COVID-19

Wadanda ya kamata su samu alurar COVID-19 mRNA (bisa shawarwarin WHO na 2024):

Mutanen da ke cikin babban hadari (HIGH priority):

• Tsofaffi masu shekaru 60+

• Mata masu juna biyu

• Masu cututtuka na yau da kullum: ciwon sukari, cututtukan zuciya, cututtukan huhu, cutar koda, cutar hanta

• Masu raunin garkuwar jiki (HIV, transplant recipients, cancer patients)

• Ma'aikatan kiwon lafiya

Mutanen da ke cikin matsakaicin hadari (MEDIUM priority):

• Manya matasa masu lafiya (shekaru 18-59) da ba su da cututtuka

• Yara da matasa masu cututtuka na yau da kullum

Yara masu lafiya (LOW priority):

• WHO ba ta sake ba da shawarar ga yara masu lafiya a matsayin ruwan dare ba — amma kasashe na iya yanke shawara bisa yanayin su

A Nijeriya:

• NPHCDA na ci gaba da ba da shawarar allura ga mutanen da ke cikin hadari

• Yakin rigakafin ya rage sosai bayan 2022 — amma har yanzu ana samun allurar a wasu wuraren kiwon lafiya

Ba a ba da alurar COVID-19 mRNA ga wadannan mutane ba:

Matsanancin rashin lafiya (anaphylaxis) bayan shan alurar COVID-19 da ta gabata: Idan mutum ya samu anaphylaxis bayan allura ta farko, ba a ba da sauran allura na wannan nau'in ba.

Rashin lafiyar PEG (polyethylene glycol): Allurar mRNA suna dauke da PEG. Mutanen da ke da matsanancin rashin lafiyar PEG ba za su samu alurar mRNA ba.

Ba a hana ba da alurar ga:

• Mata masu juna biyu — WHO ta ba da shawarar su samu alurar saboda hadarin COVID-19 mai tsanani a lokacin juna biyu ya fi hadarin alurar

• Masu shayar da nono — tana da aminci

• Masu HIV — ana ba da shawarar musamman

• Masu cututtuka na autoimmune — tana da aminci

• Mutanen da suka taba kamuwa da COVID-19 — har yanzu ana ba da shawarar alurar

NAFDAC ta amince da allurar COVID-19 daban-daban don amfani a Nijeriya bayan bincike mai zurfi.

Sakamako na alurar COVID-19 mRNA:

Sakamako na yau da kullum (50-80% na masu shan allura):

• Zafin wurin allura (80-90%) — mafi yawan sakamako

• Gajiya (50-65%)

• Ciwon kai (40-55%)

• Ciwon tsokoki (30-45%)

• Sanyi da kuna (15-35%)

• Zazzabi (10-20%) — ya fi yawa bayan allura ta biyu

• Ciwon gidauniyoyi (20-30%)

Wadannan sakamako suna warwarewa cikin kwanaki 1-3 kuma alamun ne cewa garkuwar jiki na yin aiki.

Sakamako marasa yawa amma masu muhimmanci:

• Myocarditis/pericarditis: Kusan 1-4 cikin 100,000. Ya fi shafar matasa maza (shekaru 16-30), yawanci bayan allura ta biyu. Yawancin shari'o'i masu sauki ne kuma suna warwarewa.

• Anaphylaxis: 2-5 cikin miliyan allura — shi ya sa ake jira minti 15-30 bayan allura.

• Lymphadenopathy: Kumburin kwayar lymph — 5-10%, tana warwarewa cikin makonni.

A Nijeriya: NPHCDA ta kafa tsarin sa ido kan sakamako (AEFI surveillance) don allurar COVID-19. Babu sakamako masu tsanani da yawa da aka ruwaito a Nijeriya.

Yadda ake ba da alurar COVID-19 mRNA:

Pfizer-BioNTech (Comirnaty®):

• Primary series: Allura 2, tazarar makonni 3-8

• Booster: Watanni 6+ bayan primary series

• Adadin: 0.3 mL (manya), 0.2 mL (yara 5-11), 0.1 mL (yara 6 watanni-4 shekaru)

• IM injection (deltoid)

Moderna (Spikevax®):

• Primary series: Allura 2, tazarar makonni 4-8

• Booster: Watanni 6+ bayan primary series

• Adadin: 0.5 mL (manya), 0.25 mL (yara 6 watanni-11 shekaru)

• IM injection (deltoid)

WHO jadawali na musamman (2024):

• Mutanen da ke cikin babban hadari: Primary series + booster kowace watanni 6-12

• Masu raunin garkuwar jiki: Primary series na allura 3 + boosters

A Nijeriya:

• NPHCDA ta yi amfani da nau'o'in allurar daban-daban (mix-and-match) bisa samuwa

• Allurar suna samuwa a manyan asibitoci da wuraren kiwon lafiya na gwamnati

Ingancin alurar COVID-19 mRNA:

Kariya daga cutar mai tsanani da mutuwa (2024 data):

• Bayan allura 2 + booster: 80-90% kariya daga shiga asibiti da mutuwa

• Kariya ta fi dawwama ga cutar mai tsanani fiye da kamuwa da cutar gaba daya

Kariya daga kamuwa da cutar:

• Bayan allura 2: 50-70% kariya daga kamuwa (ya danganta da variant)

• Bayan booster: 60-80% na dan lokaci, amma yana raguwa cikin watanni 4-6

Variants:

• Allurar farko (Wuhan strain): >90% inganci ga Wuhan da Alpha

• Omicron da variants na baya: Kariya daga kamuwa ta ragu amma kariya daga cutar mai tsanani ta dawwama

• Sabbin allurar da aka sabunta (XBB.1.5, JN.1) sun fi dacewa da variants na yanzu

Kariya na tsawon lokaci:

• Immune memory (T-cells, B-cells) na ci gaba da kasancewa har watanni 12+ bayan allura

• Booster na farfado da kariya da inganta ta

A Nijeriya:

• NPHCDA ta kiyasta cewa yakin rigakafin ya taimaka wajen rage mutuwar COVID-19

• Amma karancin karbar allura (kasa da 15% na al'umma sun samu cikakken rigakafi zuwa 2023) ya sa al'umma ta fi dogara ga natural immunity

Mu'amalar alurar COVID-19 mRNA da wasu magunguna:

Wasu allurar: WHO ta canza shawarar ta — yanzu ana iya ba da alurar COVID-19 tare da wasu allurar a lokaci guda ko a kowane tazara. Ba a bukatar jira kwanaki 14 kamar yadda aka fara ba da shawara.

Magunguna masu rage garkuwar jiki: Ingancin alurar na iya raguwa — ana ba da shawarar karin allura (allura ta 3 a matsayin primary series) da kuma booster na musamman.

Magungunan rage gudan jini (anticoagulants): Ana iya ba da alurar amma a matse wurin na minti 2 bayan allura don rage zubar jini.

Monoclonal antibodies da convalescent plasma: Sai a jira akalla kwanaki 90 bayan karbar su kafin shan alurar COVID-19.

A Nijeriya: NPHCDA ta amince da ba da alurar COVID-19 tare da sauran allurar NPI ga yara — wannan ya taimaka wajen sauƙaƙa yakin rigakafi.

Pregnancy: Recommended (WHO, ACIP).

COVID-19 mRNA vaccines (Comirnaty, Spikevax) are safe and recommended during pregnancy.

• Pregnant women are at increased risk of severe COVID-19, ICU admission, preterm delivery, and maternal death.

• Vaccination during pregnancy provides passive antibody transfer to the neonate.

• Can be administered at any gestational age. No evidence of teratogenicity or adverse pregnancy outcomes in large observational studies (V-safe, VAERS, global registries).

• WHO SAGE and CDC/ACIP both recommend COVID-19 vaccination for pregnant individuals.

Breastfeeding: Safe and recommended.

COVID-19 mRNA vaccines are safe during breastfeeding. mRNA does not enter breast milk in functional form. Antibodies generated by maternal vaccination are detected in breast milk and may provide passive protection to the breastfed infant.

Pediatric use:

• Comirnaty (Pfizer-BioNTech): approved from 6 months of age. Age-adjusted doses:

  • 6 months–4 years: 3 µg (0.2 mL), 3-dose primary series.
  • 5–11 years: 10 µg (0.2 mL).
  • ≥12 years: 30 µg (0.3 mL) — adult dose.

• Spikevax (Moderna): approved from 6 months of age. Age-adjusted doses:

  • 6 months–5 years: 25 µg (0.25 mL), 2-dose series.
  • 6–11 years: 50 µg (0.5 mL).
  • ≥12 years: 50–100 µg — adult dose.

• Annual updated booster formulations target circulating variants.

• Myocarditis risk is lower in children <12 years than in adolescent/young adult males.

Geriatric use: Priority group for vaccination.

• Adults ≥65 years are at highest risk of severe COVID-19 outcomes and are a priority group for vaccination and boosters.

• Immune response may be lower (immunosenescence), hence the recommendation for regular booster doses.

• High-dose and adjuvanted formulations are not available for mRNA vaccines, but additional booster doses compensate.

• Adverse event profile is generally milder in older adults compared to younger recipients (less reactogenicity).

• Annual updated boosters strongly recommended for all adults ≥65 years.

Matakan kariya da lura:

Sarkar sanyi (cold chain):

• Pfizer mRNA: Ana bukatar -90°C zuwa -60°C don ajiya na tsawon lokaci; 2-8°C na tsawon makonni 10

• Moderna mRNA: -25°C zuwa -15°C don ajiya; 2-8°C na tsawon kwanaki 30

• Wannan matsalar sarkar sanyi ta sa allurar mRNA sun fi wahala a rarrabawa a Nijeriya idan aka kwatanta da AstraZeneca (2-8°C)

Bayan shan allurar:

• Sai a jira minti 15-30 (minti 30 ga masu tarihin rashin lafiya) a wurin da aka yi allurar

• Idan ka samu zazzabi, ana iya shan paracetamol

• Nemi likita idan ka samu ciwon kirji, gajiya ta wahala, ko bugun zuciya maras daidaituwa cikin kwanaki 14 bayan allura

Bayani game da allurar zamani (2024-2026):

• WHO ta sabunta shawarar — booster na yau da kullum ya fi muhimmanci ga mutanen da ke cikin babban hadari

• Sabon nau'in allurar da aka sabunta don variants na JN.1/XBB suna samuwa

A Nijeriya:

• NPHCDA na ci gaba da yakin wayar da kai game da muhimmancin allurar COVID-19 ga mutanen da ke cikin hadari

• Vaccine hesitancy har yanzu babban kalubale ne — ilimi da amana suna da muhimmanci