{"id":77519,"date":"2025-04-29T00:14:44","date_gmt":"2025-04-28T22:14:44","guid":{"rendered":"https:\/\/www.infokuryr.cz\/n\/?p=77519"},"modified":"2025-04-28T15:51:17","modified_gmt":"2025-04-28T13:51:17","slug":"pouze-mirna-ochrana-bivalentni-vakciny-covid-19-selhavaji-u-starsich-lidi-rychleji-nez-se-ocekavalo","status":"publish","type":"post","link":"https:\/\/www.infokuryr.cz\/n\/2025\/04\/29\/pouze-mirna-ochrana-bivalentni-vakciny-covid-19-selhavaji-u-starsich-lidi-rychleji-nez-se-ocekavalo\/","title":{"rendered":"Pouze m\u00edrn\u00e1 ochrana: Bivalentn\u00ed vakc\u00edny COVID-19 selh\u00e1vaj\u00ed u star\u0161\u00edch lid\u00ed rychleji, ne\u017e se o\u010dek\u00e1valo"},"content":{"rendered":"
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D\u016fle\u017eit\u00e1 nov\u00e1 studie veden\u00e1 Dr. Ausendou Machadovou a kolegy z Instituto Nacional de Sa\u00fade Doutor Ricardo Jorge (Lisabon, Portugalsko) uv\u00e1d\u00ed pouze m\u00edrnou a v\u00fdrazn\u011b klesaj\u00edc\u00ed ochranu p\u0159ed hospitalizacemi a \u00famrt\u00edmi u star\u0161\u00edch lid\u00ed s bivalentn\u00edmi mRNA vakc\u00ednami COVID-19. Zji\u0161t\u011bn\u00ed publikovan\u00e1 v\u00a0<\/span>BMC Infectious Diseases<\/span><\/em>\u00a0(svazek 25, \u010dl\u00e1nek 590, 2025) vyvol\u00e1vaj\u00ed d\u016fle\u017eit\u00e9 ot\u00e1zky ohledn\u011b udr\u017eitelnosti a p\u0159edpoklad\u016f pl\u00e1nov\u00e1n\u00ed ve\u0159ejn\u00e9ho zdrav\u00ed, kter\u00e9 jsou z\u00e1kladem strategie posilov\u00e1n\u00ed mRNA pro star\u0161\u00ed lidi.<\/span><\/p>\n

Hypot\u00e9za a n\u00e1vrh studie<\/span><\/h3>\n

V\u00fdzkumn\u00edci p\u0159edpokl\u00e1dali, \u017ee bivalentn\u00ed mRNA vakc\u00edny COVID-19 by poskytly trvalou ochranu p\u0159ed z\u00e1va\u017en\u00fdm onemocn\u011bn\u00edm COVID-19 u lid\u00ed ve v\u011bku 65 let a star\u0161\u00edch. V r\u00e1mci n\u00e1rodn\u00ed kohortov\u00e9 studie t\u00fdm analyzoval elektronick\u00e1 zdravotn\u00ed data ze \u0161esti celost\u00e1tn\u00edch portugalsk\u00fdch datab\u00e1z\u00ed a sledoval 2 151 531 jedinc\u016f po dobu osmi m\u011bs\u00edc\u016f od z\u00e1\u0159\u00ed 2022 do kv\u011btna 2023. \u00da\u010dinnost vakc\u00edny (VE) byla hodnocena pomoc\u00ed \u010dasov\u011b z\u00e1visl\u00e9ho Coxova regresn\u00edho modelu upraven\u00e9ho o demografick\u00e9 a klinick\u00e9 faktory. VE byl m\u011b\u0159en v n\u011bkolika intervalech po vakcinaci.<\/span><\/p>\n

V\u00fdsledky<\/span><\/h3>\n

Studie zjistila, \u017ee u dosp\u011bl\u00fdch ve v\u011bku 65\u201379 let dos\u00e1hla VE proti hospitalizaci vrcholu 66,5 % kr\u00e1tce po o\u010dkov\u00e1n\u00ed, ale o \u0161est a\u017e osm m\u011bs\u00edc\u016f pozd\u011bji prudce klesla na 33,8 %. U osob ve v\u011bku 80 let a star\u0161\u00edch byla po\u010d\u00e1te\u010dn\u00ed VE proti hospitalizaci je\u0161t\u011b ni\u017e\u0161\u00ed, a to 46,9 %, a po 182 dnech klesla na 29,8 %. Podobn\u00e9 vzorce byly pozorov\u00e1ny u \u00famrt\u00ed souvisej\u00edc\u00edch s COVID-19: V mlad\u0161\u00ed kohort\u011b klesl VE po \u0161esti m\u011bs\u00edc\u00edch na 52,7 % a u nejstar\u0161\u00edch dosp\u011bl\u00fdch pouze na 39,3 %. Pozoruhodn\u00e9 je, \u017ee odhady VE z Portugalska byly podstatn\u011b ni\u017e\u0161\u00ed ne\u017e p\u0159edchoz\u00ed v\u00fdsledky z Izraele, seversk\u00fdch zem\u00ed a metaanal\u00fdzy, co\u017e nazna\u010duje, \u017ee region\u00e1ln\u00ed rozd\u00edly mohou b\u00fdt zp\u016fsobeny variantn\u00ed dynamikou (jako je vznik sublini\u00ed XBB) a ji\u017e existuj\u00edc\u00ed imunitou.<\/span><\/p>\n

Omezen\u00ed a kritick\u00e1 anal\u00fdza<\/span><\/h3>\n

P\u0159esto\u017ee byla studie rozs\u00e1hl\u00e1 a dob\u0159e strukturovan\u00e1, p\u0159etrv\u00e1vaj\u00ed v\u00fdznamn\u00e1 omezen\u00ed. Za prv\u00e9, \u00fadaje o skute\u010dn\u00e9m zdrav\u00ed nebyly shrom\u00e1\u017ed\u011bny pro v\u00fdzkumn\u00e9 \u00fa\u010dely, co\u017e zavedlo potenci\u00e1ln\u00ed nespr\u00e1vnou klasifikaci. Za druh\u00e9, nedostatek systematick\u00e9ho genotypov\u00e1n\u00ed variant b\u011bhem sledov\u00e1n\u00ed omezoval schopnost rozli\u0161it sl\u00e1bnouc\u00ed imunitu vakc\u00edny od imunitn\u00edho \u00faniku nov\u00fdch variant. Krom\u011b toho mo\u017en\u00e9 podhodnocen\u00ed d\u0159\u00edv\u011bj\u0161\u00edch infekc\u00ed SARS-CoV-2 mohlo zkreslit odhady VE sm\u011brem dol\u016f, pokud se omylem nebrala v \u00favahu p\u0159irozen\u00e1 imunita. Navzdory t\u011bmto probl\u00e9m\u016fm \u00fadaje uk\u00e1zaly jasn\u00fd a znepokojiv\u00fd vzorec rychl\u00e9ho poklesu imunity.<\/span><\/p>\n

Z\u00e1v\u011bry a d\u016fsledky<\/span><\/h3>\n

Auto\u0159i dosp\u011bli k z\u00e1v\u011bru, \u017ee ka\u017edoro\u010dn\u00ed posilova\u010de COVID-19 jsou pravd\u011bpodobn\u011b nezbytn\u00e9 k udr\u017een\u00ed ochrany u star\u0161\u00edch lid\u00ed. Znepokojiv\u00e9 zji\u0161t\u011bn\u00ed, \u017ee \u00fa\u010dinnost vakc\u00edny u star\u0161\u00edch lid\u00ed kles\u00e1 na p\u0159ibli\u017en\u011b 30\u201350 % b\u011bhem \u0161esti a\u017e osmi m\u011bs\u00edc\u016f, m\u00e1 v\u0161ak dalekos\u00e1hl\u00e9 d\u016fsledky.<\/span><\/p>\n

Pokud bivalentn\u00ed posilovac\u00ed vakcinace mRNA poskytuj\u00ed pouze skromnou, rychle klesaj\u00edc\u00ed ochranu \u2013 zejm\u00e9na proti vysoce imunitn\u011b vyh\u00fdbav\u00fdm variant\u00e1m, jako je XBB \u2013 ka\u017edoro\u010dn\u00ed posilovac\u00ed kampan\u011b by mohly dos\u00e1hnout pouze \u010d\u00e1ste\u010dn\u00e9ho sn\u00ed\u017een\u00ed rizika. Tv\u016frci politik, l\u00e9ka\u0159i a v\u00fdvoj\u00e1\u0159i vakc\u00edn proto mus\u00ed v\u00e1\u017en\u011b zv\u00e1\u017eit, zda lze budouc\u00ed vakc\u00edny vyrobit odoln\u011bj\u0161\u00ed, zda jsou dosta\u010duj\u00edc\u00ed varianty adapta\u010dn\u00edch strategi\u00ed a jak lze l\u00e9pe koordinovat na\u010dasov\u00e1n\u00ed o\u010dkov\u00e1n\u00ed, aby se zabr\u00e1nilo mezer\u00e1m v ochran\u011b b\u011bhem vrcholn\u00e9 sez\u00f3ny respira\u010dn\u00edch vir\u016f.<\/span><\/p>\n

Tato portugalsk\u00e1 studie p\u0159id\u00e1v\u00e1 k rostouc\u00edm mezin\u00e1rodn\u00edm d\u016fkaz\u016fm, \u017ee zat\u00edmco bivalentn\u00ed mRNA vakc\u00edny zlep\u0161uj\u00ed kr\u00e1tkodobou ochranu p\u0159ed z\u00e1va\u017en\u00fdm onemocn\u011bn\u00edm COVID-19, jejich p\u0159\u00ednos v pr\u016fb\u011bhu \u010dasu v\u00fdrazn\u011b kles\u00e1 a m\u00e1 v\u00fdznamn\u00e1 omezen\u00ed, zejm\u00e9na mezi nejzraniteln\u011bj\u0161\u00ed populac\u00ed.<\/span><\/p>\n

Vedouc\u00ed v\u00fdzkumn\u00edk \/ vy\u0161et\u0159ovatel<\/span><\/h3>\n

Ausenda Machado<\/span><\/strong>\u00a0, Departamento de Epidemiologia, Instituto Nacional de Sa\u00fade Doutor Ricardo Jorge, Lisabon; Centro de Investiga\u00e7\u00e3o em Sa\u00fade P\u00fablica, Universidade NOVA de Lisboa, Lisabon, Portugalsko; odpov\u00eddaj\u00edc\u00ed autor.<\/span><\/p>\n<\/div>\n<\/div>\n

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Zdroj<\/a><\/span><\/h3>\n

 <\/p>\n<\/div>\n<\/div>\n","protected":false},"excerpt":{"rendered":"

D\u016fle\u017eit\u00e1 nov\u00e1 studie veden\u00e1 Dr. Ausendou Machadovou a kolegy z Instituto Nacional de Sa\u00fade Doutor…<\/p>\n","protected":false},"author":2,"featured_media":77520,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":[],"categories":[7],"tags":[593,6069,839,651],"_links":{"self":[{"href":"https:\/\/www.infokuryr.cz\/n\/wp-json\/wp\/v2\/posts\/77519"}],"collection":[{"href":"https:\/\/www.infokuryr.cz\/n\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.infokuryr.cz\/n\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.infokuryr.cz\/n\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.infokuryr.cz\/n\/wp-json\/wp\/v2\/comments?post=77519"}],"version-history":[{"count":0,"href":"https:\/\/www.infokuryr.cz\/n\/wp-json\/wp\/v2\/posts\/77519\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.infokuryr.cz\/n\/wp-json\/wp\/v2\/media\/77520"}],"wp:attachment":[{"href":"https:\/\/www.infokuryr.cz\/n\/wp-json\/wp\/v2\/media?parent=77519"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.infokuryr.cz\/n\/wp-json\/wp\/v2\/categories?post=77519"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.infokuryr.cz\/n\/wp-json\/wp\/v2\/tags?post=77519"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}