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。1062Please respect copyright.PENANA2dv1Qyb9tC
1062Please respect copyright.PENANAMgCGWLW9YO
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。1062Please respect copyright.PENANAnkwDb8o0td
1062Please respect copyright.PENANAiRzPhbeZ1S
(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。1062Please respect copyright.PENANAJSBjRR6C1V
1062Please respect copyright.PENANAZc7IVvOmAc
1062Please respect copyright.PENANAiMVq0ZkWzy
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。1062Please respect copyright.PENANAhxbYVUO2X1
1062Please respect copyright.PENANAQpB17IITNe
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。1062Please respect copyright.PENANACFjCBQl8kS
1062Please respect copyright.PENANAdNqpdkKoSb
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。1062Please respect copyright.PENANA0mkQWGmIfS
1062Please respect copyright.PENANAu5V9aqA9fa
1062Please respect copyright.PENANA0djIkp1Fmx
(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。1062Please respect copyright.PENANAiswUnzTIml
1062Please respect copyright.PENANA4o7PMITsCB
1062Please respect copyright.PENANACZnyn5XUUR
疫苗主要功用有三,學界現時的研究相對上側重在第一點。1062Please respect copyright.PENANAFfkeGhJWcH
1062Please respect copyright.PENANAN9ghJg8L3Z
一:抗體能夠阻礙病毒進入人體細胞。1062Please respect copyright.PENANAMAfs6p0L8v
1062Please respect copyright.PENANAYoPzAGZfmZ
二:抗體能夠標記病毒,1062Please respect copyright.PENANAoYUlPzZ90G
指示其他免疫細胞前來消滅病毒。1062Please respect copyright.PENANA42H7jizymN
1062Please respect copyright.PENANAwPs1tcwm9I
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。1062Please respect copyright.PENANAS0tIVm2746
1062Please respect copyright.PENANAPpsmSbTMIR
(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。1062Please respect copyright.PENANAolv39uAA4n
1062Please respect copyright.PENANAudcFegUtLc
1062Please respect copyright.PENANAijaFe0U4VB
1062Please respect copyright.PENANAnsVAuSeQZd
不能夠阻礙病毒進入細胞的抗體,學界則稱之為Non-Neutralization Antibody。1062Please respect copyright.PENANASpYzOlz4O7
1062Please respect copyright.PENANA3t4k1jGSfw
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。1062Please respect copyright.PENANArNy7PhjXc7
1062Please respect copyright.PENANAXBIjMVYeAd
(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。1062Please respect copyright.PENANAsJwI17yR29
1062Please respect copyright.PENANA7QeSjipRpJ
1062Please respect copyright.PENANAdhCM3P8Rrz
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。1062Please respect copyright.PENANAbP9Wpe8bG9
1062Please respect copyright.PENANAphC621igDz
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。1062Please respect copyright.PENANANfDUDTlg6K
1062Please respect copyright.PENANAFX52W4uz2V
(圖5)滅活病毒疫苗有較大成數會產生Non-Neutralization Antibody,那又如何呢?1062Please respect copyright.PENANAgo1zx4GuaT
1062Please respect copyright.PENANATiOk8l4FqK
1062Please respect copyright.PENANAIoEbftgF2l
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。1062Please respect copyright.PENANAzndbSIIaiO
80%的兒童注射後出現嚴重呼吸症狀,2名兒童死亡。1062Please respect copyright.PENANA4PYeaCYGws
1062Please respect copyright.PENANAE33rmCeSI4
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。1062Please respect copyright.PENANAVgQ7b2FUXf
1062Please respect copyright.PENANAfZKLs6ZXMR
1062Please respect copyright.PENANAX4qlUoj7o8
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。1062Please respect copyright.PENANAUv9Ac1KgkI
1062Please respect copyright.PENANAz0cQ5FOLyn
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。1062Please respect copyright.PENANAgNF4jephd1
1062Please respect copyright.PENANAfFrZBhxK5P
那時候已有超過830,000兒童注射疫苗,震驚四方。1062Please respect copyright.PENANAnuh0D7CdQn
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。1062Please respect copyright.PENANAtTZaGdrtSx
1062Please respect copyright.PENANAA8hv1bZj1s
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?1062Please respect copyright.PENANAxpV1Q82KHJ
1062Please respect copyright.PENANARFjugk35TA
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。1062Please respect copyright.PENANAe5iWNP2Xmf
1062Please respect copyright.PENANA5zhssAM1zr
現時學界共識是,Neutralization Antibody :Non-Neutralization Antibody比例越高的話,1062Please respect copyright.PENANAVE4J4tBSfo
ADE產生的機率便越低。1062Please respect copyright.PENANAWE7kfzswKs
但非常遺憾的是,亦有個別例子Neutralization Antibody 會引發ADE症狀。1062Please respect copyright.PENANAE0Y6KSyVJQ
1062Please respect copyright.PENANAJ542xw6YNM
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,1062Please respect copyright.PENANAqxNhR2ndBs
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。1062Please respect copyright.PENANACucvMlmFI4
1062Please respect copyright.PENANANSZCfA8CAk
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。1062Please respect copyright.PENANAsuawobc4u2
1062Please respect copyright.PENANAW4FZO651Ot
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。1062Please respect copyright.PENANAMbnHZWbdCx
較好的ADE情況,將為注射疫苗後更大機會染上武漢肺炎。1062Please respect copyright.PENANAsMeOS6fPV1
1062Please respect copyright.PENANAZILNm5k5zz
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。1062Please respect copyright.PENANAFHrgsORsKG
1062Please respect copyright.PENANALWki4STwEG
ADE症狀延伸閱讀:https://lihkg.com/thread/2161912/page/11062Please respect copyright.PENANASkJMFwECqG
1062Please respect copyright.PENANAJHVQD7opjL
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。1062Please respect copyright.PENANAIMtcLxoeOK
1062Please respect copyright.PENANAlkEN89M3SN
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/toc1062Please respect copyright.PENANA2q0ES88F8U
1062Please respect copyright.PENANAHipvHpCwnc
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。1062Please respect copyright.PENANAPb0zfeHYHZ
1062Please respect copyright.PENANAEIaIOhMkbj
Link:1062Please respect copyright.PENANAkWmeprkPbr
https://www.penana.com/user/27349/%E8%96%AF%E4%BB%94%E8%81%9E%E8%8C%B1%E8%8E%89/portfolio1062Please respect copyright.PENANAOFV6yl4HTu
1062Please respect copyright.PENANArajSMs7JSr
有興趣接收科學資訊的話,歡迎follow IG: potatopigtongue。1062Please respect copyright.PENANAqGDUaOVDUS
1062Please respect copyright.PENANAhP61Vp4Jku
https://www.instagram.com/potatopigtongue/1062Please respect copyright.PENANAPlfisrD6Q7
1062Please respect copyright.PENANApnhZ71tDlG
1062Please respect copyright.PENANAYLM2XTXvWU
Ref1:https://science.sciencemag.org/content/370/6522/12631062Please respect copyright.PENANAJqNYPqohTn
Ref2:https://www.nature.com/articles/nm0109-%20%20211062Please respect copyright.PENANAuCTLgtnAzN
Ref3:https://jvi.asm.org/content/jvi/94/17/e01083-20.full.pdf1062Please respect copyright.PENANApVzdUuTe0u
Ref4:https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(20)30843-4/fulltext1062Please respect copyright.PENANA7K2uVYXk1q
Ref5:https://www.sciencemag.org/news/2019/04/dengue-vaccine-fiasco-leads-criminal-charges-researcher-philippines1062Please respect copyright.PENANAmsVhDypM17