香港政府發板決定購置輝瑞及科興武肺病毒疫苗,林鄭月蛾及一眾首長斷言會率先注射,以身展示疫苗的安全性。1071Please respect copyright.PENANAtF8FABZdbb
1071Please respect copyright.PENANALM2luqyhWz
本文章將綜合中國武肺疫苗的現況、簡介疫苗的理念,引據各方科學證據及歷史前例,對文章命題作一簡略探討。1071Please respect copyright.PENANA3LmTLFElVw
1071Please respect copyright.PENANAkXlqiedq79
(圖1)圖中為中國Phase疫苗3臨床研究的地域分佈概覽。依據官方說法,疫苗研發之時乃為中國武肺感染人數貧乏之時,為了探討疫苗效用,中國唯有選址國外將第三期臨床實驗,其人數及地域已詳列在圖中。1071Please respect copyright.PENANAtwD79EcisO
1071Please respect copyright.PENANAWXrVVL7yMt
1071Please respect copyright.PENANA8gzqd2ntul
中國現時進入Phase3臨床研究的疫苗公司共有3間,分別為國營CNBG、科興 Sinovac及康希諾Cansino。1071Please respect copyright.PENANALwKFcMhexN
1071Please respect copyright.PENANAV1xh2F1HHN
其中國營CNBG及科興 Sinovac生產的疫苗均為滅活病毒疫苗,而香港政府則已決定選購科興 Sinovac生產的滅活病毒疫苗,唯政府專家小組已公開向傳媒表明沒有提議政府選購中國疫苗。1071Please respect copyright.PENANAL7NC9GvCLB
1071Please respect copyright.PENANAl3eZxlutuC
除香港外,巴西政府在9月時份用上9千萬美金向科興 Sinovac購置4千6百萬枝滅活病毒疫苗,唯香港政府現時並沒有向外公開購置金額。1071Please respect copyright.PENANA7Uv75ZyP45
1071Please respect copyright.PENANA6ObE1qPB5G
1071Please respect copyright.PENANApi55IfgRuv
(圖2)注射武肺疫苗的主要目的,就是誘導身體產生對抗武肺病毒的抗體。1071Please respect copyright.PENANABn9cYS7pVp
1071Please respect copyright.PENANAxEpPGv4XpE
1071Please respect copyright.PENANAbTfWMCkzlT
疫苗主要功用有三,學界現時的研究相對上側重在第一點。1071Please respect copyright.PENANAXW3E2zrPo4
1071Please respect copyright.PENANAIjhwSBZlgZ
一:抗體能夠阻礙病毒進入人體細胞。1071Please respect copyright.PENANAXKuoZyezqH
1071Please respect copyright.PENANAavaFev6YJa
二:抗體能夠標記病毒,1071Please respect copyright.PENANAmLo5bhhN5c
指示其他免疫細胞前來消滅病毒。1071Please respect copyright.PENANANlKbguW5IH
1071Please respect copyright.PENANA6yQwzn1aGn
三:某情況下,抗體更能夠指示免疫細胞殺滅已受病毒感染的細胞。1071Please respect copyright.PENANA8DPerj3rQI
1071Please respect copyright.PENANAC3B94koLNR
(圖3)用二分法來界定抗體種類的話,能夠阻礙病毒進入細胞的抗體,學界稱之為Neutralization Antibody。1071Please respect copyright.PENANAJn6WGhVbVP
1071Please respect copyright.PENANAu0PbY79yvV
1071Please respect copyright.PENANAlsHj4WGkDa
1071Please respect copyright.PENANAbz4zlCfZfF
不能夠阻礙病毒進入細胞的抗體,學界則稱之為Non-Neutralization Antibody。1071Please respect copyright.PENANAfuP4R8iGTI
1071Please respect copyright.PENANAQiLFQtLGSk
換句話說,抗體並不是越多就越好,要有足夠多數量的Neutralization Antibody才能達到防疫功效。1071Please respect copyright.PENANAUbnck5OvmL
1071Please respect copyright.PENANAEkIQCy1zJR
(圖4)用上滅活病毒製作疫苗的話,人體產生的抗體會拼合在病毒不同位置之上。1071Please respect copyright.PENANAnSESSr7cpf
1071Please respect copyright.PENANAbk44lE59ob
1071Please respect copyright.PENANAXDagE2jq2A
若抗體並非拼合在S protein裡頭的關鍵位置上,產生的抗體有較大成數無法阻礙病毒進入細胞,亦即為Non-Neutralization Antibody。1071Please respect copyright.PENANAzIjIsuc3Yh
1071Please respect copyright.PENANAun0b5ra9cU
相反,其他主流疫苗用上不同方式在人體內表達武肺S protein,人體產生的抗體主力針對S protein,較大成數為Neutralization Antibody。1071Please respect copyright.PENANAYM0H2G6Hgb
1071Please respect copyright.PENANALoe5pKuZhU
(圖5)滅活病毒疫苗有較大成數會產生Non-Neutralization Antibody,那又如何呢?1071Please respect copyright.PENANAeBRXZtJFNn
1071Please respect copyright.PENANANpbqPm7ttz
1071Please respect copyright.PENANAb1WQkiD555
在1960年,美國利用滅活病毒製作人類呼吸道合胞病毒 (Respiratory syncytial virus)疫苗。1071Please respect copyright.PENANAdAxzyOcWZN
80%的兒童注射後出現嚴重呼吸症狀,2名兒童死亡。1071Please respect copyright.PENANARTeeUEkUZP
1071Please respect copyright.PENANAK49zRSIyIP
事後發現,滅活病毒所製作的疫苗所產生的Non-Neutralization Antibody數量對比Neutralization Antibody為多,因此出現名為ADE的症狀,引致注射疫苗的兒童比沒有注射的兒童更容易遭受病毒侵襲以及出現嚴症。1071Please respect copyright.PENANAuZ2SVB6V0n
1071Please respect copyright.PENANAWXWPj8Ci6h
1071Please respect copyright.PENANAOYYcmd4Llp
2016年,WHO世衛批准菲律賓為9歲以下的兒童注射以登革熱滅活病毒製作的Dengvaxia疫苗 ,認可其安全性。1071Please respect copyright.PENANA8uRH77ioeb
1071Please respect copyright.PENANAEnTXeMs49q
奈何,2017年疫苗公司發現疫苗會產生名為ADE的症狀,亦即會導致注射疫苗的人士更容易染上登革熱或出現嚴症,下令立即停止注射。1071Please respect copyright.PENANAzhpRf25yQt
1071Please respect copyright.PENANA5vnY7xVkuB
那時候已有超過830,000兒童注射疫苗,震驚四方。1071Please respect copyright.PENANAva3riad4R7
2018年9月,「官方」數字為130兒童因注射疫苗而死亡,其中19人體內發現登革熱病毒,引證ADE的存在。1071Please respect copyright.PENANAsuZWRgi7ai
1071Please respect copyright.PENANAVDrx6ZlBim
既然擁有1960年ADE的先例,何解50年後菲律賓會再度出現ADE慘劇呢?1071Please respect copyright.PENANAyzBxCzNW0g
1071Please respect copyright.PENANAzllUgN4FQB
其中之一的原因是,ADE無法在動物模型確實呈現,因此非常困難能夠預先作出探討。1071Please respect copyright.PENANA2kV8udSnPZ
1071Please respect copyright.PENANALwsusyNV7v
現時學界共識是,Neutralization Antibody :Non-Neutralization Antibody比例越高的話,1071Please respect copyright.PENANAfbRZhRhsjj
ADE產生的機率便越低。1071Please respect copyright.PENANAApMxj0uZF3
但非常遺憾的是,亦有個別例子Neutralization Antibody 會引發ADE症狀。1071Please respect copyright.PENANArUyNRIFFBH
1071Please respect copyright.PENANAfFao4DjJna
會否出現ADE症狀,只有依靠觀察人體臨床研究的結果才能得知,1071Please respect copyright.PENANAvdzQoHVNul
這亦是為何第一間踏入臨床第三期研究的Moderna其正式完整報告官方日期為2022年7月,到那時候才會有相對確實資料疫苗會否引起ADE症狀。1071Please respect copyright.PENANA2ivSztbHei
1071Please respect copyright.PENANANaLehwzUcf
現時Moderna/輝瑞Pfizer/牛津AstraZeneca的中期第三期報告,無一能夠對ADE的安全性作出探討。1071Please respect copyright.PENANAYW2IUpy4oa
1071Please respect copyright.PENANAE7MNnj8hqD
根據現時資料,最壞的ADE情況,將會是注射疫苗後的7-14日產生嚴重過敏免疫反應,肺部無法正常運作窒息而死。1071Please respect copyright.PENANAwo9afJvMXJ
較好的ADE情況,將為注射疫苗後更大機會染上武漢肺炎。1071Please respect copyright.PENANAMJoD67MTNx
1071Please respect copyright.PENANAlNzecD7S6m
在此,讓我們祝褔林鄭及三萬警察在注射疫苗後會出現ADE症狀,亦懇求麵神祝褔林鄭注射疫苗後不會出現ADE症狀。1071Please respect copyright.PENANACM4XC5wItL
1071Please respect copyright.PENANAhjXmKPWl8s
ADE症狀延伸閱讀:https://lihkg.com/thread/2161912/page/11071Please respect copyright.PENANAgdW2WO3tK8
1071Please respect copyright.PENANA2ZivHKS8Dx
如果想我快啲出文的話,請入去Penana網站科普專欄–薯不揀單俾一個like以及Bookmark,這對我非常之重要。1071Please respect copyright.PENANAdOHPw1fyKw
1071Please respect copyright.PENANAtcaLf3GMdB
Link: https://www.penana.com/story/66244/%E7%A7%91%E6%99%AE%E5%B0%88%E6%AC%84-%E8%96%AF%E4%B8%8D%E6%8F%80%E5%96%AE/toc1071Please respect copyright.PENANA3aVcMFLVQL
1071Please respect copyright.PENANAgEK067Qjzm
同時亦可以在Penana網站裡按「買一嚿/半嚿薯仔」,以課金的方式推動我繼續搜羅資料寫文,多謝。1071Please respect copyright.PENANA1g8Vpvvyjh
1071Please respect copyright.PENANA8l0YXBLcw7
Link:1071Please respect copyright.PENANAm1eOSxW5AQ
https://www.penana.com/user/27349/%E8%96%AF%E4%BB%94%E8%81%9E%E8%8C%B1%E8%8E%89/portfolio1071Please respect copyright.PENANAa6FgwtGvQF
1071Please respect copyright.PENANAPlk9K0HKlp
有興趣接收科學資訊的話,歡迎follow IG: potatopigtongue。1071Please respect copyright.PENANASX5vzBrSk3
1071Please respect copyright.PENANAVw87mXMLX8
https://www.instagram.com/potatopigtongue/1071Please respect copyright.PENANAhCPQpB2MY6
1071Please respect copyright.PENANAPSjdBRz8Gs
1071Please respect copyright.PENANAQudvj8Hztt
Ref1:https://science.sciencemag.org/content/370/6522/12631071Please respect copyright.PENANADtVLaK15uE
Ref2:https://www.nature.com/articles/nm0109-%20%20211071Please respect copyright.PENANAJiLpf59Sqi
Ref3:https://jvi.asm.org/content/jvi/94/17/e01083-20.full.pdf1071Please respect copyright.PENANAEDNc2b71gW
Ref4:https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(20)30843-4/fulltext1071Please respect copyright.PENANA0mlD3uqf1P
Ref5:https://www.sciencemag.org/news/2019/04/dengue-vaccine-fiasco-leads-criminal-charges-researcher-philippines1071Please respect copyright.PENANAmnXbCfXNF1