How to hit the fourth pins of the new crown vaccine?Do you need to strengthen your needle every year in the future?

In the long run, people's enthusiasm for vaccination

It will slowly reduce, even

Subsequent listing for Omikon's binary vaccine

It is also mainly vaccinated in the "fragile crowd"

So far, the total number of new crowns in the world has exceeded 500 million, and the number of deaths exceeds 6.31 million. At the same time, the amount of vaccination is also growing. According to statistics from Our World In Data Platform at Oxford University, as of June 17, a total of 11.98 billion new crown virus vaccines were vaccinated in the world.

South Africa has experienced the latest BA.4/5 mutation. From the data point of view, among the people who have been vaccinated in South Africa, the severe and mortality rate is far lower than those who have not vaccinated or have not been completely vaccinated. At the same time, in the past week, the Canadian Prime Minister Trudeau, who had vaccinated the new crown vaccine, confirmed the new crown virus for the second time. On June 15, local time, the National Institute of Allergic and Infectious Diseases (NIAID), Dr. Anthony Fugic Virus Test of the National Institute of Allergic and Infectious Diseases (NIAID), which was vaccinated by 4 stitches.

"Today's new crown vaccine has changed from preventing infection to preventing hospitalization, severe illnesses, and death. Many of the newly added infected people at this stage are vaccines or have been infected before. Antibodies. "Chen Xi, an associate professor of global health and economics at Yale University in the United States, said in an interview with" China News Weekly "that for this part of the crowd, even infection, the symptoms are not serious.

Based on the new crown vaccine developed by the primitive virus, the effects of various mutant strains in Omikon are gradually weakening. In this context, the public is concerned about how to fight the fourth pins of the new crown vaccine? What role will the vaccine play in the process of ending the new crowns?

On April 5th, the local people were vaccinated with new crown vaccines in Pennsylvania. Photo/Visual China

Mutations are constantly, and infection is universal again

After being discovered for the first time in South Africa in November last year, Omikon has been as broken and has swept the world with his own power. Nowadays, all kinds of mutant strains in Omikon have blossomed everywhere. From the initial BA.1 and BA.2, it has been evolved to today's BA.4/5.

Recently, the popularity of BA.2.12.1 and BA.4/5 has continued to increase its popularity in the United States and South Africa. In the United States, although BA.2.12.1 is still dominating, the proportion of BA.4/5 is gradually rising. According to the weekly estimated data of the US Centers for Disease Prevention (CDC), as of June 11, the popularity of BA.4 and BA.5 in the United States was 8.3 % and 13.3 %, respectively. It was 1.0 % on May 7, and the difference in 35 days reached more than 20 times. In the past 28 days, the number of new cases in the United States reached 29.726 million.

As the country with the highest number of new crown vaccines in the world, Israel took off the pressure of BA.5 less than 2 months after taking off the mask on April 24 this year, and was considering restoring the indoor mask order. With the proportion of Omiko's mutant BA.5 in Israel, the number of new cases in Israel exceeded 10,000 again. In late May, the new daily increase in Israel fell to 2,000 cases. On June 19, local time, Israeli reported 10202 new crown nucleic acid detection was positive, and the positive detection rate reached 27.9 %.

BA.4/5 was first tested in South Africa in January and February this year, respectively, and became the country's main strain in May. Studies have shown that in addition to sharing Omikon's previous sub -types of the same mutation, BA.4/5 also has different new mutations. New mutations allow it to escape the existing immune system of the human body and make vaccination or vaccination or People who have infected the new coronal virus repeatedly infected. At the same time, some studies are predicted by animal models, BA.4/5 may also cause lung infection.

Jin Dongyan, a professor at the School of Biomedicine of the University of Hong Kong and a virus expert, told China News Weekly that the infectiousness of BA.4/5 may be "strong" than BA.1 and BA.2, but the degree of "strong" is limited. As far as the proliferation speed of the virus is concerned, the initial period of BA1 and BA2 can be described by "wind rolls and clouds". Now with the increase in vaccine coverage and the number of natural infections, the diffusion speed of the BA.4/5 strains has been limited. Essence "Even if BA.4/5 will become mainstream strains in the future, most of the infected people will belong to mild, and the overall harm is not high." In Jin Dongyan, in terms of current research, the infection method of BA.4/5 is still still The above respiratory tract is mainly due to lung infection. From the perspective of the data released by the WHO and the Centers for Disease Control and Prevention, the pathogenicity of BA.4/5 has basically not increased. It is unknown whether BA.4/5 can become global pop strains.

According to GLOBAL News, Trudeau vacated the first acupuncture of Oxford-Astraon adenovirus virus vaccine in April 2021. In July of the same year, the second needle Modner vaccine was vaccinated and inoculated on January 4 this year. The third dose is enhanced. On January 31 this year, Trudeau, who had been vaccinated with three doses of the new -dose of vaccine at the time, confirmed that the virus test results of him and his child were positive. Today, Trudeau was infected for more than 4 months.

Niaid said in a statement that the 81 -year -olds, the 81 -year -old, have mild symptoms, have received two intensive treatment, and are currently being treated with antiviral drugs Paxlovid. The statement stated that the previous four -shot vaccine had been vaccinated, including two doses to enhance the needle, and the first two needles they were vaccinated were Modner vaccines. At present, BA.4 and BA.5 have become the dominant variants of Portugal. Although Portugal's vaccination rate exceeds 85 %, it has just experienced a large number of Omikon BA.1 and BA.2 from the end of 2021 to the beginning of 2022 to early 2022. Infection, Portugal still has a new wave of infection, and the positive detection rate once was as high as 50.63 %. The number of new deaths also returned to the level at the peak of Omikon infection from January to February 2022.

On June 14, a study published in the "Science" published in the London Institute of Technology in the United Kingdom showed that the protection of Omikon's protection of Omikon was related to whether individuals had been infected by new crown viruses and the types of strains. For example, a person has been infected with a primitive strain before the new crown vaccine was vaccinated, and the antibody titer of the Omircon strain produced after the three -dose vaccine will decrease significantly. In other words, the original plant infection reduces the ability of vaccine immunity and later Omikon infection of "awakening" immune response. The study also confirmed that the infection of Omikon and its subtypes did not prevent re -infections against the strains and its variants, that is, natural infections could not be equivalent to natural vaccines. This also explains that breakthrough infections and repeated infections are common phenomena in the Omikon variant epidemic.

Lu Mengji, a professor at the Institute of Virus Research at the University of Essen University of Medicine at the University of Essen, told the China News Weekly that from the data of many countries, the positive rate of new crowns increased, but the mortality rate did not increase significantly. After most people repeat the infection, the symptoms are not serious, and this trend is more obvious this year.

"The overall situation is very different before Omik Rong's popularity." In Jin Dongyan's view, from the perspective of the fifth wave of Hong Kong's epidemic, 80 % of the infected people have a breakthrough infection like a little. People have been vaccinated before, and most of them are mild.

In the fifth wave of epidemic in Hong Kong, from the perspective of mortality data, the average mortality rate corresponding to the vaccination of 0 to 3 vaccines is 3.04 %, 1.03 %, 0.17 %, and 0.04 %, respectively. The mortality rates were 0.35 % and 0.06 %, respectively, and the mortality rates of two -needle and three -needle compound MRNA vaccine were 0.05 % and 0.03 %, respectively. From the perspective of infection rate, the infection rate of people who have not been vaccinated is as high as 30.9 %, the infection rate of two -pin vaccine is still over 20 %. The infection rate of vaccine is 4.0 %.

Jin Dongyan said that in the Hong Kong epidemic, the mortality rate and infection rate of three -needle vaccine have decreased significantly. In terms of prevention of infection, it is obviously not enough to get only two stitches. In his opinion, even if a three -pin vaccine was taken, the infection rate could only be reduced accordingly, and the infection could not be completely prevented. However, even if the person who has three stitches is infected, it will quickly produce antibodies, so you can see that some people have a short course of disease, mild symptoms, and low infectivity. The existing detection methods are sometimes difficult to test. People can consider shortening the isolation period.

On June 18, the China Centers for Disease Prevention published a multi -center and large -scale clinical follow -up research results led by Zhang Wenhong, the director of the Department of Infectious Department of Huashan Hospital affiliated to Fudan University. The study was incorporated into the 33,816 non -basic disease in the Shanghai epidemic, or infected with non -severe Omircor in the stable period of the basic disease. Studies have shown that more than 22 of more than 30,000 people have progressing as severe, and the overall severity rate is 0.065 %. Compared with patients who have not progressed as severe infections, the proportion of non -vaccination to severe infections was 54.5 %, which was higher than the former of the former.

On May 25, the 200th district of Zhahua East Road, Mayor of Shanghai, Shanghai, was waiting for the vaccine in the outdoor observation area after vaccination. Photography/Magazine reporter Caiqin

Should the fourth pins be hit? how to spell?

As the large -scale infections driven by Omikon and its various mutations sub -types have been rolled around the world, the effectiveness of the original new crown vaccine has decreased to varying degrees. A clinical trial published in "Liuye Knife" shows that after the vaccination of two doses of Jeongxia adenovirus vectors, and then vaccinated a dose of Pfizer vaccine, the vaccine effectiveness was reduced to 8.8 % after 25 weeks; even if three needles were vaccinated Pfizer's MRNA vaccine, 10 weeks later, the effectiveness of the vaccine was still not high, a decrease of 45.7 %. When dealing with the original strain virus, the efficiency of the mRNA vaccine is as high as 90 %. In this case, more and more countries have begun to plan or start the fourth vaccination of the new crown vaccine, including Japan, Italy, the United Kingdom, Israel, Singapore, Denmark, and Chile. As BA.5 is occupying an absolute advantage in Israel, Israeli experts said that the possibility of providing fifth needle vaccine for the elderly and low immune function should be considered.

On January 3 this year, the Israeli government launched a project to vaccinate the fourth pill vaccine for high -risk people. People who are 60 years of age or immune defects can be vaccinated by 4 months after the third needle. So far, more than 700,000 people in Israel have vaccinated the fourth pool Pfizer vaccine.

In March of this year, more than 1.25 million research results released by the Xieba Medical Center in Israel were included in the data over the age of 60 and had received at least three doses of Pfizer vaccine. The results of the study showed that after the fourth dose of Pfizer vaccine, the new crown infection rate and severity rate were lower than that of only three doses of vaccine. Studies have also shown that the anti -infection effect of the fourth dose of vaccine is short -lived and has not weakened the effect on the prevention of severe illness. It is worth noting that as of now, the fourth shot of Pfizer vaccine in Israel is not specifically developed for Omikon strains. At the end of January this year, Pfizer/Biontech revealed to the outside world that clinical trials were launched for the new crown vaccine specifically for Omikon poison. But so far, the two companies have not announced relevant experimental data or results.

"From the time of the vaccine, the attenuation of the body's antibodies needs to be vaccinated every year." Chen Xi said, but this is not aimed at all ages. Specifically, in the United States, if the first enhancement of the needle is more than 4 months old, the age of 50, or the age of 12 or more suffers from immune dysfunction, it meets the conditions of the second dose to enhance the needle. At present, people over the age of 65 and people with basic diseases are recommended to vaccinate the fourth shot, and the best time to vaccine is autumn and winter. Chen Xi said that this is because autumn and winter is also a high incidence of influenza. The second dose of inoculation can make the medical resources not be able to withstand too much burden. Moreover, choosing this time node, because the antibody of the inoculating person has dropped to a certain extent and needs to be reinforced.

Jin Dongyan pointed out that for domestic, three -needle dying vaccine is a basic disk. As for whether the fourth pins should be played and what to fight, it depends on the further disclosure of the specific data. There is no specific data of the fourth pins. At the moment, the urgent charge is to vaccinate the third needle, "the third in vaccination rate in China has not reached a very high level."

Jin Dongyan said that if the second -generation vaccine of Omikon will be strengthened in the future, the effect will naturally be better than the existing vaccine, because it belongs to the "right medicine". The elderly over 60 years of age and people in the age of 60 may consider the fourth shot of vaccination. In the future, it may develop to determine whether to fight through the level of antibodies in the body.

A domestic public health expert who reluctant to name to China News Weekly said that according to his understanding, several domestic R & D pipelines are stepping up the development of a new second -generation vaccine for the Omikon poison strains, but I do not know if they can rush to rush There were results before October.

On May 31, the University of Hong Kong Medical College and Sinopharm Group announced the cooperation to launch the vaccine clinical trial of the second -generation Omiko strain. Adult volunteers with two or three doses or MRNA new crown vaccines. According to Jin Dongyan's understanding, the above clinical trials should be disclosed in more complete data after 2 to 3 months. At that time, it is just autumn and winter. This vaccine is expected to come in handy.

On June 8th, Modner announced the clinical results of the second -valent vaccine of the Omikon strain and the primitive strain. The results of the study show that when this vaccine is inoculated as the fourth pinston, the neutral antibody increase of the Omikon strain is 1.75 times higher than the original vaccine. Modner also mentioned that the vaccine as an original vaccine with a high tolerance of needle is generally good, and the side effects are equivalent to the 50 micrograms.

From the current point of view, the vaccination rate of the elderly vaccine in China is far from enough. Chen Xi believes that the fourth pins vaccine is more for the elderly who are infected with high risks or basic diseases. The second -generation vaccine research and development of the second -generation vaccine for Omiko strains enters the clinical phase III and needs to be included in a large number of subjects. After the Chinese epidemic controls, people who participate in clinical trials will lack clinical trials. If they choose to do clinical trials abroad, there are also fewer problems such as racial differences, high risks abroad, and basic diseases with basic diseases.

The vaccine demand for "bottlenecks"

Unlike the hot market market in 2021, this year's global vaccine industry is undergoing "pass" that supply excess supply. In the United States, a large number of new crown vaccines have been thrown into the trash. So far, CVS, the largest drug store chain in the United States, wasted nearly 11.8 million doses of vaccines, and about 10 million doses of Wal -Mart's distribution were thrown away. In addition, Oklahma has discarded more than 1.1 million doses of new crown vaccines. Chen Xi said that at present, the overcapacity of American vaccine companies, vaccine coverage in many communities has been saturated, and a large amount of vaccine waste has occurred.

On April 11, the analysis agency Airfinity LTD posted on the official website that since the beginning of 2022, the global vaccination rate has dropped rapidly. The agency has reduced the global sales forecast of this year's new crown vaccine from US $ 80.8 billion to $ 64.1 billion, and predicts that this year's annual demand will be 6 billion, and by 2023 to 2 billion to 4 billion doses.

As of now, the annual production capacity of Koxing's new crown vaccine has reached more than 2 billion doses. According to data disclosure of Guotai Junan Report, in 2022, the new crown vaccine production of Chinese medicine reached 7 billion to 8 billion doses, and the production capacity of Kangshino and Zhifei this year was 500 million to 700 million and 300 million to 600 million doses.

At present, most vaccine resources are concentrated in countries with good economic conditions, and the number of immunization in Africa and other countries is currently very limited. The latest data released by the African CDC on June 10 showed that only about 17.3 % of the African population completed the vaccination of 2 doses of vaccine.

"The new crown vaccine is more important in the early days of the epidemic. Taking Africa as an example, 95 % of the human body in the region has produced new coronal virus antibodies. If it is still provided with vaccines developed for the original strains, it is not of great significance. And for the locals, the new crown is no longer their main issue. "Lu Mengji said. "The vaccination status and progress of vaccines in the world are different." Jin Dongyan said that the demand for foreign vaccines has now reached the bottleneck period, and some places in Europe have begun to stop vaccine. In these countries, the high vaccine coverage and liberalization of epidemic prevention measures have made the level of immune barriers higher in the crowd. For Africa and other places, although the vaccination level is low, the local natural infection rate is very high.

"The situation in China is very different. The current three -needle vaccination rate of domestic vaccines is not high, and the natural infection rate is not high. Once the epidemic has a large scale again, those who have not vaccinated or those who have basic diseases are still facing. Higher intensive or risk of death. "In Jin Dongyan's view, vaccination is still the most effective and cost -effective way against the new coronal virus. When the domestic three -pin vaccination rate reaches more than 90 %, the possibility of policy adjustment will be greater.

Chen Xi analyzed that vaccine companies are now watching. With factors such as new variants and rising diseases, the corresponding market size of the new crown vaccine will naturally grow. Manufacturers will adjust the vaccine and develop a large -scale development through gene sequencing, otherwise the company will choose to "keep the soldiers".

On June 15, local time, the US Food and Drug Administration approved the MRNA new crown vaccine developed by children from 6 months to 5 years old, which means that the vaccination group of the new crown vaccine was extended to about 19 million babies across the United States in the United States Toddlers and children apply for preschool. But Chen Xi believes that this market is limited. He revealed that the United States had done an internal investigation and was willing to inoculate the new crown vaccine for children under 5 years old.

"In Germany, the binary vaccine for Omikon is expected to come out in September this year, but it is unlikely to be vaccinated on a large scale in the future." Lu Mengji believes that if you miss this time, even if the subsequent vaccine is listed, the significance and value It will also be greatly reduced. In Lu Mengji, after the occurrence of the above -mentioned second -generation vaccine, it will definitely promote the market, but in the long run, this effect will gradually fade, because the impact of the new crown virus will gradually decrease. "For most people, it may be up to the upper limit for the fourth shot."

"The vaccine market with a large amount of capital is more like a short -term phase. If the technology itself has no long -term competitiveness, for these vaccine manufacturers, this wave of dividends will dissipate sooner or later. For those companies that have reached a certain level of production capacity In terms of the trend of demand, damage is undoubtedly huge. "Lu Mengji said.

Many views believe that the new crown epidemic may eventually move towards a local disease. In the large sample research led by Zhang Wenhong and others, in the face of the super -communication Omikon poison, the important point is to identify patients with mild illness, find out the fragile crowd, and take a series of protection for the fragile people. Measures, including the sufficient coverage of vaccines, and special protection for fragile people in the epidemic period, may significantly reduce the severe disease and mortality of the fragile population, and reduce the damage of Omikon to lower.

Send 2022.6.27 Total Issue 1049 "China News Weekly" magazine

Magazine title: How to fight the fourth pins of the new crown vaccine?

Reporter: Niuhe ([email protected])

Edit: Du Wei

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