Yau shekara hudu ke nan da duniya ceto, ko ba, ta hanyar mu'ujiza ta allurar rigakafin Covid mRNA.
Har ila yau, an yi shekaru da yawa tun lokacin da wani editan mujallar nazarin halittu ya ƙi amincewa da wasiƙara ta farko kan batun. Kuma jerin shari'o'ina na wasiƙun da aka ƙi a kan allurar Covid suna ci gaba da haɓaka. Makin yanzu shine 5:0. Kin amincewa da ƙarshe kwanan nan ya fito daga editan littafin Jaridar Cutar, inda "Kowace fitowa [kuma] tana kawo muku… sashe na wasiku masu rai." Wasiƙata marar rai tana magana akan a binciken na rashin lafiyan allurar rigakafi a Ostiriya.
Shin jerin shari'a na ya isa ya ba da dalili? Wataƙila shi ne. Tabbas, dalilin gama-gari na iya zama kimiyya mara inganci. Zan iya bayar, watakila, kallo ɗaya mai karyatawa? Nawa harafi na biyu (wanda aka ƙi The Lancet) zai bayyana a cikin 2021 abin da Høeg et al. fallasa a 2023 a cikin wani wasika cewa ko ta yaya ya shiga The New England Journal of Medicine. Editan rashin kulawa, ina tsammani. Wataƙila shi ko ita ba edita ba ne.
Na tabbata cewa wasiƙata ta biyar da aka ƙi ba ita ce kawai wani mugunyar rubutun da ba shi da cancantar kimiyya. Tabbas ba shi da alaƙa da yuwuwar cewa wasiƙar, tare da martanin marubutan, na iya haifar da bincike mai tayar da hankali. Don haka, bari in raba wasiƙa ta a nan. Za ku zama alƙali kuma: cancanta ko rashin cancanta?
Don yin shi mafi ban sha'awa, zan haɗa da bincike da aka ambata a cikin wasiƙar (ba tare da bayyana sakamakon ban tsoro ba). Ba shi da wahala a ƙididdigewa, duk da haka. Takardar ta nuna shaidar mace-mace masu nasaba da rigakafin—daga Covid-a cikin makonni biyu na allura a cikin mutanen da suka kamu da cutar a baya. Ko kuma bari in bayyana shi cikin ra'ayin mazan jiya: Shaidar tana da kyau aƙalla kamar shaidar takardar don tasirin rigakafin cutar ta Covid-2021 a faɗuwar XNUMX.
Harafin
Bari 15, 2025
Jaridar Cutar
Ga Editan:
Riedmann et al. bayar da rahoto mai zurfi, cikakken bincike game da lafiyar al'amuran rigakafin rigakafi a Austria, wanda ya haɗa da sabon salo.1 An yi daidai da waɗanda ba a yi musu alluran rigakafi ba don yin maganin alurar riga kafi akan sauye-sauye da yawa, kuma marubutan sun kwatanta sakamako da yawa a cikin makonni biyu bayan kammala allurai daban-daban. Tebu 3 (labarin) da Tebura S44-S45 (ƙarin daftarin aiki) suna nuna sakamako don mace-mace duka, mutuwar COVID-19, da mace-mace COVID-19.
Tun da rashin lafiyar alluran rigakafi ya ragu akan lokaci, zai zama mai ban sha'awa don tsawaita nazarin ƙungiyoyin da suka dace zuwa makonni 4 da makonni 8. Yawancin karatu sun ƙididdige tasiri sama da watanni ɗaya zuwa biyu bayan allurar rigakafi, wanda wani lokaci ya zo daidai da tsawon lokacin guguwar COVID-19.
Marubutan sun ambaci hanyar gyare-gyare na asali, wanda aka samo daga ra'ayin daidaita ƙimar abin da ya faru a baya.2-5 Adadin haɗarin COVID-19 mace-mace ya kasu kashi-kashi ta hanyar haɗarin mutuwan marasa COVID-19. Kodayake ba cikakke ba ne, yana iya ba da ƙarin haske lokacin da aka tsawaita bin diddigin, kuma adadin mutuwar COVID-19 ya fi girma. Aiwatar da hanyar don mutuwar 19 COVID-19 (Table 3, cikakken rigakafin farko) har yanzu yana da kyau don cire son zuciya. Bayan gyare-gyare na ƙayyadaddun ƙayyadaddun ƙayyadaddun ƙayyadaddun ƙayyadaddun ƙayyadaddun ƙayyadaddun ƙayyadaddun ƙayyadaddun ƙayyadaddun ƙayyadaddun ƙayyadaddun ƙayyadaddun ƙayyadaddun ƙayyadaddun ƙayyadaddun ƙayyadaddun ƙayyadaddun ƙayyadaddun ƙayyadaddun ƙayyadaddun ƙayyadaddun ƙayyadaddun ƙayyadaddun ƙayyadaddun ƙayyadaddun ƙayyadaddun ƙayyadaddun ƙayyadaddun gyare-gyare ba su da ƙasa 1, ko ana amfani da ma'auni na haɗari ko ƙimar kuɗi.
A wani bayanin kula, da alama an yi kuskuren ma'aunin ƙima a cikin Tebura S44-S45 azaman ma'auni na haɗari da kuma daidaita ma'aunin haɗari.
gaske,
Eyal Shahar, MD, MPH
Farfesa Emeritus
Jami'ar Arizona
References:
- Riedmann U, Chalupka A, Richter L, et al. Ƙarƙashin ƙishin lafiya a cikin masu karɓar rigakafin SARS-CoV-2 da suka kamu da cutar a baya: Nazarin ƙungiyar. Jaridar Cutar, Juzu'i na 90, fitowa ta 6, 2025, 106497, ISSN 0163-4453, https://doi.org/10.1016/j.jinf.2025.106497
- Tannen RL. Pharmacoepidemiol Drug Saf. 2008 Yuli; 17 (7): 671-85. doi: 10.1002/pds.1584. Saukewa: 18327852
- Pálinkás A, Sándor J. Tasirin rigakafin COVID-19 a cikin hana duk wani sanadin mace-mace tsakanin manya yayin bullar annoba ta uku a Hungary: Nazarin ƙungiyar gamayya na ƙasa baki ɗaya. Magunguna (Basel). 2022 Juni 24;10(7):1009. doi: 10.3390/alurar rigakafi10071009. PMID: 35891173; Saukewa: PMC9319484.
- Atanasov V, Barreto N, Whittle J, et al. Fahimtar tasirin rigakafin COVID-19 akan mutuwa ta amfani da sabon ma'auni: Yawan yawan mace-macen COVID. Magunguna (Basel). 2023 Fabrairu 7; 11 (2): 379. doi: 10.3390/alurar rigakafi11020379. PMID: 36851256; Saukewa: PMC9959409.
- Shahar E. Akan hanyoyin da za a kawar da son zuciya mai lafiya. A cikin: Maudu'ai a cikin Epidemiology da Kididdiga. Amazon Kindle Ebooks (2025)
Kin amincewa
Bayan kwana biyu, saƙo mai dauke da rubutu na tukunyar jirgi ya sauka a akwatin saƙo na.
Lambar Rubutun: YJINF-D-25-00940
Taken Labari: Wasika zuwa ga Edita
Marubuci mai dacewa: Farfesa Emeritus Eyal Shahar
An ƙaddamar da shi zuwa: Jaridar Kamuwa da cuta
Dear Professor Emeritus Shahar,
Godiya da yawa don ƙaddamar da rubutun ku zuwa Jaridar Kamuwa da cuta. Abin takaici muna karɓar takardu da yawa fiye da yadda muke da sarari don bugawa don haka za mu iya aiwatar da taƙaitaccen adadin ƙaddamarwa. Abin baƙin ciki, bayan la'akari da masu gyara, wannan takarda ba ta cimma cikakkiyar fifiko ba. Da fatan za a lura ba mu ƙarfafa sake aikawa da takarda tare da yanke shawara na kin amincewa ba.
Na yi nadama game da wannan yanke shawara mara kyau kuma ba za mu iya samar da ƙarin takamaiman dalilai na ƙin yarda ba, kuma ina fata za ku ci gaba da ƙaddamar da aikinku zuwa Jaridar Kamuwa da cuta a nan gaba.
Naku da gaske,
Farfesa Robert Charles Karanta
Edita
Jaridar Cutar
Na yi mamaki a hankali. Abin sha'awa, an rubuta rubutun tukunyar jirgi don rubuce-rubucen da aka ƙi (takardu). Shin ba su da kwatankwacin rubutu na haruffan da aka ƙi? Sau nawa ne wannan mujallar ta ƙi yin watsi da wasiƙu? Hasashenku yana da kyau kamar nawa. Wataƙila ma yana kama da nawa.
analysis
An rubuta lambobin da ke ƙasa daga Tebur 3 a cikin labarin (2 Version, gyara). Waɗannan su ne bayanai da sakamakon da wasiƙata ke nufi. An ƙara ƙimar ƙaƙƙarfan aminci (ƙididdigewa na). Zan rubuta ƙarin akan wannan fihirisar ƙididdiga daga baya, amma ƙarami lambar, mafi kyawun ƙimar haɗarin haɗari (HR).
Tables. Matsakaicin haɗari (HR) da tazarar amincewar kashi 95% (CI) don Covid da kuma mace-macen da ba na Covid ba bisa ga adadin alluran rigakafin a cikin makonni biyu bayan rigakafin. An daidaita abubuwan sarrafawa (ba a yi musu allurar ba a cikin taga lokacin) da kowane rukuni na mutanen da aka yi wa alurar riga kafi akan rukunin shekaru, jinsi, da mazaunin gidan reno.
Matsakaicin haɗarin mutuwa ya fito ne daga ƙungiyoyin da suka dace, don haka an cire ruɗani ta shekaru, jinsi, da mazaunin gidan reno. Wadanda ba a yi wa allurar ba kuma an yi daidai da ranar rigakafin, don haka an kauce wa ruɗar da yanayin lokaci. Sauran rikice-rikicen shine lafiyar alurar riga kafi. Mutanen da aka yi wa allurar sun fi koshin lafiya, a matsakaita, fiye da takwarorinsu da ba a yi musu rigakafin ba, sabili da haka, ana sa ran yawan mace-macen su na Covid ya ragu ko da an yi musu allurar placebo. Kuna iya ganin cewa haɗarin mutuwa daga ba Covid Sanadin sun kasance ƙananan (ƙirar haɗari <1). Wannan saboda sun fi koshin lafiya, ba wai don allurar rigakafin Covid maganin ba ne. Alamun lafiyayyen maganin alurar riga kafi ya bayyana duniya. Ba ya ɓace bayan makonni biyu.
Koyaya, marubutan ba su zaɓi mutu-hard ba tare da rigakafi ba. Sun rubuta: "Rukunin kulawar da ba a yi musu allurar ba ba su da rubuce-rubucen rigakafin har zuwa kwanaki 14 bayan ranar rigakafin da ta dace."
Wanda ke nufin cewa an ƙididdige ƙiyasin rashin lafiya na allurar rigakafin a kan ƙungiyar da ta haɗa da mutanen da aka yi musu allurar daga baya. Ƙimar son zuciya ta gaskiya ta yi girma.
Komawa kan teburin da ke sama.
Duk abubuwan haɗarin mutuwar Covid sun yi ƙasa da 1, kuma duk suna da son zuciya. Babu fa'ida da ake tsammanin a cikin wannan taga lokacin (makonni biyu). Kamar yadda na rubuta a wasika ta kuma wasu wurare, akwai hanyar kawar da son zuciya, wanda ba cikakke ba ne amma ya fi kyau fiye da gyara kwata-kwata. Raba rabon haɗarin mutuwar Covid ta hanyar haɗari na rashin mutuwar Covid.
A wannan yanayin, idan sakamakon ya kasance kusan 1, an cire son zuciya. Idan har yanzu yana ƙasa da 1, ba a cire son zuciya gabaki ɗaya ba. Idan yana sama da 1, yakamata mu damu. Shin muna lura da ƙarin haɗarin mutuwa wanda rashin lafiyar alluran rigakafi ya rufe shi?
Ana nuna sakamakon a cikin tebur.
Table. Matsakaicin haɗari: son zuciya da gyara
Bayan gyara, haɗarin haɗarin mutuwar Covid cikin makonni biyu na allurar farko da ta biyu sune 1.48 da 1.91, bi da bi.
Shin wannan gaskiya ne? Yiwuwa. Lokacin bayan allurar nan da nan yana da haɗari ga kamuwa da cuta da mutuwa. Na gani a cikin bayanai daga Isra'ila, Denmark, Da kuma Sweden. Wasu kuma sun yi rubutu game da wannan.
Dangane da allura ta uku (0.29/0.30=0.97), zan iya bayar da bayanai masu gasa guda biyu:
Na farko gajere ne. Wadancan mutanen da aka yi wa allurar rigakafin rashin lafiya wadanda suka kamu da cutar sun mutu bayan allura daya ko biyu. Babu mutane masu saukin kamuwa da ya rage cikin wadanda suka kai kashi na uku.
Bayani na biyu yana da tsawo. Adadin haɗarin mutuwa na Covid (0.29) mara kyau ne. Ya dogara ne akan abubuwan da suka faru guda hudu kawai. Ta yaya za mu san yadda talauci yake, in ji, idan aka kwatanta da ƙididdiga na allurai biyu da kashi ɗaya? Muna ƙididdige fihirisar da ake kira ma'auni mai ƙayyadaddun aminci: iyakar babba ta raba ta ƙananan iyaka. Matsakaicin shine 9.7 don masu karɓa na kashi uku tare da 2.9 (masu allurai biyu) da 2.8 (kashi ɗaya).
Idan kun ƙididdige ƙimar ƙayyadaddun amincewa daga yawancin karatu, kamar yadda na yi a cikin shekaru, za ku gano cewa binciken da ya dace ya haifar da rabo a kusa da 2, da ƙananan ƙananan ƙananan (ƙananan abubuwan da suka faru) suna haifar da rabo a arewacin 5. Kusa da 10 shine abin da kuka samu lokacin da aka samo asali daga abubuwa hudu a cikin rukuni ɗaya. Mafi mahimmanci, cancantar ƙididdigewa yana da alaƙa da alaƙa da iyakacin amincewa, ba ga "mahimmancin ƙididdiga ba." Zan bayyana dalilin da ya sa ba da jimawa ba.
An yi wa biliyoyin alurar riga kafi, kuma muna ƙoƙarin zana ra'ayi daga al'amuran 19 da abubuwan 21 saboda takarda ɗaya bayan ɗaya ta cire bayanai daga farkon lokacin rigakafin.
Bugu da ƙari, ƙarin bin diddigin ƙungiyoyin da suka dace na iya ba da haske na musamman game da tasirin rigakafin na gaskiya saboda waɗanda ba a yi musu allurar ba sun dace da ranar rigakafin. (Yaƙin neman zaɓe sau da yawa ya zo daidai da raƙuman ruwa na Covid, wanda ya haifar da ruɗani.) Marubuta suna da kusan cikakkiyar tsarin bincike: manyan ƙungiyoyi, masu daidaitawa akan maɓalli masu mahimmanci, da bayanai game da mutuwar Covid-19 waɗanda ke ba da damar gyara asali na ƙiyayyar allurar lafiya. Amma da wuya mu ga bayanan saboda wasiƙara ba ta da wata fa'ida. Watakila wata wasika ta kawo wannan kuma a karbe ta. Ko watakila a'a.
Bari in sake maimaita bayanina na masu ra'ayin mazan jiya a farkon:
Shaidar da na nuna anan tana da kyau aƙalla kamar shaidar tasirin rigakafin cutar ta Covid-2021 a faɗuwar XNUMX.
An rubuta lambobin da ke ƙasa daga Tebur 2 a cikin labarin (2 Version, gyara). An ƙara ƙimar ƙaƙƙarfan aminci (ƙididdigewa na).
Table. Matsakaicin haɗari (HR) da 95% tazarar amincewa (95% CI) don mace-macen Covid bisa ga adadin allurai a cikin Oktoba da Nuwamba 2021 (yawan nauyin cututtuka). Rukunin tunani ba shi da alurar riga kafi, yana ba da damar canza matsayin rigakafin.
Kamar yadda kuke gani, adadin mutuwar Covid ya yi ƙasa da a cikin ƙungiyoyin da suka dace, kuma ƙimar ƙayyadaddun dogaro ya fi girma sosai. Matsakaicin ƙayyadaddun aminci na allurai uku ya karya rikodin (20).
Ina iya jin marubuta da masu karatu: “Amma duk kididdigar da ke sama suna da mahimmanci a kididdiga. Babban iyaka na tazarar amincewa yana ƙasa 1, wanda ke nuna p- darajar <0.05.
Lallai. Duk da haka, "mahimmancin ƙididdiga" ba shine abin da kuke tsammani ba.
Ba game da ingancin kimantawa ba ne.
Kwas ɗin faɗuwa (ga waɗanda ke sha'awar kididdiga da ilimin harshe)
An ɗauki misalina daga allurai 3 (tebur a sama): HR (95% CI): 0.04 (0.01-0.20). Ƙididdiga (0.04) yana da mahimmancin ƙididdiga.
Table. Amfani da cin zarafi na "mahimmancin ƙididdiga" da kuma madaidaiciyar madadin (raɗin ƙayyadaddun amincewa)
Duk da'awar (hukunce-hukunce) a jere na farko na teburin karya ne - babu shakka karya ne. An samo su ne daga mummunar fassarar fassarar “mahimmanci mai mahimmanci,” wanda ke da tushen tarihi-harshe.
Lokacin da aka ƙirƙira kalmar shekaru da yawa da suka gabata, sifa “mahimmanci” yana da wata ma’ana dabam. A cikin ƙarshen karni na 19 na Ingilishi, yana nufin cewa kimantawa nuna (nuna) shaida a kan null. Maganar ba ta nufin kowane ingancin ƙima. A cikin shekaru da yawa, ma'anar ma'anar kalmar "mahimmanci" ta maye gurbin ma'anar asali, kuskuren ƙaddamar da halaye ga kimanta kanta (mahimmanci, tabbatacce, abin dogara, wanda ba zai yiwu ba saboda dama).
Babu ɗayan waɗannan fassarorin da ke da tushe a cikin gwajin ƙididdiga. Tunanin buri ne. Kin amincewa da hasashe maras tushe yana dogara ne akan kimanta (ta hanyar kididdigar gwaji); ba ya ba da kiyasin da wani tabbaci. Idan muna son koyo game da halayen da ke da alaƙa da bazuwar ƙiyasin, muna buƙatar dogaro da daidaitaccen kuskure kaɗai, kuma ƙimar ƙayyadaddun aminci shine ƙaramin lissafi akan daidaitaccen kuskure. Mafi kusancin shi zuwa 1, mafi kyawun kimantawa. Wani hazikin masanin annoba ya yi shawara wannan fihirisar shekaru da yawa da suka wuce, amma wani lokacin labari da ingantattun ra'ayoyi suna daɗe da barci.
Kuna iya karanta labarin harshe a cikin littafin Shayi Tasting Lady: Yadda Kididdigar Juyin Halitta Kimiyya a Karni na Ashirin da David Salsburg. Sakin layi ɗaya a shafi na 98 shine mai buɗe ido.
Epilogue
Akwai abubuwa da yawa da za a rubuta akan wannan takarda da ta ƙunshi shafuka 72 na ƙarin bincike; wasu daga ciki an "neman su yayin aikin bita." Zan iya tunanin yaƙin tare da masu bita masu ƙiyayya lokacin da batun shine rashin lafiyar alluran rigakafi.
Na riga na sami kusan layuka 100 na bayanai da bincike a cikin fayil na Excel. (Sake dubawa: kashi na uku ba shi da amfani, kuma ƙarin allurai na iya zama mafi muni.) Shin zan aika da rubutu zuwa ga Farfesa Read, wanda ya yi fatan cewa zan ci gaba da gabatar da aikina ga Jaridar Cutar?
Bari inyi tunani akai.
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Dokta Eyal Shahar farfesa ne a fannin kiwon lafiyar jama'a a fannin cututtukan cututtuka da kididdiga. Binciken nasa yana mayar da hankali ne akan ilimin cututtuka da kuma hanyoyin. A cikin 'yan shekarun nan, Dr. Shahar ya ba da gudummawa sosai ga hanyoyin bincike, musamman a fannin zane-zane da kuma son zuciya.
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