COVID-19 Vaccination Recommendations: Challenges and Strategies for High-Risk Populations

吳至行 吳至行,洪暐傑 Chih-Hsing Wu,黃駿豐 黃駿豐,劉晏孜 劉晏孜,程劭儀 程劭儀,張家禎 張家禎,彭莉甯 Chia-Jan Chang,顏啟華 Li-Ning Peng,黃振國 Chi-Hua Yen

doi:10.53106/168232812024093403001

Abstract

COVID-19（新冠併發重症）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。 &nbsp;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. &nbsp;

Full Text