透析患者新型冠狀病毒疾病（COVID-19）疫苗接種之現況與建議

COVID-19 Vaccination Recommendations for Dialysis Patients

吳勝文(Sheng-Wen Wu)

《腎臟與透析》 33卷3期 (2021/09) Pp. 144-147

https://doi.org/10.6340/KD.202109_33(3).0008

摘要

新型冠狀病毒有高傳染力及重症死亡率。洗腎患者因免疫功能低下，其罹病的風險及疾病嚴重度更會明顯增加。施打疫苗所產生的主動免疫，才能進一步降低患者重症及死亡率。目前少量的證據顯示，洗腎病人施打兩劑疫苗可以產生一定的anti-S immunoglobulin G（IgG）抗體濃度且副作用不會比正常人高。期待每一種疫苗在洗腎病人上有更多的臨床證據，提供我們規劃最佳的疫苗施打策略。最後強調，疫苗不是萬靈丹，提醒大家即使完整接種完疫苗後，個人保護一樣不能少。

關鍵字

新型冠狀病毒 ； 洗腎 ； 疫苗 ； 死亡率

並列摘要

New coronavirus disease (COVID-19) is an infectious disease caused by a newly discovered coronavirus (severe acute respiratory syndrome coronavirus-2, SARS-CoV-2). Patients with chronic kidney disease or dialysis-dependence are more likely to develop serious illnesses. In addition to the practice of social distancing and mask-wearing, urgent access to safe and effective vaccines is critical to stop the COVID-19 pandemic. Until now, mRNA vaccine (Pfizer and Moderna Company) and Adenovirus-based vaccine (AstraZeneca and Johnson & Johnson Company) were proved effective and safe vaccines in the general population, but there are limitations to the data on dialysis patients. The serum anti-SARS-CoV-2 S antibody responsiveness was relatively low in dialysis patients. Furthermore, dialysis patients have lower serum neutralizing anti-SARS-CoV-2 S antibody levelsthan general populations, but the antibody level could increase robustly after the second dose of vaccination. In consideration of the high mortality rate in dialysis patients with COVID-19, although vaccination is encouraged, further research should be conducted to clarify the optimal vaccination programs. Even after everyone has been fully vaccinated, strict adherence to preventive measures is still important to avoid breakthrough infection.

並列關鍵字

SARS-CoV-2 ； dialysis ； vaccine ； mortality