{"id":6209,"date":"2023-09-21T09:58:30","date_gmt":"2023-09-21T06:58:30","guid":{"rendered":"https:\/\/www.klimik.org.tr\/koronavirus\/?p=6209"},"modified":"2023-09-26T12:33:40","modified_gmt":"2023-09-26T09:33:40","slug":"covid-19-asilariyla-ilgili-guncel-bilgilendirme-notu","status":"publish","type":"post","link":"https:\/\/www.klimik.org.tr\/koronavirus\/covid-19-asilariyla-ilgili-guncel-bilgilendirme-notu\/","title":{"rendered":"COVID-19 A\u015f\u0131lar\u0131yla \u0130lgili G\u00fcncel Bilgilendirme Notu"},"content":{"rendered":"

COVID-19 a\u015f\u0131lar\u0131n\u0131n ne faydas\u0131 oldu? <\/strong><\/span><\/p>\n

COVID-19\u2019a kar\u015f\u0131 ilk kullan\u0131ma giren ve orijinal Wuhan SARS-CoV-2 su\u015funu i\u00e7eren tek de\u011ferli a\u015f\u0131lar g\u00fcn\u00fcm\u00fcze kadar yakla\u015f\u0131k 14 milyar doz uygulanm\u0131\u015f olup, a\u011f\u0131r COVID-19\u2019u ve buna ba\u011fl\u0131 \u00f6l\u00fcmleri engellemede >%90\u2019dan fazla etkili olarak 20 milyondan fazla ki\u015finin hayat\u0131n\u0131 kurtarm\u0131\u015ft\u0131r (1).<\/p>\n

COVID-19 a\u015f\u0131lar\u0131 g\u00fcvenli midir? <\/strong><\/span><\/p>\n

\u0130lk yap\u0131lmaya ba\u015fland\u0131\u011f\u0131 g\u00fcnden beri COVID-19 a\u015f\u0131lar\u0131n\u0131n etkinli\u011fini ve g\u00fcvenirli\u011fini d\u00fczenli bir \u015fekilde izleyen Birle\u015fik Krall\u0131k Sa\u011fl\u0131k G\u00fcvenli\u011fi Ajans\u0131\u2019n\u0131n k\u0131sa s\u00fcre \u00f6nce yay\u0131mlad\u0131\u011f\u0131 raporda bu a\u015f\u0131lar\u0131n yararlar\u0131n\u0131n, potansiyel risklerinden \u00e7ok \u00e7ok fazla oldu\u011funun belirlendi\u011fi bildirilmi\u015ftir (2).<\/p>\n

COVID-19 a\u015f\u0131lar\u0131 neden g\u00fcncellenmelidir?<\/strong><\/span><\/p>\n

SARS-CoV-2\u2019ye kar\u015f\u0131 a\u015f\u0131 korumas\u0131 zamanla ve yeni ortaya \u00e7\u0131kan, ba\u011f\u0131\u015f\u0131kl\u0131ktan ka\u00e7an varyantlar nedeniyle azalmaktad\u0131r. A\u015f\u0131lar\u0131n COVID-19\u2019a ba\u011fl\u0131 hastane yat\u0131\u015f\u0131 ve \u00f6l\u00fcm\u00fc engellemedeki etkinlikleri de daha az oranda olmakla birlikte azalmaktad\u0131r. Son 2 y\u0131ld\u0131r bu sorunla ba\u015fa \u00e7\u0131kabilmek ve COVID-19 a\u015f\u0131lar\u0131n\u0131n etkinli\u011fini art\u0131rabilmek i\u00e7in, dola\u015f\u0131mda olan yeni SARS-CoV-2 varyantlar\u0131n\u0131 i\u00e7eren g\u00fcncellenmi\u015f a\u015f\u0131lar geli\u015ftirilmektedir.<\/p>\n

COVID-19 a\u015f\u0131lar\u0131 ne \u015fekilde g\u00fcncellenmi\u015ftir? <\/strong><\/span><\/p>\n

mRNA COVID-19 a\u015f\u0131lar\u0131n\u0131n ilk g\u00fcncellemesi Haziran 2022\u2019de yap\u0131lm\u0131\u015f ve bu a\u015f\u0131n\u0131n i\u00e7inde orijinal Wuhan su\u015fununkine ek olarak BA.4-BA.5 omikron varyant\u0131n\u0131n spike proteinini kodlayan mRNA da yer alm\u0131\u015ft\u0131r. Bu iki de\u011ferli COVID-19 a\u015f\u0131lar\u0131 Ekim 2022\u2019den itibaren ABD, Avrupa, Kanada gibi y\u00fcksek gelirli \u00fclkelerde hem primer a\u015f\u0131lama i\u00e7in hem de belli risk gruplar\u0131na bir veya iki hat\u0131rlatma dozu \u015feklinde uygulanm\u0131\u015ft\u0131r (2-4). \u0130lerleyen s\u00fcre\u00e7te DS\u00d6 COVID-19 A\u015f\u0131 \u0130\u00e7eri\u011fi \u0130zleme Komitesi (TAG-CO-VAC), hastal\u0131\u011f\u0131n seyri, s\u0131kl\u0131\u011f\u0131, da\u011f\u0131l\u0131m\u0131, dola\u015f\u0131mdaki varyantlar\u0131n durumu ve kullan\u0131mdaki a\u015f\u0131lar\u0131n etkinli\u011fi gibi konular\u0131 de\u011ferlendirerek yeni COVID-19 a\u015f\u0131s\u0131n\u0131n tek de\u011ferli olmas\u0131n\u0131 ve XBB.1\u2019den t\u00fcreyen XBB.1.5 veya XBB.1.16 su\u015flar\u0131n\u0131 i\u00e7ermesini \u00f6nermi\u015ftir. Bu \u00f6neri ge\u00e7en sonbaharda uygulanan iki de\u011ferli a\u015f\u0131ya kar\u015f\u0131 geli\u015fmi\u015f antikorlar\u0131n XBB.1\u2019den t\u00fcremi\u015f su\u015flar\u0131 yeterince n\u00f6tralize edememesi ve orijinal su\u015fun tekrarlayan uygulamas\u0131n\u0131n yeni su\u015flara kar\u015f\u0131 ba\u011f\u0131\u015f\u0131k yan\u0131tta azalmaya (immune imprinting) yol a\u00e7abilmesi nedenleriyle yap\u0131lm\u0131\u015ft\u0131r (5). XBB.1.5 su\u015funu i\u00e7eren yeni tek de\u011ferli mRNA COVID-19 a\u015f\u0131lar\u0131 da k\u0131sa s\u00fcre \u00f6nce \u00fcretilerek gerekli onaylar\u0131 alm\u0131\u015f ve yine y\u00fcksek gelirli \u00fclkelerde ve \u00f6zellikle risk gruplar\u0131na olmak \u00fczere Eyl\u00fcl 2023 itibariyle uygulanmaya ba\u015flanm\u0131\u015ft\u0131r (5-7).<\/p>\n

G\u00fcncellenen COVID-19 a\u015f\u0131lar\u0131 daha m\u0131 etkilidir? <\/strong><\/span><\/p>\n

Ge\u00e7en sonbaharda hem orijinal su\u015fu i\u00e7eren tek de\u011ferli a\u015f\u0131yla hem de yeni iki de\u011ferli a\u015f\u0131yla yap\u0131lan hat\u0131rlatma dozlar\u0131n\u0131n, COVID-19\u2019a ba\u011fl\u0131 \u00f6l\u00fcmleri azaltmada olduk\u00e7a etkili oldu\u011fu g\u00f6r\u00fclm\u00fc\u015f, ancak iki de\u011ferli a\u015f\u0131lar\u0131n etkinli\u011finin, eski a\u015f\u0131dan belirgin olarak daha y\u00fcksek oldu\u011fu belirlenmi\u015ftir: ABD\u2019de a\u015f\u0131s\u0131zlarda COVID-19\u2019a ba\u011fl\u0131 mortalite oran\u0131, a\u015f\u0131l\u0131lardan delta d\u00f6neminde 16.2, BA.1 d\u00f6neminde 11.5 ve BA.2 d\u00f6nemindeyse 5.3 kat daha y\u00fcksek olmu\u015ftur. Orijinal a\u015f\u0131yla hat\u0131rlatma dozu yap\u0131lanlarda \u00f6l\u00fcm oran\u0131 iki de\u011ferli a\u015f\u0131yla a\u015f\u0131lananlardan 2.6 kat daha y\u00fcksek bulunmu\u015ftur. \u0130ki de\u011ferli a\u015f\u0131yla kar\u015f\u0131la\u015ft\u0131r\u0131ld\u0131\u011f\u0131nda a\u015f\u0131s\u0131zlarda mortalite oran\u0131 65-79 ya\u015f grubu i\u00e7in 23.7, \u226580 ya\u015f i\u00e7in 10.3 kat daha y\u00fcksek olmu\u015ftur. Orijinal su\u015f i\u00e7eren a\u015f\u0131yla hat\u0131rlatma dozu yap\u0131lanlarla kar\u015f\u0131la\u015ft\u0131r\u0131ld\u0131\u011f\u0131ndaysa mortalite a\u015f\u0131s\u0131zlarda 65\u201379 ya\u015fta 8.3 kat, \u226580 ya\u015f grubundaysa 4.2 kat daha y\u00fcksek olmu\u015ftur (8, 9). G\u00fcncel \u0130ngiltere verilerine g\u00f6re de, >65 ya\u015fta \u00f6l\u00fcme kar\u015f\u0131 a\u015f\u0131 etkinli\u011fi hat\u0131rlatma dozundan >20 hafta sonra %68.2, >40 hafta sonraysa %56.9 olarak hesaplanm\u0131\u015f, 2022\u2019de uygulanan bivalan a\u015f\u0131lar\u0131n >50 ya\u015fta, a\u015f\u0131dan sonraki ilk 10 haftada hastane yat\u0131\u015f\u0131na kar\u015f\u0131 ek %47\u2019lik bir koruma sa\u011flad\u0131\u011f\u0131 g\u00f6r\u00fclm\u00fc\u015ft\u00fcr.<\/p>\n

COVID-19 a\u015f\u0131lar\u0131 gebelere neden yap\u0131lmal\u0131d\u0131r? Etkili ve g\u00fcvenli midir?<\/strong><\/span><\/p>\n

Gebenin COVID-19 olmas\u0131n\u0131n hem kendisine hem karn\u0131ndaki fetusa hem de do\u011fduktan sonra bebe\u011fe olumsuz etkileri oldu\u011fu g\u00f6sterilmi\u015ftir. Hastal\u0131k, gebelerde, gebe olmayanlardan daha a\u011f\u0131r seyretmekte, d\u00fc\u015f\u00fck vb gebelik komplikasyonlar\u0131na yol a\u00e7maktad\u0131r. Bu nedenlerle gebeler COVID-19 a\u015f\u0131lamas\u0131nda en \u00f6ncelikli gruplar aras\u0131nda yer almaktad\u0131r.<\/p>\n

COVID-19 i\u00e7in yap\u0131lan mRNA primer a\u015f\u0131lama ve hat\u0131rlatma dozlar\u0131, gebeleri a\u011f\u0131r COVID-19\u2019dan korumak i\u00e7in en g\u00fcvenli ve en etkili yoldur. \u0130ngiltere\u2019de do\u011fum yapm\u0131\u015f gebelerin % 70-75\u2019inin COVID-19\u2019a kar\u015f\u0131 a\u015f\u0131land\u0131\u011f\u0131 belirlenmi\u015ftir (2). Gebelerde COVID-19 a\u015f\u0131lamas\u0131n\u0131n hem gebeyi hem anne karn\u0131ndaki fetusu hem de 6 ayl\u0131k olana kadar yeni do\u011fan\u0131 korumas\u0131 nedeniyle \u00fc\u00e7 katmanl\u0131 koruma sa\u011flad\u0131\u011f\u0131 unutulmamal\u0131d\u0131r.<\/p>\n

Eyl\u00fcl 2023\u2019te y\u00fcksek gelirli \u00fclkelerde uygulanmaya ba\u015flanan ve XBB.1.5 varyant\u0131n\u0131 i\u00e7eren g\u00fcncellenmi\u015f mRNA a\u015f\u0131lar\u0131 yeni varyantlara kar\u015f\u0131 da etkili midir? <\/strong><\/span><\/p>\n

En g\u00fcncel a\u015f\u0131 olan XBB.1.5 su\u015funu i\u00e7eren tek de\u011ferli mRNA a\u015f\u0131lar\u0131n\u0131n, XBB.1.5, XBB.1.6, XBB.2.3.2 gibi XBB\u2019yle ili\u015fkili varyantlara kar\u015f\u0131, ayn\u0131 zamanda k\u0131sa s\u00fcre \u00f6nce tan\u0131mlanm\u0131\u015f EG.5.1 (Eris) , FL.1.5.1 varyantlar\u0131na kar\u015f\u0131 da olmak \u00fczere potent n\u00f6tralizan antikor yan\u0131t\u0131 olu\u015fturdu\u011fu g\u00f6sterilmi\u015ftir (10). Ek olarak laboratuvar \u00e7al\u0131\u015fmalar\u0131ndan elde edilmi\u015f veriler, g\u00fcncellenmi\u015f tek de\u011ferli a\u015f\u0131lar\u0131n BA.2.86 varyant\u0131na kar\u015f\u0131 da yeterli n\u00f6tralizan antikor olu\u015fturabilece\u011fini g\u00f6stermi\u015ftir (11-13, 7).<\/p>\n

COVID-19 a\u015f\u0131lar\u0131 kimlere yap\u0131lmal\u0131d\u0131r? <\/strong><\/span><\/p>\n

A\u015f\u0131yla veya hastal\u0131\u011f\u0131 ge\u00e7irerek ba\u011f\u0131\u015f\u0131kl\u0131k kazanm\u0131\u015f ki\u015fi say\u0131s\u0131n\u0131n artmas\u0131yla birlikte, DS\u00d6-SAGE, COVID-19 a\u015f\u0131lama \u00f6nerilerini g\u00fcncellemi\u015ftir: Ya\u015fl\u0131lar (>50y), a\u011f\u0131r komorbiditesi (diabetes mellitus ve kalp hastal\u0131klar\u0131 gibi) veya ciddi obezitesi olan gen\u00e7 eri\u015fkinler, >6 ayl\u0131k \u00e7ocuklar dahil t\u00fcm ba\u011f\u0131\u015f\u0131kl\u0131\u011f\u0131 bask\u0131lanm\u0131\u015flar (HIV\u2019le ya\u015fayan bireyler, solid organ veya kemik ili\u011fi al\u0131c\u0131lar\u0131 vb.), gebeler ve sa\u011fl\u0131k \u00e7al\u0131\u015fanlar\u0131 COVID-19 a\u015f\u0131lamas\u0131 i\u00e7in y\u00fcksek \u00f6ncelikli gruplar olarak tan\u0131mlanm\u0131\u015ft\u0131r. Bu gruplar i\u00e7in primer a\u015f\u0131lama ve ilk hat\u0131rlatma dozlar\u0131n\u0131n ard\u0131ndan 6-12 ay sonra tekrarlanacak hat\u0131rlatma dozlar\u0131 \u00f6nerilmi\u015ftir. Komorbiditesi olmayan <50 ya\u015f ki\u015filer ve komorbiditesi olan 6 ay-17 ya\u015f \u00e7ocuklar orta riskli grup olarak de\u011ferlendirilmi\u015f ve bunlara primer a\u015f\u0131lama ve ilk hat\u0131rlatma dozlar\u0131n\u0131n ard\u0131ndan rutin ek hat\u0131rlatma dozlar\u0131 \u00f6nerilmemi\u015ftir. Komorbiditesi olmayan \u00b36 ay-17 ya\u015f \u00e7ocuklarsa d\u00fc\u015f\u00fck riskli grup olarak tan\u0131mlanm\u0131\u015f olup, bunlar\u0131n primer a\u015f\u0131lamas\u0131 konusuna, \u00fclkelerin olanaklar\u0131na ve hastal\u0131k y\u00fck\u00fcne g\u00f6re karar verilmesi \u00f6nerilmi\u015f, bu gruba da rutin hat\u0131rlatma dozlar\u0131 \u00f6nerilmemi\u015ftir (14) (Tablo 1)<\/strong><\/a>.<\/p>\n

Avrupa \u00fclkeleri ve ABD gibi y\u00fcksek gelirli \u00fclkelerde \u00b36 ay -17 ya\u015f t\u00fcm \u00e7ocuklara COVID-19 a\u015f\u0131lamas\u0131 \u00f6nerilmektedir.<\/p>\n

\u0130zolasyon \u00f6nlemlerinin kald\u0131r\u0131lm\u0131\u015f olmas\u0131 ve hafif seyirli hastal\u0131\u011fa kar\u015f\u0131 koruman\u0131n a\u015f\u0131lamalardan k\u0131sa s\u00fcre sonra azalmas\u0131 nedeniyle SARS-CoV-2\u2019nin toplumdan eradike edilmesi beklenmemektedir. G\u00fcn\u00fcm\u00fczde a\u015f\u0131laman\u0131n esas amac\u0131 COVID-19\u2019a ba\u011fl\u0131 hastane yat\u0131\u015flar\u0131n\u0131 ve \u00f6l\u00fcmleri azaltmakt\u0131r. Bu nedenle de \u00c7in, Fransa, Almanya, \u0130ngiltere ve Meksika gibi bir\u00e7ok \u00fclke g\u00fcncellenmi\u015f COVID-19 a\u015f\u0131s\u0131 ek dozlar\u0131n\u0131 sadece a\u011f\u0131r COVID-19 i\u00e7in en y\u00fcksek riskte olan gruplara \u00f6nermektedir (7). Ancak COVID-19 a\u015f\u0131lar\u0131n\u0131n akut COVID-19 sonras\u0131 durumlar\u0131 %40 oran\u0131nda azaltt\u0131\u011f\u0131 da g\u00f6sterilmi\u015ftir (15). Bu nedenle baz\u0131 uzmanlar ve ABD gibi baz\u0131 \u00fclkelerin sa\u011fl\u0131k otoriteleri ek dozlar\u0131 hem riskli gruplara bula\u015fma riskini hem COVID-19 s\u0131kl\u0131\u011f\u0131n\u0131 hem de akut COVID sonras\u0131 durumlar\u0131 azaltmak \u00fczere \u00b3 6 aydan itibaren herkese \u00f6nermektedir (5, 7, 15).<\/p>\n

Yeni XBB.1.5. a\u015f\u0131s\u0131yla primer ba\u011f\u0131\u015f\u0131klaman\u0131n, ba\u011f\u0131\u015f\u0131kl\u0131\u011f\u0131 bask\u0131lanm\u0131\u015flar ve \u22656 ay-4 ya\u015f aras\u0131 \u00e7ocuklar d\u0131\u015f\u0131nda tek doz olarak yap\u0131lmas\u0131 \u00f6nerilmektedir (Tablo 2)<\/strong><\/a>.<\/p>\n

Eyl\u00fcl 2023\u2019ten itibaren COVID-19\u2019un primer a\u015f\u0131lamas\u0131 ve hat\u0131rlatma dozu olarak hangi a\u015f\u0131lar\u0131n uygulanmas\u0131 en do\u011frusudur? <\/strong><\/span><\/p>\n

Dola\u015f\u0131mdaki su\u015flara kar\u015f\u0131, eski a\u015f\u0131lardan belirgin olarak daha etkili olmalar\u0131 ve ilk a\u015f\u0131lar\u0131n \u00e7ok fazla yineleyen uygulamalar\u0131nda, yeni su\u015flara kar\u015f\u0131 zay\u0131f yan\u0131t (immune imprinting) geli\u015fme riski nedeniyle, COVID-19\u2019un hem primer ba\u011f\u0131\u015f\u0131klamas\u0131nda hem de hat\u0131rlatma dozu olarak en g\u00fcncel a\u015f\u0131lar\u0131n kullan\u0131lmas\u0131 \u00f6nerilmektedir. \u015eu anda y\u00fcksek gelirli \u00fclkeler orijinal su\u015fu i\u00e7eren ilk a\u015f\u0131lar\u0131 ve 2022\u2019de kullan\u0131ma sokulmu\u015f iki de\u011ferli a\u015f\u0131lar\u0131 kullan\u0131mdan kald\u0131rm\u0131\u015ft\u0131r, Eyl\u00fcl 2023 itibariyle bu \u00fclkelerde hem primer a\u015f\u0131lamada hem de hat\u0131rlatma dozu olarak kullan\u0131lmak \u00fczere XBB.1.5 omikron su\u015funu i\u00e7eren SARS-CoV-2 a\u015f\u0131lar\u0131n\u0131 kullan\u0131lmaya ba\u015flam\u0131\u015ft\u0131r (1,7) (Tablo 2)<\/strong><\/a>.<\/p>\n

G\u00fcncellenmi\u015f COVID-19 a\u015f\u0131lar\u0131na eri\u015filemeyen \u00fclkemiz gibi \u00fclkelerde ne yapmal\u0131d\u0131r? <\/strong><\/span><\/p>\n

COVID-19\u2019dan korunmada en g\u00fcncel a\u015f\u0131lar\u0131n en etkili oldu\u011fu bilimsel olarak g\u00f6sterilmi\u015f olmakla birlikte, XBB.1.5 i\u00e7eren yeni a\u015f\u0131lara d\u00fcnyan\u0131n pek \u00e7ok \u00fclkesinde ula\u015f\u0131labilmesi m\u00fcmk\u00fcn olamayacakt\u0131r. Orijinal su\u015fu i\u00e7eren ilk COVID-19 mRNA a\u015f\u0131lar\u0131n\u0131n, a\u011f\u0131r hastal\u0131\u011fa ve \u00f6l\u00fcme kar\u015f\u0131 halen bir miktar koruma sa\u011flad\u0131\u011f\u0131 ger\u00e7e\u011fine dayanarak, yeni g\u00fcncellenmi\u015f a\u015f\u0131lara ula\u015f\u0131lamayan \u00fclkelerde, eski a\u015f\u0131lar\u0131n \u00f6zellikle y\u00fcksek riskli gruplarda ve primer a\u015f\u0131lama i\u00e7in ve ilk hat\u0131rlatma dozu olarak halen kullan\u0131labilece\u011fi d\u00fc\u015f\u00fcn\u00fclmektedir (13). Bu gerek\u00e7elerle; \u00f6zellikle ba\u011f\u0131\u015f\u0131kl\u0131\u011f\u0131 bask\u0131lanm\u0131\u015f ki\u015filere, ileri ya\u015fta (>75) olup altta yatan ciddi hastal\u0131\u011f\u0131 olanlara son a\u015f\u0131lar\u0131ndan veya COVID-19 hastal\u0131\u011f\u0131ndan 6-12 ay sonra orijinal su\u015fu i\u00e7eren a\u015f\u0131yla hat\u0131rlatma yap\u0131labilir. Bu ki\u015filerde a\u015f\u0131lama karar\u0131 hekime dan\u0131\u015f\u0131larak bireysel olarak verilmelidir. Bu risk gruplar\u0131 d\u0131\u015f\u0131nda kalan ve primer a\u015f\u0131lama \u015femas\u0131n\u0131 mRNA a\u015f\u0131lar\u0131 ile tamamlam\u0131\u015f olan ki\u015filere orijinal su\u015f i\u00e7eren a\u015f\u0131lar ile hat\u0131rlatma dozu yap\u0131lmas\u0131, a\u015f\u0131 etkinli\u011findeki azalma ve hastal\u0131k seyrine s\u0131n\u0131rl\u0131 etkileri nedeniyle \u00f6nerilmemektedir. \u00a0\u00dclkemizde, dola\u015f\u0131mdaki varyantlara kar\u015f\u0131 daha\u00a0 etkili bir koruma sa\u011flayan XBB.1.5 omikron su\u015funu i\u00e7eren SARS-CoV-2 a\u015f\u0131lar\u0131n\u0131n olabilecek en k\u0131sa s\u00fcrede kullan\u0131ma girmesine y\u00f6nelik giri\u015fimler yap\u0131lmal\u0131d\u0131r.<\/p>\n

COVID-19 a\u015f\u0131lar\u0131 konusunda gelecekten ne beklenmektedir? <\/strong><\/span><\/p>\n

Geli\u015ftirilmi\u015f ve g\u00fcncellenmi\u015f COVID-19 a\u015f\u0131lar\u0131 a\u011f\u0131r hastal\u0131\u011fa kar\u015f\u0131 korumada olduk\u00e7a ba\u015far\u0131l\u0131 olmalar\u0131 nedeniyle halen kullan\u0131lmakla birlikte, varyantlardan etkilenmeyen pan-koronavirus a\u015f\u0131lar\u0131n\u0131n ve ayn\u0131 zamanda nazal uygulananlar gibi hafif hastal\u0131\u011f\u0131 da engelleyebilecek yeni a\u015f\u0131lar\u0131n geli\u015ftirilmesi gerekmekte ve bu konularda yo\u011fun ara\u015ft\u0131rmalar devam etmektedir.<\/p>\n

Tablo 1.<\/strong> COVID-19 as\u0327\u0131lamas\u0131 ic\u0327in o\u0308ncelikli gruplar ve o\u0308neriler. (B\u00fcy\u00fctmek i\u00e7in tabloya t\u0131klay\u0131n\u0131z.) \"\"<\/a><\/em><\/p>\n

Tablo 2.<\/strong> XBB.1.5. ic\u0327eren gu\u0308ncel mRNA as\u0327\u0131lar\u0131 ic\u0327in uygulama o\u0308nerileri (B\u00fcy\u00fctmek i\u00e7in tabloya t\u0131klay\u0131n\u0131z.)\u00a0\"\"<\/a>
\n<\/em><\/p>\n

Kaynaklar<\/strong><\/p>\n

    \n
  1. Interim Clinical Considerations for Use of COVID-19 Vaccines Currently Authorized in the United States. [Internet]. USA, Center for Disease Control (CDC). (September 15, 2023; cited September 17, 2023). Available from:<\/em> https:\/\/www.cdc.gov\/vaccines\/covid-19\/clinical-considerations\/covid-19-vaccines-us.html<\/a><\/li>\n
  2. COVID-19 vaccine surveillance report Week 23. [Internet]. UK, Health Security Agency, (June 8, 2023; cited September 17, 2023).<\/em><\/li>\n
  3. JCVI statement on spring 2023 COVID-19 vaccinations. [Internet]. UK, Department of Health and Social Care. (February 22, 2023; cited September 17, 2023). Available from: https:\/\/www.gov.uk\/government\/publications\/spring-2023-covid-19-vaccination-programme-jcvi-advice-22-february-2023\/jcvi-statement-on-spring-2023-covid-19-vaccinations-22-february-2023<\/a><\/li>\n
  4. FDA Takes Action on Updated mRNA COVID-19 Vaccines to Better Protect Against Currently Circulating Variants. [Internet]. USA, Food and Drug Administration ( September 11, 2023; cited September 17, 2023) Available from: https:\/\/www.fda.gov\/news-events\/press-announcements\/fda-takes-action-updated-mrna-covid-19-vaccines-better-protect-against-currently-circulating<\/a>,<\/li>\n
  5. Statement on the antigen composition of COVID-19 vaccines. [Internet]. World Health Organization (May 18, 2023; cited July 18, 2023). Available from: https:\/\/www.who.int\/news\/item\/18-05-2023-statement-on-the-antigen-composition-of-covid-19-vaccines<\/a><\/li>\n
  6. ECDC-EMA statement on updating COVID-19 vaccines composition for new SARS-CoV-2 virus variants.EMA\/257222\/2023. [Internet]. European Medicines Agency (June 6, 2023; cited September 17, 2023) available from: https:\/\/www.ema.europa.eu\/en\/documents\/other\/ecdc-ema-statement-updating-covid-19-vaccines-composition-new-sars-cov-2-virus-variants_en.pdf<\/a><\/li>\n
  7. Lenharo M. COVID boosters are back: what scientists say about whether to get one. Nature. 2023. doi: 10.1038\/d41586-023-02840-x.<\/li>\n
  8. Tenforde MW, Weber ZA, Natarajan K, et al.\u00a0Early Estimates of Bivalent mRNA Vaccine Effectiveness in Preventing COVID-19-Associated Emergency Department or Urgent Care Encounters and Hospitalizations Among Immunocompetent Adults – VISION Network, Nine States, September-November 2022. MMWR 2022 \/ 71(5152);1616\u20131624, https:\/\/www.cdc.gov\/mmwr\/volumes\/71\/wr\/mm715152e1.htm<\/a><\/li>\n
  9. Johnson AG, Linde L, Ali AR, DeSantis A, Shi M, Adam C, et al. COVID-19 Incidence and Mortality Among Unvaccinated and Vaccinated Persons Aged \u226512 Years by Receipt of Bivalent Booster Doses and Time Since Vaccination – 24 U.S. Jurisdictions, October 3, 2021-December 24, 2022. MMWR Morb Mortal Wkly Rep. 2023;72(6):145-152. doi: 10.15585\/mmwr.mm7206a3.<\/li>\n
  10. Chalkias S, McGhee N, Whatley JL, Essink B, Brosz A, Tomassini JE,\u00a0et al. Safety and Immunogenicity of XBB.1.5-Containing mRNA Vaccines medRxiv\u00a008.22.23293434;\u00a0doi:https:\/\/doi.org\/10.1101\/2023.08.22.23293434<\/li>\n
  11. Qu P, Xu K, Faraone JN, Goodarzi N, Zheng YM, Carlin C,\u00a0et al. Immune Evasion, Infectivity, and Fusogenicity of SARS-CoV-2 Omicron BA.2.86 and FLip Variants. bioRxiv [Preprint] (September 11,2023;\u00a0https:\/\/doi.org\/10.1101\/2023.09.11.557206<\/a><\/li>\n
  12. Sheward Dj, Yang Y, Westerberg M, \u00d6ling S, Muschiol S, Sato T, et al. Sensitivity of BA.2.86 to prevailing neutralising antibody responses. bioRxiv [Preprint] September 2, 2023; doi: https:\/\/doi.org\/10.1101\/2023.09.02.556033<\/li>\n
  13. Jian F, Yang S,\u00a0Yu Y, Song W, Yisimayi A, Chen X, et al. Convergent evolution of SARS-CoV-2 XBB lineages on receptor-binding domain 455-456 enhances antibody evasion and ACE2 binding. bioRxiv\u00a0[Preprint] August 30, 2023; https:\/\/doi.org\/10.1101\/2023.08.30.555211<\/li>\n
  14. WHO SAGE Roadmap for prioritizing uses of COVID-19 vaccines. [Internet]. World Health Organization (March 30,2023; cited July 18, 2023). Available from: https:\/\/www.who.int\/publications-detail-redirect\/WHO-2019-nCoV-Vaccines-SAGE-Roadmap<\/li>\n
  15. Watanabe A, Iwagami M, Yasuhara J, Takagi H, Kuno T. Protective effect of COVID-19 vaccination against long COVID syndrome: A systematic review and meta-analysis. Vaccine. 2023 10;41(11):1783-1790. doi: 10.1016\/j.vaccine.2023.02.008.<\/li>\n<\/ol>\n","protected":false},"excerpt":{"rendered":"

    COVID-19 a\u015f\u0131lar\u0131n\u0131n ne faydas\u0131 oldu? COVID-19\u2019a kar\u015f\u0131 ilk kullan\u0131ma giren ve orijinal Wuhan SARS-CoV-2 su\u015funu i\u00e7eren tek de\u011ferli a\u015f\u0131lar g\u00fcn\u00fcm\u00fcze kadar yakla\u015f\u0131k 14 milyar doz uygulanm\u0131\u015f olup, a\u011f\u0131r COVID-19\u2019u ve buna ba\u011fl\u0131 \u00f6l\u00fcmleri engellemede >%90\u2019dan fazla etkili olarak 20 milyondan fazla ki\u015finin hayat\u0131n\u0131 kurtarm\u0131\u015ft\u0131r (1). COVID-19 a\u015f\u0131lar\u0131 g\u00fcvenli midir? \u0130lk yap\u0131lmaya ba\u015fland\u0131\u011f\u0131 g\u00fcnden beri COVID-19 a\u015f\u0131lar\u0131n\u0131n etkinli\u011fini ve g\u00fcvenirli\u011fini d\u00fczenli bir \u015fekilde izleyen Birle\u015fik Krall\u0131k Sa\u011fl\u0131k G\u00fcvenli\u011fi Ajans\u0131\u2019n\u0131n k\u0131sa s\u00fcre \u00f6nce yay\u0131mlad\u0131\u011f\u0131 raporda bu a\u015f\u0131lar\u0131n yararlar\u0131n\u0131n, potansiyel risklerinden \u00e7ok \u00e7ok fazla oldu\u011funun belirlendi\u011fi bildirilmi\u015ftir (2). COVID-19 a\u015f\u0131lar\u0131 neden g\u00fcncellenmelidir? SARS-CoV-2\u2019ye kar\u015f\u0131 a\u015f\u0131 korumas\u0131 zamanla ve yeni ortaya \u00e7\u0131kan, ba\u011f\u0131\u015f\u0131kl\u0131ktan ka\u00e7an […]<\/p>\n","protected":false},"author":4,"featured_media":6210,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[1],"tags":[],"_links":{"self":[{"href":"https:\/\/www.klimik.org.tr\/koronavirus\/wp-json\/wp\/v2\/posts\/6209"}],"collection":[{"href":"https:\/\/www.klimik.org.tr\/koronavirus\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.klimik.org.tr\/koronavirus\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.klimik.org.tr\/koronavirus\/wp-json\/wp\/v2\/users\/4"}],"replies":[{"embeddable":true,"href":"https:\/\/www.klimik.org.tr\/koronavirus\/wp-json\/wp\/v2\/comments?post=6209"}],"version-history":[{"count":4,"href":"https:\/\/www.klimik.org.tr\/koronavirus\/wp-json\/wp\/v2\/posts\/6209\/revisions"}],"predecessor-version":[{"id":6214,"href":"https:\/\/www.klimik.org.tr\/koronavirus\/wp-json\/wp\/v2\/posts\/6209\/revisions\/6214"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.klimik.org.tr\/koronavirus\/wp-json\/wp\/v2\/media\/6210"}],"wp:attachment":[{"href":"https:\/\/www.klimik.org.tr\/koronavirus\/wp-json\/wp\/v2\/media?parent=6209"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.klimik.org.tr\/koronavirus\/wp-json\/wp\/v2\/categories?post=6209"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.klimik.org.tr\/koronavirus\/wp-json\/wp\/v2\/tags?post=6209"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}