Gwajin da aka sarrafa bazuwar yana nuna raguwar yawan mace-mace daga Covid-adenovirus-vector allurar (RR=0.37, 95%CI: 0.19-0.70) amma ba daga allurar mRNA ba (RR=1.03, 95%CI 0.63-1.71).
Wannan shine hukunci daga sabon Nazarin Danish by Dr. Christine Benn da abokan aiki. Shin an ba wa mutane alluran rigakafin da ba sa aiki (Pfizer/Moderna) maimakon allurar da ke aiki (AstraZeneca/Johnson & Johnson)? Bari mu sanya wannan binciken cikin mahallin sannan mu zurfafa cikin lambobi.
A cikin magani, ma'aunin zinare don shaida shine bazuwar gwaje-gwajen sarrafawa (RCT), saboda suna guje wa nuna son kai ga ko a kan maganin. Bugu da ƙari, babban sakamako shine mutuwa. Shin waɗannan alluran rigakafin suna ceton rayuka? Don haka, binciken Danish yana amsa tambayar da ta dace tare da bayanan da suka dace.
Shi ne nazari na farko da ya yi haka.
Lokacin da Hukumar Abinci da Magunguna ta Amurka (FDA) ta amince da allurar rigakafin Pfizer da Moderna mRNA, wannan shawarar ta dogara ne akan RCTs. RCTs da aka ƙaddamar ga FDA sun nuna cewa alluran rigakafin suna rage cututtukan cututtukan Covid. Ta hanyar daukar mafi yawan matasa da masu matsakaicin shekaru, waɗanda ba za su iya mutuwa daga Covid komai ba, ba a tsara karatun ba don tantance ko allurar kuma tana rage mace-mace.
An zaci hakan a matsayin wani bayani, ko da yake yana iya yiwuwa ko a'a. Hakanan ba a tsara RCTs don tantance ko alluran sun rage watsawa ba, amma wannan wani labari ne na daban na wani lokaci.
An samar da allurar rigakafin don Covid, amma don kimanta rigakafin da kyau, dole ne mu kalli mutuwar da ba ta Covid-19 ba. Shin akwai mummunan halayen da ba a yi niyya ba wanda ke kai ga mutuwa? Ba ma son rigakafin da zai ceci rayukan wasu mutane amma yana kashe adadin sauran mutane daidai. Hakanan ana iya samun fa'idodin da ba a yi niyya ba, kamar na faruwa kariya daga wasu cututtuka. Don kwatanta gaskiya, wannan kuma ya kamata ya zama wani ɓangare na lissafin.
Duk da yake kowane mutum RCT ya kasa tantance ko rigakafin Covid ya rage mace-mace, RCTs sun rubuta duk mace-mace, kuma don haɓaka girman samfurin, binciken Danish ya tattara RCTs da yawa. Akwai nau'ikan alluran rigakafi guda biyu daban-daban na Covid, allurar rigakafin adenovirus-vector (AstraZeneca, Johnson & Johnson, Sputnik) da rigakafin mRNA (Pfizer da Moderna), kuma sun yi nazari guda ɗaya ga kowane nau'in. Ga sakamakon:
| Nau'in Alurar riga kafi | Mutuwa / Alurar riga kafi | Mutuwa / Gudanarwa | Hadarin Dangi | 95% Intacin Zuciya |
| Adenovirus - vector | 16 / 72138 | 30 / 50026 | 0.37 | 0.19 - 0.70 |
| mRNA | 31 / 37110 | 30 / 37083 | 1.03 | 0.63 - 1.71 |
Akwai bayyananniyar shaida cewa allurar rigakafin adenovirus-vector sun rage mace-mace. Ga kowane mace-mace 100 a cikin waɗanda ba a yi musu allurar ba, akwai mutuwar 37 kawai a cikin waɗanda aka yi wa rigakafin, tare da tazarar amincewar kashi 95% na mutuwar 19 zuwa 70. Wannan sakamakon ya fito ne daga RCTs daban-daban guda biyar don alluran rigakafi guda uku, amma ana yin su da farko ta hanyar AstraZeneca da Johnson & Johnson.
Ga allurar mRNA, a gefe guda, babu wata shaida ta raguwar mace-mace. Ga kowane mace-mace 100 a cikin waɗanda ba a yi musu allurar ba, akwai mutuwar 103 a cikin waɗanda aka yi wa rigakafin, tare da tazarar amincewar kashi 95% na mutuwar 63 zuwa 171. Wato, rigakafin mRNA na iya rage mace-mace kadan, ko kuma su kara shi; ba mu sani ba. Magungunan Pfizer da Moderna sun ba da gudummawa daidai ga wannan sakamakon, don haka babu wata shaida da ke nuna cewa ɗayan ya fi ɗayan.
Yayin da mace-mace duka shine abin da ke da mahimmanci ga lafiyar jama'a, akwai sha'awar kimiyya don sanin yadda alluran rigakafin daban-daban ke shafar nau'ikan mace-mace daban-daban. Masana kimiyyar Danish sun tuntuɓi masu binciken RCT don samun bayani kan ko kowace mutuwa ta kasance saboda Covid, cututtukan zuciya, hatsarori, ko wasu dalilai.
Ga allurar rigakafin mRNA, an sami raguwar mutuwar Covid amma an sami karuwar mutuwar cututtukan zuciya, amma babu wani muhimmin ƙididdiga. Don haka, ko wanne sakamako na iya kasancewa saboda dama bazuwar. A madadin, allurar rigakafin na iya rage haɗarin mutuwar Covid yayin da ke ƙara haɗarin mutuwar cututtukan zuciya. Ba mu sani ba, kuma Pfizer da Moderna ba su tsara RCTs don sanar da mu ba.
Ga allurar rigakafin adenovirus-vector, an sami raguwar ƙididdiga a duka biyun Covid da mutuwar cututtukan zuciya, da alama ba za a sami dama ba. An ɗan sami raguwar wasu mace-mace, wanda ƙila ya kasance saboda kwatsam.
Ƙarfin binciken Danish shine cewa ya dogara ne akan gwaje-gwajen da aka bazu. Babban rauni na farko shine cewa lokacin bibiyar gajere ne. Wannan saboda masana'antun sun ƙare gwajin asibiti da wuri, bayan da alluran rigakafin sun sami izinin amfani da gaggawa.
Wani rauni kuma shine bayanan baya ba mu damar tantance yadda waɗannan sakamakon zasu iya bambanta ta shekaru. Yayin da kowa zai iya kamuwa da cutar, akwai fiye da a bambanci sau dubu cikin hadarin mutuwa daga Covid tsakanin manya da matasa.
Shin allurar rigakafin suna rage yawan mace-mace a cikin tsofaffi? Wannan hasashe ne mai ma'ana. Samari fa? Ba mu sani ba. Wannan ba laifin masu binciken Danish bane. Sun yi aiki mai ban sha'awa don fitar da bayanai da yawa kamar yadda zai yiwu daga RCTs da masana'antu ke tallafawa.
Wasu na iya sukar binciken Danish don har yanzu ba a sake nazarin takwarorinsu ba, amma ya kasance. Ni da abokan aiki da yawa sun sake duba shi, kuma dukanmu muna da shekaru da yawa na gogewa tare da waɗannan nau'ikan karatu. Cewa har yanzu masu bitar mujallolin ba su sake nazarin sa ba ba shi da wani amfani.
An amince da allurar rigakafin mRNA bisa ragi a cikin cututtukan cututtuka maimakon mace-mace. Cewa Pfizer da Moderna ba su ƙirƙira RCTs ɗin su ba don tantance ko allurar rage mace-mace ba ta da uzuri, saboda za su iya yin hakan cikin sauƙi.
Cewa har yanzu FDA ta amince da su don amfani da gaggawa abu ne mai yiwuwa. Yawancin tsofaffin Amurkawa suna mutuwa daga Covid, kuma dole ne su yanke shawarar kan duk bayanan da ake samu a lokacin.
Yanzu mun san ƙarin. Idan Pfizer da Moderna suna son ci gaba da siyar da waɗannan alluran rigakafin, ya kamata mu buƙaci su gudanar da ingantaccen gwajin asibiti wanda ke tabbatar da cewa allurar tana rage mace-mace.
Hakanan mahimmanci, gwamnati, hukumomi, da jami'o'i yakamata su daina ba da umarnin alluran rigakafi lokacin da gwaje-gwajen da aka sarrafa bazuwar ke nuna sakamako mara kyau ga mace-mace.
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Martin Kulldorff masanin cututtukan cututtuka ne kuma masanin halittu. Shi Farfesa ne na Magunguna a Jami'ar Harvard (a kan hutu) kuma Fellow a Kwalejin Kimiyya da 'Yanci. Bincikensa ya mayar da hankali kan barkewar cututtuka da kuma lura da rigakafin rigakafi da amincin magunguna, wanda ya samar da SaTScan, TreeScan, da software na RSequential kyauta. Co-Marubucin Babban Sanarwa na Barrington.
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