今年的新冠疫苗

本文內容轉自USA Facts網站。

As has been the case each year since 2022, updated COVID-19 vaccines were released leading into the fall season, and the shots should be broadly available to people age 6 months and up. For the first time, however, the vaccines are not approved for all age groups, and the vaccines are recommended by the Centers for Disease Control and Prevention only after a discussion with a health care provider. 有更新的Covid疫苗，但CDC要求你和醫生「討論」，並非所有年齡段的人都容易得到疫苗。

Experts emphasize that there has been no real change in the benefits or risks of the vaccines, which are quite safe and offer additional protection against the coronavirus. Vaccination can benefit everyone but is particularly important for those at higher risk of severe illness, including older people, very young children, pregnant people and those with certain other risk factors. 疫苗的安全性和有效性未變，高危群組包括老人、幼兒、懷孕等等。

In the end, the CDC recommendation means that most people who want a vaccine — even if they do not meet the approval criteria — can get one, although doing so may be more difficult.

Here, we explain what’s different this year and walk through the complexities of getting vaccinated under the new rules. 在此解釋一下今年的新規定。

What happened this year that’s different from the past?
In previous years, the Food and Drug Administration either approved or authorized COVID-19 vaccines for all ages 6 months and older, and the CDC also recommended the vaccines for all, while noting that vaccination is most important for higher-risk groups.

This August, the FDA approved the COVID-19 vaccines, but only for those age 65 and older or for those with a risk factor. At some point for each vaccine, according to FDA memos, the head of the vaccines division, an administration official, had overruled career staff that had recommended approval for a broader population. 今年政府官員駁回了FDA專業人員的6個月以上全部接種建議。

The CDC’s Advisory Committee on Immunization Practices(ACIP) voted on Sept. 19 to recommend COVID-19 vaccination for everyone 6 months of age and up, but only after consultation with a health care provider, or what’s known as shared clinical decision-making.

The panel originally had been scheduled to vote on the COVID-19 vaccine recommendations in June. But that month, Health and Human Services Secretary Robert F. Kennedy Jr. dismissed the committee and installed new members of his choice. The CDC director, who had just been confirmed by the Senate, was fired in August, and other top officials resigned. Meanwhile, Kennedy has repeatedly made false or misleading claims about COVID-19 vaccines this year.
小肯尼迪部長反復散佈關於今年新冠疫苗的虛假誤導。

At its September meeting, ACIP did not complete its normal procedure of gathering and presenting the evidence behind its recommendations. Members made misleading and unfounded claims about vaccine safety, despite a lack of data showing new safety concerns. The CDC then did not announce that it had accepted ACIP’s recommendations until Oct. 6.

It’s worth noting that before Kennedy dismissed the prior advisory panel, the group was considering making age- and risk-based recommendations, given evidence that hospitalization rates in healthy older children and younger adults had declined from the early phase of the pandemic.

However, these recommendations would likely have been quite different from those the CDC ultimately made. Guidance that was being considered more decisively recommended the shots to very young children, older adults and other people at high risk of severe disease, rather than only recommending the shots after consultation with a health care provider.
被小肯尼迪解散的ACIP原本考慮將2歲以內嬰孩列在高危群組中。

Amid growing doubts about the vaccine guidance coming from the CDC, states and expert organizations have issued their own updated COVID-19 vaccine recommendations — some that are different from the agency’s for the first time in decades. 各州和專家機構紛紛發佈自己的新冠疫苗建議。

What do experts say about who should get the vaccines?
There is broad agreement among experts that vaccination is most important for people age 65 and older, those who are pregnant, babies and toddlers from 6 through 23 months, and people with health conditions that put them at high risk of severe COVID-19.

This advice is backed by clear patterns in the recent data on hospitalization rates for COVID-19, Dr. Fiona Havers, an infectious disease physician and respiratory virus and vaccine policy expert, told us. Havers formerly led the CDC’s Respiratory Virus Hospitalization Surveillance Network team before resigning in June, citing the corruption of CDC processes under Kennedy.

People age 75 and older have the highest rate of hospitalization, Havers said, and those age 65 to 74 have “very high rates” of hospitalization. “At the other extreme, very young children, particularly children under 2, and especially those babies less than 6 months of age, have high hospitalization rates for COVID,” she said. Outside these extremes of age, she said, those still at highest risk for severe COVID-19 are those with underlying medical conditions. 加強針能夠減少重症急診的需要。

The COVID-19 vaccines were originally demonstrated to be effective at preventing symptomatic disease in randomized controlled trials. The CDC and others have monitored vaccine effectiveness since then, finding consistently that additional doses add protection, on top of the immunity people already have from past vaccination and infection. 疫苗防止/減輕感染症狀，加強針增加免疫保護。

The 2024-2025 vaccines reduced the risk of hospitalization and critical illness in adults age 65 and older, data presented at the September ACIP meeting showed, with the best and most lasting protection against critical illness. For children and adults more generally, the additional vaccine doses also lowered the rate of urgent care and emergency room visits.

Havers explained that vaccination during pregnancy is also “really important,” not only because pregnancy puts a person at risk of complications from COVID-19, but also because vaccination during pregnancy protects the baby. Babies under 6 months of age cannot yet be vaccinated against COVID-19. “The best way to protect them is for the moms to be vaccinated during pregnancy,” she said.
孕婦接種能夠保護嬰孩。

The latest guidance from the American College of Obstetricians and Gynecologists states that it “continues to recommend that all pregnant and lactating individuals receive an updated COVID-19 vaccine or ‘booster.’”

Guidance issued in August by the American Academy of Pediatrics recommends vaccination for all children from 6 through 23 months and older children who fall into various high-risk groups or whose household members are at high risk. The guidance states that older kids without risk factors can get vaccinated if a “parent or guardian desires their protection from COVID-19.”

The American Academy of Family Physicians, meanwhile, issued recommendations for children and pregnant people that match the AAP and ACOG recommendations. AAFP also recommends COVID-19 vaccination for all adults, with an emphasis on its importance for people with high-risk conditions, those who have never gotten a COVID-19 vaccine, and people age 65 and older.

Dr. Margot Savoy, chief medical officer for the American Academy of Family Physicians, told Spotlight PA that it broadly recommended vaccination in adults because there are few who don’t either fall into a high-risk group or live with someone who does. “So why make it more complicated than it needs to be?”

New recommendations from states or coalitions of states often draw on guidance from these expert organizations. State recommendations vary in their details, such as how broadly they recommend the vaccines for younger adults, but generally emphasize the importance of vaccination for the high-risk groups described above. As of a Sept. 24 review by the health policy research group KFF, 22 states “specifically identify non-federal entities as sources for their vaccine recommendations, either in addition to or instead of CDC/ACIP.”

But even if a person is not at high risk for severe disease or hospitalization, Havers explained, getting a vaccine can offer benefits. “You are likely to have milder disease if you are recently vaccinated and then you get COVID than if you hadn’t been vaccinated,” she said.
即使不屬於高危群組，接種的人感染新冠後症狀較輕。

If older children have been previously vaccinated and are not in a high-risk group, the choice to vaccinate “could be considered ‘low risk, low reward,’” an informational page on COVID-19 vaccinations from the Children’s Hospital of Philadelphia states.

Havers said that “the best protection is going to be within the first couple of months after getting a vaccine.” Given that there has historically been a winter wave of COVID-19, “now is not a bad time to get” a vaccine, she said.