Coronavirus vaccines may not work in some people. It’s because of their underlying conditions.

冠狀病毒疫苗可能對(duì)某些人不起作用。因?yàn)樗麄冇袧撛诘募膊　?/b>

Early research shows that 15 to 80 percent of people with certain medical conditions, such as specific blood cancers or organ transplants, are generating few antibodies after receiving coronavirus vaccines.

早期研究表明，15%到80%患有某些疾病的人，比如特定的血癌或器官移植，在接受冠狀病毒疫苗后產(chǎn)生的抗體很少。
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By Ariana Eunjung Cha
May 18, 2021 at 8:00 p.m. GMT+8
Maria Hoffman feels as though she has been left behind. Her adopted hometown of Charleston, S.C., is hopping — with restaurants and bars fully open, park concerts in full swing and maskless friends reuniting with hugs on streets.

瑪麗亞·霍夫曼覺(jué)得自己好像被留下了。她定居的家鄉(xiāng)南卡羅來(lái)納州查爾斯頓（Charleston，S.C.）正在跳動(dòng)——餐館和酒吧已全面開放，公園音樂(lè)會(huì)如火如荼地舉行，沒(méi)戴口罩的朋友們?cè)诮稚蠐肀F(tuán)聚。

Hoffman, 39, is fully vaccinated and eager to rejoin the world. But as a kidney transplant patient, she is hesitant to participate for fear of becoming infected. “Risk is very different for people in my situation,” she said. “I am 100 percent acting like I am not immunized.”

39歲的霍夫曼已經(jīng)接種了疫苗，渴望重返世界。但作為一名腎移植患者，她不敢參與，因?yàn)楹ε卤桓腥?。“?duì)于我在這種情況下，風(fēng)險(xiǎn)是完全不同的，”她說(shuō)我百分之百表現(xiàn)得好像我沒(méi)有接種疫苗?！?/b>

The state worker is among millions of immunocompromised Americans, about 3 to 4 percent of the U.S. population, for whom the shots may not work fully, or at all, and who are unsure of their place in a country that is increasingly opening up. Emerging research shows that 15 to 80 percent of those with certain conditions, such as specific blood cancers or who have had organ transplants, are generating few antibodies.

這名國(guó)家工作人員是數(shù)百萬(wàn)免疫功能低下的美國(guó)人中的一員，約占美國(guó)人口的3%至4%，對(duì)他們來(lái)說(shuō)，注射可能無(wú)法完全奏效，或者根本無(wú)法奏效，他們不確定自己在一個(gè)日益開放的國(guó)家中的位置。新的研究表明，15%到80%的患有某些疾病的人，比如特定的血癌或接受過(guò)器官移植的人，產(chǎn)生的抗體很少。

Federal health officials’ decision last week to rescind almost all masking and distancing recommendations for those who are fully vaccinated only added to the sense of fear, isolation and confusion for those with immune issues. On Twitter and other social media platforms, many such patients expressed frustration that the change might leave them with less — not more — freedom as their risk of infection grows as more of their neighbors and co-workers ditch their masks.

聯(lián)邦衛(wèi)生官員上周決定撤銷針對(duì)那些完全接種疫苗的人的口罩和距離建議，這會(huì)增加那些有免疫問(wèn)題的人的恐懼感、孤立感和困惑感。在Twitter和其他社交媒體平臺(tái)上，許多這樣的患者表示沮喪，因?yàn)殡S著越來(lái)越多的鄰居和同事扔掉口罩，他們感染的風(fēng)險(xiǎn)越來(lái)越大，這種改變可能會(huì)讓他們的自由更少，而不是更多。

Hoffman, who has been advised by her doctors to act as though she never got the shots, recounted how she visited a grocery store Thursday but became anxious and left after a maskless man struck up a conversation.

醫(yī)生建議霍夫曼要像從來(lái)沒(méi)有打過(guò)針?biāo)频纳?。霍夫曼講述了她星期四去一家雜貨店，但在一個(gè)沒(méi)戴口罩的男人搭話后，她感到焦慮，于是離開了。

“I wear my mask out of respect for others, and for those who are sick,” she said. “If you aren’t wearing a mask, we can’t make you now.”

她說(shuō)：“我戴口罩是為了尊重別人，也為了那些生病的人?！比绻銢](méi)有戴口罩，我們不能強(qiáng)迫你?！?/b>

Vaccine makers excluded immunocompromised people from their clinical trials in an understandable rush to develop a way to protect as many people as quickly as possible. As a result, there’s limited information about how this group is reacting to the shots, as well as to the loosening of Centers for Disease Control and Prevention restrictions.

疫苗生產(chǎn)商將免疫功能低下的人排除在臨床試驗(yàn)之外，這是可以理解的，他們急于開發(fā)一種能夠盡快保護(hù)盡可能多的人的方法。因此，關(guān)于這一群體對(duì)疫苗注射以及疾病控制和預(yù)防中心放寬限制的反應(yīng)的信息有限。

The ability of such patients to fend off the novel coronavirus is not just a footnote in the pandemic involving one unlucky group — but potentially a critical part of the narrative about how new, more contagious variants are continuing to emerge worldwide.

這類患者抵御新型冠狀病毒的能力不僅是涉及一個(gè)不幸群體的大流行中的一個(gè)注腳，而且可能是敘述新的、更具傳染性的變種如何在世界范圍內(nèi)繼續(xù)出現(xiàn)的一個(gè)關(guān)鍵部分。
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The interaction between immunocompromised people and the virus is perhaps one of the pandemic’s most fraught questions. Case studies have detailed how some patients can have active infections for many months — resulting in questions about whether they can act as incubators for mutations that lead to new variants and underscoring the need for an effective vaccine strategy not just for their sake, but for the greater good.

免疫功能低下的人和病毒之間的相互作用可能是大流行中最令人擔(dān)憂的問(wèn)題之一。案例研究詳細(xì)說(shuō)明了一些患者如何在數(shù)月內(nèi)發(fā)生活動(dòng)性感染，由此產(chǎn)生了一個(gè)問(wèn)題，即他們是否可以充當(dāng)導(dǎo)致新變異的突變的孵化器，并強(qiáng)調(diào)需要一種有效的疫苗策略，不僅是為了他們，而且是為了更大的利益。

CDC Director Rochelle Walensky and White House adviser Anthony S. Fauci highlighted the challenges of such patients and the vaccines in a recent news briefing in which they acknowledged that the first documented case of the so-called New York variant, B. 1.526, was found in a patient with advanced AIDS.

疾病控制中心主任羅謝爾瓦倫斯基和白宮顧問(wèn)安東尼S。Fauci在最近的一次新聞簡(jiǎn)報(bào)中強(qiáng)調(diào)了這類患者和疫苗面臨的挑戰(zhàn)，他們?cè)诤?jiǎn)報(bào)中承認(rèn)，第一例有記載的所謂紐約變種B。1.526，在一名晚期艾滋病患者中發(fā)現(xiàn)。

“Early studies actually show that these variants could emerge in a single host — in a single immunocompromised host,” Walensky said.

沃倫斯基說(shuō)：“早期的研究實(shí)際上表明，這些變異可能出現(xiàn)在一個(gè)單一的宿主身上——在一個(gè)免疫功能低下的宿主身上?！薄?/b>
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But neither the federal government nor vaccine makers Pfizer-BioNTech and Moderna has stepped up to do a comprehensive study about whether the vaccines protect people with immune issues. As such, most of the research has been conducted piecemeal in academic centers — and many are reaching differing, sometimes conflicting, conclusions.

但無(wú)論是聯(lián)邦政府還是疫苗制造商輝瑞生物科技公司（Pfizer BioNTech）和摩德納公司（Moderna）都沒(méi)有加緊對(duì)疫苗是否能保護(hù)有免疫問(wèn)題的人進(jìn)行全面研究。因此，大多數(shù)研究都是在學(xué)術(shù)中心零零碎碎地進(jìn)行的——許多研究得出了不同的、有時(shí)相互矛盾的結(jié)論。

Early data suggests that the vaccines offer some protection, although perhaps to a lesser degree, for most patients with HIV and autoimmune conditions such as rheumatoid arthritis. But there’s worry about people with blood cancers and transplant recipients. Some of the weakened response appears to be related to certain immunosuppressive drugs, and potentially a commonly prescribed steroid.

早期的數(shù)據(jù)表明，疫苗對(duì)大多數(shù)艾滋病患者和類風(fēng)濕性關(guān)節(jié)炎等自身免疫性疾病有一定的保護(hù)作用，盡管保護(hù)程度可能較低。但是有人擔(dān)心血癌患者和移植受者。一些減弱的反應(yīng)似乎與某些免疫抑制藥物有關(guān)，也可能與常用的類固醇有關(guān)。

“The overwhelming majority of transplant patients, even after a second dose of the vaccine, appear to have suboptimal protection — if any protection — from the vaccine, which is frightening, disappointing and a bit surprising,” said Dorry Segev, a researcher at the Johns Hopkins University School of Medicine.

約翰·霍普金斯大學(xué)醫(yī)學(xué)院研究員多里·塞格夫說(shuō)：“絕大多數(shù)移植患者，即使接種了第二劑疫苗，對(duì)疫苗的保護(hù)（如果有保護(hù)的話）似乎也不理想，這是令人恐懼、失望和有點(diǎn)驚訝的。”。

For most of the pandemic, Segev said, it was rare to see transplant recipients get sick with covid-19, the disease caused by the coronavirus, because they had been so careful about staying at home. But that changed over the past two months, with newly infected patients now coming in at a pace of nearly one each day, he said.

塞格夫說(shuō)，在大流行的大部分時(shí)間里，很少看到移植受者感染冠狀病毒引起的covid-19，因?yàn)樗麄円恢狈浅Ｐ⌒牡卮粼诩依铩５谶^(guò)去的兩個(gè)月里，情況發(fā)生了變化，新感染的病人現(xiàn)在幾乎每天都有一個(gè)。

Many tell the same story: After being fully vaccinated, they had finally ventured out for a meal, reunited with family members or otherwise relaxed their social distancing precautions.

許多人講述了同樣的故事：在接種完疫苗后，他們終于冒險(xiǎn)出去吃飯，與家人團(tuán)聚，或者以其他方式放松社交距離的預(yù)防措施。

“We expected a slightly blunted effect,” Segev said, “not something this stark.”

“我們預(yù)計(jì)會(huì)有一點(diǎn)減弱的影響，”塞格夫說(shuō)，“不會(huì)有這么明顯的影響?！?/b>

The good news, he and other researchers say, is that scientists are prepared with some potential solutions, such as boosters or high-dose shots. They just need to scramble to study them so they can offer them as soon as possible.

他和其他研究人員說(shuō)，好消息是，科學(xué)家們已經(jīng)準(zhǔn)備好了一些可能的解決方案，比如助推器或高劑量注射。他們只需要迅速地研究它們，以便盡快提供它們。

Immune mystery

免疫之謎

The body’s immune system can be a capricious thing.

人體的免疫系統(tǒng)可能是一個(gè)反復(fù)無(wú)常的東西。

It can serve as a defensive shield one minute, and then shift into overdrive the next and attack itself. Many scientists believe that figuring out the puzzle of how the different components work together and how to control them is one of the holy grails of medicine that could lead to cures for many of the ills that plague humanity.

它可以在前一分鐘充當(dāng)防御盾牌，然后在下一分鐘轉(zhuǎn)換到超速檔并攻擊自己。許多科學(xué)家認(rèn)為，找出不同成分如何協(xié)同工作以及如何控制它們的謎團(tuán)，是能夠治愈許多困擾人類的疾病的醫(yī)學(xué)圣杯之一。

But compared with, say, the heart, researchers’ understanding of the immune system is still limited. They’ve long known, for example, that vaccines work better in some people than others but they are still trying to figure out why.

但與心臟相比，研究人員對(duì)免疫系統(tǒng)的了解仍然有限。例如，他們?cè)缇椭酪呙缭谀承┤松砩媳仍谄渌松砩闲Ч?，但他們?nèi)栽谠噲D找出原因。

From studying other vaccines, for instance, they know that age and underlying conditions can be factors. People older than 65 have been shown to produce 50 to 75 percent fewer antibodies in response to flu shots than their younger counterparts, which is why manufacturers produce a high-dose version for them. HIV patients often receive three hepatitis B shots, instead of two.

例如，通過(guò)對(duì)其他疫苗的研究，他們知道年齡和潛在條件可能是一個(gè)因素。研究表明，65歲以上的人注射流感疫苗后產(chǎn)生的抗體比年輕人少50%到75%，這就是為什么制造商為他們生產(chǎn)高劑量疫苗的原因。艾滋病患者通常接受三次乙肝疫苗注射，而不是兩次。

Given this knowledge, some differences in the coronavirus vaccine response of immunocompromised people were expected.

鑒于這一知識(shí)，免疫功能低下人群的冠狀病毒疫苗反應(yīng)可能存在一些差異。

Most of the work has looked at only one facet of the immune response — the creation of antibodies, which are simple to measure with a blood test. Studies have mostly focused on the mRNA vaccines made by Pfizer-BioNTech and Moderna because they are most widely used.

大部分工作只關(guān)注了免疫反應(yīng)的一個(gè)方面——抗體的產(chǎn)生，這很容易用血液測(cè)試來(lái)衡量。研究主要集中在輝瑞生物科技公司（Pfizer BioNTech）和Moderna公司生產(chǎn)的mRNA疫苗上，因?yàn)樗鼈兊膽?yīng)用最為廣泛。
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At the University of California at San Francisco, Monica Gandhi and her colleagues found that HIV patients seem to produce fewer antibodies on average, but she is optimistic that the amount is sufficient to protect most people.

在加州大學(xué)舊金山分校，莫妮卡·甘地和她的同事發(fā)現(xiàn)，艾滋病患者平均產(chǎn)生的抗體似乎較少，但她樂(lè)觀地認(rèn)為，這一數(shù)量足以保護(hù)大多數(shù)人。

She said one recent study showed that another arm of the immune system — T cells, or the white blood cells that fight infection — appear to respond to the vaccines similarly in both HIV patients and those without the disease.

她說(shuō)，最近的一項(xiàng)研究表明，免疫系統(tǒng)的另一個(gè)分支——T細(xì)胞，或抗感染的白細(xì)胞——對(duì)艾滋病患者和無(wú)艾滋病患者的疫苗反應(yīng)相似。

“With the antibody response being blunted, but the T-cell response not, it may mean more susceptibility to mild infection, but not likely severe disease,” she said.

她說(shuō)：“抗體反應(yīng)減弱，但T細(xì)胞反應(yīng)沒(méi)有減弱，這可能意味著更容易受到輕度感染，但不太可能是嚴(yán)重疾病?！薄?/b>

Gandhi said that although more research is needed, the strong T-cell response may reflect how many people with HIV in the United States are quite healthy because they are treated with retroviral drugs. She said the situation may be different in Africa and other parts of the world for those not on treatment. She said she gave one of her vaccinated patients who had zero antibody response an extra dose of the Johnson & Johnson coronavirus vaccine.

甘地說(shuō)，盡管還需要更多的研究，但強(qiáng)大的T細(xì)胞反應(yīng)可能反映出美國(guó)有多少艾滋病毒感染者相當(dāng)健康，因?yàn)樗麄兘邮芰四孓D(zhuǎn)錄病毒藥物治療。她說(shuō)，對(duì)于那些沒(méi)有接受治療的人來(lái)說(shuō)，非洲和世界其他地區(qū)的情況可能不同。她說(shuō)，她給一個(gè)抗體反應(yīng)為零的接種過(guò)疫苗的病人額外注射了強(qiáng)生冠狀病毒疫苗。

For most of her patients, however, she said she has “no concerns yet.”

然而，對(duì)于她的大多數(shù)病人，她說(shuō)她“還沒(méi)有擔(dān)心”

“We are a very tightknit HIV community. We all talk, and would know if we were seeing a lot of breakthrough infections,” she said. “But fortunately we are not.”

“我們是一個(gè)非常緊密的艾滋病社區(qū)。她說(shuō)：“我們都在交談，如果有很多爆發(fā)性的感染，我們會(huì)知道?！钡疫\(yùn)的是我們沒(méi)有?！?/b>

‘Disheartening’

'令人沮喪'

The results have been more disappointing for some other types of immunocompromised patients.

對(duì)于其他類型的免疫功能低下患者來(lái)說(shuō)，結(jié)果更令人失望。
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Mounzer Agha, a hematologist at the University of Pittsburgh Medical Center and lead author of a study on blood cancers and the vaccines posted online before peer review, described how crushed he felt when he saw the low antibody results for nearly half of the 67 patients his group tracked.

匹茲堡大學(xué)醫(yī)學(xué)中心的血液學(xué)專家、同行評(píng)議前在網(wǎng)上發(fā)布的一項(xiàng)關(guān)于血癌和疫苗的研究的主要作者M(jìn)ounzer Agha描述了當(dāng)他看到他的小組跟蹤的67名患者中近一半的抗體水平低下時(shí)，他是多么的沮喪。

Patients on treatments that impact B-cell function appeared to have the weakest results. That made sense to him because B cells produce antibodies.

接受影響B(tài)細(xì)胞功能治療的患者似乎效果最差。這對(duì)他來(lái)說(shuō)是有意義的，因?yàn)锽細(xì)胞產(chǎn)生抗體。

But the data also contained what he called an “unwelcome surprise”: Patients with a condition known as chronic lymphocytic leukemia had a very weak response even if they were not undergoing treatment. The condition, which affects the blood and bone marrow, can sometimes be asymptomatic.

但這些數(shù)據(jù)也包含了他所謂的“不受歡迎的驚喜”：患有慢性淋巴細(xì)胞白血病的患者即使沒(méi)有接受治療，反應(yīng)也非常微弱。這種影響血液和骨髓的疾病有時(shí)是無(wú)癥狀的。

“When I found patients who had never received therapy still did not respond to the vaccine, that was very disheartening,” he said. “Now what are you going to do for these individuals?”

他說(shuō)：“當(dāng)我發(fā)現(xiàn)從未接受過(guò)治療的病人仍然對(duì)疫苗沒(méi)有反應(yīng)時(shí)，這是非常令人沮喪的?！爆F(xiàn)在你要為這些人做些什么？”

Agha said his clinic has been scrambling to reassess care plans in the context of the pandemic. Some patients who are more stable are taking cancer treatment “holidays” while they get the vaccine; others have opted to forgo the shots.

阿加說(shuō)，他的診所一直在迅速地重新評(píng)估大流行背景下的護(hù)理計(jì)劃。一些病情較穩(wěn)定的患者在接種疫苗的同時(shí)正在“休假”接受癌癥治療；其他人則選擇放棄注射。

“The information has come out so recently that there are no clinical guidelines, and decisions have to be made on a case-by-case basis on the fly,” he said.

他說(shuō)：“這些信息是最近才出來(lái)的，因此沒(méi)有臨床指南，必須在工作中根據(jù)具體情況作出決定?！?。
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Agha said he fears that for some patients, the vaccines may never work even at higher doses, and that they will have to rely on the inoculation of those around them for their safety.

阿加說(shuō)，他擔(dān)心，對(duì)一些病人來(lái)說(shuō)，疫苗可能永遠(yuǎn)不會(huì)起作用，甚至在更高的劑量，他們將不得不依靠接種周圍的人，他們的安全。

“Everyone should get the vaccine for the sake of their loved ones,” he urged. “Everyone knows someone who has cancer. And if you care about that person, you should get the vaccine and tell your friends to get it.”

“為了親人，每個(gè)人都應(yīng)該接種疫苗，”他敦促道每個(gè)人都知道有人得了癌癥。如果你關(guān)心那個(gè)人，你應(yīng)該接種疫苗，并告訴你的朋友接種?！?/b>

As for transplant patients, the early data are also concerning: A May 5 study published in JAMA found that 46 percent of 658 transplant patients did not mount an antibody response after two doses of the Pfizer-BioNTech or Moderna vaccines.

至于移植患者，早期的數(shù)據(jù)也涉及到：5月5日發(fā)表在JAMA的一項(xiàng)研究發(fā)現(xiàn)，658名移植患者中，46%的患者在兩劑輝瑞B(yǎng)ioNTech或Moderna疫苗后沒(méi)有產(chǎn)生抗體反應(yīng)。

“Although this study demonstrates an improvement in … antibody responses in transplant recipients after dose two … these data suggest that a substantial proportion of transplant recipients likely remain at risk for covid-19 after 2 doses of mRNA vaccine,” the researchers wrote. They think this lack of reaction is probably a result of the immunosuppressive drugs they take.

研究人員寫道：“盡管這項(xiàng)研究表明，第二劑后，移植受者的抗體反應(yīng)有所改善……但這些數(shù)據(jù)表明，相當(dāng)一部分移植受者可能在第二劑mRNA疫苗后仍有感染covid-19的風(fēng)險(xiǎn)?！?。他們認(rèn)為這種缺乏反應(yīng)可能是他們服用免疫抑制藥物的結(jié)果。

Segev, a co-author, said that although antibody reaction is only part of the picture, “knowing what we know about immunosuppression, I would be surprised if transplant patients who had no antibody response had a robust T-cell response.”

合著者塞格夫說(shuō)，雖然抗體反應(yīng)只是其中的一部分，“了解我們對(duì)免疫抑制的了解，如果沒(méi)有抗體反應(yīng)的移植患者有強(qiáng)大的T細(xì)胞反應(yīng)，我會(huì)感到驚訝。”

“The irony of it all is transplant patients were being very, very careful,” he said, adding: “It’s a very scary problem.”

“諷刺的是，移植病人要非常非常小心，”他說(shuō)，“這是一個(gè)非?？膳碌膯?wèn)題。”
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In St. Louis, Washington University’s Alfred Kim said that although the majority of patients with autoimmune conditions who were studied are mounting a healthy antibody response, about 15 percent had very blunted or undetectable antibody responses. The participants in the study had a wide range of illnesses, including inflammatory bowel disease, systemic lupus and rheumatoid arthritis.

在圣路易斯，華盛頓大學(xué)的Alfred Kim說(shuō)，盡管被研究的大多數(shù)患有自身免疫疾病的患者都出現(xiàn)了健康的抗體反應(yīng)，但大約15%的患者的抗體反應(yīng)非常遲鈍或無(wú)法檢測(cè)到。參與研究的人患有多種疾病，包括炎癥性腸病、系統(tǒng)性狼瘡和類風(fēng)濕性關(guān)節(jié)炎。
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The original study, which has not yet been peer reviewed, was based on 133 people, but it has now grown to more than 300, with similar results.

最初的研究還沒(méi)有經(jīng)過(guò)同行評(píng)審，是以133人為研究對(duì)象的，但現(xiàn)在已經(jīng)發(fā)展到300多人，結(jié)果相似。

As with the blood cancer study, many of those most severely affected were on B-cell-depleting medications, such as rituximab, used to treat certain autoimmune diseases and cancer, or ocrelizumab, a newer drug for multiple sclerosis.

與血癌研究一樣，許多受影響最嚴(yán)重的患者服用了B細(xì)胞消耗藥物，如用于治療某些自身免疫性疾病和癌癥的利妥昔單抗，或用于治療多發(fā)性硬化癥的新型藥物奧列珠單抗。

Patients taking drugs for rheumatoid arthritis were likely to have a moderately reduced response.

服用類風(fēng)濕性關(guān)節(jié)炎藥物的患者可能會(huì)有中度的緩解。

Kim, an assistant professor in the division of rheumatology, said one perplexing finding is that steroid use also appeared to diminish the vaccine response. Although he cautioned that only a small number of patients were involved, he said prednisone, which is used to treat such conditions as arthritis in adults and breathing difficulties in children, appeared to result in a tenfold reduction in antibody production, regardless of the dose given if administered around the time of the vaccine.

風(fēng)濕病學(xué)系的助理教授Kim說(shuō)，一個(gè)令人困惑的發(fā)現(xiàn)是類固醇的使用似乎也減少了疫苗的反應(yīng)。盡管他提醒說(shuō)，只有少數(shù)患者參與，但他說(shuō)，用于治療成人關(guān)節(jié)炎和兒童呼吸困難等疾病的強(qiáng)的松似乎會(huì)導(dǎo)致抗體產(chǎn)生量減少10倍，而不管疫苗接種前后給藥的劑量是多少。

“Right now, we’re telling them to pretend they weren’t vaccinated,” Kim said. “That is the easiest solution but it’s only a short-term one. The step beyond is: What do we do to mitigate this?”

“現(xiàn)在，我們告訴他們要假裝沒(méi)有接種疫苗，”金說(shuō)這是最簡(jiǎn)單的解決辦法，但只是短期的。接下來(lái)的步驟是：我們?cè)撛趺醋鰜?lái)緩解這種情況？”

Boosting immunity

增強(qiáng)免疫力

Numerous potential solutions for the immunocompromised are being debated. One simple idea is to provide one or more booster shots for those with weak responses. So an immunocompromised person might get three doses of the Pfizer-BioNTech or Moderna vaccine, instead of two.

免疫功能低下的許多潛在解決方案正在辯論中。一個(gè)簡(jiǎn)單的想法是為那些反應(yīng)較弱的人提供一個(gè)或多個(gè)助推器注射。所以一個(gè)免疫功能低下的人可能會(huì)得到三劑輝瑞生物技術(shù)或摩德納疫苗，而不是兩劑。

Another possibility is to try preventive doses of lab-produced antibody proteins known as monoclonal antibodies that until now have been mostly used as treatments for those who are infected with the coronavirus.

另一種可能性是嘗試預(yù)防劑量的實(shí)驗(yàn)室產(chǎn)生的抗體蛋白，稱為單克隆抗體，迄今為止，這些抗體主要用于治療那些感染冠狀病毒的人。

One thing doctors don’t recommend is for vaccinated people to get antibody tests. First of all, no one knows what levels of antibodies are effective against the virus. Moreover, Kim emphasized that antibodies are only one part of the immune system and that it’s possible that the vaccines have activated other, more difficult-to-measure components.

醫(yī)生不推薦的一件事是讓接種疫苗的人接受抗體檢測(cè)。首先，沒(méi)有人知道抗體的水平對(duì)病毒有效。此外，金先生強(qiáng)調(diào)，抗體只是免疫系統(tǒng)的一部分，疫苗可能激活了其他更難測(cè)量的成分。

“It’s not something that we can act on,” he said of such information. “All it can do is mount worries for the patient.”

“我們無(wú)法采取行動(dòng)，”他談到這些信息時(shí)說(shuō)它所能做的就是為病人增加憂慮?！?/b>

Many physicians urge immunocompromised patients to continue to practice social distancing and take other precautions.

許多醫(yī)生敦促免疫受損的患者繼續(xù)進(jìn)行社會(huì)隔離，并采取其他預(yù)防措施。

Seville Christian, 60, an HIV-positive substance abuse counselor in San Francisco, has been working in person through the pandemic and said she plans to continue to do so.

60歲的塞維利亞·克里斯蒂安是舊金山的艾滋病毒陽(yáng)性藥物濫用顧問(wèn)，在這場(chǎng)流行病期間她一個(gè)人工作，她說(shuō)她計(jì)劃繼續(xù)這樣做。

But she said optional social outings will remain off the table. Even though she planned to get her second shot May 12, she will go to restaurants only for takeout, meet friends virtually and minimize her time in stores until the science is clearer.

但她說(shuō)，社交活動(dòng)會(huì)繼續(xù)停止。盡管她計(jì)劃5月12日打第二針疫苗，但她還是會(huì)去餐館買外賣，盡量減少和朋友見(jiàn)面以及呆在商店里的時(shí)間，直到研究更清楚為止。

She’s still weighing whether return to her to church, fully masked, when it reopens.

她也考慮是否回到教堂，戴著口罩，當(dāng)它重新開放的時(shí)候。

“I wish I could go back to normal, but there are still a lot of questions I have,” Christian said.

“我希望我能回到正常的狀態(tài)，但我還有很多問(wèn)題，”Christian說(shuō)。

Hoffman, too, is struggling to navigate the new normal in Charleston. After having a kidney transplant at age 9 and spending most of her childhood in hospitals, she is acutely aware of her mortality. So she said she tries to find the right balance between living her life and staying safe.

霍夫曼也在努力適應(yīng)在查爾斯頓的新常態(tài)。在9歲接受腎臟移植，并將大部分童年都花在醫(yī)院后，她敏銳地意識(shí)到自己的死亡命運(yùn)。所以她說(shuō)她試圖在生活和安全之間找到正確的平衡。

When a friend gets married in Ohio in a few weeks, she hopes to go and participate in the outdoor events. She is also talking to friends about reserving a socially distant spot for an outdoor band performance. But otherwise, she’s continuing to keep her distance from others.

當(dāng)一個(gè)朋友會(huì)在俄亥俄州數(shù)周后結(jié)婚，她希望出去并參加這個(gè)戶外活動(dòng)。她還和朋友們談?wù)摚瑸榱丝磻敉鈽?lè)隊(duì)表演預(yù)留一個(gè)社交距離較遠(yuǎn)的地點(diǎn)。否則，她將繼續(xù)保持與他人的距離。

“I just love talking to people and meeting people,” she said. “It has been crazy and lonely.”

“我只是喜歡與人交談以及認(rèn)識(shí)別人?！彼f(shuō)，“這是瘋狂和孤獨(dú)。”