{"id":85554,"date":"2025-08-15T00:20:41","date_gmt":"2025-08-14T22:20:41","guid":{"rendered":"https:\/\/www.infokuryr.cz\/n\/?p=85554"},"modified":"2025-08-14T12:06:16","modified_gmt":"2025-08-14T10:06:16","slug":"velka-studie-ukazuje-temer-polovina-svedskych-zdravotniku-chybela-v-praci-po-ockovani-proti-covidu","status":"publish","type":"post","link":"https:\/\/www.infokuryr.cz\/n\/2025\/08\/15\/velka-studie-ukazuje-temer-polovina-svedskych-zdravotniku-chybela-v-praci-po-ockovani-proti-covidu\/","title":{"rendered":"Velk\u00e1 studie ukazuje: T\u00e9m\u011b\u0159 polovina \u0161v\u00e9dsk\u00fdch zdravotn\u00edk\u016f chyb\u011bla v pr\u00e1ci po o\u010dkov\u00e1n\u00ed proti COVIDu"},"content":{"rendered":"
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T\u00fdm veden\u00fd\u00a0<\/span>Dr. Annou-Karin Lidstr\u00f6m<\/span><\/strong>\u00a0a kolegy z\u00a0<\/span>Univerzitn\u00ed nemocnice v Uppsale<\/span><\/strong>\u00a0a spolupracovn\u00edkem z\u00a0<\/span>Univerzity v Groningenu<\/span><\/strong>\u00a0(Nizozemsko) uv\u00e1d\u00ed v \u010dasopise\u00a0<\/span>Vaccine<\/span><\/em>\u00a0v\u00fdsledky studie o ne\u017e\u00e1douc\u00edch \u00fa\u010dinc\u00edch l\u00e9k\u016f (ADR) a protil\u00e1tkov\u00e9 odpov\u011bdi u 3 805 \u0161v\u00e9dsk\u00fdch zdravotnick\u00fdch pracovn\u00edk\u016f o\u010dkovan\u00fdch v roce 2021.<\/span><\/p>\n

Hypot\u00e9za: Profily vedlej\u0161\u00edch \u00fa\u010dink\u016f, m\u00edra absence z d\u016fvodu nemoci a titry protil\u00e1tek se mohou li\u0161it v z\u00e1vislosti na o\u010dkovac\u00edm sch\u00e9matu, v\u011bku, pohlav\u00ed a dob\u011b od o\u010dkov\u00e1n\u00ed. V\u00fdsledky nazna\u010duj\u00ed v\u00fdznamn\u00e9, m\u011b\u0159iteln\u00e9 provozn\u00ed dopady na nemocni\u010dn\u00ed person\u00e1l \u2013 a specifick\u00e9 rozd\u00edly v vedlej\u0161\u00edch \u00fa\u010dinc\u00edch i imunitn\u00ed odpov\u011bdi v z\u00e1vislosti na vakc\u00edn\u011b.<\/span><\/p>\n

Design a metoda studie<\/span><\/h2>\n

V\u00fdzkumn\u00edci provedli prospektivn\u00ed observa\u010dn\u00ed studii zdravotnick\u00fdch pracovn\u00edk\u016f, kte\u0159\u00ed dostali dv\u011b z\u00e1kladn\u00ed d\u00e1vky vakc\u00edny proti COVID-19. Byly zkoum\u00e1ny n\u00e1sleduj\u00edc\u00ed o\u010dkovac\u00ed re\u017eimy:\u00a0<\/span>Comirnaty<\/span><\/strong>\u00a0(Pfizer-BioNTech),\u00a0<\/span>Spikevax<\/span><\/strong>\u00a0(Moderna),\u00a0<\/span>Vaxzevria<\/span><\/strong>\u00a0(AstraZeneca) a dv\u011b heterologn\u00ed kombinace (\u00a0<\/span>Vaxzevria + Spikevax<\/span><\/strong>\u00a0,\u00a0<\/span>Vaxzevria + Comirnaty<\/span><\/strong>\u00a0).<\/span><\/p>\n

\u00da\u010dastn\u00edci vyplnili strukturovan\u00e9 dotazn\u00edky t\u00fdkaj\u00edc\u00ed se ne\u017e\u00e1douc\u00edch \u00fa\u010dink\u016f a 30 a\u017e 100 dn\u00ed po o\u010dkov\u00e1n\u00ed podstoupili testov\u00e1n\u00ed na IgG proti viru SARS-CoV-2 (anti-S IgG). K anal\u00fdze souvislost\u00ed mezi typem vakc\u00edny, demografick\u00fdmi \u00fadaji, hladinami protil\u00e1tek a kategoriemi ne\u017e\u00e1douc\u00edch \u00fa\u010dink\u016f byla pou\u017eita multivaria\u010dn\u00ed regrese.<\/span><\/p>\n

V\u00fdsledky<\/span><\/h2>\n

Kontrast mezi o\u010dkovac\u00edmi re\u017eimy byl v\u00fdrazn\u00fd. Jedna z nejkomplexn\u011bj\u0161\u00edch studi\u00ed ne\u017e\u00e1douc\u00edch \u00fa\u010dink\u016f vakc\u00edny proti COVID-19 u zdravotnick\u00fdch pracovn\u00edk\u016f v re\u00e1ln\u00e9m sv\u011bt\u011b uk\u00e1zala:<\/span><\/p>\n

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  • V\u00fdskyt onemocn\u011bn\u00ed po o\u010dkov\u00e1n\u00ed se zna\u010dn\u011b li\u0161il \u2013 od\u00a0<\/span>pouh\u00fdch 12 %<\/span><\/strong>\u00a0u dvou d\u00e1vek vakc\u00edny Comirnaty a\u017e po\u00a0<\/span>48 %<\/span><\/strong>\u00a0u kombinovan\u00e9 vakc\u00edny Vaxzevria + Spikevax.<\/span><\/li>\n
  • Tato mezera p\u0159edstavuje v\u00fdznamn\u00e9 provozn\u00ed riziko pro nemocnice, kter\u00e9 jsou ji\u017e tak pod tlakem.<\/span><\/li>\n<\/ul>\n

    Vzorec ne\u017e\u00e1douc\u00edch \u00fa\u010dink\u016f byl tak\u00e9 jasn\u011b rozpoznateln\u00fd: hore\u010dka, zimnice, bolest hlavy, \u00fanava a bolest sval\u016f nebo kloub\u016f se vyskytovaly v\u00fdrazn\u011b \u010dast\u011bji u vakc\u00edny Spikevax a heterologn\u00edch kombinac\u00ed ne\u017e u vakc\u00edny Comiraty.<\/span><\/p>\n

    Statistick\u00e9 rozd\u00edly byly pozoruhodn\u00e9: ve srovn\u00e1n\u00ed s vakc\u00ednou Comiraty byla pravd\u011bpodobnost hore\u010dky nebo zimnice u vakc\u00edny Vaxzevria a\u017e\u00a0<\/span>desetkr\u00e1t vy\u0161\u0161\u00ed ; pravd\u011bpodobnost pracovn\u00ed neschopnosti byla\u00a0<\/span><\/strong>t\u0159ikr\u00e1t a\u017e \u0161estkr\u00e1t vy\u0161\u0161\u00ed<\/span><\/strong>\u00a0u vakc\u00edny Spikevax nebo kombinovan\u00fdch re\u017eim\u016f\u00a0.<\/span><\/p>\n

    Pokud jde o imunitn\u00ed odpov\u011b\u010f, Spikevax dos\u00e1hl nejvy\u0161\u0161\u00edch pr\u016fm\u011brn\u00fdch hladin protil\u00e1tek, n\u00e1sledovan\u00fd Vaxzevria + Spikevax, zat\u00edmco Vaxzevria samotn\u00fd si vedl nejslab\u0161\u00ed.<\/span><\/p>\n

    Mlad\u0161\u00ed p\u0159\u00edjemci vykazovali nejen siln\u011bj\u0161\u00ed protil\u00e1tkovou odpov\u011b\u010f, ale tak\u00e9 v\u00edce vedlej\u0161\u00edch \u00fa\u010dink\u016f. Mu\u017ei obecn\u011b hl\u00e1sili m\u00e9n\u011b vedlej\u0161\u00edch \u00fa\u010dink\u016f ne\u017e \u017eeny \u2013 trend zn\u00e1m\u00fd z jin\u00fdch studi\u00ed. Shlukov\u00e1n\u00ed syst\u00e9mov\u00fdch symptom\u016f nazna\u010duje b\u011b\u017en\u00e9 fyziologick\u00e9 spou\u0161t\u011b\u010de, pravd\u011bpodobn\u011b souvisej\u00edc\u00ed s aktivac\u00ed imunitn\u00edho syst\u00e9mu.<\/span><\/p>\n

    Z\u00e1va\u017en\u00e9 reakce, jako je anafylaxe, byly vz\u00e1cn\u00e9, ale velk\u00fd po\u010det zam\u011bstnanc\u016f, kte\u0159\u00ed si po o\u010dkov\u00e1n\u00ed vzali jeden nebo v\u00edce dn\u00ed pracovn\u00ed neschopnosti, vedl k v\u00fdznamn\u00fdm kr\u00e1tkodob\u00fdm n\u00e1klad\u016fm pro syst\u00e9m zdravotn\u00ed p\u00e9\u010de. To nazna\u010duje, \u017ee v\u00fdb\u011br vakc\u00edny a strategie jej\u00edho zav\u00e1d\u011bn\u00ed mohou p\u0159\u00edmo ovlivnit p\u0159ipravenost \u2013 d\u016fle\u017eit\u00fd faktor pro budouc\u00ed masov\u00e9 o\u010dkovac\u00ed kampan\u011b.<\/span><\/p>\n

    Omezen\u00ed<\/span><\/h2>\n

    Mlad\u0161\u00ed \u017eeny byly ve studii nadm\u011brn\u011b zastoupeny \u2013 to odr\u00e1\u017e\u00ed demografick\u00e9 \u00fadaje o syst\u00e9mu zdravotn\u00ed p\u00e9\u010de, ale omezuje p\u0159enositelnost. Ne\u017e\u00e1douc\u00ed \u00fa\u010dinky byly zaznamen\u00e1v\u00e1ny prost\u0159ednictv\u00edm vlastn\u00edho hl\u00e1\u0161en\u00ed, co\u017e m\u016f\u017ee v\u00e9st k zkreslen\u00ed v odezvy. \u00dadaje o p\u0159edchoz\u00edch infekc\u00edch COVID-19 nebyly shroma\u017e\u010fov\u00e1ny, i kdy\u017e by to mohlo ovlivnit profil ne\u017e\u00e1douc\u00edch \u00fa\u010dink\u016f.<\/span><\/p>\n

    Proto\u017ee se jednalo o observa\u010dn\u00ed studii, nelze prok\u00e1zat kauzalitu. Alokace vakc\u00edny byla zalo\u017eena na dostupnosti a politice, nikoli na randomizaci.<\/span><\/p>\n

    Zat\u00edmco 1,7 % a\u017e 6,9 % \u00fa\u010dastn\u00edk\u016f hl\u00e1silo p\u0159etrv\u00e1vaj\u00edc\u00ed p\u0159\u00edznaky (\u010dasto bolest hlavy, \u00fanavu nebo lok\u00e1ln\u00ed bolest), v t\u00e9to kohort\u011b nebyly zji\u0161t\u011bny \u017e\u00e1dn\u00e9 d\u016fkazy o dlouhodob\u00e9 invalidit\u011b, hospitalizaci ani trval\u00e9m po\u0161kozen\u00ed zdrav\u00ed v d\u016fsledku o\u010dkov\u00e1n\u00ed proti COVID-19. Studie v\u0161ak nebyla navr\u017eena k posouzen\u00ed morbidity, ale sp\u00ed\u0161e reaktogenity a d\u016fsledk\u016f pro person\u00e1l.<\/span><\/p>\n

    Financov\u00e1n\u00ed a zve\u0159ej\u0148ov\u00e1n\u00ed informac\u00ed<\/span><\/h2>\n

    Financov\u00e1no\u00a0<\/span>Nadac\u00ed rodiny Olinder Nielsenov\u00fdch<\/span><\/strong>\u00a0. Nebyly hl\u00e1\u0161eny \u017e\u00e1dn\u00e9 st\u0159ety z\u00e1jm\u016f.<\/span><\/p>\n

    Z\u00e1v\u011br a d\u016fsledky<\/span><\/h2>\n

    Praktick\u00e1 studie ukazuje, \u017ee a\u010dkoli v\u00e1\u017en\u00e1 zran\u011bn\u00ed souvisej\u00edc\u00ed s o\u010dkov\u00e1n\u00edm byla vz\u00e1cn\u00e1, n\u011bkter\u00e9 o\u010dkovac\u00ed sch\u00e9mata vedla k v\u00fdznamn\u00e9mu zhor\u0161en\u00ed zdravotn\u00edch pracovn\u00edk\u016f v kritick\u00e9 pandemick\u00e9 situaci. Auto\u0159i doporu\u010duj\u00ed rozvrhnout budouc\u00ed hromadn\u00e9 o\u010dkovac\u00ed kampan\u011b \u2013 zejm\u00e9na s vyu\u017eit\u00edm nov\u00fdch platforem \u2013 a zav\u00e9st pohotovostn\u00ed pl\u00e1ny, aby se minimalizovaly provozn\u00ed naru\u0161en\u00ed.<\/span><\/p>\n

    Osoby s rozhodovac\u00ed pravomoc\u00ed\u00a0mus\u00ed p\u0159i v\u00fdb\u011bru a pou\u017e\u00edv\u00e1n\u00ed vakc\u00edn v kl\u00ed\u010dov\u00fdch skupin\u00e1ch zohled\u0148ovat klinickou bezpe\u010dnost\u00a0<\/span>a organiza\u010dn\u00ed odolnost.<\/span><\/strong><\/p>\n

    Indik\u00e1tor s\u00edly d\u016fkaz\u016f TrialSite\u2122<\/span><\/strong><\/p>\n

    \n\n\n\n\n\n\n\n\n\n
    faktor<\/span><\/th>\nSk\u00f3re (0\u201310)<\/span><\/th>\nD\u016fvod<\/span><\/th>\n<\/tr>\n<\/thead>\n
    N\u00e1vrh a rozsah studie<\/span><\/td>\n8<\/span><\/td>\nVelk\u00e1 kohorta pacient\u016f z re\u00e1ln\u00e9ho sv\u011bta v oblasti zdravotn\u00ed p\u00e9\u010de; prospektivn\u00ed design<\/span><\/td>\n<\/tr>\n
    Statistick\u00e1 p\u0159esnost<\/span><\/td>\n8<\/span><\/td>\nV\u00edcerozm\u011brn\u00e1 regrese; jasn\u00e1 stratifikace<\/span><\/td>\n<\/tr>\n
    Omezen\u00ed dat<\/span><\/td>\n6<\/span><\/td>\nVlastn\u00ed hl\u00e1\u0161en\u00ed; \u017e\u00e1dn\u00e9 \u00fadaje o p\u0159edchoz\u00edch infekc\u00edch; observa\u010dn\u00ed zkreslen\u00ed<\/span><\/td>\n<\/tr>\n
    Financov\u00e1n\u00ed a transparentnost informac\u00ed o zem\u00edch p\u016fvodu<\/span><\/td>\n10<\/span><\/td>\nTransparentn\u00ed financov\u00e1n\u00ed; \u017e\u00e1dn\u00e9 relevantn\u00ed konflikty z\u00e1jm\u016f<\/span><\/td>\n<\/tr>\n
    Pou\u017eitelnost v praxi<\/span><\/td>\n9<\/span><\/td>\nVysok\u00fd v\u00fdznam pro lidsk\u00e9 zdroje a strategick\u00e9 pl\u00e1nov\u00e1n\u00ed ve zdravotnictv\u00ed<\/span><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/figure>\n

    Celkov\u00e9 hodnocen\u00ed:<\/span><\/strong>\u00a082 % \u2013 Siln\u00e9 d\u016fkazy z re\u00e1ln\u00e9ho sv\u011bta s m\u00edrn\u00fdmi omezen\u00edmi<\/span><\/p>\n

    Zdroj:<\/span><\/strong>\u00a0Lidstr\u00f6m, A.-K., Albinsson, B., Sund, F. a kol.\u00a0<\/span>Ne\u017e\u00e1douc\u00ed \u00fa\u010dinky l\u00e9k\u016f po o\u010dkov\u00e1n\u00ed 3805 zdravotnick\u00fdch pracovn\u00edk\u016f proti SARS-CoV-2 zp\u016fsobuj\u00ed zna\u010dn\u00e9 selh\u00e1n\u00ed nemoci a koreluj\u00ed s o\u010dkovac\u00edm re\u017eimem, v\u011bkem, pohlav\u00edm a s\u00e9rologickou odpov\u011bd\u00ed.\u00a0<\/span><\/em>Vaccine<\/span><\/em>\u00a0, ro\u010d. 62, 30. srpna 2025, 127553. doi:10.1016\/j.vaccine.2025.127553.<\/span><\/p>\n<\/div>\n<\/div>\n

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

    \"\"<\/p>\n

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

    T\u00fdm veden\u00fd\u00a0Dr. Annou-Karin Lidstr\u00f6m\u00a0a kolegy z\u00a0Univerzitn\u00ed nemocnice v Uppsale\u00a0a spolupracovn\u00edkem z\u00a0Univerzity v Groningenu\u00a0(Nizozemsko) uv\u00e1d\u00ed v…<\/p>\n","protected":false},"author":2,"featured_media":82445,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":[],"categories":[7],"tags":[23,677,213,124],"_links":{"self":[{"href":"https:\/\/www.infokuryr.cz\/n\/wp-json\/wp\/v2\/posts\/85554"}],"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=85554"}],"version-history":[{"count":0,"href":"https:\/\/www.infokuryr.cz\/n\/wp-json\/wp\/v2\/posts\/85554\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.infokuryr.cz\/n\/wp-json\/wp\/v2\/media\/82445"}],"wp:attachment":[{"href":"https:\/\/www.infokuryr.cz\/n\/wp-json\/wp\/v2\/media?parent=85554"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.infokuryr.cz\/n\/wp-json\/wp\/v2\/categories?post=85554"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.infokuryr.cz\/n\/wp-json\/wp\/v2\/tags?post=85554"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}