{"id":4011,"date":"2021-09-17T19:33:53","date_gmt":"2021-09-17T17:33:53","guid":{"rendered":"https:\/\/www.mc-praha.cz\/mcp\/?p=4011"},"modified":"2021-09-23T13:54:51","modified_gmt":"2021-09-23T11:54:51","slug":"vakciny-proti-covid-19-a-jejich-pouziti-u-deti-a-mladistvych","status":"publish","type":"post","link":"https:\/\/www.mc-praha.cz\/mcp\/vakciny-proti-covid-19-a-jejich-pouziti-u-deti-a-mladistvych\/","title":{"rendered":"Vakc\u00edny proti COVID-19 a jejich pou\u017eit\u00ed u d\u011bt\u00ed a mladistv\u00fdch"},"content":{"rendered":"

Vakcinace proti COVID-19 se v p\u0159\u00edpad\u011b dosp\u011bl\u00fdch ukazuje b\u00fdt do zna\u010dn\u00e9 m\u00edry efektivn\u00ed v prevenci z\u00e1va\u017en\u00e9ho pr\u016fb\u011bhu a \u00famrtnosti na toto onemocn\u011bn\u00ed. T\u00e9ma vakcinace specifick\u00e9 kategorie d\u011bt\u00ed a mladistv\u00fdch je v\u011bdeckou komunitou i laiky \u0161iroce diskutov\u00e1no a vy\u017eaduje n\u00e1le\u017eit\u00e9 zv\u00e1\u017een\u00ed.<\/strong><\/p>\n

V kv\u011btnu 2021 EU schv\u00e1lila pou\u017eit\u00ed vakc\u00edny od spole\u010dnosti Pfizer-BioNTech pro v\u011bkovou kategorii 12+. Pokyny WHO ze dne 14. \u010dervence 2021 uv\u00e1d\u00ed: \u201eD\u011bti a mladistv\u00ed m\u00edvaj\u00ed ve srovn\u00e1n\u00ed s dosp\u011bl\u00fdmi m\u00edrn\u011bj\u0161\u00ed onemocn\u011bn\u00ed, tak\u017ee pokud nejsou sou\u010d\u00e1st\u00ed skupiny s vy\u0161\u0161\u00edm rizikem z\u00e1va\u017en\u00e9ho onemocn\u011bn\u00ed COVID-19, je jejich o\u010dkov\u00e1n\u00ed m\u00e9n\u011b nal\u00e9hav\u00e9 ne\u017e u star\u0161\u00edch lid\u00ed, osob chronicky nemocn\u00fdch a zdravotnick\u00fdch pracovn\u00edk\u016f. Strategick\u00e1 poradn\u00ed skupina odborn\u00edk\u016f WHO (SAGE) dosp\u011bla k z\u00e1v\u011bru, \u017ee vakc\u00edna spole\u010dnosti Pfizer\u2013BioNTech je vhodn\u00e1 pro pou\u017eit\u00ed u osob ve v\u011bku 12 let a star\u0161\u00edch. D\u011btem ve v\u011bku od 12 do 15 let, kter\u00e9 jsou vystaveny vysok\u00e9mu riziku, m\u016f\u017ee b\u00fdt tato vakc\u00edna nab\u00eddnuta stejn\u011b jako dal\u0161\u00edm prioritn\u00edm skupin\u00e1m. Studie na t\u00e9ma o\u010dkov\u00e1n\u00ed pro d\u011bti pokra\u010duj\u00ed a WHO bude aktualizovat sv\u00e1 doporu\u010den\u00ed, jakmile by d\u016fkazy nebo epidemiologick\u00e1 situace vy\u017eadovaly zm\u011bnu politiky\u201c.<\/p>\n

Jednotliv\u00e9 \u010dlensk\u00e9 zem\u011b EU tedy uplat\u0148uj\u00ed p\u0159i o\u010dkov\u00e1n\u00ed d\u011bt\u00ed nad 12 let vlastn\u00ed strategie. Za\u010dalo se o\u010dkovat nap\u0159\u00edklad ve Francii, Nizozem\u00ed, It\u00e1lii. V N\u011bmecku se o\u010dkuje jen v doporu\u010den\u00fdch p\u0159\u00edpadech na z\u00e1klad\u011b zdravotn\u00ed anamn\u00e9zy. V Anglii se \u0159\u00edd\u00ed doporu\u010den\u00edm Joint Committee on Vaccination and Immunisation (ICVI) o\u010dkovat d\u011bti 12+, pokud jsou vystaveny vy\u0161\u0161\u00edmu riziku onemocn\u011bn\u00ed COVID-19 z d\u016fvodu t\u011b\u017ek\u00e9 neurodisability (stavy jako mozkov\u00e1 obrna, autismus nebo epilepsie), Downova syndromu, siln\u011b oslaben\u00e9ho imunitn\u00edho syst\u00e9mu (v\u010detn\u011b n\u011bkter\u00fdch d\u011bt\u00ed s rakovinou) a mnoho\u010detn\u00fdch poruch s u\u010den\u00edm. Ml\u00e1de\u017e ve v\u011bku 16\u201317 let s vy\u0161\u0161\u00edm rizikem lze o\u010dkovat dle st\u00e1vaj\u00edc\u00edch pravidel. JCVI tak\u00e9 doporu\u010dil imunizaci 12\u201317let\u00fdch, kte\u0159\u00ed \u017eij\u00ed s lidmi s oslaben\u00fdm imunitn\u00edm syst\u00e9mem, jako formu nep\u0159\u00edm\u00e9 ochrany t\u011bchto \u010dlen\u016f rodiny.<\/p>\n

Do za\u010d\u00e1tku srpna 2021 nebyla v r\u00e1mci EU schv\u00e1lena k pou\u017eit\u00ed pro d\u011bti mlad\u0161\u00ed 12 let \u017e\u00e1dn\u00e1 z doposud vyvinut\u00fdch vakc\u00edn proti COVID-19; v\u00fdstupy z klinick\u00fdch studi\u00ed f\u00e1ze 3 t\u00fdkaj\u00edc\u00ed se jejich bezpe\u010dnosti a \u00fa\u010dinnosti pro tyto d\u011bti jsou zat\u00edm omezen\u00e9. V sou\u010dasnosti b\u011b\u017e\u00ed v\u00edce ne\u017e 30 mezin\u00e1rodn\u00edch studi\u00ed, kter\u00fdch se \u00fa\u010dastn\u00ed d\u011bti ve v\u011bku od 6 m\u011bs\u00edc\u016f do 12 let. Posuzuj\u00ed se ot\u00e1zky bezpe\u010dnosti vakc\u00edn, imunogenicity, d\u00e1vkov\u00e1n\u00ed a o\u010dkovac\u00edho sch\u00e9matu.<\/p>\n

O\u010dkov\u00e1n\u00ed d\u011bt\u00ed a mladistv\u00fdch proti COVID-19 vyvol\u00e1v\u00e1 mnoho ot\u00e1zek:<\/strong><\/p>\n

\n

Pro\u010d je onemocn\u011bn\u00ed COVID-19 u d\u011bt\u00ed m\u00e9n\u011b \u010dast\u00e9 a m\u00edv\u00e1 relativn\u011b m\u00edrn\u011bj\u0161\u00ed pr\u016fb\u011bh?<\/span>
\n<\/strong>
\nNab\u00edz\u00ed se zde n\u011bkolik mo\u017en\u00fdch vysv\u011btlen\u00ed, mezi kter\u00e9 pat\u0159\u00ed obvykle zdrav\u011bj\u0161\u00ed d\u00fdchac\u00ed apar\u00e1t spolu s odli\u0161nou expres\u00ed receptor\u016f ACE2 a syst\u00e9mu renin\u2013angiotensin ne\u017e u dosp\u011bl\u00fdch. D\u011bti maj\u00ed vedle siln\u00fdch vrozen\u00fdch imunitn\u00edch reakc\u00ed m\u00e9n\u011b dynamickou adaptivn\u00ed imunitn\u00ed odpov\u011b\u010f, ni\u017e\u0161\u00ed hladiny interleukinu (IL)-6, IL-10, myeloperoxid\u00e1zy a P-selektinu a vy\u0161\u0161\u00ed hladiny intracelul\u00e1rn\u00ed adhezivn\u00ed molekuly 1 (ICAM-1). Rovn\u011b\u017e maj\u00ed p\u0159irozen\u011b vy\u0161\u0161\u00ed po\u010det lymfocyt\u016f a nejsou zat\u00ed\u017eeny \u00fa\u010dinky st\u00e1rnut\u00ed. U d\u011bt\u00ed byly tak\u00e9 odhaleny vysok\u00e9 titry protil\u00e1tek IgG proti respira\u010dn\u00edmu syncyti\u00e1ln\u00edmu viru a mykoplazmov\u00e9 pneumonii, kter\u00e9 mohou zaji\u0161\u0165ovat k\u0159\u00ed\u017eovou ochranu proti infekci virem SARS-CoV-2.
\nJedna z teori\u00ed \u0159\u00edk\u00e1, \u017ee mal\u00e9 d\u011bti jsou \u010dast\u011bji vystaveny b\u011b\u017en\u00fdm koronavir\u016fm a pravideln\u011b t\u00edm tr\u00e9nuj\u00ed imunitn\u00ed syst\u00e9m, kter\u00fd jim pak poskytuje vy\u0161\u0161\u00ed ochranu. Dal\u0161\u00edm vysv\u011btlen\u00edm je, \u017ee d\u011bti maj\u00ed v horn\u00edch d\u00fdchac\u00edch cest\u00e1ch m\u00e9n\u011b receptor\u016f ACE2, SARS-CoV-2 m\u00e1 tedy hor\u0161\u00ed p\u0159\u00edstup do bun\u011bk.<\/p>\n

\n

Je v\u016fbec pot\u0159eba d\u011bti proti COVID-19 o\u010dkovat, p\u0159\u00edpadn\u011b i plo\u0161n\u011b?<\/span>
\n<\/strong>
\nJak podrobn\u011bji uvedeno v\u00fd\u0161e, pokyny WHO z poloviny \u010dervence 2021 uv\u00e1d\u00ed, \u017ee o\u010dkov\u00e1n\u00ed d\u011bt\u00ed, pokud nejsou sou\u010d\u00e1st\u00ed skupiny s vy\u0161\u0161\u00edm rizikem z\u00e1va\u017en\u00e9ho onemocn\u011bn\u00ed COVID-19, je m\u00e9n\u011b nal\u00e9hav\u00e9 ne\u017e u star\u0161\u00edch lid\u00ed, osob s chronick\u00fdm onemocn\u011bn\u00edm a zdravotnick\u00fdch pracovn\u00edk\u016f\u201c.<\/p>\n

Auto\u0159i studie v \u010cR<\/em><\/strong> nazvan\u00e9 \u201eV\u00fdvoj epidemie SARS-CoV-2 u d\u011bt\u00ed v populaci \u010cesk\u00e9 republiky\u201c monitorovali incidenci SARS-CoV-2 v d\u011btsk\u00e9 populaci i dle v\u011bkov\u00fdch skupin v obdob\u00ed od z\u00e1\u0159\u00ed 2020 do b\u0159ezna 2021. V\u00fdskyt infekce byl velmi mal\u00fd. D\u011bti od 2 do 8 let maj\u00ed setrvale n\u00edzkou incidenci. Stoupaj\u00edc\u00ed incidence onemocn\u011bn\u00ed u d\u011bt\u00ed je vid\u011bt v\u017edy, kdy\u017e se v\u00fdznamn\u011b zv\u00fd\u0161\u00ed v\u00fdskyt onemocn\u011bn\u00ed u dosp\u011bl\u00fdch osob.<\/p>\n

Podobn\u00e9 z\u00e1v\u011bry vypl\u00fdvaj\u00ed ze zahrani\u010dn\u00edch studi\u00ed. Vl\u00e1dn\u00ed poradci pro o\u010dkov\u00e1n\u00ed ve Velk\u00e9 Brit\u00e1nii<\/em><\/strong> \u0159\u00edkaj\u00ed, \u017ee p\u0159\u00ednos o\u010dkov\u00e1n\u00ed je u zdrav\u00fdch d\u011bt\u00ed velmi mal\u00fd. T\u00e9m\u011b\u0159 v\u0161echny d\u011bti a mlad\u00ed lid\u00e9 jsou vystaveni velmi n\u00edzk\u00e9mu riziku onemocn\u011bn\u00ed a jen velmi m\u00e1lo d\u011bt\u00ed na COVID-19 v\u00e1\u017en\u011b onemocn\u00ed nebo zem\u0159e. Jejich imunitn\u00ed syst\u00e9m b\u00fdv\u00e1 velmi siln\u00fd. Data pro Anglii nazna\u010duj\u00ed, \u017ee v prvn\u00edch 12 m\u011bs\u00edc\u00edch pandemie zde zem\u0159elo na COVID-19 asi 25 d\u011bt\u00ed. V\u011bt\u0161ina z nich m\u011bla v\u00e1\u017en\u00e9 p\u0159edchoz\u00ed zdravotn\u00ed probl\u00e9my, v\u010detn\u011b komplexn\u00ed neurodisability. Pouze \u0161est z nich bylo p\u0159ed touto infekc\u00ed bez zdravotn\u00edho z\u00e1znamu. Na<\/strong> Islandu<\/strong><\/em> bylo zji\u0161t\u011bno, \u017ee d\u011bti mlad\u0161\u00ed 15 let maj\u00ed 2\u00d7 men\u0161\u00ed pravd\u011bpodobnost, \u017ee budou infikovan\u00e9, a tak\u00e9 2\u00d7 men\u0161\u00ed pravd\u011bpodobnost, \u017ee budou \u0161\u00ed\u0159it virus na dal\u0161\u00ed osoby ne\u017e star\u0161\u00ed lid\u00e9. T\u00e9m\u011b\u0159 v\u0161echny p\u0159enosy SARS-CoV-2 na d\u011bti poch\u00e1zely od dosp\u011bl\u00fdch, nikoliv od jin\u00fdch d\u011bt\u00ed. Z\u00e1v\u011brem tamn\u00ed studie bylo, \u017ee infikovan\u00ed dosp\u011bl\u00ed p\u0159edstavuj\u00ed pro d\u011bti mlad\u0161\u00ed 15 let v\u011bt\u0161\u00ed nebezpe\u010d\u00ed ne\u017e d\u011bti pro dosp\u011bl\u00e9. V\u00a0\u010c\u00edn\u011b<\/strong><\/em> u d\u011bt\u00ed mlad\u0161\u00edch 12 let doch\u00e1zelo po expozici SARS-CoV-2 k infekci m\u00e9n\u011b \u010dasto ne\u017e u dosp\u011bl\u00fdch. Ve \u0160v\u00fdcarsku<\/strong><\/em> bylo zji\u0161t\u011bno, \u017ee mal\u00e9 d\u011bti onemocn\u00ed m\u00e9n\u011b \u010dasto ne\u017e star\u0161\u00ed \u010dlenov\u00e9 dom\u00e1cnosti. V\u00fdsledky rakousk\u00e9 studie<\/strong><\/em> nazna\u010dily, \u017ee u \u0161kol\u00e1k\u016f byla m\u00edra infekce SARS-CoV-2 n\u00edzk\u00e1, p\u0159\u00edznaky onemocn\u011bn\u00ed byly m\u00edrn\u00e9 nebo byly d\u011bti zcela asymptomatick\u00e9. Data ze st\u0159edn\u00edch \u0161kol v\u00a0USA<\/em><\/strong> uk\u00e1zala, \u017ee je po\u010det v\u00fdskyt\u016f pozitivn\u00edch osob t\u00e9m\u011b\u0159 3\u00d7 vy\u0161\u0161\u00ed ne\u017e na \u0161kol\u00e1ch z\u00e1kladn\u00edch. Kritickou hranic\u00ed je v\u011bk mezi 10 a 12 lety. P\u0159ibli\u017en\u011b v obdob\u00ed puberty se z\u0159ejm\u011b zvy\u0161uje riziko n\u00e1kazy a p\u0159enosu viru mezi studenty.<\/p>\n

Z\u016fst\u00e1v\u00e1 tedy ot\u00e1zkou, zda m\u00edsto diskutovan\u00e9ho plo\u0161n\u00e9ho o\u010dkov\u00e1n\u00ed d\u011bt\u00ed nevyu\u017e\u00edt vakc\u00edny nap\u0159\u00edklad pro rizikov\u00e9 skupiny \u010di populaci v\u00a0rozvojov\u00fdch zem\u00edch.<\/p>\n

\n

M\u00e1me d\u011bti o\u010dkovat bez znalosti hladin jejich protil\u00e1tek proti SARS-CoV-2?<\/span>
\n<\/strong>
\nLze p\u0159edpokl\u00e1dat, \u017ee \u010d\u00e1st d\u011bt\u00ed a mladistv\u00fdch COVID-19 ji\u017e prod\u011blala, t\u0159eba i bezp\u0159\u00edznakov\u011b, a m\u00e1 proti t\u00e9to nemoci v t\u011ble protil\u00e1tky. Jejich hladina se v\u0161ak p\u0159ed o\u010dkov\u00e1n\u00edm b\u011b\u017en\u011b nem\u011b\u0159\u00ed. Je ot\u00e1zkou, jak m\u016f\u017ee v tomto p\u0159\u00edpad\u011b na vakc\u00ednu zareagovat imunitn\u00ed syst\u00e9m d\u00edt\u011bte, a to i v dlouhodob\u00e9m \u010dasov\u00e9m horizontu. D\u00edt\u011b nen\u00ed mal\u00fd dosp\u011bl\u00fd a v t\u00e9to oblasti chyb\u00ed v\u00fdsledky studi\u00ed.<\/p>\n

\n

Je vhodn\u00e9, aby byly d\u011bti o\u010dkov\u00e1ny jinde ne\u017e v\u00a0ordinaci sv\u00e9ho o\u0161et\u0159uj\u00edc\u00edho l\u00e9ka\u0159e?<\/strong><\/span><\/p>\n

V mo\u017enostech pediatr\u016f p\u0159\u00edtomn\u00fdch nap\u0159. v mobiln\u00edch testovac\u00edch centrech nen\u00ed p\u0159ed pod\u00e1n\u00edm vakc\u00edny d\u011bti podrobn\u011b vy\u0161et\u0159it. Detailn\u00ed anamn\u00e9zu d\u00edt\u011bte zn\u00e1 a p\u0159\u00edpadn\u00e9 kontraindikace dok\u00e1\u017ee ur\u010dit jen jeho o\u0161et\u0159uj\u00edc\u00ed l\u00e9ka\u0159.<\/p>\n

\n

Je d\u016fvodem k o\u010dkov\u00e1n\u00ed d\u011bt\u00ed proti COVID-19 argument, \u017ee j\u00edm lze ochr\u00e1nit dosp\u011bl\u00e9?<\/span>
\n<\/strong>
\nNap\u0159\u00edklad JVCI argumentuje, \u017ee pro dosp\u011bl\u00e9 je p\u0159\u00ednos o\u010dkov\u00e1n\u00ed d\u011bt\u00ed proti COVID-19 (ve smyslu omezen\u00ed p\u0159enosu COVID-19) nejasn\u00fd, proto\u017ee ji\u017e byly imunizov\u00e1ny nejrizikov\u011bj\u0161\u00ed a nejzraniteln\u011bj\u0161\u00ed v\u011bkov\u00e9 kategorie.
\nStudie z Velk\u00e9 Brit\u00e1nie publikovan\u00e1 v \u010dasopisu The Lancet porovn\u00e1vala v\u00fdskyt infekce u r\u016fzn\u00fdch v\u011bkov\u00fdch skupin. V t\u00e9to studii se zjistilo, \u017ee zdrojem infekc\u00ed jsou \u010dast\u011bji star\u0161\u00ed lid\u00e9 (nej\u010dast\u011bji ve v\u011bku 20\u201330 let), nikoliv d\u011bti.<\/p>\n

\n

Jsou vakc\u00edny proti COVID-19 vyv\u00edjen\u00e9 prim\u00e1rn\u011b pro dosp\u011bl\u00e9 bezpe\u010dn\u00e9 i pro d\u011bti?<\/span>
\n<\/strong>
\nV tuto chv\u00edli nen\u00ed odpov\u011b\u010f jednozna\u010dn\u00e1. Je t\u0159eba m\u00edt na pam\u011bti, \u017ee \u017e\u00e1dn\u00fd l\u00e9k nen\u00ed bez vedlej\u0161\u00edch \u00fa\u010dink\u016f a pro ka\u017ed\u00e9ho zcela bezpe\u010dn\u00fd. Pou\u017eit\u00ed vakc\u00edny proti COVID-19 od spole\u010dnosti Pfizer\u2013BioNTech pro v\u011bkovou kategorii 12+ bylo schv\u00e1leno na z\u00e1klad\u011b v\u00fdsledk\u016f studie na relativn\u011b mal\u00e9m po\u010dtu 1 131 d\u011bt\u00ed ve v\u011bku 12\u201315 let. Vz\u00e1cn\u011b byly po vakcinaci zaznamen\u00e1ny p\u0159\u00edpady z\u00e1n\u011btu srde\u010dn\u00edho svalu (myokaritida) a perikarditida. US Centers for Disease Control and Prevention (Americk\u00e1 centra pro kontrolu a prevenci nemoc\u00ed) v\u0161ak dosp\u011bla k z\u00e1v\u011bru, \u017ee p\u0159\u00ednosy t\u00e9to vakc\u00edny p\u0159eva\u017euj\u00ed nad riziky. A to i p\u0159es to, \u017ee v\u00fdsledky dlouhodob\u00fdch studi\u00ed zat\u00edm nejsou k dispozici, a tak rizika a komplikace, kter\u00e9 se mohou n\u00e1sledkem o\u010dkov\u00e1n\u00ed objevit a\u017e po \u010dase, nelze objektivn\u011b posoudit.<\/p>\n

Zda d\u011bti o\u010dkovat stejn\u00fdmi vakc\u00ednami jako dosp\u011bl\u00e9 z\u016fst\u00e1v\u00e1 ot\u00e1zkou. Nap\u0159\u00edklad v r\u00e1mci o\u010dkov\u00e1n\u00ed proti pneumokokovi jsou vakc\u00edny pro dosp\u011bl\u00e9 a d\u011bti rozli\u0161eny.<\/p>\n

P\u0159i rozhodov\u00e1n\u00ed ohledn\u011b o\u010dkov\u00e1n\u00ed proti COVID-19 u d\u011bt\u00ed a mladistv\u00fdch je nutn\u00e9 dob\u0159e zv\u00e1\u017eit v\u0161echny v\u00fd\u0161e zm\u00edn\u011bn\u00e9 aspekty i mnoh\u00e9 dal\u0161\u00ed, a zajistit si v tomto sm\u011bru dostatek informac\u00ed z kvalitn\u00edch zdroj\u016f. Zejm\u00e9na je nutn\u00e9 rozv\u00e1\u017eit, zda je p\u0159\u00ednos o\u010dkov\u00e1n\u00ed (ochrana zdrav\u00ed, podpora kolektivn\u00ed imunity atd.) pro tuto v\u011bkovou kategorii v\u011bt\u0161\u00ed ne\u017e rizika s n\u00edm spojen\u00e1 (ne\u017e\u00e1douc\u00ed \u00fa\u010dinky, bezpe\u010dnost, a to i v\u00a0dlouhodob\u00e9m \u010dasov\u00e9m horizontu). Teprve pak je mo\u017en\u00e9 se v tomto sm\u011bru individu\u00e1ln\u011b a odpov\u011bdn\u011b rozhodnout.<\/p>\n

RNDr. Martina \u0160indelkov\u00e1, Dr. Irina Sorokoladov\u00e1<\/p>\n

17.9.2021<\/p>\n

Zdroje:<\/p>\n

Covid: Which children are being vaccinated and why? BBC News, publikov\u00e1no 19.7.2021. https:\/\/www.bbc.com\/news\/health-57888429<\/p>\n

Hodnot\u00edc\u00ed zpr\u00e1va k vakc\u00edn\u011b Comirnaty od firem Pfizer a BioNTech zve\u0159ejn\u011bn\u00e1 Evropskou agenturou pro l\u00e9\u010div\u00e9 p\u0159\u00edpravky (EMA), publikov\u00e1no 19.2.2021. https:\/\/www.ema.europa.eu\/en\/documents\/assessment-report\/comirnaty-epar-public-assessment-report_en.pdf<\/p>\n

Hodnot\u00edc\u00ed zpr\u00e1va k vakc\u00edn\u011b Spikevax od firmy Moderna zve\u0159ejn\u011bn\u00e1 Evropskou agenturou pro l\u00e9\u010div\u00e9 p\u0159\u00edpravky (EMA), publikov\u00e1no 11.3.2021. https:\/\/www.ema.europa.eu\/en\/documents\/assessment-report\/spikevax-previously-covid-19-vaccine-moderna-epar-public-assessment-report_en.pdf<\/p>\n

Kampmann B, Okomo U (2021): COVID-19 vaccines for children in LMICs: another equity issue. The Lancet, publikov\u00e1no online 30. 7. 2021. doi: 10.1016\/S0140-6736(21)01748-7<\/p>\n

Pohludka M a kol. (2021): V\u00fdvoj epidemie SARS-CoV-2 v \u010desk\u00e9 d\u011btsk\u00e9 populaci. https:\/\/genespector.com\/documents\/Vyvoj_epidemie_SARS-CoV-2_u_deti_v_populaci_CR.pdf<\/p>\n

Sinaei R, Pezeshki S, Parvaresh S, Sinaei R (2021): Why COVID-19 is less frequent and severe in children: a narrative review. World J Pediatr,17, 10\u201320. doi: 10.1007\/s12519-020-00392-y.<\/p>\n

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