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。1051Please respect copyright.PENANAJl76ossCd9
1051Please respect copyright.PENANAa6qagz98As
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。1051Please respect copyright.PENANA3eq5UhsYcb
1051Please respect copyright.PENANAZCJWNpy22R
(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。1051Please respect copyright.PENANAjhZH5Ahdnx
1051Please respect copyright.PENANAJwJtxgs1Jf
1051Please respect copyright.PENANACQjyBlOLBN
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。1051Please respect copyright.PENANAltkheU6WOg
1051Please respect copyright.PENANAa0gwiLdLkh
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。1051Please respect copyright.PENANAJZ6VP8oLA8
1051Please respect copyright.PENANAqbvwC4IAbc
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。1051Please respect copyright.PENANAbuseyOc4zg
1051Please respect copyright.PENANAAUOpPFcdPN
1051Please respect copyright.PENANAMKpl24pjtC
(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。1051Please respect copyright.PENANAbffPmCDfCx
1051Please respect copyright.PENANADTFPQx8qyW
1051Please respect copyright.PENANAyKw1legQGe
疫苗主要功用有三,學界現時的研究相對上側重在第一點。1051Please respect copyright.PENANA16CdJRz7vx
1051Please respect copyright.PENANAkuePZSIgxk
一:抗體能夠阻礙病毒進入人體細胞。1051Please respect copyright.PENANAbcFC0fcn2g
1051Please respect copyright.PENANAZzriySRJRp
二:抗體能夠標記病毒,1051Please respect copyright.PENANApI73EsGVjP
指示其他免疫細胞前來消滅病毒。1051Please respect copyright.PENANAApJJUkd4pn
1051Please respect copyright.PENANAI6ExuQa5dn
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。1051Please respect copyright.PENANASxxW5MHN86
1051Please respect copyright.PENANAiWNuUeanc4
(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。1051Please respect copyright.PENANA4P1vZpAI33
1051Please respect copyright.PENANA1h1KkGKXRa
1051Please respect copyright.PENANAMq3tbn1W6Z
1051Please respect copyright.PENANAvUTk3Ncf0C
不能夠阻礙病毒進入細胞的抗體,學界則稱之為Non-Neutralization Antibody。1051Please respect copyright.PENANAyaKu6GJiZP
1051Please respect copyright.PENANAw37aBTNMfC
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。1051Please respect copyright.PENANAQv9kR4pXbV
1051Please respect copyright.PENANAPMXLRxslgh
(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。1051Please respect copyright.PENANApmU9tOm1hx
1051Please respect copyright.PENANASGlZroxVda
1051Please respect copyright.PENANAnDLYP7qaZy
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。1051Please respect copyright.PENANAReg8Ag0lxy
1051Please respect copyright.PENANAYifEBOtyKH
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。1051Please respect copyright.PENANAKpRQw1aCGO
1051Please respect copyright.PENANAqL7RSWGN11
(圖5)滅活病毒疫苗有較大成數會產生Non-Neutralization Antibody,那又如何呢?1051Please respect copyright.PENANAmKTpB0DcjS
1051Please respect copyright.PENANAi4qzRxcp8m
1051Please respect copyright.PENANAhsoE7nEQcz
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。1051Please respect copyright.PENANAG1v1qlZa22
80%的兒童注射後出現嚴重呼吸症狀,2名兒童死亡。1051Please respect copyright.PENANA0KYbWRk4ys
1051Please respect copyright.PENANAjkAEJ2iJgw
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。1051Please respect copyright.PENANAW7F5CD9yqs
1051Please respect copyright.PENANAd1UaivnWBj
1051Please respect copyright.PENANAHjWhY8RB3b
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。1051Please respect copyright.PENANAqZHTlBPPJP
1051Please respect copyright.PENANAGgv8Ayc6zt
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。1051Please respect copyright.PENANAJlfUO3yPw6
1051Please respect copyright.PENANA4uvPHLKzJl
那時候已有超過830,000兒童注射疫苗,震驚四方。1051Please respect copyright.PENANAcDvGMncN1g
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。1051Please respect copyright.PENANAqqBKotsbvr
1051Please respect copyright.PENANALzLl4gygVW
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?1051Please respect copyright.PENANAhQlv2bekfH
1051Please respect copyright.PENANAFGFf7q3AVp
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。1051Please respect copyright.PENANApM3Smh0Ivm
1051Please respect copyright.PENANA7LGVEZz0dN
現時學界共識是,Neutralization Antibody :Non-Neutralization Antibody比例越高的話,1051Please respect copyright.PENANA7McprJKegj
ADE產生的機率便越低。1051Please respect copyright.PENANAuo5iuSZoJV
但非常遺憾的是,亦有個別例子Neutralization Antibody 會引發ADE症狀。1051Please respect copyright.PENANA2ieqE1yYBR
1051Please respect copyright.PENANAcT3FwYDy3U
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,1051Please respect copyright.PENANAC1NhthtsFI
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。1051Please respect copyright.PENANAsRMNkKBjTz
1051Please respect copyright.PENANAVEypElwRcB
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。1051Please respect copyright.PENANAqoWva59o2i
1051Please respect copyright.PENANAplRqUzzETh
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。1051Please respect copyright.PENANAE9tcmJLumQ
較好的ADE情況,將為注射疫苗後更大機會染上武漢肺炎。1051Please respect copyright.PENANAvUhYNmGC1F
1051Please respect copyright.PENANAAagoIHH1CG
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。1051Please respect copyright.PENANA62bfXbnsF4
1051Please respect copyright.PENANAjB14lfRsVs
ADE症狀延伸閱讀:https://lihkg.com/thread/2161912/page/11051Please respect copyright.PENANAXvAQq3W1kI
1051Please respect copyright.PENANATdtOXhdkVe
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。1051Please respect copyright.PENANAaWS0CadMS1
1051Please respect copyright.PENANAt67HTTs0Qc
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/toc1051Please respect copyright.PENANA6758cWhGYI
1051Please respect copyright.PENANA0Ojtppw8YG
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。1051Please respect copyright.PENANAcSPulcS84A
1051Please respect copyright.PENANABCBSoKWpIq
Link:1051Please respect copyright.PENANASYIlZk5smR
https://www.penana.com/user/27349/%E8%96%AF%E4%BB%94%E8%81%9E%E8%8C%B1%E8%8E%89/portfolio1051Please respect copyright.PENANA4hlKuOaHSs
1051Please respect copyright.PENANAFN4m6hs7Qk
有興趣接收科學資訊的話,歡迎follow IG: potatopigtongue。1051Please respect copyright.PENANAgIKIzZd3br
1051Please respect copyright.PENANA5jpNUnDJ8F
https://www.instagram.com/potatopigtongue/1051Please respect copyright.PENANAOZpDAjcqsc
1051Please respect copyright.PENANAmiOl7EtHLS
1051Please respect copyright.PENANAOsnLFRU053
Ref1:https://science.sciencemag.org/content/370/6522/12631051Please respect copyright.PENANA6bZdbsKu6p
Ref2:https://www.nature.com/articles/nm0109-%20%20211051Please respect copyright.PENANAa4RX23fjM4
Ref3:https://jvi.asm.org/content/jvi/94/17/e01083-20.full.pdf1051Please respect copyright.PENANAmeqbZZD4ne
Ref4:https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(20)30843-4/fulltext1051Please respect copyright.PENANA1IhlKna2A9
Ref5:https://www.sciencemag.org/news/2019/04/dengue-vaccine-fiasco-leads-criminal-charges-researcher-philippines1051Please respect copyright.PENANAJhywyAAKkU