针对免疫受损患者群体的COVID-19疫苗接种建议:德尔菲小组和美国的共识声明生成
Kira Zhi Hua Lai1, Stuart Greenstein2, Rajesh Govindasamy3
1ICON Clinical Research, Dublin 18, Ireland.
Infectious diseases and therapy
|October 10, 2024
概括
在针对特定疾病的免疫功能低下患者的COVID-19疫苗初级和增强剂系列方面达成了专家共识. 然而,一些关于抗体标位和更高剂量的建议未能在医生之间达成完全一致.
科学领域:
- 免疫学 免疫学 免疫学
- 疫苗学 疫苗学 疫苗学
- 公共卫生 公共卫生
背景情况:
- 美国免疫实践咨询委员会 (ACIP) 和疾病控制中心 (CDC) 建议所有免疫功能低下的人接受COVID-19疫苗.
- 患有类风湿病,病,血液性恶性瘤和固体器官移植 (SOT) 的患者有严重COVID-19结局的风险增加.
- 针对特定疾病的疫苗接种建议对于优化这些脆弱人群的保护至关重要.
研究的目的:
- 总结专家在美国针对患有类风湿病,病,血液性恶性瘤和SOT的免疫功能低下患者的COVID-19疫苗接种策略上的共识.
- 为初级和强剂COVID-19疫苗剂量和管理制定疾病特异性建议.
主要方法:
- 一种两阶段的Delphi小组方法,涉及关键意见领袖 (KOLs) 和随后的反复修订建议.
- 与KOL进行了定性访谈,随后进行了三轮关于疫苗声明的共识建设.
- 在四个疾病领域对医生 (n=200) 进行的在线调查,以评估与共识陈述的同意.
主要成果:
- 在所有疾病群体中,对于初级和强剂COVID-19疫苗系列的建议,达成了中等至强大的共识.
- 对于初级疫苗和强剂疫苗的推,医生一致性很高 (62%-96%).
- 关于抗体标位测量,较高的疫苗剂量和接种疫苗的时间相对于疾病特异性治疗的陈述,观察到较低的一致性.
结论:
- 专家一致认为,针对疾病特异性COVID-19疫苗推的初级和强剂系列.
- 协商一致的建议被执业医生普遍接受.
- 需要进一步讨论特定方面,如抗体标位监测和免疫功能低下患者的更高剂量策略.
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