关于准备妊娠和辅助生殖技术助孕人群新型冠状病毒疫苗接种的专家建议

新型冠状病毒疫情暴发以来,世界各国加快新型冠病毒疫苗（简称新冠疫苗）的研发。已有多个候选疫苗进入Ⅲ期临床试验或附条件上市及紧急使用。虽然所有年龄段人群均对新型冠状病毒易感,但孕妇仍被排除在新冠疫苗Ⅲ期临床试验之外,因此无法确定新冠疫苗对妊娠期妇女及其子代的安全性,也缺乏孕期及准备妊娠人群新冠疫苗有效性和安全性的数据。本...     

新冠病毒疫苗序贯免疫策略研究进展

新型冠状病毒感染疫情（简称新冠疫情）的大流行,给全球生命安全和经济发展造成了严重影响。接种新型冠状病毒疫苗（简称新冠病毒疫苗）是预防新型冠状病毒（severe acute respiratory syndrome coronavirus 2,SARS-CoV-2）感染、降低其发病率和重症率的重要措施。目前全球共有6种不同技术路线的新冠病毒疫苗,即蛋白亚单位疫苗、核酸疫苗（mRNA疫苗和DNA疫苗）、病毒载体疫苗、灭活疫苗、病毒样颗粒疫苗、减毒活疫苗。序贯免疫策略是将不同技术路线的新冠病毒疫苗按照一定时间间隔、剂次完成接种,是解决疫苗短缺、应对病毒突变株、提高疫苗效力的有效策略,国内外很多学者开展了新冠病毒疫苗的序贯免疫策略研究。本文从新冠病毒灭活疫苗与mRNA疫苗、与腺病毒载体疫苗、与蛋白亚单位疫苗的序贯免疫策略及新冠病毒腺病毒载体疫苗与mRNA疫苗、与蛋白亚单位疫苗的序贯免疫策略5个方面对国内外新冠病毒疫苗序贯免疫策略的相关研究进行了概述,以期为新冠病毒疫苗的接种和免疫策略的制定提供参考依据。     

新型冠状病毒疫苗研发进展及接种意愿分析

新型冠状病毒肺炎（COVID-19）自2019年末爆发后迅速造成全球大流行,对公共卫生健康构成众大威胁。引发COVID-19的严重急性呼吸系统综合征冠状病毒-2（SARS-CoV-2）是高致病性病毒,各国采取多种防疫措施均未能从根本控制病毒传播,有效的疫苗对应控制疫情发生发展具有重要作用。各国通力合作,大力研发安全、有效的新型冠状病毒疫苗,本研究综述了新型冠状病毒疫苗研发的进展以及各国民众的疫苗接种意愿。     

儿童和青少年新型冠状病毒感染的研究进展

随着成年人大规模接种新型冠状病毒(新冠病毒)疫苗, 儿童和青少年群体由于较低疫苗覆盖率和较高接触度, 逐渐成为新冠病毒感染的脆弱人群, 有必要总结儿童和青少年群体新冠病毒感染特征、新冠病毒疫苗对于变异株的免疫效果。本文检索现有文献, 对儿童和青少年新冠病毒感染的研究进展进行综述, 分析儿童和青少年对于新冠病毒的易感性、感染者的传播力和疾病预后以及免疫应答和新冠病毒疫苗的进展等关键特征, 为新冠病毒肺炎疫情防控提供参考依据。     

接种灭活疫苗后的境外输入性新冠肺炎患者临床特征

目的 通过比较接种/未接种新型冠状病毒灭活疫苗(Vero细胞)后感染新型冠状病毒(COVID-19)的境外输入性患者的临床特征,为临床诊疗提供参考.方法 选取2021年1月4日—4月10日广州医科大学附属市八医院收治的接种灭活疫苗后境外输入性COVID-19患者(接种疫苗组),及同期来自相同输入国家的未接种新冠疫苗的确...     

新型冠状病毒肺炎长期症状及其科学防控

国内外已有较多研究发现新型冠状病毒(简称新冠病毒)感染者存在长期症状,即COVID-19长期症状(long COVID-19),也被称为COVID-19后遗症(post-COVID-19 condition)。WHO将COVID-19长期症状定义为新冠病毒感染者在感染病毒3个月后所出现的、持续至少2个月,并且无法被其他诊断所解释的症状。COVID-19长期症状包括全身症状如疲劳、头痛及呼吸困难等,影响精神与神经、呼吸、心血管和消化等多个系统。基于已有研究证据,建议加强COVID-19长期症状的科学研究、现阶段坚持“动态清零”总方针、加快推进疫苗全程接种、未来开展COVID-19长期症状的早期监测与干预,以有效防止COVID-19长期症状带来的远期疾病负担和经济负担。     

新型冠状病毒感染者特异性抗体动态变化特征研究进展

新型冠状病毒肺炎是由新型冠状病毒（新冠病毒）引起的新发传染病。新冠病毒侵入人体后,刺激免疫系统产生多种特异性抗体,来减弱或清除病原体对机体的影响。研究新冠病毒感染后人体内特异性抗体动态变化特征对于疾病认识、诊断、以及疫苗研究与防控策略制定具有重要意义。本文对国内外关于新冠病毒感染者不同类型特异性抗体产生和持续时间、抗体...     

新型冠状病毒疫苗接种对成都市境外输入病例流行病学及临床特征的影响分析

目的 分析新型冠状病毒（新冠病毒）疫苗接种对成都市境外输入病例流行病学及临床特征的影响,为新型冠状病毒肺炎疫情防控提供参考依据。方法 截至2021年4月15日,经成都市入境的新冠病毒感染病例,根据新冠病毒疫苗接种史被分为疫苗接种组和疫苗未接种组。回顾性收集和分析病例的流行病学及临床特征资料。实验室检测项目包括新冠病毒核酸检测、临床指标、血清抗体和淋巴细胞检测。采用WPS 2019软件整理数据,采用R 4.0.3软件进行统计学分析。结果 75例新冠病毒感染病例包括疫苗接种组20例（出现临床症状4例）和疫苗未接种组55例（出现临床症状16例）。疫苗接种组的首针接种时间分布为2020年7-11月,其中接种2剂次疫苗采用一次性接种方式有10例,采取2次间隔接种方式有10例,2次接种间隔14~57 d,完成疫苗接种与发病时间间隔87~224 d。两组病例的分类和临床分型的差异有统计学意义（P<0.05）,其中,疫苗接种组病例分类为无症状感染者的比例较高（40.00%,8/20）,而疫苗未接种组的临床分型以普通型的比例较高（76.36%,42/55）。两组病例的新冠病毒核酸检测2个靶标（ORF1ab和N基因）Ct值、淋巴细胞亚型、降钙素原及C反应蛋白的差异无统计学意义（P>0.05）,疫苗接种组的血清淀粉样蛋白A水平低于疫苗未接种组（P<0.05）,但新冠病毒血清抗体IgM、IgG及总抗体水平均明显高于疫苗未接种组（P<0.05）。结论 新冠病毒疫苗接种后,仍存在感染的风险,但新冠病毒侵入人体后,体内可迅速产生特异性IgM和IgG抗体,对感染者产生一定保护作用,已接种新冠病毒疫苗的病例分类以无症状感染者为主。     

接种新型冠状病毒肺炎疫苗后出现1例过敏性休克的调查处置

过敏性休克属于严重、罕见的不良反应，如不及时处理，常可危及生命。新型冠状病毒肺炎（简称“新冠病毒”）疫苗为新上市疫苗，人们对其不良反应的关注度高。本文分析1例接种新冠病毒疫苗后发生过敏性休克案例的调查处置过程，为规范接种疫苗后过敏性休克的诊断处理提供参考。     

新型冠状病毒Delta突变株致突破性感染研究现状

自2019年新型冠状病毒肺炎(coronavirus disease 2019, COVID-19)疫情暴发以来,全球多个国家相继研发出多种类型的新型冠状病毒(severe acute respiratory syndrome coronavirus 2, SARS-CoV-2)疫苗。临床研究表明,SARS-CoV-2疫苗对COVID-19疫情控制,尤其是控制重症病例发生率及死亡率起极大作用。随着SARS-CoV-2传播,进化出数种突变株,导致疫情防控形式变得尤为严峻。其中SARS-CoV-2 Delta突变株(B.1.617.2)是目前导致SARS-CoV-2疫苗突破感染的主要突变株,其感染者的病毒载量大,传播能力强,甚至出现逃避免疫现象,对当前疫情防控及疫苗研发提出了新的挑战。因此,本研究在综述Delta突变株生物学特性的基础上,探讨Delta突变株导致疫苗突破的机制,以及SARS-CoV-2刺突蛋白在接种疫苗后引发的免疫逃逸机制,并对目前临床上常用的几种疫苗进行利弊分析。     

Alignment of national COVID-19 vaccine recommendations for pregnant and lactating women

The rapid development and roll-out of coronavirus disease 2019 (COVID-19) vaccines is providing hope for a way to control the pandemic. As pregnant and lactating women are generally excluded from clinical trials, the vaccination programme was launched without adequate safety and efficacy data for pregnant women. Yet many professional organizations have recognized the need for administration of COVID-19 vaccines in pregnancy and have issued their own set of recommendations. The lack of evidence, however, has often led to confused messaging, inconsistent language and differing recommendations across organizations, potentially contributing to delay or refusal to accept vaccination by pregnant women. We summarize those differences and recommend that leaders collaborate at a country level to produce joint recommendations. We use the example of Australia, where two professional authorities along with the government and partners in New Zealand worked towards one message, consistent language and a unified recommendation. The aim was to help health professionals and women who are planning pregnancy or who are currently pregnant or breastfeeding to make an informed decision about COVID-19 vaccination. National advisory groups for immunization, professional obstetric organizations and government bodies should be encouraged to coordinate their statements on COVID-19 vaccination for pregnant and lactating women and to use similar language and phrasing for greater clarity.     

武汉地区新型冠状病毒肺炎产妇妊娠结局研究

目的总结分析武汉地区新型冠状病毒(2019-nCoV)感染对产妇及新生儿的影响。方法回顾性分析2020年1月23日至3月17日在湖北省妇幼保健院重症监护室(ICU)隔离病区住院的16例2019-nCoV核酸检测阳性(COVID-19组)和38例核酸检测阴性(对照组)产妇的临床资料及妊娠结局,并分析新型冠状病毒肺炎(COVID-19)产妇分娩的新生儿的临床资料。结果在16例确诊为2019-nCoV感染的产妇中,轻症1例(6.25%),普通型15例(93.75%)。两组产妇的年龄、孕次、分娩孕周,以及妊娠期高血压疾病、妊娠期糖尿病、发热和咳嗽的发生率差异均无统计学意义(t=-1.517~0.386、χ^2=0.012~2.048,均P>0.05)。两组产妇的羊水量、剖宫产术中出血量、胎盘重量,以及剖宫产、早产、胎儿窘迫、瘢痕子宫的发生率差异均无统计学意义(t=-0.855~1.015、χ^2=0.021~0.316,均P>0.05)。新生儿COVID-19核酸检测未发现阳性者。结论非重症感染2019-nCoV产妇与未感染产妇的妊娠结局无明显差异,COVID-19产妇分娩的新生儿未发现感染2019-nCoV。     

COVID-19 vaccination coverage and intent among women aged 18–49 years by pregnancy status,United States,April–November 2021

BackgroundPregnant and postpartum women are at increased risk for severe illness from COVID-19. We assessed COVID-19 vaccination coverage, intent, and attitudes among women of reproductive age overall and by pregnancy status in the United States.MethodsData from the National Immunization Survey Adult COVID Module collected during April 22-November 27, 2021, were analyzed to assess COVID-19 vaccination (receipt of ≥1 dose), intent for vaccination, and attitudes towards vaccination among women aged 18–49 years overall and by pregnancy status (trying to get pregnant, currently pregnant, breastfeeding, and not trying to get pregnant or currently pregnant or breastfeeding). Logistic regression and predictive marginals were used to generate unadjusted and adjusted prevalence ratios (PRs and aPRs). Trend analyses were conducted to assess monthly changes in vaccination and intent.ResultsOur analyses included 110,925 women aged 18–49 years. COVID-19 vaccination coverage (≥1 dose) was 63.2% overall (range from 53.3% in HHS Region 4 to 76.5% in HHS Region 1). Vaccination coverage was lowest among pregnant women (45.1%), followed by women who were trying to get pregnant (49.5%), women who were breastfeeding (51.5%), and all other women (64.9%). Non-Hispanic (NH) Black women who were pregnant or breastfeeding had significantly lower vaccination coverage (aPR: 0.74 and 0.66, respectively) than NH White women.DiscussionOur findings are consistent with other studies showing lower vaccination coverage among pregnant individuals, with substantially lower vaccination coverage among NH Black women who are pregnant or breastfeeding. Given the overlapping and disproportionate risks of COVID-19 and maternal mortality among Black women, it is critical that COVID-19 vaccination be strongly recommended for these populations and all women of reproductive age. Healthcare and public health providers may take advantage of every opportunity to encourage vaccination and enlist the assistance of community leaders, particularly in communities with low vaccination coverage.     

新型冠状病毒感染者核酸和抗体检测结果分析

目的了解新型冠状病毒(novel coronavirus 2019,2019-nCoV)感染者不同时期、不同类型标本中病毒核酸和抗体的检测情况,为完善新型冠状病毒肺炎(简称新冠肺炎)诊疗和防控方案提供科学依据.方法2020年2月26-27曰采集娄底市71例新冠肺炎确诊病例和25例无症状感染者的粪便、血液和咽拭子,应用R...     

新型冠状病毒肺炎隔离场所实施的消毒处理

依据目前的认知,新型冠状病毒肺炎的主要传播途径是呼吸道飞沫传播和接触传播。为做好新型冠状病毒肺炎疫情的防控工作,应选择有效消毒处理方法,使用合格的消毒产品,对隔离场所受到新型冠状病毒污染或可能污染的空气、环境物体表面实施随时消毒和终末消毒,同时做好个人防护,以切断新型冠状病毒肺炎的传播途径,降低其感染发生率,保护人民身体健康。     

COVID-19 vaccine decision-making among pregnant and lactating women in Bangladesh

Pregnant and lactating women’s vaccine decision-making process is influenced by many factors. Pregnant women were at increased risk for severe disease and poor health outcomes from COVID-19 at various time points during the pandemic. COVID-19 vaccines have been found to be safe and protective during pregnancy and while breastfeeding. In this study, we sought to examine key factors that informed the decision-making process among pregnant and lactating women in Bangladesh. We conducted 24 in-depth interviews, with 12 pregnant and 12 lactating women. These women were from three communities in Bangladesh: one urban community, and two rural communities. We used a grounded theory approach to identify emerging themes and organized emerging themes using a socio-ecological model. The socio-ecological model suggests that individuals are influenced by many levels, including individual-level influences, interpersonal-level influences, health care system-level influences, and policy-level influences. We found key factors at each socio-ecological level that influenced the decision-making process of pregnant and lactating women, including perceived benefits of vaccines and vaccine safety (individual-level), the influence of husbands and peers (interpersonal-level), health care provider recommendations and vaccine eligibility (health care system-level), and vaccine mandates (policy-level). As vaccination can reduce the effect of COVID-19 disease in mothers, infants, and unborn children, targeting critical factors that inform the decision-making process is paramount for improving vaccine acceptance. We hope the results of this study will inform vaccine acceptance efforts to ensure that pregnant and lactating women take advantage of this life-saving intervention.     

Women's views and experiences of accessing pertussis vaccination in pregnancy and infant vaccinations during the COVID-19 pandemic: A multi-methods study in the UK

BackgroundCOVID-19 changed access to healthcare, including vaccinations, in the United Kingdom (UK). This study explored UK women’s experiences of accessing pertussis vaccination during pregnancy and infant vaccinations during COVID-19.MethodsAn online cross-sectional survey was completed, between 3rd August-11th October 2020, by 1404 women aged 16+ years who were pregnant at some point after the first UK lockdown from March 23rd, 2020. Ten follow-up semi-structured interviews were conducted.ResultsMost women surveyed were pregnant (65.7%) and a third postnatal (34.3%). Almost all women (95.6%) were aware that pertussis vaccination is recommended in pregnancy. Most pregnant (72.1%) and postnatal women (84.0%) had received pertussis vaccination; however, access issues were reported.Over a third (39.6%) of women had a pregnancy vaccination appointment changed. COVID-19 made it physically difficult to access pregnancy vaccinations for one fifth (21.5%) of women and physically difficult to access infant vaccinations for almost half of women (45.8%). Nearly half of women (45.2%) reported feeling less safe attending pregnancy vaccinations and over three quarters (76.3%) less safe attending infant vaccinations due to COVID-19. The majority (94.2%) felt it was important to get their baby vaccinated during COVID-19.Pregnant women from ethnic-minorities and lower-income households were less likely to have been vaccinated. Minority-ethnicity women were more likely to report access problems and feeling less safe attending vaccinations for both themselves and their babies.Qualitative analysis found women experienced difficulties accessing antenatal care and relied on knowledge from previous pregnancies to access vaccines in pregnancy.ConclusionDuring the ongoing and future pandemics, healthcare services should prioritise equitable access to routine vaccinations, including tailoring services for ethnic-minority families who experience greater barriers to vaccination.     

COVID-19 vaccination in pregnant women in Sweden and Norway

Vaccines against SARS-CoV-2 are highly effective in preventing severe disease and mortality. Although pregnant women are at increased risk of severe COVID-19, vaccination uptake among pregnant women varies. We used the Swedish and Norwegian population-based health registries to identify pregnant women and to investigate background characteristics associated with not being vaccinated. In this study of 164 560 women giving birth between May 2021 and May 2022, 78% in Sweden and 87% in Norway have been vaccinated with at least one dose at delivery. Not being vaccinated while being pregnant was associated with age below 30 years, low education and income level, birth region other than Scandinavia, smoking during pregnancy, not living with a partner, and gestational diabetes. These results can assist health authorities develop targeted vaccination information to diminish vaccination inequality and prevent severe disease in vulnerable groups.     

新型冠状病毒感染流行期间大型综合性医院感染防控策略

目的探讨医院新型冠状病毒感染(COVID-19)疫情防控与诊疗救治并行时,如何制定COVID-19医院感染防控策略,为大型综合性医院制定疫情防控策略提供科学依据。方法医院以"管理传染源,切断传播途径,保护易感人群"为原则,分别从"管人"、"管物"、"管流程"方面提出建立应急防控组织体系、发挥疾病预防控制科的专业作用、加强门急诊的管理、加强住院患者的防控管理、管理各级各类人员、制订诊疗防控流程、环境的清洁消毒、人员培训教育、加强后勤物资保障等防控策略与具体措施。结果所有来院患者均得到科学合理接诊,医务人员身体和心理状态稳定,医护人员和住院患者均未出现COVID-19。结论研究医院的COVID-19防控策略可为疫情流行期间综合性医院院内感染防控提供参考。     

A socio-ecological exploration to identify factors influencing the COVID-19 vaccine decision-making process among pregnant and lactating women: Findings from Kenya

The vaccine decision-making process of pregnant and lactating women is complex. Regarding COVID-19, pregnant women are at increased risk for severe disease and poor health outcomes. While pregnant and lactating women were excluded from COVID-19 vaccine trials, available evidence suggests that COVID-19 vaccines are safe and protective during pregnancy. In this study, we used a socio-ecological approach to explore factors influencing the decision-making process for COVID-19 vaccines in pregnant and lactating women in Kenya, for the purpose of informing demand generation strategies. As pregnant and lactating women are influenced by many factors, we conducted 84 in-depth interviews with a variety of stakeholders, including 31 pregnant or lactating women, 20 healthcare workers such as nurses, midwives, doctors, and frontline workers, 25 male family members of pregnant or lactating women, and 8 gatekeepers such as community leaders and faith-based leaders. These individuals were recruited from six communities in Kenya: three urban, and three rural. We applied a grounded theory approach to identify emerging themes and organized emerging themes using the SAGE Vaccine Hesitancy model, which includes three categories of determinants of vaccine acceptance, including contextual influences, individual and group influences, and vaccine and vaccination specific issues. Myths, interpersonal norms, and religion emerged as themes related to contextual influences. Safety, risk perception, and the role of the healthcare worker emerged as themes related to individual and group influences. For vaccine and vaccination specific issues, emerging themes included availability, accessibility, and eligibility. While maternal immunization can substantially reduce the effect of infectious diseases in mothers and infants, vaccine acceptance is critical. However, vaccines do not save lives; vaccination does. We hope the results of this study can be used to tailor communication efforts to increase vaccine demand among pregnant and lactating women.