COVID-19 疫苗：了解事实
想了解有关 COVID-19 疫苗的事实吗？以下是您需要了解的各种疫苗和接种疫苗的益处。
来自妙佑医疗国际员工
随着 2019 冠状病毒病（COVID-19）持续引发疾病，您可能会对 COVID-19 疫苗产生疑问。了解不同类型的 COVID-19 疫苗及其作用机制、潜在副作用，以及对您和家人的益处。
COVID-19 疫苗接种的好处
接种 COVID-19 疫苗有何益处？
及时接种最新 COVID-19 疫苗可以：
- 帮助预防儿童和成人因 COVID-19 导致的重症和死亡。
- 帮助避免因 COVID-19 而需要前往医院就诊。
- 增强身体的防护能力（也称为免疫力），防止感染导致 COVID-19 的病毒。
- 与感染导致 COVID-19 的病毒相比，这是一种更安全的自我保护方式。
COVID-19 疫苗的保护程度取决于不同的因素。可影响疫苗保护程度的因素包括：年龄、既往是否曾患 COVID-19 或是否有癌症等医疗状况。
COVID-19 疫苗的保护效果还取决于引起 COVID-19 的病毒如何变化，以及疫苗能预防哪些变异株。您的受保护程度还取决于时间，例如您接种疫苗的时间。
请向医疗护理团队咨询如何才能及时接种最新版的 COVID-19 疫苗。
如果我已感染过 COVID-19，我是否还应接种 COVID-19 疫苗？
是。在您感染过 COVID-19 之后，接种疫苗可以增强您身体抵抗力，防止再次感染导致 COVID-19 的病毒。
感染过 COVID-19 或接种 COVID-19 疫苗可提供保护，也称为免疫力，使您不会再次感染导致 COVID-19 的病毒。但随着时间的推移，这种保护作用会逐渐减弱。再次感染 COVID-19 可能会导致严重疾病或医疗并发症，尤其是对于存在 COVID-19 重症风险因素的患者。
研究人员仍在继续研究第二次感染 COVID-19 时会出现的情况。再次感染通常比第一次感染症状轻微。但仍有可能发展为重症。但有些人可能会发现，每感染一次 COVID-19，他们就不得不去医院就诊，且出现糖尿病等医疗问题的风险也会随之增加。
研究发现，感染过 COVID-19 且接种了所有建议的 COVID-19 疫苗的人群，因 COVID-19 而住院治疗的可能性低于未接种疫苗或未接种所有建议剂次的人群。这种保护作用会在接种疫苗后的几个月内逐渐减弱。
此外，由于导致 COVID-19 的病毒会发生变化，也称为变异，因此接种正在传播或预计会传播的最新毒株或变异株的疫苗有助于防止再次患病。
COVID-19 疫苗的安全性和副作用
哪些 COVID-19 疫苗已获得授权或批准？
在美国境内可接种以下 COVID-19 疫苗：
- 2023-2024 年度辉瑞－生物科技 COVID-19 疫苗，可用于 6 月龄及以上人群。
- 2023-2024 年度莫德纳 COVID-19 疫苗，可用于 6 月龄及以上人群。
- 2023-2024 年度诺瓦瓦克斯 COVID-19 疫苗，可用于 12 岁及以上人群。
通常而言，具有典型免疫系统的 5 岁及以上人群可以接种适用其年龄段的任何经批准或许可的疫苗，而且通常不需要每次都接种同一款疫苗。
有些人群则应该在所有疫苗剂次接种同一疫苗制造商生产的疫苗，包括：
- 6 月龄至 4 岁儿童。
- 免疫系统功能低下的 5 岁及以上人群。
- 已接种过一剂诺瓦瓦克斯疫苗的 12 岁及以上人群应在两剂次中接种第二剂诺瓦瓦克斯疫苗。
如果您对自己或孩子接种的疫苗有任何疑问，请咨询医疗护理专业人员。如果出现以下情况，医疗护理团队可以为您提供帮助：
- 您或您孩子之前接种的疫苗已断货。
- 您不知道自己或孩子接种了哪种疫苗。
- 您或您的孩子开始接种多剂次疫苗，但由于副作用而无法完成全程接种。
COVID-19 疫情暴发伊始，对 COVID-19 疫苗的需要迫在眉睫。但是美国食品药品管理局（FDA）的疫苗审批过程可能需要数年时间。
FDA 基于比通常要求更少的数据，为 COVID-19 疫苗授予紧急使用许可。不过，相关数据仍然必须证明这些疫苗安全有效。
2022 年 8 月，FDA 向莫德纳和辉瑞－生物科技的更新版 COVID-19 疫苗授予许可。这两种疫苗目前均可预防导致 COVID-19 的原始病毒株和奥密克戎变异株。
2023 年 6 月，FDA 指示疫苗制造商更新 COVID-19 疫苗。这些疫苗经过更改，主要针对 XBB.1.5 这一导致 COVID-19 的病毒株。
2023 年 9 月和 10 月，FDA 分别向诺瓦瓦克斯、莫德纳和辉瑞－生物科技生产的更新版 2023-2024 年度 COVID-19 疫苗授予使用许可。
获得 FDA 紧急使用许可的疫苗包括：
2023-2024 年度辉瑞－生物科技 COVID-19 疫苗。这款疫苗首先针对 COVID-19 的原始病毒株进行了测试。该病毒株在 2019 年末开始传播。2020 年 12 月，研究发现辉瑞－生物科技 COVID-19 两剂次疫苗在 18 岁及以上人群预防 COVID-19 感染方面性能安全，且有效性为 91% 至 95%。这些数据有助于预测疫苗对年轻人群的防护作用。有效性因年龄而异。
辉瑞－生物科技疫苗已获批用于 12 岁及以上人群，其商品名为 Comirnaty。该疫苗已获得许可，可用于 6 月龄至 11 岁人群。该疫苗系列的接种剂数取决于个人的年龄和 COVID-19 疫苗接种史。
2023-2024 年度莫德纳 COVID-19 疫苗。该疫苗同样首先针对导致 COVID-19 的原始病毒株进行了测试。2020 年 12 月，研究发现莫德纳 COVID-19 疫苗在预防研究志愿者（均为 18 岁或以上）感染方面既安全又有效，有效性约为 93%。
根据莫德纳 COVID-19 疫苗组与安慰剂组中 COVID-19 人群的比较，该疫苗在预防 COVID-19 重症方面的有效性为 98%。此外还根据临床试验数据预测了该疫苗对年轻人群的防护作用。
该疫苗已获批用于 12 岁及以上人群，其商品名为 Spikevax。该疫苗已获得许可，可用于 6 月龄至 11 岁人群。接种剂数取决于个人的年龄和 COVID-19 疫苗接种史。
- 2023-2024 年度诺瓦瓦克斯 COVID-19 含佐剂疫苗。该疫苗目前已获得用于 12 岁及以上人群的紧急使用许可。该疫苗需接种两剂，间隔 3 周至 8 周。在德尔塔和奥密克戎变异株传播之前完成的研究表明，该疫苗预防 COVID-19 轻症、中症和重症的有效性为 90%。对于 65 岁及以上的人群，该疫苗的有效性为 79%。
COVID-19 疫苗如何发挥作用？
辉瑞－生物科技和莫德纳的 COVID-19 疫苗均使用基因工程信使 RNA（mRNA）。冠状病毒表面有一种名为 S 蛋白的刺突状结构。COVID-19 mRNA 疫苗可为细胞提供制造无害 S 蛋白片段的指令。
接种疫苗后，您的肌肉细胞开始制造 S 蛋白片段，并将其显示在细胞表面。免疫系统可以识别出这种蛋白质，并开始建立免疫反应和产生抗体。传递指令后，mRNA 会立即分解。其绝对不会进入保存 DNA 的细胞核中。
诺瓦瓦克斯 COVID-19 佐剂疫苗是一种蛋白亚单位疫苗。这一类疫苗仅包括最能刺激免疫系统的病毒部分（蛋白质）。诺瓦瓦克斯的 COVID-19 疫苗含有无害的 S 蛋白。该疫苗中还含有一种被称为佐剂的成分，有助于提高免疫系统的反应能力。
一旦免疫系统识别出 S 蛋白，该疫苗就会产生抗体和防御性白细胞。如果您之后感染了 COVID-19 病毒，这些抗体将对抗病毒。
蛋白亚基 COVID-19 疫苗不使用任何活病毒，不会导致感染 COVID-19 病毒。蛋白片段也不会进入保存 DNA 的细胞核中。
COVID-19 疫苗会让您感染 COVID-19 吗？
否。目前在美国研发和使用的 COVID-19 疫苗并未使用会导致 COVID-19 的活病毒。正因如此，COVID-19 疫苗不会导致您感染 COVID-19 或排出任何疫苗成分。
接种 COVID-19 疫苗后，身体需要几周时间才能产生免疫力。因此，在接种疫苗之前或之后的短时间内，您有可能感染导致 COVID-19 的病毒。
COVID-19 疫苗可能存在哪些一般副作用？
许多人在接种 COVID-19 疫苗后不会出现副作用。大多数副作用会在几天内消失。接种第一剂或第二剂 COVID-19 疫苗可能会引起轻微的副作用，包括：
- 注射部位疼痛、发红或肿胀。
- 发热。
- 疲劳。
- 头痛。
- 肌肉疼痛。
- 寒战。
- 关节疼痛。
- 恶心和呕吐。
- 感觉不适。
- 淋巴结肿大。
6 月龄到 3 岁的宝宝在接种疫苗后也可能会哭闹、困倦或食欲不振。这个年龄段的儿童也可能出现成人常见的副作用，症状包括注射部位疼痛、发红或肿胀，发烧或淋巴结肿大。
医疗护理团队会在您接种 COVID-19 疫苗后进行 15 分钟的观察，看看您是否出现过敏反应。
如果接种 24 小时后接种部位的发红或压痛症状加重，或者您担心有任何副作用，请联系医疗护理专业人员。
COVID-19 疫苗是否有什么长期副作用？
帮助预防 COVID-19 的疫苗均安全有效。这些疫苗已在临床试验中进行了测试。即使在美国已经接种了超过 6.5 亿剂疫苗后，在民众中监测到的副作用仍然较为罕见。
几天后仍未消失的副作用可视为长期副作用。疫苗很少引起任何长期副作用。
如果您担心副作用，可以查阅已向“美国疫苗不良事件报告系统”国家项目报备的 COVID-19 疫苗的相关安全数据。该数据向公众开放。CDC 还开发了 v-safe，这是一款基于智能手机的工具，用户可以通过该工具来报告 COVID-19 疫苗的副作用。
如果您对自己的症状有其他问题或疑虑，请咨询医疗护理专业人员。
COVID-19 疫苗可能会影响心脏吗？
在部分接种者中，COVID-19 疫苗可导致心肌炎和心包炎等心脏并发症。心肌炎是指心肌发生肿胀（也称为发炎）。心包炎是指心外膜发生肿胀（也称为发炎）。
接种 COVID-19 疫苗后发生心肌炎或心包炎的风险较低。在接种三款可用 COVID-19 疫苗中的任何一款后均有报告这两种医疗状况。大多数报告病例为 12 岁至 39 岁的男性。
如果您或您的孩子在接种 COVID-19 疫苗后出现心肌炎或心包炎，请在接种另一剂疫苗之前咨询医疗护理专业人员。
在患心肌炎或心包炎的报告病例中，更多是在接种第二剂 COVID-19 疫苗后患病，且通常发生在接种 COVID-19 疫苗后的一周内。大多数接受治疗的患者在用药和休息后感觉好转。
需要格外留意的症状包括：
- 胸部疼痛。
- 气短。
- 感觉心脏快速跳动、扑动或剧烈跳动。
如果您或您的孩子在接种 COVID-19 疫苗后的一周内出现以下任何症状，请就医。
COVID-19 疫苗接种前须知
COVID-19 疫苗是免费的吗？
在美国，接种 COVID-19 疫苗或许可以通过保险承保而免除费用。保险不负担疫苗费用或没有健康保险者，也有其他方案可供选择。未满 18 岁者可通过 Vaccines for Children 项目免费接种疫苗。成人可以通过临时的 Bridges to Access 项目免费接种 COVID-19 疫苗，预计于 2024 年 12 月结束。
如果我已有其他健康问题，可以接种 COVID-19 疫苗吗？
可以，对于已存在健康问题的人群，包括患有出现 COVID-19 重症风险更高的健康问题的人群，COVID-19 疫苗是安全的。
如果您属于中度或重度免疫系统功能低下的人群，医疗护理团队可能会建议增加 COVID-19 疫苗的剂次。如果您对何时接种 COVID-19 疫苗有任何疑问，请咨询医疗护理团队。
接种 2019 冠状病毒病（COVID-19）疫苗前后是否可以服用非处方止痛药？
请勿在接种 COVID-19 疫苗前为了预防可能的不适而服药。尚不清楚这些药物可能对疫苗有效性产生什么影响。不过，只要没有其他医学原因禁止您服用这类药物，您在接种 COVID-19 疫苗后可以使用。
过敏反应和 COVID-19 疫苗
2019 冠状病毒病（COVID-19）疫苗过敏反应的体征有哪些？
如果在接种 COVID-19 疫苗后四个小时内出现以下症状，则表示可能是出现速发型过敏反应：
如果出现任何过敏反应体征，请立即寻求帮助。将您出现的反应告知医疗护理专业人员，即使这种反应已自行消失或您没有接受急救护理。这种反应可能意味着您对疫苗过敏。您可能无法再接种同一疫苗的第二剂。不过，您在第二剂时或许可以接种其他疫苗。
如果我有过敏反应史，可以接种 COVID-19 疫苗吗？
如果您有严重过敏反应史但与疫苗或注射药物无关，仍可接种 COVID-19 疫苗。接种疫苗后，通常需要留观 30 分钟。
如果您曾对其他疫苗或注射药物出现速发型过敏反应，请咨询医疗护理专业人员您是否应该接种 COVID-19 疫苗。如果您曾对某种 COVID-19 疫苗中的任何成分出现过速发型或重度过敏反应，CDC 建议您不要接种该种疫苗。
如果您在接种首剂 COVID-19 疫苗后出现速发型或重度过敏反应，请勿接种第二剂。不过，您在第二剂时或许可以接种其他疫苗。
COVID-19 疫苗对怀孕、母乳喂养和生育能力的影响
孕期或哺乳期女性能接种 COVID-19 疫苗吗？
如果您处于妊娠期或哺乳期，CDC 建议您接种 COVID-19 疫苗。接种 COVID-19 疫苗可以防止 COVID-19 引发重症。疫苗接种还能帮助孕妇产生抗体，从而保护其婴儿。
接种 COVID-19 疫苗不会导致 COVID-19 病毒感染，对孕妇或胎儿而言也是如此。所有 COVID-19 疫苗均不含导致 COVID-19 的活病毒。
儿童和 COVID-19 疫苗
既然儿童感染 COVID-19 后极少出现严重疾病，为什么他们还需要接种 COVID-19 疫苗呢？
虽然很少见，但一些儿童在感染 COVID-19 病毒后，可能会患上 COVID-19 重症。
COVID-19 疫苗可防止孩子感染和传播导致 COVID-19 的病毒。此外还可防止孩子因感染 COVID-19 病毒发展为重症或不得不住院治疗。
接种 COVID-19 疫苗后
接种 COVID-19 疫苗后，我可以停止采取安全防护措施吗？
如果您在符合条件的情况下接种了所有建议接种的 COVID-19 疫苗，即视为您已接种最新疫苗。
如果之前您由于所在地区有大量 COVID-19 患者而无法进行某些活动，接种疫苗后可以更安全地恢复这些活动。但如果您所在地区有大量 COVID-19 住院病例，CDC 建议在室内公共场合佩戴合适的口罩，无论您是否已接种疫苗。
如果您的免疫系统功能低下或患重症的风险较高，当您所在地区有大量 COVID-19 住院病例时，请佩戴最具防护性的口罩。对于其他时间是否应该佩戴口罩，请咨询医疗护理专业人员。
CDC 建议在往返美国或美国境内的飞机、公共汽车、火车和其他公共交通上，以及在机场和火车站等地，都佩戴口罩。
如果您已接种所有建议的疫苗剂次，并与 COVID-19 病毒感染者有过密切接触，请在接触后至少 5 天再进行检测。
接种疫苗后，我还会感染 COVID-19 吗？
接种 COVID-19 疫苗可保护大多数人免于感染 COVID-19。但即使及时接种最新疫苗，也有部分人群会感染 COVID-19。这类感染被称为疫苗突破性感染。
疫苗突破性感染病例可将 COVID-19 传播给他人。然而，与未接种疫苗的人群相比，及时接种最新疫苗但出现突破性感染的人群进展为 COVID-19 重症的可能性较低。即使接种疫苗者出现症状，症状往往也比未接种疫苗者轻。
医学博士 Andrew Badley（妙佑医疗国际 COVID-19 研究工作组主管）：这些疫苗的安全性已得到广泛研究。目前共计已对大约 75,000 名患者进行测试接种，不良反应的发生率非常非常低。
这些疫苗的研发过程走的是快速审查通道，但快速审查仅限于文件工作；例如行政审批、融资时间，这些走的都是快速审查通道。因为这些疫苗是如此重要，所以招募患者的进度极快。与任何疫苗试验一样，这些试验也有详尽的随访记录。我们现在针对接种疫苗或接受安慰剂的患者累积了数月的随访数据。我们还比较了接种疫苗和接受安慰剂的患者之间的副作用发生率，结果显示除注射部位反应以外，两组之间的副作用发生率并无不同。
这些疫苗的副作用非常轻微。其中一些副作用很常见，包括注射部位反应、发热、寒战以及疼痛。极少数患者可能对疫苗出现过敏反应，主要是有既往过敏反应史的患者。据我们所知，到目前为止，过敏反应的病例数极少。
Nov. 03, 2023
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