科学美国人60秒 最新新冠：小孩子的疫苗在哪里？（在线收听）

Where Are Vaccines for Little Kids?' and the Latest on Long COVID

最新新冠：小孩子的疫苗在哪里？

Tanya Lewis: Hi, and welcome to COVID, Quickly, a Scientific American podcast series.

Josh Fischman: This is your fast-track update on the COVID pandemic. We bring you up to speed on the science behind the most urgent questions about the virus and the disease. We demystify the research and help you understand what it really means.

坦尼娅·刘易斯：嗨，欢迎收看科维德，快播，美国科学播客系列节目。

乔希·菲奇曼：这是你对新冠病毒大流行的快速更新。我们将向您介绍有关病毒和疾病的最紧迫问题背后的科学知识。我们揭开了研究的神秘面纱，并帮助您理解它的真正含义。

Lewis: I’m Tanya Lewis.

Fischman: I’m Josh Fischman.

Lewis: And we’re Scientific American’s senior health editors. Today: vaccines for the littlest kids may be almost here!

刘易斯：我是坦尼娅·刘易斯。

费奇曼：我是乔希·费奇曼。

刘易斯：我们是《科学美国人》的高级健康编辑。今天：为最小的孩子接种疫苗可能就快到了！

Fischman: And new evidence about long COVID shows who gets it most often, and what the most common symptoms are.

It’s been nearly a year and a half since COVID vaccines were authorized for adults in the U.S. Yet kids under five are still not eligible, even though testing in children began over six months ago. Could this be about to change?

费奇曼：关于长冠状病毒的新证据表明，谁最常感染，最常见的症状是什么。

美国成人接种新冠病毒疫苗已经将近一年半了，但五岁以下的儿童仍然没有资格接种，尽管六个多月前开始对儿童进行检测。这会改变吗？

Lewis: Possibly. I can understand why many parents are frustrated. They’ve been told for months that a vaccine is right around the corner. But there have been some promising developments.

Like what? Have there been good results from the tests?

刘易斯：可能吧。我能理解为什么许多父母感到沮丧。几个月来，他们被告知疫苗即将问世。但也有一些有希望的发展。

比如什么？测试结果是否良好？

Fischman: Just a couple of weeks ago, vaccine-maker Moderna announced it was filing for emergency use authorization for its vaccine for kids ages six months to six years. And Pfizer recently announced in a press release that its vaccine was 80 percent effective at preventing symptomatic COVID in kids under five, although they haven’t made the data public yet.

Does that get us any closer to getting a green light from the FDA?

菲奇曼：就在几周前，疫苗制造商摩德纳宣布，它正在申请6个月至6岁儿童疫苗的紧急使用授权。辉瑞公司最近在一份新闻稿中宣布，其疫苗在预防5岁以下儿童出现症状性新冠病毒方面有80%的有效性，尽管他们尚未公布相关数据。

这是否使我们更接近于获得FDA的批准？

Lewis: SciAm contributor Charlie Schmidt asked experts about when we can expect a vaccine for the littlest ones, what the reasons are for the holdup, and more. The FDA’s vaccine advisory committee is scheduled to meet June 8th, 21st and 22nd to discuss making younger children eligible.

刘易斯：SciAm撰稿人CharlieSchmidt向专家询问，我们何时可以为最小的婴儿接种疫苗，出现延误的原因是什么，等等。FDA疫苗咨询委员会计划于6月8日、21日和22日召开会议，讨论让年幼儿童符合资格。

Fischman: Did Charlie get any inkling of what might happen at these meetings?

Lewis: He spoke with Arnold Monto, acting chair of the advisory committee and an epidemiologist at the University of Michigan School of Public Health. Monto said the FDA could issue an EUA for kids within a day or two of those meetings, but quote “there are no guarantees.” One possibility is the committee could recommend authorizing the vaccine only for kids who are high-risk, or immunocompromised.

Fischman: Why not just authorize it for all the kids?

费奇曼：查理对这些会议上可能发生的事情有任何线索吗？

刘易斯：他与咨询委员会代理主席、密歇根大学公共卫生学院流行病学家阿诺德·蒙托进行了交谈。蒙托说，美国食品和药物管理局可以在这些会议的一两天内为儿童发放EUA，但引用“没有保证”一种可能性是，委员会可以建议仅授权高危儿童或免疫功能低下儿童接种疫苗。

费奇曼：为什么不授权给所有的孩子呢？

Lewis:  Well, the FDA has a very high bar for approving new vaccines or other biological products for children. Kids already have a pretty low risk of serious outcomes from COVID, so the companies have to show that their vaccines do not cause other problems.

Fischman: So far, they haven’t seen any serious safety issues, have they?

刘易斯：嗯，美国食品和药物管理局对批准儿童用新疫苗或其他生物制品有很高的要求。儿童感染新冠病毒的严重后果风险已经相当低，因此公司必须证明他们的疫苗不会导致其他问题。

费奇曼：到目前为止，他们还没有看到任何严重的安全问题，是吗？

Lewis:  No, most of the side effects have been mild and similar to those seen in older kids or adults. mRNA vaccines can cause side effects like fever, which may cause seizures in babies and young children. But Moderna and Pfizer have been able to achieve strong immune responses even at fairly low doses, which reduces these risks. And there haven’t been any cases of myocarditis, the heart inflammation that occured in rare cases among teenagers, mostly in boys.

Fischman: So the vaccines appear to be safe. That’s good. But how effective are they?

刘易斯：没有，大多数副作用都是轻微的，与大孩子或成年人的副作用相似。mRNA疫苗可以引起副作用，如发热，这可能会导致婴儿和幼儿癫痫发作。但Moderna和辉瑞公司已经能够在相当低的剂量下实现强大的免疫反应，从而降低了这些风险。目前还没有任何心肌炎病例，这种心脏炎症在青少年中发生的情况很少见，主要发生在男孩身上。

费奇曼：所以疫苗看起来是安全的。那很好。但它们的效果如何？

Lewis:  That’s a great question. Much of the initial data has actually come from looking at the immune response to the vaccine—in other words, the level of so-called neutralizing antibodies produced in people who are given it. By comparing these levels to levels seen in older kids or adults who had good protection against getting COVID, you can extrapolate that protection to young kids. This is known as immunobridging.

刘易斯：这是个很好的问题。许多初始数据实际上来自于对疫苗免疫反应的观察，换句话说，就是服用疫苗的人产生的所谓中和抗体的水平。通过将这些水平与对感染新冠病毒有良好保护作用的大孩子或成年人的水平进行比较，可以推断出对幼儿的保护作用。这被称为免疫桥接。

Fischman: So that’s looking at parts of the immune system and how they behave. What about real world effects? Did the vaccines lower infection rates in kids?

Lewis: For actual efficacy data, Pfizer has only announced data on about 1,700 kids, showing an efficacy rate for three doses of 80.3 percent. Moderna reported a lower efficacy rate of 37 to 51 percent for its two dose vaccine in kids under six. Whether or not that will clear the FDA’s bar remains to be seen.

费奇曼：这就是免疫系统的各个部分以及它们的行为。那么真实世界的效果呢？疫苗是否降低了儿童的感染率？

刘易斯：关于实际疗效数据，辉瑞公司只公布了大约1700名儿童的数据，显示三剂的有效率为80.3%。Moderna报告称，其两剂疫苗对6岁以下儿童的有效率较低，为37%至51%。这是否会清除FDA的禁令还有待观察。

Fischman: Ok, interesting. That’s kind of a big spread in efficacy. Is the FDA waiting to evaluate Moderna’s data until Pfizer’s data are in?

Lewis: That’s been a point of contention. Politico reported that the agency was holding off on reviewing Moderna’s submission until Pfizer’s was in. But FDA Commissioner Robert Califf told Andy Slavitt, President Biden’s former senior adviser for COVID response, on his “In the Bubble” podcast that there is quote “no reason for the FDA to wait” to review it. Pfizer expects to submit its data by the time the FDA’s advisory committee meets in June, so they may end up reviewing both Pfizer’s and Moderna’s data at the same time.

费奇曼：好的，很有趣。这在功效上有很大的差别。FDA是否正在等待辉瑞公司的数据出来后再评估Moderna的数据？

刘易斯：这是一个争论点。Politico报道称，该机构推迟审查Moderna提交的材料，直到辉瑞提交。但美国食品和药物管理局局长罗伯特·卡里夫（RobertCaliff）在其“泡沫中”的播客中告诉拜登总统前应对新冠肺炎高级顾问安迪·斯拉维特（AndySlavitt），美国食品和药物管理局（FDA）没有理由等待对其进行审查。辉瑞预计在6月FDA咨询委员会开会时提交数据，因此他们可能会同时审查辉瑞和摩德纳的数据。

Fischman: And, like lots of worried parents, we’ll be watching that closely.

Lewis:  It’s becoming clear that acute COVID isn’t the only consequence of the disease. Long COVID, symptoms that drag on, is a real problem. Two new reports shed some light on who gets it, and what it looks like.

费奇曼：就像许多担心的家长一样，我们会密切关注这一点。

刘易斯：越来越清楚的是，急性冠状病毒并不是这种疾病的唯一后果。长期的冠状病毒，持续的症状，是一个真正的问题。两份新的报告揭示了谁得到了它，以及它的样子。

Fischman: There’s still no strict definition of long COVID, Tanya. But estimates are that between 10 to 30 percent of infected people will have at least one symptom, a real disabling problem, that afflicts them at least a month after they’ve cleared the virus, and sometimes for half a year.  Often they have several symptoms.

费奇曼：对于长冠状病毒还没有严格的定义，坦尼娅。但据估计，10%至30%的感染者至少会有一种症状，一种真正的致残问题，在他们清除病毒后至少一个月，有时甚至半年后，这种症状会折磨他们。他们通常有几种症状。

Lewis: I saw a new CDC report that said one out of five infected people could develop long COVID. What are the most common problems?

Fischman: According to a new study, what affects people most often is serious fatigue, the kind that exhausts you after walking from one room in your house to another. Then there’s trouble catching your breath, loss of smell, headaches, insomnia, and memory trouble. There’s also difficulty concentrating, what people often call “brain fog.”

刘易斯：我看到美国疾病控制与预防中心的一份新报告说，每五个感染者中就有一个可能患上长冠状病毒。最常见的问题是什么？

Fischman：根据一项新的研究，最常影响人们的是严重疲劳，这种疲劳会让你在从一个房间走到另一个房间后感到筋疲力尽。还有呼吸困难、嗅觉丧失、头痛、失眠和记忆障碍。注意力也很难集中，人们通常称之为“脑雾”

This list comes from new research in the Annals of Internal Medicine, and it’s the first report from a long-term study being done by the National Institutes of Health. These people were all assessed 6 weeks after testing positive for the virus.

Lewis: Are a lot of these people older, because age seems to make people more vulnerable to COVID?

这份名单来自《内科年鉴》的最新研究，也是美国国立卫生研究院进行的一项长期研究的第一份报告。这些人在病毒检测呈阳性6周后都接受了评估。

刘易斯：这些人中有很多人年龄更大，因为年龄似乎使人更容易感染新冠病毒？

Fischman: Advanced age actually doesn’t seem to be a big risk factor, Tanya. In fact, people aged 39-50 are most likely to be diagnosed with post-COVID conditions. That comes from a huge analysis of private health insurance claims, done on more than 78,000 people, collected by a nonprofit group called FAIR Health.

费奇曼：塔尼亚，实际上，高龄似乎不是一个大的风险因素。事实上，39-50岁的人最有可能被诊断为新冠肺炎后疾病。这来自一个名为“公平健康”的非营利组织对78000多人的私人健康保险索赔进行的巨大分析。

Lewis: They did find that women were more likely than men to have long-lasting problems, didn’t they? About 60 percent compared with about 40 percent?

Fischman: Yes, they did. One other big finding was that severe disease wasn’t a risk factor. Three-quarters of these people hadn’t been hospitalized. So you can have a mild case and still suffer months later.

刘易斯：他们确实发现女性比男性更容易出现长期问题，不是吗？60%左右，而40%左右？

费奇曼：是的，他们做到了。另一个重大发现是，严重疾病不是危险因素。其中四分之三的人没有住院。所以你的病情很轻，几个月后仍然会受苦。

Lewis:  One of the problems long COVID patients have is that this isn’t an easy condition to diagnose. Is there any new info on that?

Fischman: The study confirmed that difficulty. The NIH team put people in their study through blood tests, lung tests, heart tests, and a lot more, and they didn’t find a lot of abnormalities.

刘易斯：长期冠状病毒感染患者的一个问题是，这不是一种容易诊断的疾病。这方面有什么新消息吗？

费奇曼：研究证实了这个困难。美国国立卫生研究院的研究小组让人们进行了血液测试、肺部测试、心脏测试以及更多的测试，但他们没有发现很多异常。

That means the condition is real, but the tests aren’t good enough. It’s a warning to doctors not to dismiss patients, not to say “it’s in your head” or anything like that. Physicians need to work hard to find treatments, because this population is growing as the pandemic continues, and they need help.

这意味着情况是真实的，但测试还不够好。这是对医生的一个警告，不要解雇病人，不要说“这在你脑子里”或诸如此类的话。医生需要努力寻找治疗方法，因为随着大流行的持续，这一人群正在增长，他们需要帮助。

Lewis: Now you’re up to speed. Thanks for joining us. Our show is edited by Jeff DelViscio and Tulika Bose.

刘易斯：现在你掌握了速度。谢谢你加入我们。我们的节目由Jeff DelViscio和Tulika Bose编辑。

Fischman: Come back in two weeks for the next episode of COVID, Quickly! And check out SciAm.com for updated and in-depth COVID news.

费奇曼：两周后再来看下一集《新冠肺炎》，快点！看看SciAm。com获取最新和深入的新冠病毒新闻。