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富国开始施打“加强针”,是科学还是贪婪?

富国开始施打“加强针”,是科学还是贪婪?

David Meyer 2021年07月16日
全世界近四分之一的人口已经至少接种了一剂新冠疫苗,但疫苗分配并不平等。

如今,新冠加强针疫苗引发了激烈争论。争论的焦点不仅在于是否以及在什么时间有必要接种加强针,人们还在讨论加强针背后的基本道德问题。

这是因为富裕国家目前正在考虑采用类似于流感的模式推行施打加强针疫苗,但其他国家的疫苗供应依旧捉襟见肘。

全世界近四分之一的人口已经至少接种了一剂新冠疫苗,但疫苗分配并不平等。高收入和中等以上收入国家共施打了85%的疫苗,这些国家财力雄厚,让它们可以领先于其他国家。而低收入国家仅施打了0.3%的疫苗。

因此,美国已经有48%的人口完成疫苗接种,欧洲也有足够的疫苗供应,但贫困国家的疫苗接种工作才刚刚启动。孟加拉国的外交部部长阿卜杜勒•莫门在几周前曾经抱怨:“富裕国家正在囤积疫苗。它们获得的疫苗是实际需求的几倍。”孟加拉国只有2.6%的人口完成了疫苗接种。

他的说法没有错。欧盟到2023年能够人均施打6.6剂疫苗。鉴于欧盟到7月底将有70%的成年人接种疫苗,因此这些疫苗大部分是加强针疫苗。

“令人羞愧”

世界卫生组织(World Health Organization)直言不讳地批评了疫苗分配不公的后果,并希望富裕国家将额外的疫苗转让给其他国家,而不是考虑施打加强针。

世界卫生组织的总干事谭德塞在7月12日称:“全球疫苗分配不均,供应极不平等,当一些国家还未能为其卫生工作者和最弱势群体接种疫苗时,另一些国家和地区却订购了数百万剂的疫苗加强针。”

虽然谭德塞表示,即使在接种率较高的国家,德尔塔新冠变种病毒“也再次给卫生体系带来了压力”,但他补充说:“在疫苗接种率较低的国家,情况尤其糟糕。德尔塔变种病毒以及其他高传染性变种病毒,导致新一波严重疫情,住院治疗和死亡人数激增。”

谭德塞指出:“诸位,你们是否会将没有穿戴任何防护装备的消防员派到一线?在新冠疫情中,最脆弱的是谁?是奋战在一线的医护人员、老年人和弱势群体。我们现在却在有意识地选择不为最需要帮助的人们提供保护;将‘消防员’的安危置于不顾。”

世界卫生组织的突发卫生事件规划执行主任迈克•瑞恩更加直白地表示,如果各国开始在短期内施打加强针疫苗,“当我们回首往事的时候将感到愤怒和羞愧。有些人想要占尽好处,却还不知足。”

将道德问题放在一边,从现实方面考虑,如果任由病毒在没有疫苗保护的人群中传播,它将有更高的概率发生变异,在富裕国家引发混乱,例如最早在印度发现的德尔塔变种病毒导致欧洲经济重启的趋势突然反转。

关于免疫力减弱的争论

然而,就像每年接种的流感疫苗一样,在药企推出特别针对变异毒株做出调整的新版疫苗之前,最初开发加强针疫苗的初衷,一定程度上就是为了应对这些变种病毒。

由于德尔塔变种病毒的出现,泰国和阿联酋等国家已经开始向完成接种科兴、国药和阿斯利康(AstraZeneca)疫苗的民众,提供第三剂疫苗。

尽管辉瑞(Pfizer)/BioNTech以及Moderna的信使核糖核酸(mRNA)疫苗更有效,但药厂也一直在考虑加强针疫苗的必要性。

在疫苗接种率较高的地区,尤其是以色列,德尔塔变种病毒导致感染人数激增。以色列主要接种辉瑞/BioNTech疫苗。辉瑞解释称,这种现象证明抗体效果正在减弱。该公司目前正在向美国的药品监管机构申请批准加强针疫苗,最快可在首次接种六个月后施打,尽管其依据的数据来自一项仅涉及20多人的研究。

辉瑞的研究负责人米卡埃尔•多尔斯滕在上周说:“我们相信,加强针对德尔塔变种病毒非常有效。”

但即便在以色列,政府在施打加强针疫苗方面也非常谨慎。以色列已经开始为极度脆弱的群体接种第三剂辉瑞/BioNTech疫苗。以色列的卫生部高级顾问兰•巴利塞在7月12日指出,目前依旧没有“免疫力减弱的证据”,并且在大范围施打加强针疫苗之前,必须排除“导致目前确诊病例增加的其他潜在原因”。

据《纽约时报》(New York Times)在7月12日的报道,美国政府官员也希望在看到更多证据之后,再授权施打加强针疫苗。

辉瑞和BioNTech在上周发布的一份声明中称:“基于到目前为止掌握的全部数据,辉瑞和BioNTech认为,第三剂疫苗将有助于保持最高的防护水平。”

辉瑞的一位发言人在7月13日补充说:“我们正在携手各国政府以及全球卫生合作伙伴,共同推动新冠疫苗的公平和平等分配,同时利用我们的专业知识和资源开发创新方法,帮助加强需要更多支持的医疗保健体系。”(财富中文网)

翻译:刘进龙

审校:汪皓

如今,新冠加强针疫苗引发了激烈争论。争论的焦点不仅在于是否以及在什么时间有必要接种加强针,人们还在讨论加强针背后的基本道德问题。

这是因为富裕国家目前正在考虑采用类似于流感的模式推行施打加强针疫苗,但其他国家的疫苗供应依旧捉襟见肘。

全世界近四分之一的人口已经至少接种了一剂新冠疫苗,但疫苗分配并不平等。高收入和中等以上收入国家共施打了85%的疫苗,这些国家财力雄厚,让它们可以领先于其他国家。而低收入国家仅施打了0.3%的疫苗。

因此,美国已经有48%的人口完成疫苗接种,欧洲也有足够的疫苗供应,但贫困国家的疫苗接种工作才刚刚启动。孟加拉国的外交部部长阿卜杜勒•莫门在几周前曾经抱怨:“富裕国家正在囤积疫苗。它们获得的疫苗是实际需求的几倍。”孟加拉国只有2.6%的人口完成了疫苗接种。

他的说法没有错。欧盟到2023年能够人均施打6.6剂疫苗。鉴于欧盟到7月底将有70%的成年人接种疫苗,因此这些疫苗大部分是加强针疫苗。

“令人羞愧”

世界卫生组织(World Health Organization)直言不讳地批评了疫苗分配不公的后果,并希望富裕国家将额外的疫苗转让给其他国家,而不是考虑施打加强针。

世界卫生组织的总干事谭德塞在7月12日称:“全球疫苗分配不均,供应极不平等,当一些国家还未能为其卫生工作者和最弱势群体接种疫苗时,另一些国家和地区却订购了数百万剂的疫苗加强针。”

虽然谭德塞表示,即使在接种率较高的国家,德尔塔新冠变种病毒“也再次给卫生体系带来了压力”,但他补充说:“在疫苗接种率较低的国家,情况尤其糟糕。德尔塔变种病毒以及其他高传染性变种病毒,导致新一波严重疫情,住院治疗和死亡人数激增。”

谭德塞指出:“诸位,你们是否会将没有穿戴任何防护装备的消防员派到一线?在新冠疫情中,最脆弱的是谁?是奋战在一线的医护人员、老年人和弱势群体。我们现在却在有意识地选择不为最需要帮助的人们提供保护;将‘消防员’的安危置于不顾。”

世界卫生组织的突发卫生事件规划执行主任迈克•瑞恩更加直白地表示,如果各国开始在短期内施打加强针疫苗,“当我们回首往事的时候将感到愤怒和羞愧。有些人想要占尽好处,却还不知足。”

将道德问题放在一边,从现实方面考虑,如果任由病毒在没有疫苗保护的人群中传播,它将有更高的概率发生变异,在富裕国家引发混乱,例如最早在印度发现的德尔塔变种病毒导致欧洲经济重启的趋势突然反转。

关于免疫力减弱的争论

然而,就像每年接种的流感疫苗一样,在药企推出特别针对变异毒株做出调整的新版疫苗之前,最初开发加强针疫苗的初衷,一定程度上就是为了应对这些变种病毒。

由于德尔塔变种病毒的出现,泰国和阿联酋等国家已经开始向完成接种科兴、国药和阿斯利康(AstraZeneca)疫苗的民众,提供第三剂疫苗。

尽管辉瑞(Pfizer)/BioNTech以及Moderna的信使核糖核酸(mRNA)疫苗更有效,但药厂也一直在考虑加强针疫苗的必要性。

在疫苗接种率较高的地区,尤其是以色列,德尔塔变种病毒导致感染人数激增。以色列主要接种辉瑞/BioNTech疫苗。辉瑞解释称,这种现象证明抗体效果正在减弱。该公司目前正在向美国的药品监管机构申请批准加强针疫苗,最快可在首次接种六个月后施打,尽管其依据的数据来自一项仅涉及20多人的研究。

辉瑞的研究负责人米卡埃尔•多尔斯滕在上周说:“我们相信,加强针对德尔塔变种病毒非常有效。”

但即便在以色列,政府在施打加强针疫苗方面也非常谨慎。以色列已经开始为极度脆弱的群体接种第三剂辉瑞/BioNTech疫苗。以色列的卫生部高级顾问兰•巴利塞在7月12日指出,目前依旧没有“免疫力减弱的证据”,并且在大范围施打加强针疫苗之前,必须排除“导致目前确诊病例增加的其他潜在原因”。

据《纽约时报》(New York Times)在7月12日的报道,美国政府官员也希望在看到更多证据之后,再授权施打加强针疫苗。

辉瑞和BioNTech在上周发布的一份声明中称:“基于到目前为止掌握的全部数据,辉瑞和BioNTech认为,第三剂疫苗将有助于保持最高的防护水平。”

辉瑞的一位发言人在7月13日补充说:“我们正在携手各国政府以及全球卫生合作伙伴,共同推动新冠疫苗的公平和平等分配,同时利用我们的专业知识和资源开发创新方法,帮助加强需要更多支持的医疗保健体系。”(财富中文网)

翻译:刘进龙

审校:汪皓

There is an emerging debate over COVID-19 booster shots. It’s not just about whether and when these extra vaccine doses will become necessary, but also about basic ethics.

That’s because, while rich countries are now talking about moving to a flu-style system of regular boosters, most of the world is still experiencing a huge shortage of vaccines.

Nearly a quarter of the world’s people have received at least one dose of a COVID vaccine, but distribution has been anything but equal. A whopping 85% of vaccine doses have been administered in high- and upper-middle-income countries, whose financial resources allowed them to muscle their way to the front of the queue. But low-income countries have been left with 0.3% of total doses.

So, while the U.S. has fully vaccinated 48% of its population, and Europe is now swimming in vaccines, poorer countries are still barely off the starting blocks. “Rich countries are hoarding vaccines,” complained Bangladeshi Foreign Minister A.K. Abdul Momen, whose country has fully vaccinated 2.6% of its population, a few weeks ago. “They have several times more vaccines than they need.”

He’s not wrong. The EU has secured 6.6 doses for each person through 2023. With the union being on track to vaccinate 70% of its adults by the end of July, most of that is boosters.

“Look back in shame”

The World Health Organization is blunt about the implications, and wants rich countries to send their extra doses to the rest of the world rather than talking about boosters.

“The global gap in COVID-19 vaccine supply is hugely uneven and inequitable. Some countries and regions are actually ordering millions of booster doses, before other countries have had supplies to vaccinate their health workers and most vulnerable,” said WHO Director-General Tedros Adhanom Ghebreyesus on July 12.

While Tedros noted how the Delta variant of the coronavirus is “steadily putting pressure back on health systems,” even in countries with high vaccination coverage, he added that “in countries with low vaccine coverage, the situation is particularly bad. Delta and other highly transmissible variants are driving catastrophic waves of COVID-19 cases, which are translating into high numbers of hospitalizations and death.”

“I ask you, who would put firefighters on the front line without protection?” Tedros continued. “Who are the most vulnerable to the flames of the COVID-19 pandemic? The health workers on the front lines, older persons, and the vulnerable. We are making conscious choices right now not to protect those most in need; our own firefighters.”

Mike Ryan, the WHO’s emergencies program chief, put it even more starkly, saying the world will “look back in anger, and we will look back in shame” if countries start rolling out boosters in the near-term. “These are people who want to have their cake and eat it, and then they want to make some more cake and eat it too.”

Morality aside, the practical aspect of this is that, while the virus is allowed to circulate through unprotected people, there is a greater likelihood of it mutating and causing chaos even in richer countries—an effect we’re already seeing with the Delta variant, first identified in India, leading to the sudden rollback of reopenings in Europe.

Waning immunity debate

Yet it is these variants that boosters are in part designed to address—even before the drugmakers release newly tweaked versions of their vaccines that specifically target the new strains, as happens with the annual flu jab.

Thanks to Delta, countries such as Thailand and the UAE are already offering third doses to some people who have received full regimens of Sinovac, [hotlink]Sinopharm,[/hotlink] and AstraZeneca vaccines.

Even with Pfizer/BioNTech’s and Moderna’s more effective messenger-RNA (mRNA) vaccines, the manufacturers have been talking up the need for a booster.

The Delta variant has caused infection surges even in places that have high vaccination rates, notably Israel, whose vaccination campaign has leaned heavily on Pfizer/BioNTech. Pfizer interprets this as evidence of waning antibodies, and is now asking U.S. drug regulators to approve a booster that would be given as soon as six months after the initial vaccination—even though the data supporting its push comes from a study involving fewer than two dozen people.

“We are confident that such a boost will be highly effective against the Delta variant,” Pfizer research head Mikael Dolsten said last week.

But even in Israel, which has started giving third shots of the Pfizer/BioNTech vaccine to severely vulnerable people, officials are playing it cautiously. Ran Balicer, a top adviser to the health ministry, pointed out on July 12 that there is still no “clear evidence on waning immunity” and said “other potential explanations to some of the rising current cases” would need to be ruled out before deploying boosters more widely.

U.S. officials also want to see more evidence of the need for boosters before authorizing them, the New York Times reported on July 12.

“Based on the totality of the data they have to date, Pfizer and BioNTech believe that a third dose may be beneficial to maintain the highest levels of protection,” the companies said in a statement last week.

A Pfizer spokesperson added on July 13: “We are actively working with governments all around the world as well as global health partners to work towards fair and equitable access to COVID-19 vaccines while also providing our expertise and resources for novel approaches that can help to strengthen health care systems where greater support may be needed.”

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