喊一嗓子: 猪流感来啦......

liver411

原帖由 liuxizh 于 2009-9-23 16:42 发表
盼411老师能解释一下上述几种病人为什么要打这种疫苗。

因爲孕婦，嬰兒死亡率高，6-25高發族群，慢性病患者合併症死亡多....

參考：
ACIP提出A型流感(H1N1)2009单价疫苗的使用指引



作者：Laurie Barclay, MD
出处：WebMD医学新闻

　　August 24, 2009 — 美国疾病控制与预防中心(CDC)的免疫实务谘商委员会(ACIP)提出新型A型流感(H1N1)病毒疫苗的使用指引。这些新的建议在线登载于8月21日的发病率与死亡率周报(Morbidity and Mortality Weekly Report)。
　　
　　CDC国家免疫与呼吸道疾病中心的Anne Schuchat医师等人写道，因为新的A型流感(H1N1)病毒持续在美国和全球引起疾病，防疫的努力主要聚焦在尽可能让更多建议接受施打的人能注射疫苗，且在疫苗上市后尽速施打。
　　
　　【H1N1疫苗使用】
　　Schuchat医师等人写道，因为疫苗来源增加，有其它类型对象也建议施打疫苗。这些建议试图提供疫苗计画且提供信息给照护者，协助进行计画与通知照护提供者及大众，粗估约有1.59亿人被建议优先施打A型流感(H1N1)2009单价疫苗。
　　
　　为了评估哪里些人应优先施打疫苗，ACIP在2009年7月29日回顾了流行病学资料与临床资料。ACIP也评估疫苗上市后的供应计画、以及之后6个月预期增加的疫苗使用量。预估到了2009年10月中，会有获得核准的H1N1疫苗上市。
　　
　　指引建议，一旦有了疫苗，就应开始努力施打。根据各州与当地状况，州与当地健康当局及疫苗提供者应决定管理和给予疫苗的决策。
　　
　　施打疫苗和提供健康照护时，应对以下声明和其它来自州和当地健康当局与CDC有关施打H1N1感染的信息有所警惕。CDC的流感网站与州和当地健康部门的网站都可提供更多信息。
　　
　　【ACIP的 H1N1疫苗建议】
　　ACIP的建议主要有以下三点：
　　* 首先，五类必须优先施打疫苗的族群包括孕妇、6个月以下婴儿的居家接触者或照护者(例如父母亲、兄弟姊妹和日间保母)、健康照护与紧急医疗服务人员、6个月至24岁的孩童与青年、25至64岁且因为其它医疗问题而有流感相关并发症高风险者。这些状况都会增加流感相关并发症风险，包括慢性肺部疾病，如气喘；高血压之外的心血管问题；肾脏、肝脏、认知、神经/神经肌肉、血液、或代谢异常(包括糖尿病)；药物或人类免疫不全病毒引起的免疫抑制等。
　　* 其次，如果一开始的疫苗供应无法满足需求，应在前述的优先组别(文中顺序并不代表优先序位)中建立优先顺序。应该优先施打疫苗的人，包括孕妇、6个月以下婴儿的居家接触者或照护者、直接与病患或感染物质接触的健康照护与紧急医疗服务人员、6个月至4岁的孩童、因为其它医疗问题而有流感相关并发症高风险的5 至18岁孩童与青少年 。
　　* 第三，当疫苗供应量增加时，其它符合此指引建议的成人应接受H1N1疫苗。
　　
　　此外，ACIP有关A型流感(H1N1)2009单价疫苗的其它建议如下：
　　* 预防H1N1所需的疫苗剂量尚未确认。疫苗不是储备给已经接受一剂但可能需要第二剂者，因为疫苗供应量会随著时间增加。（意指尽可能让更多人都至少先施打一剂）
　　* 预防季节性和H1N1病毒的不活化疫苗，可以皮下注射在不同部位。不过，ACIP并未建议同时给予季节性和H1N1病毒活性减毒疫苗。
　　* 所有人，包括65岁以上者，目前建议接受季节性流感疫苗者，应在疫苗上市后立即接种。有关2009至2010年季节性流感疫苗的建议之前已经公告。
　　
　　指引的作者表示，这些建议的主旨在于，尽可能尽快让更多人施打疫苗。ACIP将回顾新的流行病学资料与临床资料，之后视状况将这些建议进行改版。
　　
　　Morb Mortal Wkly Rep. 在线发表于2009年8月21日。

ACIP Issues Guidelines for Use of Influenza A (H1N1) 2009 Monovalent Vaccine

By Laurie Barclay, MD
Medscape Medical News

August 24, 2009 — The US Centers for Disease Control and Prevention's (CDC's) Advisory Committee on Immunization Practices (ACIP) has issued guidelines regarding the use of vaccine against infection with novel influenza A (H1N1) virus. The new recommendations were posted online August 21 in the Morbidity and Mortality Weekly Report.

"Because novel influenza A (H1N1) virus is continuing to cause illness in the United States and worldwide, the primary focus of vaccination efforts should be to vaccinate as many persons as possible in the recommended target groups as quickly as possible once vaccine becomes available," write Anne Schuchat, MD, and colleagues from the National Center for Immunization and Respiratory Diseases, CDC.

H1N1 Vaccine Use

"As vaccine availability increases, additional groups are recommended for vaccination.... These recommendations are intended to provide vaccination programs and providers with information to assist in planning and to alert providers and the public about target groups comprising an estimated 159 million persons who are recommended to be first to receive influenza A (H1N1) 2009 monovalent vaccine," write Dr. Schuchat and colleagues.

To assess which population groups should first be targeted for vaccination, the ACIP reviewed epidemiologic and clinical data on July 29, 2009. The ACIP also evaluated the projected supply likely to be available when the vaccine first becomes available, as well as the anticipated increase in vaccine availability during the following 6 months. By mid-October 2009, it is anticipated that licensed H1N1 vaccine will be available.

The guidelines recommend that vaccination efforts begin as soon as the vaccine is available. In accordance with state and local conditions, state and local health officials and vaccination providers should make decisions concerning vaccine administration and distribution.

Vaccination and healthcare providers should be vigilant about following announcements and other information forthcoming from state and local health departments and the CDC regarding vaccination against H1N1 virus infection. The CDC's influenza Web site and state and local health departments may provide additional information.

ACIP H1N1 Vaccine Recommendations

Key points of the ACIP recommendations include the following 3 items.

    * First, 5 general population groups that should be targeted as an initial focus of vaccination efforts are pregnant women, household contacts or caregivers for infants younger than 6 months (such as parents, siblings, and daycare providers), healthcare and emergency medical services personnel, children and young adults 6 months to 24 years of age, and persons aged 25 to 64 years who are at greater risk for influenza-related complications because of underlying medical conditions. These medical conditions increasing risk for influenza-related complications include chronic pulmonary conditions, including asthma; cardiovascular conditions except for hypertension; renal, hepatic, cognitive, neurologic/neuromuscular, hematologic, or metabolic disorders, including diabetes mellitus; and immunosuppression caused by medications or by human immunodeficiency virus.
    * Second, if initial vaccine availability is insufficient to meet demand, priority is established for a subset of persons within the initial target groups. These persons who are to receive priority for vaccination (order of target groups does not indicate priority) include pregnant women, household contacts or caregivers for infants younger than 6 months, healthcare and emergency medical services personnel in direct contact with patients or infectious material, children 6 months to 4 years of age, and children and adolescents aged 5 to 18 years who are at greater risk for influenza-related complications because of underlying medical conditions.
    * Third, as vaccine availability increases, other adult population groups should receive H1N1 vaccine in accordance with the guidelines recommendations.

In addition, ACIP made additional recommendations concerning the use of influenza A (H1N1) 2009 monovalent vaccine, as follows:

    * The number of doses of vaccine needed for immunization against H1N1 has not been determined. Vaccine should not be stockpiled for patients who already have received 1 dose but might require a second dose, because vaccine availability is expected to increase over time.
    * If different anatomic sites are used, inactivated vaccines against seasonal and H1N1 viruses may be administered simultaneously. However, ACIP does not recommend simultaneous administration of live, attenuated vaccines against seasonal and H1N1 virus.
    * All persons, including those older than 65 years of age, who are currently recommended for seasonal influenza vaccine should receive the seasonal vaccine as soon as it is available. Recommendations for use of the 2009 to 2010 seasonal influenza vaccine were previously published.

"The guiding principle of these recommendations is to vaccinate as many persons as possible as quickly as possible," the guidelines authors."ACIP will review new epidemiologic and clinical data as they become available and might revise these recommendations."

Morb Mortal Wkly Rep. Published online August 21, 2009.

心月照云溪

谢谢411老师的资料
学习了！

perfect3

411老师。现在国内不是想打就给打的。就是拿钱都买不到！我们这种三无人群不知要什麽时候！