{"id":78628,"date":"2025-05-13T00:14:30","date_gmt":"2025-05-12T22:14:30","guid":{"rendered":"https:\/\/www.infokuryr.cz\/n\/?p=78628"},"modified":"2025-05-12T12:14:42","modified_gmt":"2025-05-12T10:14:42","slug":"sokujici-zprava-posilovaci-davky-jsou-u-starsich-lidi-temer-neucinne-ockovaci-strategie-eu-pod-tlakem","status":"publish","type":"post","link":"https:\/\/www.infokuryr.cz\/n\/2025\/05\/13\/sokujici-zprava-posilovaci-davky-jsou-u-starsich-lidi-temer-neucinne-ockovaci-strategie-eu-pod-tlakem\/","title":{"rendered":"\u0160okuj\u00edc\u00ed zpr\u00e1va: Posilovac\u00ed d\u00e1vky jsou u star\u0161\u00edch lid\u00ed t\u00e9m\u011b\u0159 ne\u00fa\u010dinn\u00e9 \u2013 o\u010dkovac\u00ed strategie EU pod tlakem"},"content":{"rendered":"
<\/div>\n

\u0160okuj\u00edc\u00ed: Booster vakc\u00edna XBB.1.5 proti COVID-19 nevykazuje u star\u0161\u00edch dosp\u011bl\u00fdch t\u00e9m\u011b\u0159 \u017e\u00e1dnou \u00fa\u010dinnost \u2013 \u0160okuj\u00edc\u00ed v\u00fdsledky zpochyb\u0148uj\u00ed o\u010dkovac\u00ed strategii EU<\/span><\/strong><\/h4>\n

Rozs\u00e1hl\u00e1 mezin\u00e1rodn\u011b prov\u00e1d\u011bn\u00e1\u00a0<\/span>studie<\/span><\/a>\u00a0veden\u00e1 Jamesem Humphreysem ze spole\u010dnosti Epiconcept (Pa\u0159\u00ed\u017e) a koordinovan\u00e1 s\u00edt\u00ed VEBIS-EHR poskytla st\u0159\u00edzliv\u00e9 zhodnocen\u00ed \u00fa\u010dinnosti monovalentn\u00ed posiluj\u00edc\u00ed vakc\u00edny XBB.1.5 proti COVID-19 z roku 2023 v re\u00e1ln\u00e9m sv\u011bt\u011b. Studie proveden\u00e1 v \u0161esti evropsk\u00fdch zem\u00edch \u2013 Belgii, D\u00e1nsku, It\u00e1lii, Portugalsku, \u0160pan\u011blsku (Navarra) a \u0160v\u00e9dsku \u2013 a financovan\u00e1 Evropsk\u00fdm centrem pro prevenci a kontrolu nemoc\u00ed (ECDC), testovala \u00fast\u0159edn\u00ed hypot\u00e9zu, zda posiluj\u00edc\u00ed vakc\u00edna XBB.1.5 m\u016f\u017ee poskytnout ochranu p\u0159ed hospitalizacemi a \u00famrt\u00edmi souvisej\u00edc\u00edmi s COVID-19 b\u011bhem letn\u00ed vlny 2024, v n\u00ed\u017e dominovaly imunoinvazivn\u00ed podvarianty KP a JN.1.<\/span><\/p>\n

V\u011bdci s vyu\u017eit\u00edm retrospektivn\u00edho historick\u00e9ho kohortov\u00e9ho designu zalo\u017een\u00e9ho na harmonizovan\u00fdch elektronick\u00fdch zdravotn\u00edch z\u00e1znamech analyzovali data od v\u00edce ne\u017e 19 milion\u016f lid\u00ed ve v\u011bku 65 let a star\u0161\u00edch a sledovali v\u00fdvoj od \u010dervna do srpna 2024. \u00da\u010dinnost vakc\u00edny (VE) byla odhadnuta pomoc\u00ed Coxov\u00fdch regresn\u00edch model\u016f upraven\u00fdch podle v\u011bku, komorbidit, pohlav\u00ed a p\u0159edchoz\u00edch posilovac\u00edch o\u010dkov\u00e1n\u00ed. Sdru\u017een\u00e9 pom\u011bry rizik byly kombinov\u00e1ny pomoc\u00ed metaanal\u00fdzy s n\u00e1hodn\u00fdmi efekty.<\/span><\/p>\n

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

V\u00fdsledky jsou ohromuj\u00edc\u00ed \u2013 a znepokojiv\u00e9. U osob ve v\u011bku 65 a\u017e 79 let byla ochrana p\u0159ed hospitalizac\u00ed v\u00edce ne\u017e \u0161est m\u011bs\u00edc\u016f po o\u010dkov\u00e1n\u00ed pouze 13 % (95% interval spolehlivosti: -12 % a\u017e 33 %) a ochrana p\u0159ed \u00famrt\u00edm 39 % (95% interval spolehlivosti: -7 % a\u017e 65 %). Ve v\u011bkov\u00e9 skupin\u011b 80 let a star\u0161\u00edch klesla ochrana p\u0159ed hospitalizac\u00ed na pouh\u00fdch 7 % (95% interval spolehlivosti: -7 % a\u017e 19 %) a ochrana p\u0159ed \u00famrt\u00edm na pouh\u00e9 3 % (95% interval spolehlivosti: -23 % a\u017e 23 %).<\/span><\/p>\n

Je\u0161t\u011b znepokojiv\u011bj\u0161\u00ed je, \u017ee o\u010dkovan\u00e1 kohorta zaznamenala vy\u0161\u0161\u00ed absolutn\u00ed m\u00edru hospitalizac\u00ed a \u00famrt\u00ed ve srovn\u00e1n\u00ed s neo\u010dkovanou skupinou: 6,4 oproti 6,2 na 100 000 osobom\u011bs\u00edc\u016f (hospitalizace 65\u201379 let) a 2,1 oproti 0,9 na 100 000 osobom\u011bs\u00edc\u016f (\u00famrt\u00ed). Mezi osobami star\u0161\u00edmi 80 let byla m\u00edra hospitalizace ve o\u010dkovan\u00e9 skupin\u011b 24,9 oproti 21,9 a m\u00edra \u00famrtnosti 16,3 oproti 5,6 na 100 000 osobom\u011bs\u00edc\u016f.<\/span><\/p>\n

Tyto paradoxn\u00ed v\u00fdsledky nazna\u010duj\u00ed, \u017ee monovalentn\u00ed formulace XBB.1.5 je ve srovn\u00e1n\u00ed s nov\u011bj\u0161\u00edmi variantami omezena ve sv\u00e9 \u00fa\u010dinnosti, a to bu\u010f kv\u016fli zbytkov\u00e9mu zmatku, selek\u010dn\u00edmu zkreslen\u00ed nebo potenci\u00e1ln\u00edm biologick\u00fdm omezen\u00edm.<\/span><\/p>\n

P\u0159esto\u017ee o\u010dkovan\u00e1 populace zahrnovala v\u00edce jedinc\u016f s vysoce rizikov\u00fdmi komorbiditami (6,6 % vs. 2,1 %) a p\u0159edchoz\u00edmi posilovac\u00edmi o\u010dkov\u00e1n\u00edmi (92,7 % vs. 32,5 %), sm\u011br a rozsah rozd\u00edl\u016f v absolutn\u00edm riziku \u2013 zejm\u00e9na v \u00famrt\u00edch \u2013 je t\u011b\u017ek\u00e9 p\u0159ehl\u00e9dnout. Pozoruhodn\u00e1 byla i heterogenita mezi zem\u011bmi: nap\u0159\u00edklad v Belgii byl zji\u0161t\u011bn negativn\u00ed VE proti hospitalizac\u00edm.<\/span><\/p>\n

Pro v\u011bt\u0161inu d\u00edl\u010d\u00edch interval\u016f v prvn\u00edch 90 dnech po o\u010dkov\u00e1n\u00ed nebylo mo\u017en\u00e9 prov\u00e9st odhady z d\u016fvodu nedostate\u010dn\u00e9ho po\u010dtu p\u0159\u00edpad\u016f \u2013 to znamen\u00e1, \u017ee v t\u00e9to anal\u00fdze nelze stanovit kr\u00e1tkodobou ochranu po o\u010dkov\u00e1n\u00ed.<\/span><\/p>\n

Omezen\u00ed<\/span><\/strong><\/h3>\n

Auto\u0159i poukazuj\u00ed na n\u011bkolik metodologick\u00fdch omezen\u00ed. To zahrnuje p\u0159edev\u0161\u00edm mo\u017enost zbytkov\u00e9ho zkreslen\u00ed v d\u016fsledku nezaznamenan\u00fdch prom\u011bnn\u00fdch, jako jsou rozd\u00edly v chov\u00e1n\u00ed p\u0159i poskytov\u00e1n\u00ed l\u00e9ka\u0159sk\u00e9 pomoci nebo nezdokumentovan\u00e9 p\u0159edchoz\u00ed infekce. Zkreslen\u00ed v\u00fdb\u011bru v d\u016fsledku vy\u0161\u0161\u00ed k\u0159ehkosti o\u010dkovan\u00fdch jedinc\u016f mohlo podhodnotit VE \u2013 to v\u0161ak samo o sob\u011b nevysv\u011btluje v\u00fdznamn\u00e9 rozd\u00edly ve v\u00fdsledc\u00edch.<\/span><\/p>\n

Krom\u011b toho mohla b\u00fdt ovlivn\u011bna chybn\u00e1 klasifikace \u00fadaj\u016f o o\u010dkov\u00e1n\u00ed nebo \u00famrtnosti, zejm\u00e9na v Belgii (kde demografick\u00e9 \u00fadaje nebyly aktualizov\u00e1ny od \u010dervence 2024). Krom\u011b toho t\u00e9m\u011b\u0159 v\u0161echny o\u010dkovan\u00e9 osoby (99,8 %) ji\u017e podstoupily posilovac\u00ed d\u00e1vku p\u0159ed v\u00edce ne\u017e \u0161esti m\u011bs\u00edci, co\u017e v\u00fdznamn\u011b omezuje v\u00fdznamnost kr\u00e1tkodob\u00e9 veterin\u00e1rn\u00ed virov\u00e9 infekce. Antigenn\u00ed neshoda mezi vakcina\u010dn\u00edm kmenem (XBB.1.5) a cirkuluj\u00edc\u00edmi variantami (BA.2.86\/JN.1) mohla tak\u00e9 p\u0159isp\u011bt k \u00faniku z imunitn\u00edho syst\u00e9mu a sn\u00ed\u017een\u00ed \u00fa\u010dinnosti.<\/span><\/p>\n

Z\u00e1v\u011br a v\u00fdhled<\/span><\/strong><\/h3>\n

Tato komplexn\u00ed anal\u00fdza zalo\u017een\u00e1 na datech z elektronick\u00fdch zdravotn\u00edch z\u00e1znam\u016f (EHR) p\u0159edstavuje znepokojiv\u00fd obraz o v\u00fdkonu posilova\u010de XBB.1.5 b\u011bhem letn\u00ed vlny 2024 v EU. Vzhledem k tomu, \u017ee u star\u0161\u00edch lid\u00ed nebyla po v\u00edce ne\u017e \u0161esti m\u011bs\u00edc\u00edch po o\u010dkov\u00e1n\u00ed pozorov\u00e1na prakticky \u017e\u00e1dn\u00e1 m\u011b\u0159iteln\u00e1 ochrana p\u0159ed hospitalizac\u00ed nebo \u00famrt\u00edm, v\u00fdsledky posiluj\u00ed vol\u00e1n\u00ed po nov\u00e9 generaci vakc\u00edn proti COVID-19 \u2013 takov\u00fdch, kter\u00e9 budou antigenn\u011b l\u00e9pe shodn\u00e9 a d\u00e9le \u00fa\u010dinn\u00e9.<\/span><\/p>\n

Studie nav\u00edc nastoluje z\u00e1sadn\u00ed ot\u00e1zky ohledn\u011b u\u017eite\u010dnosti sez\u00f3nn\u00edch posiluj\u00edc\u00edch strategi\u00ed, kter\u00e9 dostate\u010dn\u011b nezohled\u0148uj\u00ed v\u00fdvoj nov\u00fdch variant ani klesaj\u00edc\u00ed imunitu.<\/span><\/p>\n

Evropsk\u00e9 zdravotnick\u00e9 org\u00e1ny by nyn\u00ed mohly muset p\u0159ehodnotit na\u010dasov\u00e1n\u00ed a slo\u017een\u00ed budouc\u00edch o\u010dkovac\u00edch kampan\u00ed \u2013 nap\u0159\u00edklad nab\u00eddkou posiluj\u00edc\u00edch d\u00e1vek na ja\u0159e pro rizikov\u00e9 skupiny nebo p\u0159echodem na \u0161ir\u0161\u00ed \u010di pan-sarbekovir\u00e1ln\u00ed vakc\u00edny.<\/span><\/p>\n

Tato zpr\u00e1va zd\u016fraz\u0148uje nal\u00e9havost transparentnosti a adaptace o\u010dkovac\u00ed politiky na z\u00e1klad\u011b d\u016fkaz\u016f \u2013 od teoretick\u00fdch modelov\u00fdch p\u0159edpoklad\u016f sm\u011brem k re\u00e1ln\u00fdm \u00fadaj\u016fm o \u00fa\u010dinnosti. Varovn\u00e9 sign\u00e1ly u\u017e nejsou nen\u00e1padn\u00e9. V\u00fdsledky si zaslou\u017e\u00ed odborn\u00e9 i politick\u00e9 p\u0159ehodnocen\u00ed.<\/span><\/p>\n

\u0158editel v\u00fdzkumu \/ \u0159e\u0161itel:<\/strong><\/span>
\nJames Humphreys, Epiconcept, Pa\u0159\u00ed\u017e, Francie<\/span>
\nBaltazar Nunes, Epiconcept, Pa\u0159\u00ed\u017e, Francie;<\/span>
\nEvropsk\u00fd program pro v\u00fdcvik v interven\u010dn\u00ed epidemiologii (EPIET),<\/span>
\nEvropsk\u00e9 centrum pro prevenci a kontrolu nemoc\u00ed, Stockholm, \u0160v\u00e9dsko<\/span><\/p>\n

V\u011bdci zapojen\u00ed do studie pracuj\u00ed pod n\u00e1zvem VEBIS-EHR Working Group.<\/span><\/p>\n

Zdroj:\u00a0<\/strong>MedRxiv<\/a><\/em><\/p>\n

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

\u0160okuj\u00edc\u00ed: Booster vakc\u00edna XBB.1.5 proti COVID-19 nevykazuje u star\u0161\u00edch dosp\u011bl\u00fdch t\u00e9m\u011b\u0159 \u017e\u00e1dnou \u00fa\u010dinnost \u2013 \u0160okuj\u00edc\u00ed…<\/p>\n","protected":false},"author":2,"featured_media":74269,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":[],"categories":[7],"tags":[41,940,213,8041,651],"_links":{"self":[{"href":"https:\/\/www.infokuryr.cz\/n\/wp-json\/wp\/v2\/posts\/78628"}],"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=78628"}],"version-history":[{"count":0,"href":"https:\/\/www.infokuryr.cz\/n\/wp-json\/wp\/v2\/posts\/78628\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.infokuryr.cz\/n\/wp-json\/wp\/v2\/media\/74269"}],"wp:attachment":[{"href":"https:\/\/www.infokuryr.cz\/n\/wp-json\/wp\/v2\/media?parent=78628"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.infokuryr.cz\/n\/wp-json\/wp\/v2\/categories?post=78628"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.infokuryr.cz\/n\/wp-json\/wp\/v2\/tags?post=78628"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}