vaccines:Here is a closer look at what we know so far
More COVID-19 news:More than a million children around the world may have been orphaned by the pandemic
It's crucial, Segev said, to track patients as they try different protective approaches to ensure that they are safe and that others can learn from their experiences.
Dr. Jason Goldman, who represented the American College of Physicians at Thursday's meeting, said he saw six COVID-19 patients in his clinic Wednesday, all vaccinated, as well as a newborn, who had been infected by an unvaccinated family member.
"I worry that boosters will not be any more effective in the immunocompromised than in the initial series ," said Goldman, who practices in Coral Springs, Florida. "We need to stress the importance of creating a circle of protection for ourselves and our family, friends and loved ones… by making sure everyone gets vaccinated."
Contact Karen Weintraub at [email protected].
Health and patient safety coverage at USA TODAY is made possible in part by a grant from the Masimo Foundation for Ethics, Innovation and Competition in Healthcare. The Masimo Foundation does not provide editorial input
Source of articles：https://www.usatoday.com/
Author：Karen Weintraub
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