Abramson and other experts argue th

Abramson and other experts argue that the effects of the campaign need to be studied. One important question is safety. The yellow fever vaccine is itself a living virus that can replicate inside the body and, in very rare cases, cause a disease in which the vaccine virus proliferates in multiple organs, often leading to death. Although a lower dose would be expected to lead to fewer side effects, that may not be the case. Some researchers have argued that lower doses may be slower to kick the immune system into gear, which could cause the vaccine virus to linger in the body for longer and actually increase the risk of some side effects. A few studies have found no such effect, but because severe side effects are very rare (about one in 2 million), small trials cannot provide definitive answers.
The other question is efficacy. A recent study on 749 men in Brazil showed that a 46-fold diluted vaccine triggered the same antibody response as a full dose. A study in the Netherlands found that a fifth of a normal dose injected intradermally was just as effective as a normal dose injected subcutaneously (the usual route).
But more data on the efficacy of the lower dose need to be collected, especially because an African population may react differently to those studied in the trials. Ideally, scientists would set up a randomized, controlled clinical trial to assess the immune response to the lower dose, says Tom Monath, a virologist who has studied yellow fever for decades and currently works at NewLink Genetics, a biotech company in Ames, Iowa. But Monath concedes that that is unlikely given the time pressure and the logistical problems. At the very least, researchers should collect blood samples and compare the antibody responses from people who received the full and the lower dose, he argues. “It wouldn't be a formal study but it would give you some confidence that people have responded appropriately,” Monath says. "I think that really should be done.”
Another important question is whether 0.1 milliliters of the vaccine also offers lifelong protection. If not, the population will have to be revaccinated in the future. It’s also not clear whether lower doses will be protective in young children.
In a paper advocating the dose-sparing strategy that Monath and eight other scientists just submitted, they go one step further. "If the worst-case scenario were to come to pass and yellow fever spread in Asia, serious consideration should be given to using a one-tenth dose,” the authors write. "Although it would probably protect any age group for only a few months, a one-tenth dose should mitigate the severity of a yellow fever infection, preventing some deaths.“

結果 (中文) 1:

艾布拉姆森和其他专家认为，市场活动的效果需要进行研究。一个重要的问题是安全。黄热病疫苗本身就是一种活病毒，可以在体内复制，在非常罕见的情况下，造成一种疾病的疫苗病毒遍布多个器官，往往导致死亡。虽然预计低剂量将导致副作用更少，这可能并非如此。一些研究者认为低剂量可能较慢呼呼免疫系统，从而可能导致疫苗病毒在体内持续时间更长，实际上增加了一些副作用的风险。几项研究已经发现没有这样的效果，而是因为严重的副作用是非常罕见的 （约一中 200 万），小型试验不能提供确定的答案。另一个问题是疗效。749 人在巴西的最近研究表明 46-fold 稀释的疫苗触发作为充分剂量相同的抗体反应。荷兰的一项研究发现，有五分之一的皮内注射正常剂量是和正常剂量皮下注射 （惯常航线） 一样有效。但是，低剂量疗效更多数据需要收集，尤其是因为非洲人口到那些研究试验可能作出不同的反应。理想情况下，科学家们将设置随机、 对照的临床试验以评估对低剂量免疫反应说汤姆 Monath，一名病毒学家已经研究了几十年的黄热病，目前在 NewLink 遗传学，艾姆斯，爱荷华州一家生物科技公司工作。但 Monath 也承认这是不太可能给出的时间压力和后勤问题。至少，他认为研究人员应收集血液样本和比较人收到充分和低剂量的抗体反应。"它不是一个正式的研究，但它会给你一些信心人有适当地作出回应，"Monath 说。"我认为，是否真的应该能做到。另一个重要的问题是是否 0.1 毫升的疫苗也提供终身保护。如果不是，人口将不得不在未来 revaccinated。它也是不清楚低剂量会否在年幼的儿童保护。在提倡节省剂量战略，Monath 和八个其他科学家，只是提交一篇论文，他们走一步。作者写道"如果最坏的情况是要来传递和黄热病在亚洲蔓延，严重应考虑到使用的十分之一剂量，"。"虽然只有几个月可能会保护任何年龄组，十分之一剂量应减少黄热病感染，防止一些人死亡的严重程度。"