More than five kinds of vaccines have been put into use, and more than 30 million people have been vaccinated. Is the new crown vaccine safe?

世界上有多少种新疫苗

How many new vaccines in the world

2021年1月19日，联合国和世界卫生组织关于全球疫苗的最新报告是，目前，该机构疫苗注册平台上有52种新的冠状病毒疫苗处于临床评价阶段，162种疫苗处于临床前评价阶段。

On January 19, 2021, the latest report of the United Nations and the World Health Organization (who) on global vaccines is that at present, there are 52 new coronal vaccines in the clinical evaluation stage and 162 vaccines in the preclinical evaluation stage on the agency's vaccine registration platform.

这些疫苗可分为核酸疫苗、灭活疫苗、腺病毒载体疫苗、重组蛋白疫苗和减毒疫苗五大类。

These vaccines can be divided into five categories: nucleic acid vaccine, inactivated vaccine, adenovirus vector vaccine, recombinant protein vaccine and attenuated vaccine.

然而，目前世界上只有三种疫苗：一种是mRNA信使RNA疫苗，由美国辉瑞公司和摩德纳公司生产；第二种是腺病毒疫苗，由英国阿斯利康公司和俄罗斯卫星5号公司代表；灭活疫苗以国药集团和科兴公司的疫苗为代表。

However, at present, there are only three types of vaccines in the world: one is mRNA messenger RNA vaccine, which is produced by Pfizer and Modena in the United States; the second is adenovirus vaccine, represented by AstraZeneca in the United Kingdom and Russian satellite 5; the inactivated vaccine is represented by vaccines of Sinopharm group and Kexing company.

也就是说，美国的辉瑞和摩德纳、英国的阿斯利康、俄罗斯的卫星5号以及中国的国药和科兴疫苗是世界上主要的疫苗新品种。

In other words, Pfizer and Modena in the United States, AstraZeneca in the United Kingdom, Russian satellite 5, and Sinopharm and Kexing vaccines in China are the main new vaccines to be vaccinated in the world.

然而，世卫组织最重要的是美国辉瑞制药公司和德国biontech制药公司研制的mRNA疫苗，有效率为90%。

However, the most important thing for who is the mRNA vaccine developed by Pfizer, an American pharmaceutical company, and biontech, a German pharmaceutical company, with an effective rate of 90%.

世卫组织不仅早在2020年12月31日就批准了辉瑞/生物技术公司的疫苗，而且还批准了唯一一种获得紧急使用许可证的新疫苗。这意味着，那些不具备独立药品审计能力的欠发达国家也可以通过联合国获得疫苗。

Who not only approved Pfizer / biontech vaccine as early as (December 31, 2020), but also authorized the only new vaccine with emergency use license. This means that those less developed countries that do not have the ability of independent drug audit can also obtain the vaccine through the United Nations.

根据世卫组织202年12月31日的通告，辉瑞/生物科技公司研发的新型冠状病毒疫苗符合该组织的安全性和有效性标准，"其防疫效果超过其潜在风险"

According to the WHO Circular on December 31, 202, the new coronal vaccine developed by Pfizer / biontech meets the safety and effectiveness standards of the organization, "its anti epidemic effect exceeds its potential risk."

世卫组织还指出，疫苗需要在零下60摄氏度下冷冻保存，这对许多国家来说非常困难。因此，世卫组织将与有兴趣获得疫苗的政府合作，寻找解决办法。

Who also pointed out that the vaccine needs to be cryopreserved below minus 60 degrees Celsius, which is very difficult for many countries. As a result, who will work with governments interested in acquiring the vaccine to find solutions.

在国家一级，英国、欧盟、美国、中国、俄罗斯等国家的药品监管部门也批准了一种或多种疫苗。因此，世界上使用的疫苗至少有五种。

At the national level, the drug regulatory authorities of the United Kingdom, the European Union, the United States, China, Russia and other countries have also approved one or more vaccines. Therefore, there are at least five kinds of vaccines in use in the world.

目前，世界上已有47个国家和地区开展了新皇冠疫苗免疫工作，接种人数已超过3000万，其中只有一个是低收入国家。

At present, 47 countries and regions in the world have launched the new crown vaccine immunization work, and the number of vaccinations has exceeded 30 million, of which only one is a low-income country.

为确保世界各国都能公平获得挽救生命的新型皇冠疫苗，世卫组织等多个机构联合推出"新型皇冠疫苗准入机制"，争取为全球82个低收入和低收入国家采购和交付新型皇冠疫苗，协助90多个中高收入和高收入国家购买疫苗，覆盖全球80%的人口。

In order to ensure that all countries in the world can have fair access to life-saving new crown vaccine, who and many other agencies jointly launched the "new crown vaccine access mechanism" to seek to purchase and deliver new crown vaccine for 82 low-income and low-income countries around the world, and assist more than 90 middle - and high-income and high-income countries to purchase vaccines, covering a total of 80% of the global population.

此外，世卫组织还建立了新型冠状病毒肺炎（COVID-19）疫苗全球获取（COVAX）机制，并宣布了一项订购前协议，将购买多达4000万份辉瑞/生物泰克疫苗。

In addition, novel coronavirus pneumonia (COVID-19) vaccine global access (COVAX) mechanism was established by WHO, and a pre order agreement was announced to purchase up to 40 million Pfizer /BioNTech vaccines.

covax机制还宣布，通过与印度血清研究所和英国阿斯利康的现有协议，在获得世卫组织紧急使用清单后，预计2021年第一季度将提供近1.5亿剂阿斯利康/牛津候选疫苗。

The covax mechanism also announced that through the existing agreements with the Serum Institute of India and AstraZeneca in the UK, it is expected that nearly 150 million doses of AstraZeneca / Oxford candidate vaccine will be available in the first quarter of 2021 after obtaining the WHO emergency use list.

据估计，到2021年底，covax预计将提供至少20亿剂疫苗，其中包括至少13亿剂疫苗给参与全球疫苗和免疫联盟covax先期市场承诺的92个低收入经济体。

It is estimated that by the end of 2021, covax is expected to provide at least 2 billion doses of vaccine, including at least 1.3 billion doses to 92 low-income economies participating in the covax advance market commitment of the global alliance for vaccines and immunization.

有多少人接种疫苗才能获胜

How many people are vaccinated to win

目前，每天约有241万种新型冠状病毒疫苗注入人们的手臂。中国已接种疫苗2276.7万次。

At present, there are about 2.41 million new coronal vaccines injected into people's arms every day. China has been vaccinated 22.767 million times.

中国和世界新型冠状病毒肺炎预防（新）冠肺炎？

China and the world novel coronavirus pneumonia to prevent (New) crown pneumonia?

疫苗不是万能的，但是没有它们是绝对不可能的。疫苗接种等措施，如日常防控、治疗、控制传染源等措施，可以结合起来取胜。

Vaccines are not omnipotent, but they are absolutely impossible without them. Vaccination and other measures, such as daily prevention and control, treatment, control of infectious sources and other measures, can be combined to win.

现在我们将集中讨论疫苗的作用。

Now we're going to focus on the role of vaccines.

新型冠状病毒肺炎应作为一个标准加以抑制。群体免疫是指大部分人或动物群体对传染病具有免疫力，使其他没有免疫力的个体免受感染。

Novel coronavirus pneumonia should be suppressed as a standard. Group immunity means that a large proportion of human or animal groups are immune to infectious diseases, so that other individuals without immunity are protected from infection.

抗药性个体的比例越高，易感个体与受感染个体接触的可能性越小，越容易受到保护。

The higher the proportion of resistant individuals is, the less likely the susceptible individuals are to contact with the infected individuals, and the more vulnerable they are to be protected.

同时，世界卫生组织（世卫组织）支持通过接种疫苗进行大规模免疫，而不是让疾病在人口的任何部分传播，因为这将导致不必要的病例和死亡。

At the same time, the World Health Organization (who) supports mass immunization through vaccination, rather than allowing the disease to spread in any part of the population, because it will lead to unnecessary cases and deaths.

人口免疫是一个抽象的问题，也是一个可以量化的具体问题，但不同的情况需要分析。

Population immunization is an abstract problem, and it is also a specific problem that can be quantified, but different situations need to be analyzed.

究其原因，有许多变量或因素，如基础感染数（R0）低、死亡率低、病毒突变率低、病毒突变能力增强率低（包括毒力变化、致死条件变化、寄主适应性变化等）、区域人口少、区域面积小等，人群平均健康水平高，康复后终身免疫率高。

The reason is that it has many variables or factors, such as low basic infection number (R0), low mortality rate, low virus mutation rate, low virus mutation ability enhancement rate (including virulence change, lethal condition change, host adaptability change, etc.), small regional population, small regional area, high average health level of population, and high lifelong immunity rate after rehabilitation.

这些因素很难确定，因此存在很多争议。但是，针对某些疾病，也有具体的数据和成功的经验。

These factors are difficult to confirm, so there is a lot of controversy. However, specific to some diseases, there are also specific data and successful experience.

世界卫生组织公布的成功病例表明，约95%的人口需要接种麻疹疫苗。

The successful cases given by the World Health Organization and recognized that about 95% of the population needs to be vaccinated for measles.

由于麻疹不会在接种疫苗的人群中传播，剩下的5%将得到保护。另一方面，小儿麻痹症需要80%的人口接种疫苗。

Since measles does not spread among vaccinated people, the remaining 5% will be protected. Polio, on the other hand, requires about 80% of the population to be vaccinated.

世卫组织疫苗研发委员会顾问、中国疾病预防控制中心中国新皇冠疫苗技术审评首席专家邵一鸣认为，人群免疫屏障水平y可按以下公式计算：（1-1/R0）x100%。

Shao Yiming, consultant of who vaccine R & D Committee and chief expert of China Center for Disease Control and Prevention (CDC) of China new crown vaccine technology review, concluded that the level of population immune barrier y can be calculated according to the formula: (1-1 / R0) x 100%.

其中，R0是一个感染者平均向几个人传播病毒的能力，新冠状病毒的R0是3，y是66%。由于疫苗保护率不到100%，且疫苗在运输和使用中丢失，我国需要80%以上的人口接种疫苗才能建立起人口免疫屏障，而这一时间段约为两年。

Among them, R0 is the ability of an infected person to transmit the virus to several people on average, R0 of new coronavirus is 3, y is 66%. Because the vaccine protection rate is less than 100%, and the loss of vaccine in transportation and use, China needs more than 80% of the population to be vaccinated in order to establish the population immune barrier, and this time period is about two years.

疫苗接种效果评价

Effect evaluation of vaccination

当然，接种疫苗要看效果。

Vaccination, of course, depends on the effect.

我们先来看看中国的疫苗。根据国家食品药品监督管理局批准的分析数据，我国灭活疫苗的保护效果为79.34%，高于世界卫生组织50%的目标。

Let's look at China's vaccine first. According to the analysis data approved by the State Food and drug administration, the protective efficacy of inactivated vaccine in China is 79.34%, higher than the 50% target of the World Health Organization.

如果有效率超过70%，大多数疫苗可以在中国销售。而且，在呼吸系统疾病疫苗总保护率相对较低的情况下，我国新皇冠疫苗属于一级疫苗。

Most vaccines can be marketed in China if the effective rate exceeds 70%. Moreover, in the case of relatively low general protection rate of respiratory disease vaccine, China's new crown vaccine belongs to the first-class level.

从接种效果看，已接种疫苗2000多万剂，未收到严重不良反应报告。

From the perspective of vaccination effect, more than 20 million doses of vaccine have been inoculated, and no serious adverse reaction report has been received.

当然也有一些不良反应，主要是局部反应，主要是接种部位疼痛。全身反应主要包括头痛、肌痛和发热。

Of course, there were some adverse reactions, mainly local reactions, mainly pain at the inoculation site. Systemic reactions mainly include headache, myalgia and fever.

而且，有些不良反应不是疫苗引起的，而是其他疾病的偶联反应。如果接受者处于某种疾病的潜伏期或前驱期，有一种尚未发现的基础性疾病，而该疾病在接种疫苗后巧合发生，则与疫苗本身无关。

Moreover, some of the adverse reactions are not caused by vaccines, but the coupling reactions of other diseases. If the recipient is in the latent or prodromal stage of a certain disease, there is a basic disease that has not been found, and the disease happens coincidentally after vaccination, it has nothing to do with the vaccine itself.

从安全性和有效性这两个主要指标来看，中国疫苗获得了信任。目前，世界上至少有24个国家（大部分是低收入国家）与中国疫苗企业签订了采购协议。国药集团预计2021年产能将超过10亿剂。

According to the two main indicators of safety and effectiveness, China's vaccine has gained trust. At present, at least 24 countries in the world (most of them are low-income countries) have signed purchase agreements with Chinese vaccine companies. Sinopharm expects its production capacity to exceed 1 billion doses in 2021.

另一家中国公司科兴生物表示，该公司具备每年生产10亿剂疫苗的基本条件，可以满足5亿人的疫苗接种需求。

Another Chinese company, Kexing biology, says it has the basic conditions to produce 1 billion doses a year, which can meet the vaccination needs of 500 million people.

在世界范围内，以色列和阿拉伯联合酋长国已为大约1/4的人口（每人超过200万人）接种了疫苗，在接种人口比例方面居世界领先地位。

Worldwide, Israel and the United Arab Emirates have vaccinated about 1 / 4 of the population (more than 2 million people each), leading the world in the proportion of vaccinated population.

英国和挪威为高危人群接种了疫苗。英国已经为400多万人接种了疫苗，其中大部分是医务人员和老年人，包括养老院的老年人。挪威养老院的老人已经接种了疫苗，大约有4万人。德国接受了约61.4万剂疫苗。

The UK and Norway have vaccinated high-risk groups. The UK has vaccinated more than 4 million people, most of them are medical staff and the elderly, including the elderly in nursing homes. The elderly in nursing homes in Norway have been vaccinated, about 40000 people. Germany received about 614000 doses of vaccine.

根据美国疾病预防控制中心发布的信息，从2020年12月21日到今年1月10日，美国共有400多万人接种了摩德纳新皇冠疫苗。其中10人出现严重过敏反应，需注射肾上腺素治疗。不良反应发生率约为250/100万，43人出现口咽部瘙痒、咽痛、皮疹等轻度过敏反应。所有过敏反应患者均痊愈，无一例死亡。

According to the information released by the Centers for Disease Control and prevention of the United States, from December 21, 2020 to January 10, this year, more than 4 million people in the United States were vaccinated with Modena new crown vaccine. Among them, 10 people had severe allergic reactions and needed to be treated with epinephrine injection. The adverse reaction rate was about 2.5/1 million, and 43 people had mild allergic reactions such as mouth and throat itching, tight throat and rash. All the patients with allergic reaction recovered successfully and no one died.

在接种疫苗的国家中，以色列的效果更好。

Among the vaccinated countries, the effect of Israel is better.

在以色列，辉瑞/biontechmrna疫苗分两次接种。总体结果显示，辉瑞/biontechmrna疫苗可以预防某些接种者的感染或缩短感染持续时间。

In Israel, Pfizer / biontech mRNA vaccines were administered in two doses. The overall results showed that Pfizer / biontech mRNA vaccines could prevent infection or shorten the duration of infection in some vaccinators.

以色列最大的医疗保健中心Clalit比较了20万60岁以上接种辉瑞疫苗的人和20万未接种的人的情况。结果发现，在两个剂量的第14天之前，两组之间的病毒感染几乎没有差异。

Clalit, Israel's largest health care center, compared the situation of 200000 people over the age of 60 who were vaccinated with Pfizer vaccine with 200000 people who were not vaccinated. It was found that there was almost no difference in the virus infection between the two groups until the 14th day of the two doses.

14天后，接种组感染率较未接种组下降33%。这一具体数据表明疫苗是有效的。

But after 14 days, the infection rate of the vaccinated group decreased by 33% compared with the non vaccinated group. This specific data shows that the vaccine is effective.

不良事件及其原因

Adverse events and their causes

疫苗有不同的技术路线，因此也有不同的效果和评价，主要体现在中国的灭活疫苗、美国的辉瑞和Moderna以及辉瑞/biontechmrna疫苗。

Vaccines have different technical routes, so they also have different effects and evaluations, which are mainly reflected in inactivated vaccines in China, Pfizer and Moderna in the United States, and Pfizer / biontech mRNA vaccines.

根据在许多国家进行的晚期疗效试验结果，据说虽然中国疫苗被认为是有效的，但其阻止病毒的能力不如美国的辉瑞和摩德纳疫苗。

According to the results of late efficacy trials conducted in many countries, it is said that although the Chinese vaccine is considered to be effective, its ability to stop the virus is not as good as the Pfizer and Moderna vaccines in the United States.

事实上，这需要详细分析。每种疫苗各有优缺点。

In fact, this needs to be analyzed in detail. Each vaccine has its own advantages and disadvantages.

到目前为止，我国还没有发生疫苗接种后死亡的严重不良事件。

So far, there is no serious adverse event of death after vaccination in China.

日前，一名参加国药疫苗试验的秘鲁志愿者去世。有人认为中国的疫苗不安全。

A few days ago, a Peruvian volunteer who participated in the trial of Sinopharm vaccine died. Some people think that China's vaccine is not safe.

然而，1月27日，参与这项研究的卡耶塔诺埃雷迪亚大学发表声明说，给志愿者注射的是安慰剂而不是疫苗，"参与者的死亡与疫苗无关"。

However, on January 27, the University of Cayetano eredia, which participated in the study, issued a statement saying that the volunteer was given a placebo instead of a vaccine, and that "the death of the participant was not related to the vaccine.".

面对病毒突变，疫苗仍然有效吗？

Is the vaccine still effective in the face of virus mutation?

到目前为止，疫苗接种的效果已经得到证实，病毒的突变并没有影响现有疫苗的效果，因为所有疫苗都是以病毒s刺突蛋白受体结合区（RBD）为原始抗体。

So far, the effect of vaccination has been confirmed, and the mutation of the virus has not affected the effect of the existing vaccines, because all vaccines are based on the virus s spike protein receptor binding region (RBD) as the original antibody.

然而，疫苗现在有效并不意味着它在未来很长一段时间内有效，因为病毒可能会发生重大变异。为此，疫苗的技术升级也提上了议事日程。

However, the fact that the vaccine is effective now does not mean that it will be effective for a long time in the future, because the virus may undergo major mutation. To this end, upgrading vaccines in technology is also on the agenda.

疫苗的升级主要涉及mRNA疫苗和灭活疫苗，因为这两种疫苗的升级速度最快，而病毒载体疫苗和重组蛋白疫苗等其他疫苗由于涉及环节较多，升级速度相对较慢。

The upgrading of vaccines mainly involves mRNA vaccines and inactivated vaccines, because the upgrading of these two vaccines is the fastest, while the upgrading of other vaccines, such as viral vectors and recombinant protein vaccines, is relatively slow due to the many links involved.

在制药公司获得变异病毒株后，中国的灭活疫苗可以在不调整其他工艺的情况下升级。

Chinese inactivated vaccines can be upgraded without any adjustment to other processes after drug companies obtain the mutated virus strains.

对于mRNA疫苗，只需改变化学合成图谱中的突变位点，就可以通过机器合成和修饰，成为一种新的疫苗。

As for the mRNA vaccine, it only needs to change the mutation site in the chemical synthesis map, and then it can be synthesized and modified by machine to become a new vaccine.

中国的灭活疫苗是以生物技术为基础的。大约需要两个月的时间来升级针对新突变株的疫苗。mRNA疫苗是一种化学合成技术，可以在几周内升级。因此，mRNA疫苗的升级速度比灭活疫苗快，但相差不超过一个月。

China's inactivated vaccine is based on biotechnology. It takes about two months to upgrade the vaccine against the new mutant strain. The mRNA vaccine is a chemical synthesis technology, which can be upgraded in a few weeks. Therefore, the upgrading of mRNA vaccine is faster than that of inactivated vaccine, but the difference should not be more than one month.

这也意味着疫苗可以快速升级以应对病毒突变，因此疫苗的有效性将得到保证。

This also means that the vaccine can be quickly upgraded to cope with the virus mutation, so the effectiveness of the vaccine will be guaranteed.

在疫苗接种策略方面，也需要调整。

In terms of vaccination strategy, it also needs to be adjusted.

现在看来，中国的疫苗接种分为三个步骤，在安全性方面有优势。

Now it seems that China's vaccination is divided into three steps and has an advantage in terms of safety.

第一步是对重点人群和感染高危人群进行疫苗接种；第二步是逐步扩大对高危人群的疫苗接种，即对感染新冠状病毒后易患重症的人群进行疫苗接种，主要包括老年人和基础疾病人群；第三步是全民接种。

The first step is to vaccinate the key population and the population with high risk of infection; the second step is to gradually expand the vaccination to the high-risk population, that is, to vaccinate the people who are prone to severe disease after infection with new coronavirus, mainly including the elderly and the population with basic diseases; the third step is to vaccinate the whole population.

这种方法将有效地保护高危人群，如老年人和基础疾病患者，因为早期接种组的结果将有效地指导晚期接种组。

This method will effectively protect high-risk groups, such as the elderly and people with basic diseases, because the results of the early vaccination group will effectively guide the late vaccination group.

接种疫苗的老人（图/网）

The vaccinated elderly (picture / network)

然而，挪威、德国等国先给老年人接种疫苗，导致老年人意外死亡。

However, countries such as Norway and Germany vaccinated the elderly first, resulting in accidental death of the elderly.

现在，挪威已经修改了它在2020年12月提出的疫苗接种建议，建议那些"极度虚弱"的人不要接种疫苗。原因是，"对于那些极度脆弱的人来说，即使是相对轻微的疫苗副作用也会产生严重后果。对于那些未来没有太多疫苗的人来说，疫苗的益处可能非常有限或微不足道。"

Now, Norway has revised its vaccination recommendation, which was made in December 2020, to recommend that people who are "extremely frail" not be vaccinated. The reason is, "for those who are extremely vulnerable, even relatively mild vaccine side effects can have serious consequences. For those who don't have much in the future, the benefits of the vaccine may be very limited or insignificant. "

*封面图片：2021年1月29日，北京医务人员为接种者接种疫苗。（袁毅/人民视野摄影）

*Cover picture: on January 29, 2021, Beijing medical workers vaccinate vaccinators. (Photo by Yuan Yi / people's vision)

Link：https://new.qq.com/omn/20210201/20210201A0300000.html

update time：2021-02-01 14:42:55