COVID-19易感染高風險族群的疫苗挑戰與接種策略建議
 

吳至行^1,2,3 洪暐傑^4,5,6 黃駿豐^7,8 劉晏孜^9,10,11 程劭儀^12,13,14
張家禎^15,16 彭莉甯^17,18 顏啟華^19,20 黃振國^21*
 

COVID-19大流行對全球，尤其是有潛在醫療狀況的易感染之高風險族群，造成深遠的影響。為因應全球不斷演變的疫情趨勢以及台灣持續增加病例的疫苗防治需求，台灣家庭醫學醫學會建立了針對易感染之高風險族群的COVID-19疫苗接種建議。本研究進行全面性的文獻回顧並經由專家小組討論後，擬定具證據力的建議以作為防疫策略參考。總計提出25項建議，說明糖尿病、肥胖症、慢性腎臟疾病、心血管疾病和呼吸系統疾病病友感染COVID-19後的重症風險為高，因此強調COVID-19 mRNA（訊息核糖核酸）疫苗在這些易感染之高風險族群中的安全性和有效性以及家庭醫師在COVID-19疫情的關鍵作用，包括常規篩檢、衛教、疫苗接種服務的提供和持續的研究。此建議為醫界與政府相關單位在為易感染高風險族群制定疫苗接種計畫時，提供了兼具客觀實證依據與符合臨床實務需求的具體指引，同時強化家庭醫師在防疫工作中的核心角色，透過持續的監測與積極推動疫苗施打，在不斷變化的COVID-19疫情趨勢中發揮重要作用。

(台灣家醫誌2024; 34: 115-124) DOI: 10.53106/168232812024093403001

關鍵詞：COVID-19疫苗、共同施打、高風險族群、mRNA（訊息核糖核酸）

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Vaccine Challenges and Vaccination Strategy Recommendations for High-Risk Populations Vulnerable to COVID-19
 

Chih-Hsing Wu^1,2,3, Wei-Chieh Hung^4,5,6, Chun-Feng Huang^7,8, Yen-Tze Liu^9,10,11,
Shao-Yi Cheng^12,13,14, Chia-Chen Chang^15,16, Li-Ning Peng^17,18, Chi-Hua Yen^19,20
and Cheng-Kuo Huang^21*
 

The COVID-19 pandemic has had a profound global impact, particularly on high-risk populations, such as those with underlying medical conditions. In response to the evolving pandemic landscape and the constant surge in the need to vaccinate among vulnerable cases in Taiwan, the Taiwan Association of Family Medicine (TAFM) has developed recommendations on COVID-19 vaccination for high-risk groups. Based on a comprehensive literature review and expert panel discussions, a total of 25 evidence-based recommendations have been developed to serve as a reference for vaccination strategies, highlighting the increased risk of severe COVID-19 outcomes among individuals with complications such as diabetes, obesity, chronic kidney disease, cardiovascular disease, and respiratory illnesses. The recommendations emphasize the safety and effectiveness of COVID-19 vaccines, particularly mRNA vaccines, for the aforementioned high-risk populations and underscore the critical roles of family physicians in response to severe COVID-19 outcomes, including routine screening, health education, vaccine administration, and continuous research to optimize strategies. The TAFM recommendations provide a robust, evidence-based framework that meets clinical practice requirements and provides effective guidelines for physicians, healthcare institutions, and governments in tailoring vaccination efforts to address the unique needs of high-risk groups in Taiwan. Ongoing monitoring and proactive vaccination drives are essential for ensuring the effectiveness of these recommendations in the evolving COVID-19 landscape, while also accentuating the continuous efforts of family physicians in preventing endemic diseases.

(Taiwan J Fam Med 2024; 34: 115-124) DOI: 10.53106/168232812024093403001

Key words: co-administration of vaccines, COVID-19 vaccines, high-risk groups, mRNA

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¹Department of Family Medicine, College of Medicine, National Cheng Kung University; ²Department of Family Medicine,National Cheng Kung University Hospital; ³Institute of Gerontology, College of Medicine, National Cheng Kung UniversityHospital; ⁴Division of Preventive Medicine, Department of Family Medicine, E-Da Hospital; ⁵School of Medicine for InternationalStudents, College of Medicine, I-Shou University; ⁶School of Medicine, College of Medicine, I-Shou University; ⁷Departmentof Family Medicine, College of Medicine, National Yang Ming Chiao Tung University; ⁸Division of Family Medicine, EnChu Kong Hospital; ⁹Department of Family Medicine, Changhua Christian Hospital; ¹⁰Graduate Institute of Clinical Medicine,College of Medicine, National Chung Hsing University; ¹¹Department of Post-Baccalaureate Medicine, College of Medicine,National Chung Hsing University; ¹²Department of Family Medicine, National Taiwan University Hospital; ¹³Department ofFamily Medicine, College of Medicine, National Taiwan University; ¹⁴Institute of Preventive Medicine, College of PublicHealth, National Taiwan University; ¹⁵Department of Family Medicine, Kaohsiung Medical University Chung-Ho MemorialHospital; ¹⁶Department of Medicine, College of Medicine, Kaohsiung Medical University; ¹⁷Department of Geriatrics, Centerfor Geriatrics and Gerontology, Taipei Veterans General Hospital; ¹⁸Department of Family Medicine, School of Medicine,National Yang Ming Chiao Tung University; ¹⁹Department of Medicine, Chung Shan Medical University Hospital; ²⁰Departmentof Family and Community Medicine, Chung Shan Medical University Hospital; ²¹Huang Cheng Kuo Clinic
Received: August 30, 2024; Revised: September 18, 2024; Accepted: September 20, 2024.
^*Corresponding author