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Son iki haftada aşılamada hızlanan Türkiye 'de, şimdiye dek ilk doz aşı olanların sayısı 31 milyona, iki doz aşılananların sayısı ise 15 milyona ulaştı. Sağlık Bakanı Fahrettin Koca , 25 Haziran Cuma gününden itibaren 18 yaşından gün alan tüm vatandaşlar için aşı randevularının tanımlanacağını açıkladı. Bundan böyle risk grubu, meslek, yaş sınırına bakılmaksızın isteyen herkes aşı olabilecek.
Öte yandan bilim çevrelerinde, dünyada 12 yaş üstü çocuklar ve 20 yaş öncesi gençleri aşılayan ülkelerden elde edilen verilerin değerlendirilerek, bu yaş grubu için aşı dozlarının düşürülmesi veya iki doz arası sürenin uzatılması yönünde görüşler tartışılmaya başlandı.
Sağlık Bakanlığı Koronavirüs Bilim Kurulu Üyesi ve İstanbul Üniversitesi İstanbul Tıp Fakültesi Mikrobiyoloji ve Enfeksiyon Hastalıkları Anabilim Dalı Öğretim Üyesi Prof. Dr. Serap Şimşek Yavuz , çocuk ve genç erişkin nüfusta daha düşük doz aşılamalara dair çalışmaların sürdüğüne işaret ederek "Çocukların aşılanması ile ilgili tabii çok soru işareti var. Bununla ilgili çalışmalar devam ediyor. Biliyorsunuz genç erişkinleri aşılayan ülkeler var. Oradaki sonuçları gözlüyoruz. Genç erişkinlerde elimizdeki aşıların dozunun fazla gelebileceği ile ilgili görüşler olduğu için, onların güvenlik verileri değerlendirilip belki doz azaltılması düşünülebilir" dedi.
"BÜYÜKLER AŞILANDIKÇA ÇOCUKLAR DA KORUNUYOR" Özellikle mRNA aşılarında 20 yaş altı grup ve çocuklar için daha az dozla aşı çalışmalarının yapıldığına da işaret eden Prof. Dr. Yavuz, iki doz arası sürenin de uzatılabileceğini söyleyerek "Bu çalışmaların çok kısa bir sürede sonuçlarını göreceğiz ve hangi dozlarda daha güvenli bir şekilde bu aşılar kullanılabilecek, bu belirlenecek. Yine ülkemizde de kullanılan CoronaVac aşısı, çocuklarda kullanımı için Çin'de onay aldı. Faz 2 çalışmasını bitirdiler ama henüz yayını okumadık.
Sonuçlarını bilmiyoruz. Onların da bir iki ay içinde sonuçları ortaya çıkmış olacak. Hem mRNA aşılarından hem de CoronaVac aşısında ve diğer bazı aşılarda da çocuk yaş grubundaki çalışmaları devam ediyor. Onları gördükten sonra çocuklar için aşıları Türkiye'de de daha rahatlıkla uygulayabileceğiz. Ama her koşulda şunu rahatlıkla söyleyebiliriz ki, çocuklar şu an aşılanmayan gruptalar ve onların okuluna gidebilmesi, normal hayatlarına dönebilmesi için öncelikle büyüklerin aşılanması gerekiyor.
İsrail'de büyükler aşılandıktan sonra toplumdaki bağışıklık oranı yüzde 70'lere yaklaştı ve çocuklarda görülen enfeksiyon oranları çok çok azaldı. Yani büyükleri ne kadar aşılayabilirsek çocuklarda o kadar az enfeksiyon göreceğiz" şeklinde konuştu.
YENİ NESİL AŞI MI HATIRLATMA DOZU MU? Bağışıklık sistemini yeterince uyaran bir aşının bütün varyantlarda etkili olabileceğini söyleyen Prof. Dr. Yavuz, asıl önemli olanın hatırlatma dozu olduğunu ve bunun da mutant suşlara göre yenilenmiş aşılarla yapılmasa bile koruyuculuk sağlayabileceğini söyleyerek, her yeni varyantta aşıların yenilenmesi mi gerekecek tartışmalarına dair ise şu bilgileri verdi:
"Aşılar, yeterince bağışıklık oluşturduğu sürece tüm varyantlarda işe yarar aslına bakarsanız. O nedenle hatırlatma dozları da yapıldığı zaman, varyantlardaki etkinlik de artacaktır. Ama tabii şu anda araştırılan bir diğer konu da virüsün antijen yapısı değişirse, aşıya bu mutant virüsün antijenini koyarsak acaba daha mı iyi yanıt oluşur? Onun için de şöyle çalışmalar yapılıyor, yeni aşılara o mutant suşlar konarak diğer mutantlara karşı da etkinliğine bakılıyor. Mesela Beta (Güney Afrika) varyantı kullanarak yapılan çalışmalar var.
O varyantla geliştirilen aşıların, diğer bütün varyantlarda da gayet güzel etkili olan bir aşı ortaya çıkıyor. Ama temel nokta, şu anda elimizdeki aşılarla etkili bir yanıt oluşturmak. Elimizdeki şu an yapmakta olduğumuz mRNA aşıları çift dozda zaten çok etkili bir yanıt oluşturduğu için , büyük oranda varyantlardan da korumuş oluyor. Yani üçüncü dozu yeni varyanta göre üretilmiş aşı olarak da yapsanız, şu andaki aşıdan da rapel dozu yapsanız, bağışık cevabınız arttığı için, varyantlardan da koruyor."
İKİ DOZ ARASI SÜRE VE AŞISIZLAR DELTA VARYANTINI BASKIN HALE GETİRDİ Yüksek orandaki aşılamalara rağmen Delta varyantının baskın hale geldiği İngiltere'de vaka sayılarının artmasının asıl nedeninin aşısız grup olduğuna dikkat çeken Prof. Dr. Yavuz, bir diğer nedenin de İngiltere'de iki aşı dozu arası sürenin 3 aya kadar uzatılması olduğunu söyledi.
Prof. Dr. Yavuz, "İngiltere'de şöyle bir durum var biliyorsunuz. Orada tek doz aşılayıp arkasından 3 ay geçtikten sonra ikinci dozları yaptılar. Delta varyantına karşı tek doz zaten etkili değil. Bizde öyle bir şey olmayacak. 3 ay uzamayacak iki doz arası, en fazla 6 hafta için de yapılması planlanıyor. Orada aşıya rağmen Delta varyantının artmasının bir sebebi bu.
Ama asıl birinci neden aşısız grup. Çünkü İngiltere'de Delta varyantı ile hasta olanların yüzde 85'i aşısız nüfustan. Dolayısıyla İngiltere her ne kadar çok aşı yapıyor olsa da aşısız gruplar da bu artışta etkili oldu. Özellikle onlar okulları da açtılar biliyorsunuz. Çocuklarda okullarda pikler görüldü. Hatta çocukları aşılamanın yolları araştırılıyor şu an. Dolayısıyla orada esas olan aşısızlar, ikinci neden de tek doz aşı olması. Temel olarak (iki doz) mRNA aşıları şu anda halen iyi çalışıyor Delta varyantına karşı. Diğer aşılar konusunda emin olamıyoruz, çünkü çalışmalarda henüz mRNA aşılarını gördük" dedi.
"ADENOVİRÜS AŞISI ÜZERİNE mRNA AŞILARI EN İYİ SONUCU VERDİ" Prof. Dr. Yavuz, iki dozu farklı aşılarla yapılan etkinlik araştırmalarına da değinerek şu bilgileri verdi: "Elimizdeki veri sadece şu, adenovirüs aşısı (AstraZeneca aşısı) üzerine mRNA aşısı yaptığımız zaman çok daha iyi bağışıklık oluşturuyor. Yani iki dozda aynı aşıyı yapmak yerine böyle bir farklı ardışık aşı yaptığınızda çok daha iyi bir bağışık yanıt elde ediyorsunuz. Ama bu veri adenovirüs sonrası mRNA aşısına dair elde edilen veri. Bizim yapmakta olduğumuz inaktif virüs aşısından sonra ikinci dozu adenovirüs aşısıyla ya da mRNA aşısıyla yaptığımızda sonuç nasıl olacak, böyle bir çalışmanın yürütüldüğünü söylüyor Sağlık Bakanlığı. Sonuçlarını yakında görürüz herhalde diye düşünüyorum."
"RUSYA'DAN GELENLERE TARAMA VE GEREKİRSE İZOLASYON YAPILMALI" Türkiye 'deki vaka sayısının henüz sıfırlanmış olmadığına ve günlük halen 5 binler seviyesinde sürdüğüne de dikkat çeken Prof. Dr. Serap Şimşek Yavuz , özellikle turizm sezonunun açılmasıyla beraber Delta varyantının pik yaptığı ülkelerden biri olan Rusya'dan gelecek turistler için tarama ve izolasyon zorunluluğu getirilmesi gerektiğini söyledi ve ekledi: "Haftalık vaka sayısına baktığımızda halen (100 bin nüfusta) 50 civarında seyrediyor. Hala çok düşük değil. Ne yazık ki Delta varyantı kaygısı taşıyoruz biz de. Rusya'da şu anda Delta varyantının pik yaptığını biliyoruz. En azından oradan gelenlerde bir tarama testi ile pozitif olanların izolasyonunun sağlanması gerekiyor. Akılcı bir yaklaşım olarak bunun uygulanabileceğini düşünüyorum.
Aslında Sputnik V aşısı da yüzde 90'ın üzerinde etkili çıkmıştı. Oxford (AstraZeneca) ve Jansenn gibi o da bir adenovirüs aşısı. Aşıların etkinliğine baktığınızda mRNA aşıları bağışık cevabı uyarma anlamında en iyisi gibi görünüyor. Adenovirüs aşıları orta seviyede, inaktif aşılar ise biraz daha altta görünüyor bu anlamda. Dolayısıyla Rusya'da hele de nüfusun çoğunda henüz tek doz aşılama yapıldıysa Delta varyantının baskın hale gelmesi kaçınılmaz olmuştur. Oradaki sorun o olabilir diye öngörüyoruz, ama tahmin bu sadece."