AŞILAMAYA RAĞMEN GÖRÜLEN COVID-19 VAKALARI: BİR LİTERATÜR İNCELEMESİ

Yıl 2023, Cilt: 4 Sayı: 1, 79 - 97, 29.03.2023

Mesut Can Türkoğlu

Öz

Bulaşıcı hastalıklar yaşamın her safhasında karşılaşılan durumlardır. Yüzyıllar boyunca ortaya çıkan ve insanların çeşitli yöntemlerle çare bulmaya çalıştığı bulaşıcı hastalıkların, ortadan kaldırılması ya da etkilerinin azaltılması için en temel ihtiyaç aşılardır. 2019’un sonundan beri dünyayı kasıp kavuran ve Mart 2020 itibariyle Dünya Sağlık Örgütünün pandemi olarak ilan ettiği COVID-19 salgını da bulaşıcılığı ve öldürücülüğü yüksek seviyede olan bir hastalık olmasından dolayı, aşılamayı adeta zorunlu kılmaktadır. Çeşitli ülkelerin öncülüğünde yürütülen aşı çalışmalarında bugün önemli bir yol kat edilmiş, COVID-19 aşılarının önemi ve hastalığı önleme noktasında etkililik düzeyi pek çok bilimsel araştırma ve deney sonrasında tescillenmiştir. Bazı insanlar ise tüm aşılarını olmasına karşın bu virüsle yine de enfekte olabilmekte ve virüsü etrafındaki insanlara da yayabilmektedir. Tam aşılamaya rağmen meydana gelen COVID-19 vakalarının toplumlarda görülme sıklığı fazla değildir. Bazı dezavantajlı gruplarda daha sık rastlanan bu vakalar, kronik hastalığı olmayan ve bağışıklığı güçlü kişilerde çoğunlukla belirti bile olmadan atlatılmaktadır. Ancak daha önce çeşitli ağır hastalıklar atlatan ve bağışıklık sistemi zayıf düşen, özellikle yaşı da ileri olan kişilerde aşılamaya rağmen COVID-19 virüsü görmek mümkün olabilmektedir. Üretilen hiçbir aşı, COVID-19’a karşı yüzde yüz koruma sağlamamakta, üstelik aşıların koruma etkisi belli süreler sonunda azalmaktadır. COVID-19 sürecinde ortaya çıkan çeşitli mutant varyantlar da aşıların etkisini azaltıp COVID-19 vakalarını tetikleyici nitelikte olmuştur. Bu çalışmanın amacı; tam aşılamaya rağmen bireylerde görülen COVID-19 vakaları hakkında bilgiler verip aşılı olmasına karşın hastalığa yakalanan bireylerin enfekte olma nedenlerini ve çeşitli çözüm önerilerini irdelemektir. Çalışmada ayrıca toplumun sağlık düzeyinin kişisel sağlığın iyileştirilmesinden geçtiği göz önüne alınmış ve COVID-19 özelinde virüslerle mücadele edilmesinin altı çizilmiştir.

Anahtar Kelimeler

COVID-19, Aşı, Bağışıklık, Enfeksiyon, Varyant

CASES OF COVID-19 OCCURING DESPITE VACCINATION: A LITERATURE REVIEW

Öz

Infectious diseases are encountered at every stage of life. Vaccines are the most basic need to eliminate or reduce the effects of infectious diseases that have emerged for centuries, and people have tried to find solutions through various methods. The COVID-19 epidemic, which has ravaged the world since the end of 2019 and was declared a pandemic by the World Health Organization as of March 2020, also makes vaccination mandatory, as it is a highly contagious and lethal disease. Vaccine studies carried out under the leadership of various countries have come a long way today. The importance of COVID-19 vaccines and their effectiveness in preventing the disease have been documented after many scientific research and experiments. Some people can still be infected with this virus even though they have all their vaccinations and can spread it to people around them. The incidence of COVID-19 cases occurring despite complete vaccination is not high in populations. These cases, which are more common in some disadvantaged groups, are mostly overcome without symptoms in people who do not have chronic diseases and are immune-competent. However, it is possible to see the COVID-19 virus despite vaccination in people who have previously survived various severe diseases and whose immune system is weakened, especially in older people. No vaccine produced provides 100% protection against COVID-19; moreover, the protective effect of vaccines decreases after a certain time. Various mutant variants that emerged during the COVID-19 process have also reduced the effectiveness of vaccines and triggered COVID-19 cases. This study aims to provide information about the cases of COVID-19 seen in individuals despite complete vaccination and to examine the reasons for the infection of individuals who are vaccinated despite being vaccinated and various solutions. In the study, it was also taken into account that the health level of the society was passed through the improvement of personal health, and it was emphasized that the fight against viruses in particular for COVID-19.

Anahtar Kelimeler

COVID-19, Vaccine, Immunity, Infection, Variant

Kaynakça

• Aktekin, M. (2021). Bağışıklama çalışmalarının COVID-19 salgınına etkisi. Türk Tabipler Birliği - Yeni Koronavirüs Pandemisi Sürecinde Türkiye'de COVID-19 Aşılaması ve Bağışıklama Hizmetlerinin Durumu, 77-82.
• Andrews, N., Stowe, J., Kirsebom, F., Toffa, S., Rickeard, T., Gallagher, E., ... ve Lopez Bernal, J. (2022). Covid-19 vaccine effectiveness against the Omicron (B. 1.1. 529) variant. New England Journal of Medicine, 386(16), 1532-1546.
• Bernal, J. L., Andrews, N., Gower, C., Robertson, C., Stowe, J., Tessier, E., ... ve Ramsay, M. (2021). Effectiveness of the Pfizer-BioNTech and Oxford-AstraZeneca vaccines on covid-19 related symptoms, hospital admissions, and mortality in older adults in England: test negative case-control study. bmj, 373.
• Budak, F. ve Korkmaz, Ş. (2020). COVID-19 pandemi sürecine yönelik genel bir değerlendirme: Türkiye örneği. Sosyal Araştırmalar ve Yönetim Dergisi, (1), 62-79.
• Centers For Disease Control and Prevention (CDC) (2021a). The possibility of COVID-19 after vaccination: Breakthrough infections. Erişim adresi: https://www.cdc.gov/coronavirus/2019-ncov/vaccines/effectiveness/why-measure-effectiveness/breakthrough-cases.html Erişim tarihi: 20.09.2022.
• Centers For Disease Control and Prevention (CDC) (2021b). Measles, Mumps, and Rubella (MMR) vaccination: What everyone should know. Erişim adresi: https://www.cdc.gov/vaccines/vpd/mmr/public/index.html Erişim tarihi: 15.09.2022.
• Centers For Disease Control and Prevention (CDC) (2022). COVID-19 vaccines for moderately or severely immunocompromised people. Erişim adresi: https://www.cdc.gov/coronavirus/2019-ncov/vaccines/recommendations/immuno.html?CDC_AA_refVal=https%3A%2F%2Fwww.cdc.gov%2Fvaccines%2Fcovid-19%2Fhcp%2Fimmunocompromised-patients.html Erişim tarihi: 20.09.2022.
• Davies, N. G., Abbott, S., Barnard, R. C., Jarvis, C. I., Kucharski, A. J., Munday, J. D., ... ve Edmunds, W. J. (2021). Estimated transmissibility and impact of SARS-CoV-2 lineage B. 1.1. 7 in England. Science, 372(6538), eabg3055.
• Demircioğlu, M. ve Eşiyok, S. (2020). COVID-19 salgını ile mücadelede kümeleme analizi ile ülkelerin sınıflandırılması. İstanbul Ticaret Üniversitesi Sosyal Bilimler Dergisi, 19(37), 369-389.
• Elliott, P., Haw, D., Wang, H., Eales, O., Walters, C. E., Ainslie, K. E., ... ve Riley, S. (2021). Exponential growth, high prevalence of SARS-CoV-2, and vaccine effectiveness associated with the Delta variant. Science, 374(6574), eabl9551.
• European Medicines Agency (b.t.). COVID-19 vaccines: Key facts. Erişim adresi: https://www.ema.europa.eu/en/human-regulatory/overview/public-health-threats/coronavirus-disease-covid-19/treatments-vaccines/vaccines-covid-19/covid-19-vaccines-key-facts#immunity-(protection)-section Erişim tarihi: 11.09.2022.
• Grange, Z., Buelo, A., Sullivan, C., Moore, E., Agrawal, U., Boukhari, K., ... ve Murray, J. L. (2021). Characteristics and risk of COVID-19-related death in fully vaccinated people in Scotland. The Lancet, 398(10313), 1799-1800.
• Griffin, J. B., Haddix, M., Danza, P., Fisher, R., Koo, T. H., Traub, E., ... ve Balter, S. (2021). SARS-CoV-2 infections and hospitalizations among persons aged≥ 16 years, by vaccination status—Los Angeles County, California, May 1–July 25, 2021. Morbidity and Mortality Weekly Report, 70(34), 1170.
• Gupta, R. K. ve Topol, E. J. (2021). COVID-19 vaccine breakthrough infections. Science, 374(6575), 1561-1562.
• Gupta-Smith, V. ve O’Brien, K. (2021). Episode #49 - Can I get infected after vaccination? World Health Organization, Science in 5. Erişim adresi: https://www.who.int/emergencies/diseases/novel-coronavirus-2019/media-resources/science-in-5/episode-49-can-i-get-infected-after-vaccination Erişim tarihi: 21.09.2022
• Hall, V., Foulkes, S., Insalata, F., Kirwan, P., Saei, A., Atti, A., ... ve Hopkins, S. (2022). Protection against SARS-CoV-2 after Covid-19 vaccination and previous infection. New England Journal of Medicine, 386(13), 1207-1220.
• Jacobson, K. B., Pinsky, B. A., Rath, M. E. M., Wang, H., Miller, J. A., Skhiri, M., ... ve Holubar, M. (2021). Post-vaccination SARS-CoV-2 infections and incidence of the B. 1.427/B. 1.429 variant among healthcare personnel at a northern California academic medical center. MedRXIV.
• Jain, V. K., Iyengar, K. P. ve Ish, P. (2021). Elucidating causes of COVID-19 infection and related deaths after vaccination. Diabetes & Metabolic Syndrome: Clinical Research & Reviews, 15(5), 102212.
• Juthani, P. V., Gupta, A., Borges, K. A., Price, C. C., Lee, A. I., Won, C. H. ve Chun, H. J. (2021). Hospitalisation among vaccine breakthrough COVID-19 infections. The Lancet Infectious Diseases, 21(11), 1485-1486.
• Kader, Ç. (2019). Aşı karşıtlığı: Aşı kararsızlığı ve aşı reddi. Eskişehir Türk Dünyası Uygulama ve Araştırma Merkezi Halk Sağlığı Dergisi, 4(3), 377.
• Kazak, A., Hintistan, S. ve Önal, B. (2020). Dünyada ve Türkiye’de COVID-19 aşı geliştirme çalışmaları. Celal Bayar Üniversitesi Sağlık Bilimleri Enstitüsü Dergisi, 7(4), 571-575.
• Ke, R., Martinez, P. P., Smith, R. L., Gibson, L. L., Achenbach, C. J., McFall, S., ... ve Brooke, C. B. (2022). Longitudinal analysis of SARS-CoV-2 vaccine breakthrough infections reveals limited infectious virus shedding and restricted tissue distribution. Open forum infectious diseases içinde (Vol. 9, No. 7, p. ofac192). Oxford University Press.
• Klompas, M. (2021). Understanding breakthrough infections following mRNA SARS-CoV-2 vaccination. Jama, 326(20), 2018-2020.
• Lamptey, E. (2021). Should breakthrough SARS-CoV-2 infection affect our confidence in the COVID-19 vaccines?. Infection & Chemotherapy, 53(4), 676.
• Lipsitch, M., Krammer, F., Regev-Yochay, G., Lustig, Y. ve Balicer, R. D. (2022). SARS-CoV-2 breakthrough infections in vaccinated individuals: Measurement, causes and impact. Nature Reviews Immunology, 22(1), 57-65.
• Maragakis, L. ve Kelen, G. D. (2021). Breakthrough infections: Coronavirus after vaccination. Johns Hopkins Medicine. Erişim adresi: https://www.hopkinsmedicine.org/health/conditions-and-diseases/coronavirus/breakthrough-infections-coronavirus-after-vaccination Erişim tarihi: 22.09.2022.
• Mayo Clinic (2022). COVID-19 vaccines: Get the facts. Erişim adresi: https://www.mayoclinic.org/diseases-conditions/coronavirus/in-depth/coronavirus-vaccine/art-20484859 Erişim tarihi: 22.09.2022.
• Nordström, P., Ballin, M. ve Nordström, A. (2022). Risk of infection, hospitalisation, and death up to 9 months after a second dose of COVID-19 vaccine: A retrospective, total population cohort study in Sweden. The Lancet, 399(10327), 814-823.
• Regev-Yochay, G., Gonen, T., Gilboa, M., Mandelboim, M., Indenbaum, V., Amit, S., ... ve Lustig, Y. (2022). Efficacy of a fourth dose of COVID-19 mRNA vaccine against omicron. New England Journal of Medicine, 386(14), 1377-1380.
• Roy, B., Dhillon, J. K., Habib, N. ve Pugazhandhi, B. (2021). Global variants of COVID-19: Current understanding. Journal of Biomedical Sciences, 8(1), 8-11.
• Sun, J., Zheng, Q., Madhira, V., Olex, A. L., Anzalone, A. J., Vinson, A., ... ve Chirischilles, E. A. (2022). Association between immune dysfunction and COVID-19 breakthrough infection after SARS-CoV-2 vaccination in the US. JAMA Internal Medicine, 182(2), 153-162.
• Teran, R. A., Walblay, K. A., Shane, E. L., Xydis, S., Gretsch, S., Gagner, A., ... ve Black, S. R. (2021). Postvaccination SARS‐CoV‐2 infections among skilled nursing facility residents and staff members—Chicago, Illinois, December 2020–March 2021. American Journal of Transplantation, 21(6), 2290-2297.
• Tinker, B. ve Fox, M. (2021). So far, 5,800 fully vaccinated people have caught Covid anyway in US, CDC says. Erişim adresi: https://edition.cnn.com/2021/04/14/health/breakthrough-infections-covid-vaccines-cdc/index.html Erişim Tarihi: 01.10.2022.
• Washington State Department of Health (2022). SARS-CoV-2 vaccine breakthrough surveillance and case information resource. Erişim adresi: https://doh.wa.gov/sites/default/files/2022-02/420-339-VaccineBreakthroughReport.pdf Erişim tarihi: 23.09.2022
• World Health Organization (2022). COVID-19 vaccine tracker and landscape. Erişim adresi: https://www.who.int/publications/m/item/draft-landscape-of-covid-19-candidate-vaccines Erişim tarihi: 29.09.2022
• World Health Organization (b.t.). Vaccines and immunization. Erişim adresi: https://www.who.int/health-topics/vaccines-and-immunization#tab=tab_1 Erişim tarihi: 13.09.2022.