B\u1ec7nh truy\u1ec1n nhi\u1ec5m g\u00e2y ra nguy c\u01a1 \u0111\u1eb7c bi\u1ec7t \u0111\u1ed1i v\u1edbi tr\u1ebb s\u01a1 sinh, v\u00e0 hi\u1ec7n \u0111ang c\u00f3 nhu c\u1ea7u to\u00e0n c\u1ea7u v\u1ec1 vi\u1ec7c b\u1ea3o v\u1ec7 nh\u00f3m \u0111\u1ed1i t\u01b0\u1ee3ng d\u1ec5 t\u1ed5n th\u01b0\u01a1ng n\u00e0y. Do g\u1eb7p nhi\u1ec1u th\u00e1ch th\u1ee9c trong vi\u1ec7c ph\u00e1t tri\u1ec3n c\u00e1c lo\u1ea1i vaccin hi\u1ec7u qu\u1ea3 \u1edf tr\u1ebb s\u01a1 sinh, n\u00ean ch\u1ec9 c\u00f3 vaccin vi\u00eam gan B v\u00e0 vaccin<\/strong> lao \u0111\u01b0\u1ee3c ti\u00eam trong 28 ng\u00e0y \u0111\u1ea7u \u0111\u1eddi, v\u00e0 ngay c\u1ea3 nh\u1eefng lo\u1ea1i vaccin n\u00e0y c\u0169ng ch\u1ee7 y\u00eau \u0111\u01b0\u1ee3c khuy\u1ebfn ngh\u1ecb cho c\u00e1c nh\u00f3m nguy c\u01a1 cao. Kh\u00e1ng th\u1ec3 t\u1eeb m\u1eb9 c\u00f3 th\u1ec3 truy\u1ec1n qua nhau thai v\u00e0 mang l\u1ea1i m\u1ed9t s\u1ed1 b\u1ea3o v\u1ec7 cho tr\u1ebb s\u01a1 sinh, do \u0111\u00f3 m\u1ed9t chi\u1ebfn l\u01b0\u1ee3c thay th\u1ebf l\u00e0 ti\u00eam vaccin cho ph\u1ee5 n\u1eef trong thai k\u1ef3. Ph\u01b0\u01a1ng ph\u00e1p n\u00e0y \u0111\u00e3 \u0111\u01b0\u1ee3c \u00e1p d\u1ee5ng th\u00e0nh c\u00f4ng \u0111\u1ec1 b\u1ea3o v\u1ec7 tr\u1ebb s\u01a1 sinh kh\u1ecfi b\u1ec7nh u\u1ed1n v\u00e1n v\u00e0 ho g\u00e0, v\u00e0 nh\u1eefng lo\u1ea1i vaccin \u0111\u01b0\u1ee3c ti\u00eam ch\u1ee7 y\u1ebfu \u0111\u1ec1 b\u1ea3o v\u1ec7 m\u1eb9 trong thai k\u1ef3 nh\u01b0 vaccin c\u00fam v\u00e0 Covid-19 c\u0169ng mang l\u1ea1i m\u1ed9t ph\u1ea7n mi\u1ec5n d\u1ecbch cho tr\u1ebb s\u01a1 sinh. G\u1ea7n \u0111\u00e2y, m\u1ed9t lo\u1ea1i vaccin ng\u1eeba RSV \u0111\u00e3 \u0111\u01b0\u1ee3c ph\u00ea duy\u1ec7t \u0111\u1ec3 s\u1eed d\u1ee5ng trong thai k\u1ef3 nh\u1eb1m b\u1ea3o v\u1ec7 tr\u1ebb s\u01a1 sinh, v\u00e0 m\u1ed9t lo\u1ea1i vaccin m\u1edbi c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c tri\u1ec3n khai trong thai k\u1ef3 \u0111\u1ec3 ng\u0103n ng\u1eeba nhi\u1ec5m tr\u00f9ng do li\u00ean c\u1ea7u khu\u1ea9n nh\u00f3m B \u1edf tr\u1ebb nh\u1ecf c\u0169ng \u0111ang s\u1eafp ra m\u1eaft.<\/p>\n Tr\u1ebb s\u01a1 sinh \u0111\u1eb7c bi\u1ec7t d\u1ec5 b\u1ecb t\u1ed5n th\u01b0\u01a1ng tr\u01b0\u1edbc c\u00e1c b\u1ec7nh truy\u1ec1n nhi\u1ec5m do h\u1ec7 mi\u1ec5n d\u1ecbch c\u1ee7a c\u00e1c tr\u1ebb c\u00f2n \u0111ang trong qu\u00e1 tr\u00ecnh ph\u00e1t tri\u1ec3n. \u0110\u1eb7c bi\u1ec7t, tr\u1ebb thi\u1ebfu tr\u00ed nh\u1edb mi\u1ec5n d\u1ecbch b\u1ea3o v\u1ec7 v\u00ec h\u1ea7u nh\u01b0 ch\u01b0a t\u1eebng ti\u1ebfp x\u00fac v\u1edbi m\u1ea7m b\u1ec7nh tr\u01b0\u1edbc \u0111\u00f3. N\u0103m 2015, c\u00f3 kho\u1ea3ng 610.000 tr\u1ebb s\u01a1 sinh tr\u00ean to\u00e0n th\u1ebf gi\u1edbi t\u1eed vong do b\u1ec7nh truy\u1ec1n nhi\u1ec5m, t\u01b0\u01a1ng \u0111\u01b0\u01a1ng v\u1edbi t\u1ef7 l\u1ec7 4.4 ca t\u1eed vong tr\u00ean 100.000 ca sinh s\u00f4ng. Ph\u1ea7n l\u1edbn c\u00e1c ca t\u1eed vong x\u1ea3y ra t\u1ea1i c\u00e1c qu\u1ed1c gia c\u00f3 thu nh\u1eadp th\u1ea5p v\u00e0 trung b\u00ecnh. \u1ede c\u00e1c n\u01b0\u1edbc c\u00f3 thu nh\u1eadp cao h\u01a1n, b\u1ec7nh truy\u1ec1n nhi\u1ec5m \u00edt khi g\u00e2y t\u1eed vong nh\u01b0ng v\u1eabn l\u00e0 nguy\u00ean nh\u00e2n g\u00e2y nh\u1eadp vi\u1ec7n v\u00e0 t\u1ea1o g\u00e1nh n\u1eb7ng l\u1edbn cho gia \u0111\u00ecnh v\u00e0 h\u1ec7 th\u1ed1ng y t\u00ea, c\u0169ng nh\u01b0 c\u00f3 th\u1ec3 \u0111\u1ec3 l\u1ea1i h\u1eadu qu\u1ea3 l\u00e2u d\u00e0i cho tr\u1ebb nh\u1ecf. V\u00ec v\u1eady, nhu c\u1ea7u b\u1ea3o v\u1ec7 tr\u1ebb s\u01a1 sinh kh\u1ecfi c\u00e1c b\u1ec7nh truy\u1ec1n nhi\u1ec5m l\u00e0 m\u1ed9t v\u1ea5n \u0111\u1ec1 to\u00e0n c\u1ea7u.<\/p>\n B\u00e0i vi\u1ebft n\u00e0y tr\u00ecnh b\u00e0y v\u1ec1 c\u00e1ch m\u00e0 vi\u1ec7c ti\u00eam vaccin trong thai k\u1ef3 v\u00e0 khi m\u1edbi sinh c\u00f3 th\u1ec3 gi\u00fap b\u1ea3o v\u1ec7 tr\u1ebb s\u01a1 sinh kh\u1ecfi b\u1ec7nh truy\u1ec1n nhi\u1ec5m, b\u1eb1ng c\u00e1ch ng\u0103n ng\u1eeba nhi\u1ec5m b\u1ec7nh ho\u1eb7c l\u00e0m gi\u1ea3m m\u1ee9c \u0111\u1ed9 n\u1eb7ng c\u1ee7a b\u1ec7nh n\u1ebfu kh\u00f4ng th\u1ec3 ng\u0103n ng\u1eeba ho\u00e0n to\u00e0n. B\u00e0i vi\u1ebft t\u1eadp trung v\u00e0o c\u00e1c lo\u1ea1i vacxin \u0111\u01b0\u1ee3c ph\u00e1t tri\u1ec3n \u0111\u1ec1 b\u1ea3o v\u1ec7 tr\u1ebb s\u01a1 sinh (d\u01b0\u1edbi 28 ng\u00e0y tu\u1ed5i). Tuy nhi\u00ean, c\u0169ng c\u1ea7n l\u01b0u \u00fd r\u1eb1ng nh\u1eefng bi\u1ec7n ph\u00e1p nh\u1eb1m b\u1ea3o v\u1ec7 tr\u1ebb s\u01a1 sinh v\u1eabn c\u00f3 th\u1ec3 ti\u1ebfp t\u1ee5c mang l\u1ea1i hi\u1ec7u qu\u1ea3 b\u1ea3o v\u1ec7 trong 3 \u0111\u1ebfn 6 th\u00e1ng \u0111\u1ea7u \u0111\u1eddi<\/p>\n M\u1ed9t ph\u1ea7n l\u00fd do khi\u1ebfn tr\u1ebb s\u01a1 sinh d\u1ec5 b\u1ecb nhi\u1ec5m tr\u00f9ng l\u00e0 do h\u1ec7 mi\u1ec5n d\u1ecbch \u1edf giai \u0111o\u1ea1n s\u01a1 sinh v\u1eabn c\u00f2n \u201cch\u01b0a tr\u01b0\u1edfng th\u00e0nh\u201d v\u1ec1 m\u1eb7t ch\u1ee9c n\u0103ng. Tuy nhi\u00ean, ng\u00e0y c\u00e0ng c\u00f3 s\u1ef1 \u0111\u1ed3ng thu\u1eadn r\u1eb1ng thu\u1eadt ng\u1eef \u201cch\u01b0a tr\u01b0\u1edfng th\u00e0nh\u201d c\u00f3 th\u1ec3 kh\u00f4ng ch\u00ednh x\u00e1c, v\u00e0 tr\u1ea1ng th\u00e1i n\u00e0y c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c xem l\u00e0 m\u1ed9t c\u01a1 ch\u1ebf gi\u00fap b\u1ea3o v\u1ec7 tr\u1ebb s\u01a1 sinh kh\u1ecfi c\u00e1c ph\u1ea3n \u1ee9ng mi\u1ec5n d\u1ecbch qu\u00e1 m\u1ee9c \u0111\u1ed1i v\u1edbi kh\u00e1ng nguy\u00ean m\u00f4i tr\u01b0\u1eddng v\u00f4 h\u1ea1i v\u00e0 c\u00e1c vi sinh v\u1eadt c\u1ed9ng sinh \u2013 nh\u1eefng y\u00eau t\u00f4 m\u00e0 c\u01a1 th\u1ec3 l\u1ea7n \u0111\u1ea7u ti\u1ebfp x\u00fac sau khi sinh. Tuy nhi\u00ean, \u0111i\u1ec1u n\u00e0y l\u1ea1i \u0111\u1eb7t ra th\u00e1ch th\u1ee9c cho vi\u1ec7c ti\u00eam ch\u1ee7ng \u1edf tr\u1ebb s\u01a1 sinh, v\u00ec ch\u00fang t\u1ea1o ra \u0111\u00e1p \u1ee9ng mi\u1ec5n d\u1ecbch k\u00e9m hi\u1ec7u qu\u1ea3 h\u01a1n v\u1edbi m\u1ed9t s\u1ed1 lo\u1ea1i vaccin so v\u1edbi tr\u1ebb l\u1edbn v\u00e0 ng\u01b0\u1eddi tr\u01b0\u1edfng th\u00e0nh.<\/p>\n Kh\u00e1ng th\u1ec3 t\u1eeb m\u1eb9 c\u00f3 th\u1ec3 \u0111i qua nhau thai v\u00e0 \u0111\u01b0\u1ee3c ti\u1ebft v\u00e0o s\u1eefa m\u1eb9, mang l\u1ea1i cho tr\u1ebb s\u01a1 sinh m\u1ed9t ph\u1ea7n b\u1ea3o v\u1ec7 tr\u01b0\u1edbc c\u00e1c th\u00e1ch th\u1ee9c kh\u00e1ng nguy\u00ean m\u00e0 ng\u01b0\u1eddi m\u1eb9 \u0111\u00e3 t\u1eebng g\u1eb7p ph\u1ea3i. Do \u0111\u00f3, m\u1ed9t chi\u1ebfn l\u01b0\u1ee3c \u0111\u01b0\u1ee3c \u00e1p d\u1ee5ng l\u00e0 ti\u00eam vaccin trong th\u1eddi k\u1ef3 mang thai v\u00e0 d\u1ef1a v\u00e0o kh\u00e1ng th\u1ec3 t\u1eeb m\u1eb9 \u0111\u1ec1 b\u1ea3o v\u1ec7 cho tr\u1ebb s\u01a1 sinh. Tuy nhi\u00ean, ti\u00eam vaccin<\/strong> s\u1ed1ng b\u1ecb ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh trong thai k\u1ef3 do kh\u1ea3 n\u0103ng r\u1eb1ng c\u00e1c m\u1ea7m b\u1ec7nh n\u00e0y d\u00f9 \u0111\u00e3 \u0111\u01b0\u1ee3c l\u00e0m suy y\u1ebfu v\u1eabn c\u00f3 th\u1ec3 g\u00e2y b\u1ec7nh qua nhau thai v\u00e0 thai nhi tr\u00ean l\u00fd thuy\u1ebft. V\u00ec v\u1eady, vi\u1ec7c ti\u00eam vaccin cho tr\u1ebb s\u01a1 sinh \u0111\u01b0\u1ee3c \u01b0u ti\u00ean trong tr\u01b0\u1eddng h\u1ee3p ch\u1ec9 c\u00f3 vaccin s\u1ed1ng gi\u1ea3m \u0111\u1ed9c l\u1ef1c (ch\u1eb3ng h\u1ea1n nh\u01b0 vaccin BCG ph\u00f2ng b\u1ec7nh lao). Ti\u00eam ch\u1ee7ng cho tr\u1ebb s\u01a1 sinh c\u0169ng \u0111\u01b0\u1ee3c \u01b0u ti\u00ean trong tr\u01b0\u1eddng h\u1ee3p kh\u00e1ng th\u1ec3 t\u1eeb m\u1eb9 kh\u00f4ng mang l\u1ea1i s\u1ef1 b\u1ea3o v\u1ec7 cho tr\u1ebb s\u01a1 sinh (v\u00ed d\u1ee5 nh\u01b0 vaccin HBV ph\u00f2ng vi\u00eam gan B).<\/p>\n M\u1eb7c d\u00f9 thai k\u1ef3 kh\u00f4ng ph\u1ea3i l\u00e0 tr\u1ea1ng th\u00e1i b\u1ecb \u1ee9c ch\u1ebf mi\u1ec5n d\u1ecbch, nh\u01b0ng n\u00f3 c\u00f3 nh\u1eefng thay \u0111\u1ed5i t\u00ecnh v\u00ec trong \u0111\u00e1p \u1ee9ng mi\u1ec5n d\u1ecbch to\u00e0n th\u00e2n. Do \u0111\u00f3, khi m\u1ee5c ti\u00eau c\u1ee7a m\u1ed9t ch\u01b0\u01a1ng tr\u00ecnh ti\u00eam ch\u1ee7ng l\u00e0 \u0111\u1ec3 b\u1ea3o v\u1ec7 tr\u1ebb s\u01a1 sinh th\u00f4ng qua vi\u1ec7c truy\u1ec1n kh\u00e1ng th\u1ec3 qua nhau thai, th\u00ec \u0111i\u1ec1u quan tr\u1ecdng l\u00e0 ph\u1ea3i x\u00e1c nh\u1eadn r\u0103ng lo\u1ea1i vaccin s\u1eed d\u1ee5ng c\u00f3 kh\u1ea3 n\u0103ng t\u1ea1o ra ph\u1ea3n \u1ee9ng kh\u00e1ng th\u1ec3 th\u00edch h\u1ee3p.<\/p>\n Vaccin u\u1ed1n v\u00e1n, b\u1ea1ch h\u1ea7u, ho g\u00e0 v\u00f4 b\u00e0o (Tdap) th\u01b0\u1eddng \u0111\u01b0\u1ee3c ti\u00eam trong thai k\u1ef3 nh\u1eb1m b\u1ea3o v\u1ec7 tr\u1ebb s\u01a1 sinh kh\u1ecfi b\u1ec7nh u\u1ed1n v\u00e1n v\u00e0 ho g\u00e0. Tuy nhi\u00ean, b\u1eb1ng ch\u1ee9ng v\u1ec1 ph\u1ea3n \u1ee9ng mi\u1ec5n d\u1ecbch \u0111\u1eb7c hi\u1ec7u trong thai k\u1ef3 \u0111\u1ed1i v\u1edbi lo\u1ea1i vaccin n\u00e0y c\u00f2n ch\u01b0a th\u1ed1ng nh\u1ea5t. M\u1ed9t s\u1ed1 nghi\u00ean c\u1ee9u cho th\u1ea5y kh\u00f4ng c\u00f3 s\u1ef1 kh\u00e1c bi\u1ec7t v\u1ec1 n\u1ed3ng \u0111\u1ed9 kh\u00e1ng th\u1ec3 gi\u1eefa ph\u1ee5 n\u1eef mang thai v\u00e0 kh\u00f4ng mang thai sau khi ti\u00eam Tdap. Tuy nhi\u00ean, nh\u1eefng nghi\u00ean c\u1ee9u kh\u00e1c l\u1ea1i ghi nh\u1eadn r\u0103ng m\u1eb7c d\u00f9 ti\u00eam Tdap trong thai k\u1ef3 v\u1eabn t\u1ea1o ra n\u1ed3ng \u0111\u1ed9 kh\u00e1ng th\u1ec3 b\u1ea3o v\u1ec7, nh\u01b0ng ph\u1ea3n \u1ee9ng mi\u1ec5n d\u1ecbch n\u00e0y v\u1eabn th\u1ea5p h\u01a1n so v\u1edbi khi ti\u00eam ngo\u00e0i thai k\u1ef3.<\/p>\n \u0110\u1ed1i v\u1edbi vaccin c\u00fam v\u00e0 Covid-19, n\u1ed3ng \u0111\u1ed9 kh\u00e1ng th\u1ec3 t\u1ea1o ra khi ti\u00eam trong thai k\u1ef3 nh\u00ecn chung t\u01b0\u01a1ng \u0111\u01b0\u01a1ng v\u1edbi khi ti\u00eam ngo\u00e0i thai k\u1ef3. Tuy nhi\u00ean, c\u00e1c nghi\u00ean c\u1ee9u s\u1eed d\u1ee5ng ph\u01b0\u01a1ng ph\u00e1p huy\u1ebft thanh h\u1ecdc \u0111\u00e3 ch\u1ec9 ra m\u1ed9t s\u1ed1 kh\u00e1c bi\u1ec7t t\u1ec9nh t\u00ea gi\u1eefa nh\u00f3m mang thai v\u00e0 kh\u00f4ng mang thai sau khi ti\u00eam vaccin Covid-19: li\u1ec1u \u0111\u1ea7u ti\u00ean c\u1ee7a vaccin mRNA Covid-19 t\u1ea1o ra kh\u00e1ng th\u1ec3 c\u00f3 kh\u1ea3 n\u0103ng g\u1eafn k\u1ebft v\u1edbi th\u1ee5 th\u1ec3 Fc, nh\u01b0ng v\u1edbi t\u1ed1c \u0111\u1ed9 ch\u1eadm h\u01a1n m\u1ed9t ch\u00fat \u1edf nh\u00f3m mang thai so v\u1edbi nh\u00f3m kh\u00f4ng mang thai. M\u1ed9t nghi\u00ean c\u1ee9u kh\u00e1c so s\u00e1nh ba lo\u1ea1i vaccin Covid-19 ti\u00eam trong thai k\u1ef3 c\u0169ng cho th\u1ea5y c\u00f3 s\u1ef1 gi\u1ea3m nh\u1eb9 v\u1ec1 ch\u1ee9c n\u0103ng trung gian qua kh\u1ea3ng th\u1ebf khi ti\u00eam trong tam c\u00e1 nguy\u1ec7t th\u1ee9 hai, so v\u1edbi tam c\u00e1 nguy\u1ec7t th\u1ee9 nh\u1ea5t ho\u1eb7c th\u1ee9 ba.<\/p>\n T\u00f3m l\u1ea1i, vi\u1ec7c ti\u00eam ch\u1ee7ng trong thai k\u1ef3 c\u00f3 th\u1ec3 t\u1ea1o ra ph\u1ea3n \u1ee9ng kh\u00e1ng th\u1ec3 kh\u00e1c bi\u1ec7t trong m\u1ed9t s\u1ed1 tr\u01b0\u1eddng h\u1ee3p. Tuy nhi\u00ean, ph\u1ea3n \u1ee9ng kh\u00e1ng th\u1ec3 t\u1ea1o ra v\u1eabn \u0111\u1ee7 \u0111\u1ec3 b\u1ea3o v\u1ec7. V\u00e0 v\u00ec n\u1ed3ng \u0111\u1ed9 kh\u00e1ng th\u1ec3 c\u00f3 xu h\u01b0\u1edbng gi\u1ea3m d\u1ea7n theo th\u1eddi gian, vi\u1ec7c ti\u00eam vaccin trong thai k\u1ef3 v\u1eabn \u0111\u01b0\u1ee3c \u01b0u ti\u00ean \u0111\u1ec1 t\u00f4i \u0111a h\u00f3a kh\u1ea3 n\u0103ng b\u1ea3o v\u1ec7 tr\u1ebb s\u01a1 sinh, h\u01a1n l\u00e0 ch\u1ec9 ti\u00eam ch\u1ee7ng tr\u01b0\u1edbc khi mang thai.<\/p>\n (a) H\u1ec7 tu\u1ea7n ho\u00e0n c\u1ee7a m\u1eb9 v\u00e0 thai nhi \u0111\u01b0\u1ee3c ng\u0103n c\u00e1ch b\u1edfi c\u00e1c t\u1ebf b\u00e0o nu\u00f4i d\u1ea1ng nhung mao (villous trophoblast), m\u00f4 li\u00ean k\u1ebft c\u1ee7a thai nhi v\u00e0 c\u00e1c t\u1ebf b\u00e0o n\u1ed9i m\u00f4 c\u1ee7a thai nhi. IgG \u0111\u01b0\u1ee3c v\u1eadn chuy\u1ec3n xuy\u00ean qua l\u1edbp t\u1ebf b\u00e0o h\u1ee3p b\u00e0o (syncytiotrophoblast) th\u00f4ng qua c\u01a1 ch\u1ebf xuy\u00ean m\u00e0ng trung gian th\u1ee5 th\u1ec3 Fc \u1edf tr\u1ebb s\u01a1 sinh (neonatal Fc receptor – FcRn), chi ti\u1ebft \u0111\u01b0\u1ee3c th\u1ec3 hi\u1ec7n \u1edf h\u00ecnh (b). C\u00e1ch IgG di chuy\u1ec3n qua m\u00f4 li\u00ean k\u1ebft v\u00e0 l\u1edbp n\u1ed9i m\u00f4 c\u1ee7a thai nhi v\u1eabn ch\u01b0a \u0111\u01b0\u1ee3c hi\u1ec3u r\u00f5, nh\u01b0ng FcRn v\u00e0 c\u00e1c th\u1ee5 th\u1ec3 Fcy kh\u00e1c \u0111\u01b0\u1ee3c bi\u1ec3u hi\u1ec7n tr\u00ean c\u00e1c \u0111\u1ea1i th\u1ef1c b\u00e0o nhau thai (t\u1ebf b\u00e0o Hofbauer) v\u00e0 t\u1ebf b\u00e0o n\u1ed9i m\u00f4 thai nhi c\u00f3 th\u1ec3 \u0111\u00f3ng vai tr\u00f2 trong qu\u00e1 tr\u00ecnh n\u00e0y. (b) C\u00e1c t\u1ebf b\u00e0o h\u1ee3p b\u00e0o (syncytiotrophoblast) h\u1ea5p thu IgG t\u1eeb m\u1eb9 th\u00f4ng qua c\u01a1 ch\u1ebf \u1ea9m b\u00e0o. C\u00e1c t\u00fai ch\u1ee9a IgG s\u1ebd h\u00f2a h\u1ee3p v\u1edbi endosome ch\u1ee9a FcRn, gi\u00fap b\u1ea3o v\u1ec7 IgG kh\u00f4ng b\u1ecb enzym ph\u00e2n h\u1ee7y trong m\u00f4i tr\u01b0\u1eddng pH th\u1ea5p. Khi endosome ti\u00ean g\u1ea7n v\u1ec1 ph\u00eda thai nhi v\u00e0 h\u1ee3p nh\u1ea5t v\u1edbi m\u00e0ng t\u1ebf b\u00e0o \u1edf ph\u00eda n\u00e0y, pH t\u0103ng d\u1ea7n khi\u1ebfn FcRn gi\u1ea3i ph\u00f3ng IgG v\u00e0o m\u00f4 li\u00ean k\u1ebft d\u1ea1ng nhung mao.<\/p>\n N\u1ec1n t\u1ea3ng cho chi\u1ebfn l\u01b0\u1ee3c ti\u00eam ch\u1ee7ng trong thai k\u1ef3 nh\u1eb1m b\u1ea3o v\u1ec7 tr\u1ebb s\u01a1 sinh ch\u00ednh l\u00e0 qu\u00e1 tr\u00ecnh truy\u1ec1n kh\u00e1ng th\u1ec3 t\u1eeb m\u1eb9 qua nhau thai m\u1ed9t c\u00e1ch hi\u1ec7u qu\u1ea3. Trong s\u1ed1 5 l\u1edbp kh\u00e1ng th\u1ec3, IgG l\u00e0 lo\u1ea1i duy nh\u1ea5t c\u00f3 th\u1ec3 \u0111i qua nhau thai, v\u00e0 qu\u00e1 tr\u00ecnh n\u00e0y \u0111\u01b0\u1ee3c trung gian c\u1ee5 th\u1ec3 b\u1edfi th\u1ee5 th\u1ec3 Fc \u1edf tr\u1ebb s\u01a1 sinh. \u0110\u1ec3 di chuy\u1ec3n t\u1eeb m\u00e1u m\u1eb9 sang tu\u1ea7n ho\u00e0n thai nhi, kh\u00e1ng th\u1ec3 ph\u1ea3i \u0111i qua c\u00e1c t\u1ebf b\u00e0o nu\u00f4i (trophoblast) bao ph\u1ee7 nhung mao nhau thai, ti\u1ebfp theo l\u00e0 m\u00f4 li\u00ean k\u1ebft d\u1ea1ng nhung mao, v\u00e0 sau c\u00f9ng l\u00e0 c\u00e1c t\u1ebf b\u00e0o n\u1ed9i m\u00f4 \u0111\u00ea v\u00e0o mao m\u1ea1ch c\u1ee7a thai nhi. FcRn \u0111\u01b0\u1ee3c bi\u1ec3u hi\u1ec7n r\u00f5 r\u00e0ng \u1edf c\u00e1c t\u1ebf b\u00e0o nu\u00f4i d\u1ea1ng nhung mao, v\u00e0 c\u01a1 ch\u1ebf m\u00e0 FcRn v\u1eadn chuy\u00ean IgG qua l\u1edbp t\u1ebf b\u00e0o n\u00e0y \u0111\u00e3 \u0111\u01b0\u1ee3c x\u00e1c \u0111\u1ecbnh th\u00f4ng qua c\u00e1c t\u1ebf b\u00e0o c\u00f3 ngu\u1ed3n g\u1ed1c t\u1eeb trophoblast ho\u1eb7c c\u00e1c d\u00f2ng t\u1ebf b\u00e0o \u0111\u01b0\u1ee3c bi\u1ec3n \u0111\u1ed1i \u0111\u1ec3 bi\u1ec3u hi\u1ec7n FcRn. T\u1ebf b\u00e0o trophoblast d\u1ea1ng nhung mao h\u1ea5p thu IgG t\u1eeb m\u00e1u m\u1eb9 qua c\u01a1 ch\u1ebf \u1ea9m b\u00e0o. Trong endosome, FcRn s\u1ebd g\u1eafn v\u1edbi IgG \u1edf \u0111i\u1ec1u ki\u1ec7n pH th\u1ea5p, b\u1ea3o v\u1ec7 n\u00f3 kh\u00f4ng b\u1ecb enzym ph\u00e2n h\u1ee7y trong qu\u00e1 tr\u00ecnh v\u1eadn chuy\u1ec3n sang ph\u00eda thai nhi. Khi endosome h\u1ee3p nh\u1ea5t v\u1edbi m\u00e0ng ph\u00eda thai nhi, pH t\u0103ng l\u00ean khi\u00ean FcRn gi\u1ea3i ph\u00f3ng IgG v\u00e0o m\u00f4 li\u00ean k\u1ebft d\u1ea1ng nhung mao. C\u00e1ch IgG ti\u1ebfp t\u1ee5c di chuy\u1ec3n qua m\u00f4 li\u00ean k\u1ebft v\u00e0 v\u00e0o m\u1ea1ch m\u00e1u c\u1ee7a thai nhi v\u1eabn ch\u01b0a r\u00f5 r\u00e0ng. C\u00e1c \u0111\u1ea1i th\u1ef1c b\u00e0o nhau thai (t\u1ebf b\u00e0o Hofbauer) c\u00f3 FcRn v\u00e0 c\u00e1c<\/p>\n th\u1ee5 th\u1ec3 Fcy kh\u00e1c, c\u00f3 th\u1ec3 h\u1ed7 tr\u1ee3 cho qu\u00e1 tr\u00ecnh n\u00e0y. Trong khi \u0111\u00f3, v\u1eabn ch\u01b0a c\u00f3 s\u1ef1 \u0111\u1ed3ng thu\u1eadn v\u1ec1 vi\u1ec7c li\u1ec7u c\u00e1c t\u1ebf b\u00e0o n\u1ed9i m\u00f4 d\u1ea1ng nhung mao c\u00f3 FcRn hay kh\u00f4ng, v\u00e0 r\u1ea5t c\u00f3 th\u1ec3 nh\u1eefng th\u1ee5 th\u1ec3 IgG kh\u00e1c s\u1ebd \u0111\u00f3ng vai tr\u00f2 trung gian trong vi\u1ec7c \u0111\u01b0a IgG v\u00e0o c\u00e1c mao m\u1ea1ch c\u1ee7a thai nhi. Trong c\u00e1c ph\u00e2n l\u1edbp IgG, IgG1 \u0111\u01b0\u1ee3c truy\u1ec1n qua nhau thai hi\u1ec7u qu\u1ea3 nh\u1ea5t, ti\u1ebfp theo l\u00e0 IgG4, r\u1ed3i \u0111\u1ebfn IgG2 v\u00e0 IgG3. Do \u0111\u00f3, m\u1ee9c \u0111\u1ed9 m\u00e0 c\u00e1c vaccin k\u00edch th\u00edch t\u1ea1o ra t\u1eebng ph\u00e2n l\u1edbp IgG n\u00e0y c\u00f3 th\u1ec3 \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn hi\u1ec7u qu\u1ea3 b\u1ea3o v\u1ec7 tr\u1ebb s\u01a1 sinh c\u1ee7a c\u00e1c lo\u1ea1i vaccin kh\u00e1c nhau.<\/p>\n Trong tam c\u00e1 nguy\u1ec7t \u0111\u1ea7u ti\u00ean, qu\u00e1 tr\u00ecnh truy\u1ec1n IgG qua nhau thai di\u1ec5n ra r\u1ea5t \u00edt. Vi\u1ec7c v\u1eadn chuy\u1ec3n n\u00e0y \u0111\u01b0\u1ee3c thi\u1ebft l\u1eadp d\u00e2n trong tam c\u00e1 nguy\u1ec7t th\u1ee9 hai: t\u1eeb tu\u1ea7n thai th\u1ee9 12 \u0111\u1ebfn 22, n\u1ed3ng \u0111\u1ed9 IgG trong m\u00e1u cu\u1ed1ng r\u1ed1n c\u1ee7a thai nhi ch\u1ec9 \u0111\u1ea1t kho\u1ea3ng 10% so v\u1edbi n\u1ed3ng \u0111\u1ed9 trong m\u00e1u m\u1eb9, v\u00e0 \u0111\u1ebfn cu\u1ed1i tam c\u00e1 nguy\u1ec7t th\u1ee9 hai, t\u1ef7 l\u1ec7 n\u00e0y t\u0103ng l\u00ean kho\u1ea3ng 50%. Trong tam c\u00e1 nguy\u1ec7t th\u1ee9 ba, t\u1ed1c \u0111\u1ed9 truy\u1ec1n t\u0103ng m\u1ea1nh v\u00e0 \u0111\u1ebfn l\u00fac sinh n\u1ed3ng \u0111\u1ed9 IgG \u1edf thai nhi th\u01b0\u1eddng v\u01b0\u1ee3t qua c\u1ea3 n\u1ed3ng \u0111\u1ed9 \u1edf m\u1eb9. Do \u0111\u00f3, th\u1eddi \u0111i\u1ec3m ti\u00eam ch\u1ee7ng l\u00fd t\u01b0\u1edfng nh\u1ea5t \u0111\u1ec3 t\u1ed1i \u01b0u h\u00f3a l\u01b0\u1ee3ng IgG \u0111\u1eb7c hi\u1ec7u trong m\u00e1u cu\u1ed1ng r\u1ed1n \u1edf tr\u1ebb sinh \u0111\u1ee7 th\u00e1ng l\u00e0 t\u1eeb tu\u1ea7n 26 \u0111\u1ebfn tu\u1ea7n 34 c\u1ee7a thai k\u1ef3, m\u1eb7c d\u00f9 t\u1ef7 l\u1ec7 tr\u1ebb c\u00f3 huy\u1ebft thanh h\u1ecdc d\u01b0\u01a1ng t\u00ednh \u1edf b\u1ea5t k\u1ef3 m\u1ee9c \u0111\u1ed9 n\u00e0o v\u1eabn t\u01b0\u01a1ng t\u1ef1 n\u00eau ti\u00eam ch\u1ee7ng di\u1ec5n ra b\u1ea5t k\u1ef3 l\u00fac n\u00e0o trong kho\u1ea3ng tu\u1ea7n th\u1ee9 13 \u0111\u1ebfn 34. M\u1ed9t th\u1eed nghi\u1ec7m ng\u1eabu nhi\u00ean cho th\u1ea5y vi\u1ec7c ti\u00eam ph\u00f2ng t\u1eeb tu\u1ea7n 23 \u0111\u1ebfn 32 cho k\u1ebft qu\u1ea3 n\u1ed3ng \u0111\u1ed9 kh\u00e1ng th\u1ec3 IgG \u1edf tr\u1ebb s\u01a1 sinh t\u01b0\u01a1ng \u0111\u01b0\u01a1ng nhau \u0111\u1ed1i v\u1edbi hai trong ba kh\u00e1ng nguy\u00ean c\u1ee7a b\u1ec7nh ho g\u00e0 \u0111\u01b0\u1ee3c nghi\u00ean c\u1ee9u. Ng\u01b0\u1ee3c l\u1ea1i, n\u1ebfu ti\u00eam ch\u1ee7ng sau tu\u1ea7n th\u1ee9 32-34, m\u1ee9c IgG \u0111\u1eb7c hi\u1ec7u \u1edf tr\u1ebb s\u01a1 sinh s\u1ebd th\u1ea5p h\u01a1n v\u00ec kh\u00f4ng c\u00f3 \u0111\u1ee7 th\u1eddi gian \u0111\u1ec3 m\u1eb9 t\u1ea1o ra \u0111\u00e1p \u1ee9ng mi\u1ec5n d\u1ecbch v\u00e0 truy\u1ec1n kh\u00e1ng th\u1ec3 qua nhau thai tr\u01b0\u1edbc khi sinh. C\u00e1c nghi\u00ean c\u1ee9u \u0111\u00e1nh gi\u00e1 hi\u1ec7u qu\u1ea3 c\u1ee7a ti\u00eam ph\u00f2ng trong thai k\u1ef3 \u0111\u1ec3 b\u1ea3o v\u1ec7 tr\u1ebb s\u01a1 sinh ph\u00e2n l\u1edbn cho th\u1ea5y ti\u00eam ph\u00f2ng mu\u1ed9n h\u01a1n trong thai k\u1ef3 mang l\u1ea1i hi\u1ec7u qu\u1ea3 b\u1ea3o v\u1ec7 cao h\u01a1n. Tuy nhi\u00ean, n\u00eau m\u1ee5c ti\u00eau ch\u00ednh l\u00e0 b\u1ea3o v\u1ec7 m\u1eb9 kh\u1ecfi b\u1ec7nh n\u1eb7ng trong thai k\u1ef3, ti\u00eam ph\u00f2ng c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n s\u1edbm h\u01a1n, d\u00f9 c\u00f3 th\u1ec3 l\u00e0m gi\u1ea3m hi\u1ec7u qu\u1ea3 b\u1ea3o v\u1ec7 cho tr\u1ebb sau sinh.<\/p>\n Khi m\u1ee5c ti\u00eau ch\u00ednh l\u00e0 b\u1ea3o v\u1ec7 em b\u00e9 sau sinh:<\/p>\n Khi m\u1ee5c ti\u00eau ch\u00ednh l\u00e0 b\u1ea3o v\u1ec7 m\u1eb9 v\u00e0 thai nhi trong thai k\u1ef3:<\/p>\n C\u00e1c l\u01b0u \u00fd chung:<\/p>\n \u01af\u1edbc t\u00ednh th\u1eddi gian b\u00e1n h\u1ee7y c\u1ee7a kh\u00e1ng th\u1ec3 IgG truy\u1ec1n t\u1eeb m\u1eb9 sang tr\u1ebb s\u01a1 sinh dao \u0111\u1ed9ng t\u1eeb 28.7 ng\u00e0y \u0111\u00ean 48.4 ng\u00e0y, t\u00f9y thu\u1ed9c v\u00e0o kh\u00e1ng nguy\u00ean \u0111\u1eb7c hi\u1ec7u. \u0110\u1ed1i v\u1edbi IgG1 kh\u00e1ng \u0111\u1ed9c t\u1ed1 u\u1ed1n v\u00e1n, n\u1ed3ng \u0111\u1ed9 kh\u00e1ng th\u1ec3 gi\u1ea3m xu\u1ed1ng c\u00f2n 10% so v\u1edbi l\u00fac m\u1edbi sinh sau 4 th\u00e1ng v\u00e0 3% sau 6 th\u00e1ng. V\u00ec l\u00fd do n\u00e0y, s\u1ef1 b\u1ea3o v\u1ec7 t\u1eeb kh\u00e1ng th\u1ec3 m\u1eb9 truy\u1ec1n d\u00e2n suy gi\u1ea3m trong 6 th\u00e1ng \u0111\u1ea7u \u0111\u1eddi c\u1ee7a tr\u1ebb. \u0110i\u1ec1u n\u00e0y c\u0169ng \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn l\u1ecbch ti\u00eam ch\u1ee7ng cho tr\u1ebb s\u01a1 sinh, b\u1edfi v\u00ec kh\u00e1ng th\u1ec3 m\u1eb9 truy\u1ec1n c\u00f3 th\u1ec3 \u0111i\u1ec1u ch\u1ec9nh \u0111\u00e1p \u1ee9ng mi\u1ec5n d\u1ecbch c\u1ee7a tr\u1ebb \u0111\u1ed1i v\u1edbi vaccin. Trong m\u1ed9t ph\u00e2n t\u00edch t\u1ed5ng h\u1ee3p tr\u00ean 7630 tr\u1ebb, n\u1ed3ng \u0111\u1ed9 kh\u00e1ng th\u1ec3 m\u1eb9 cao g\u1ea5p \u0111\u00f4i c\u00f3 li\u00ean quan \u0111\u1ebfn n\u1ed3ng \u0111\u1ed9 kh\u00e1ng th\u1ec3 sau ti\u00eam \u1edf tr\u1ebb th\u1ea5p h\u01a1n t\u1eeb 20% \u0111\u1ebfn 28% \u0111\u1ed1i v\u1edbi vaccin b\u1ea1i li\u1ec7t b\u1ea5t ho\u1ea1t, 11% v\u1edbi \u0111\u1ed9c t\u1ed1 ho g\u00e0 v\u00e0 13% v\u1edbi \u0111\u1ed9c t\u1ed1 u\u1ed1n v\u00e1n. T\u00e1c \u0111\u1ed9ng n\u00e0y \u00edt r\u00f5 r\u1ec7t h\u01a1n \u1edf tr\u1ebb l\u1edbn h\u01a1n, khi l\u01b0\u1ee3ng kh\u00e1ng th\u1ec3 m\u1eb9 truy\u1ec1n \u0111\u00e3 gi\u1ea3m d\u1ea7n. Do \u0111\u00f3, m\u1ee5c ti\u00eau c\u1ee7a l\u1ecbch ti\u00eam ch\u1ee7ng cho tr\u1ebb s\u01a1 sinh l\u00e0 ti\u00eam c\u00e0ng s\u1edbm c\u00e0ng t\u1ed1t sau khi n\u1ed3ng \u0111\u1ed9 kh\u00e1ng th\u1ec3 m\u1eb9 truy\u1ec1n gi\u1ea3m xu\u1ed1ng d\u01b0\u1edbi ng\u01b0\u1ee1ng g\u00e2y c\u1ea3n tr\u1edf ph\u1ea3n \u1ee9ng mi\u1ec5n d\u1ecbch c\u1ee7a tr\u1ebb.<\/p>\n .Vi\u1ec7c ti\u00eam vaccin trong thai k\u1ef3 b\u1ea3o v\u1ec7 tr\u1ebb s\u01a1 sinh kh\u1ecfi b\u1ec7nh truy\u1ec1n nhi\u1ec5m th\u00f4ng qua 4 c\u01a1 ch\u1ebf sau: (a) B\u1ea3o v\u1ec7 m\u1eb9 kh\u1ecfi b\u1ec7nh n\u1eb7ng trong thai k\u1ef3, t\u1eeb \u0111\u00f3 gi\u1ea3m c\u00e1c bi\u1ebfn ch\u1ee9ng nguy hi\u1ec3m cho thai nhi. Vaccin c\u00fam v\u00e0 Covid-19 th\u01b0\u1eddng \u0111\u01b0\u1ee3c ch\u1ec9 \u0111\u1ecbnh v\u00ec l\u00fd do n\u00e0y. (b) IgG c\u1ee7a m\u1eb9 \u0111\u01b0\u1ee3c t\u1ea1o ra nh\u1edd ti\u00eam ch\u1ee7ng c\u00f3 th\u1ec3 \u0111i qua nhau thai, gi\u00fap b\u1ea3o v\u1ec7 tr\u1ebb sau sinh. \u0110\u00e2y l\u00e0 c\u01a1 ch\u1ebf ch\u00ednh \u0111\u1ed1i v\u1edbi c\u00e1c vaccin nh\u01b0 ho g\u00e0 v\u00e0 RSV. (c) IgA c\u1ee7a m\u1eb9 do ti\u00eam vaccin t\u1ea1o ra \u0111\u01b0\u1ee3c ti\u1ebft trong s\u1eefa m\u1eb9, \u0111i qua \u0111\u01b0\u1eddng ti\u00eau h\u00f3a c\u1ee7a tr\u1ebb. M\u1ed9t s\u1ed1 b\u1eb1ng ch\u1ee9ng cho th\u1ea5y vaccin c\u00fam khi ti\u00eam trong thai k\u1ef3 c\u00f3 th\u1ec3 t\u0103ng c\u01b0\u1eddng b\u1ea3o v\u1ec7 tr\u1ebb s\u01a1 sinh qua con \u0111\u01b0\u1eddng n\u00e0y. (d) Cha m\u1eb9 v\u00e0 ng\u01b0\u1eddi ch\u0103m s\u00f3c \u0111\u00e3 ti\u00eam ch\u1ee7ng s\u1ebd \u00edt c\u00f3 nguy c\u01a1 m\u1eafc b\u1ec7nh h\u01a1n, do \u0111\u00f3 \u00edt c\u00f3 kh\u1ea3 n\u0103ng l\u00e2y nhi\u1ec5m cho tr\u1ebb s\u01a1 sinh (c\u00f2n g\u1ecdi l\u00e0 hi\u1ec7u \u1ee9ng v\u1ecf b\u1ecdc).<\/p>\n M\u1ed9t c\u00e1ch kh\u00e1c m\u00e0 mi\u1ec5n d\u1ecbch c\u1ee7a m\u1eb9 c\u00f3 th\u1ec3 b\u1ea3o v\u1ec7 tr\u1ebb s\u01a1 sinh l\u00e0 th\u00f4ng qua vi\u1ec7c truy\u1ec1n kh\u00e1ng th\u1ec3 v\u00e0o s\u1eefa m\u1eb9, cho ph\u00e9p trung h\u00f2a m\u1ea7m b\u1ec7nh trong \u0111\u01b0\u1eddng ti\u00eau h\u00f3a c\u1ee7a tr\u1ebb. Th\u00e0nh ph\u1ea7n ch\u1ee7 y\u00eau l\u00e0 IgA, m\u1eb7c d\u00f9 c\u0169ng c\u00f3 th\u1ec3 ph\u00e1t hi\u1ec7n n\u1ed3ng \u0111\u1ed9 th\u1ea5p IgG v\u00e0 IgM trong s\u1eefa m\u1eb9. T\u1ebf b\u00e0o plasma \u1edf tuy\u1ebfn v\u00fa s\u1ea3n xu\u1ea5t IgA v\u00e0 IgM, sau \u0111\u00f3 c\u00e1c kh\u00e1ng th\u1ec3 n\u00e0y \u0111\u01b0\u1ee3c v\u1eadn chuy\u1ec3n qua bi\u1ec3u m\u00f4 tuy\u1ebfn v\u00fa v\u00e0o trong s\u1eefa. IgG tu\u1ea7n ho\u00e0n trong m\u00e1u m\u1eb9 c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c v\u1eadn chuy\u1ec3n v\u00e0o s\u1eefa nh\u1edd th\u1ee5 th\u1ec3 FcRn, nh\u01b0ng hi\u1ec7u qu\u1ea3 th\u1ea5p h\u01a1n nhi\u1ec1u so v\u1edbi v\u1eadn chuy\u1ec3n qua nhau thai. C\u00e1c t\u1ebf b\u00e0o ti\u1ebft IgA ch\u1ee7 y\u00eau b\u1eaft ngu\u1ed3n t\u1eeb h\u1ec7 mi\u1ec5n d\u1ecbch \u0111\u01b0\u1eddng ru\u1ed9t, do \u0111\u00f3 kh\u00e1ng th\u1ec3 \u1edf tuy\u1ebfn v\u00fa ph\u1ea3n \u00e1nh kh\u00e1ng th\u1ec3 \u1edf \u0111\u01b0\u1eddng ti\u00eau h\u00f3a. \u0110i\u1ec1u n\u00e0y gi\u00fap s\u1eefa m\u1eb9 cung c\u1ea5p \u0111\u00fang c\u00e1c lo\u1ea1i kh\u00e1ng th\u1ec3 th\u00edch h\u1ee3p nh\u1ea5t v\u1edbi m\u00f4i tr\u01b0\u1eddng \u0111\u01b0\u1eddng ru\u1ed9t c\u1ee7a tr\u1ebb, tuy nhi\u00ean c\u0169ng g\u1ee3i \u00fd r\u1eb1ng c\u00e1c vaccin ch\u1ee7 y\u1ebfu t\u1ea1o ra ph\u1ea3n \u1ee9ng IgG tu\u1ea7n ho\u00e0n \u1edf m\u1eb9 c\u00f3 th\u1ec3 c\u00f3 kh\u1ea3 n\u0103ng h\u1ea1n ch\u1ebf trong vi\u1ec7c truy\u1ec1n kh\u00e1ng th\u1ec3 b\u1ea3o v\u1ec7 qua s\u1eefa m\u1eb9. Tuy v\u1eady, v\u1eabn c\u00f3 m\u1ed9t s\u1ed1 b\u1eb1ng ch\u1ee9ng cho th\u1ea5y vi\u1ec7c nu\u00f4i con b\u1eb1ng s\u1eefa m\u1eb9 c\u00f3 th\u1ec3 mang l\u1ea1i b\u1ea3o v\u1ec7 nh\u1ea5t \u0111\u1ecbnh. Trong m\u1ed9t th\u1eed nghi\u1ec7m ng\u1eabu nhi\u00ean c\u00f3 \u0111\u1ed1i ch\u1ee9ng v\u1ec1 vi\u1ec7c ti\u00eam vaccin c\u00fam trong thai k\u1ef3, nu\u00f4i con ho\u00e0n to\u00e0n b\u1eb1ng s\u1eefa m\u1eb9 sau sinh c\u00f3 li\u00ean quan \u0111\u1ebfn vi\u1ec7c gi\u1ea3m \u0111\u00e1ng k\u00ea c\u00e1c b\u1ec7nh h\u00f4 h\u1ea5p \u1edf tr\u1ebb s\u01a1 sinh, nh\u01b0ng ch\u1ec9 trong nh\u00f3m m\u1eb9 \u0111\u00e3 \u0111\u01b0\u1ee3c ti\u00eam vaccin c\u00fam.<\/p>\n B\u00ean c\u1ea1nh kh\u1ea3 n\u0103ng b\u1ea3o v\u1ec7 tr\u1ef1c ti\u1ebfp ch\u1ed1ng l\u1ea1i m\u1ea7m b\u1ec7nh nh\u1edd kh\u00e1ng th\u1ec3 t\u1eeb m\u1eb9 truy\u1ec1n sang, ti\u00eam vaccin cho m\u1eb9 c\u00f2n c\u00f3 th\u1ec3 gi\u00e1n ti\u1ebfp b\u1ea3o v\u1ec7 tr\u1ebb b\u1eb1ng c\u00e1ch ng\u0103n ch\u1eb7n qu\u00e1 tr\u00ecnh l\u00e2y truy\u1ec1n m\u1ea7m b\u1ec7nh. Chi\u1ebfn l\u01b0\u1ee3c n\u00e0y \u0111\u00f4i khi \u0111\u01b0\u1ee3c m\u1edf r\u1ed9ng \u0111\u1ec3 ti\u00eam ch\u1ee7ng cho c\u00e1c \u0111\u1ed1i t\u01b0\u1ee3ng ti\u1ebfp x\u00fac g\u1ea7n v\u1edbi tr\u1ebb s\u01a1 sinh, v\u00e0 \u0111\u00e3 ch\u1ee9ng minh hi\u1ec7u qu\u1ea3 trong vi\u1ec7c b\u1ea3o v\u1ec7 tr\u1ebb kh\u1ecfi b\u1ec7nh c\u00fam. Chi\u1ebfn l\u01b0\u1ee3c n\u00e0y c\u0169ng \u0111\u01b0\u1ee3c \u00e1p d\u1ee5ng v\u1edbi b\u1ec7nh ho g\u00e0, nh\u01b0ng trong th\u1ef1c t\u1ebf, s\u1ed1 ng\u01b0\u1eddi c\u1ea7n ti\u00eam \u0111\u1ec3 \u0111\u1ea1t hi\u1ec7u qu\u1ea3 b\u1ea3o v\u1ec7 l\u1ea1i qu\u00e1 l\u1edbn, khi\u1ebfn chi ph\u00ed kh\u00f4ng hi\u1ec7u qu\u1ea3 \u1edf nh\u1eefng n\u01a1i c\u00f3 t\u1ef7 l\u1ec7 m\u1eafc ho g\u00e0 th\u1ea5p. Do \u0111\u00f3, hi\u1ec7u qu\u1ea3 c\u1ee7a chi\u1ebfn l\u01b0\u1ee3c t\u1ea1o v\u1ecf b\u1ecdc ph\u1ee5 thu\u1ed9c nhi\u1ec1u v\u00e0o t\u1ef7 l\u1ec7 m\u1eafc b\u1ec7nh trong c\u1ed9ng \u0111\u1ed3ng \u2013 chi\u1ebfn l\u01b0\u1ee3c n\u00e0y s\u1ebd h\u1ee3p l\u00fd h\u01a1n \u1edf c\u00e1c khu v\u1ef1c c\u00f3 nguy c\u01a1 d\u1ecbch cao.<\/p>\n Vi\u1ec7c ti\u00eam ch\u1ee7ng trong thai k\u1ef3 \u0111\u1ec3 b\u1ea3o v\u1ec7 tr\u1ebb s\u01a1 sinh l\u00e0 m\u1ed9t chi\u1ebfn l\u01b0\u1ee3c \u0111\u00e3 c\u00f3 l\u1ecbch s\u1eed l\u00e2u \u0111\u1eddi. Ngay t\u1eeb n\u0103m 1877, c\u00e1c b\u00e1o c\u00e1o \u0111\u00e3 ghi nh\u1eadn r\u0103ng tr\u1ebb s\u01a1 sinh c\u00f3 m\u1eb9 \u0111\u01b0\u1ee3c ti\u00eam vaccin \u0111\u1eadu m\u00f9a trong thai k\u1ef3 c\u0169ng \u0111\u01b0\u1ee3c b\u1ea3o v\u1ec7 kh\u1ecfi b\u1ec7nh \u0111\u1eadu m\u00f9a. T\u1eeb gi\u1eefa th\u1ebf k\u1ef7 XX tr\u1edf \u0111i, vi\u1ec7c ti\u00eam ch\u1ee7ng khi mang thai ng\u00e0y c\u00e0ng tr\u1edf th\u00e0nh m\u1ed9t c\u00f4ng c\u1ee5 quan tr\u1ecdng trong b\u1ea3o v\u1ec7 s\u1ee9c kh\u1ecfe tr\u1ebb s\u01a1 sinh.<\/p>\n U\u1ed1n v\u00e1n l\u00e0 b\u1ec7nh do b\u00e0o t\u1eed vi khu\u1ea9n Clostridium tetani x\u00e2m nh\u1eadp v\u00e0o c\u00e1c v\u1ebft th\u01b0\u01a1ng h\u1edf. Tr\u1ebb s\u01a1 sinh \u0111\u1eb7c bi\u1ec7t d\u1ec5 b\u1ecb nhi\u1ec5m u\u1ed1n v\u00e1n trong c\u00e1c \u0111i\u1ec1u ki\u1ec7n y t\u1ebf h\u1ea1n ch\u1ebf, n\u01a1i d\u1ee5ng c\u1ee5 c\u1eaft d\u00e2y r\u1ed1n kh\u00f4ng \u0111\u01b0\u1ee3c ti\u1ec7t tr\u00f9ng \u0111\u00fang c\u00e1ch. U\u1ed1n v\u00e1n s\u01a1 sinh th\u01b0\u1eddng kh\u1edfi ph\u00e1t t\u1eeb ng\u00e0y th\u1ee9 3 \u0111\u1ebfn ng\u00e0y th\u1ee9 28 sau sinh, v\u1edbi c\u00e1c bi\u1ec3u hi\u1ec7n nh\u01b0 m\u1ea5t ph\u1ea3n x\u1ea1 b\u00fa v\u00e0 co th\u1eaft c\u01a1. N\u1ebfu kh\u00f4ng \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb, u\u1ed1n v\u00e1n s\u01a1 sinh g\u1ea7n nh\u01b0 lu\u00f4n g\u00e2y t\u1eed vong, v\u00e0 ngay c\u1ea3 khi c\u00f3 ch\u0103m s\u00f3c y t\u1ebf, t\u1ef7 l\u1ec7 t\u1eed vong v\u1eabn dao \u0111\u1ed9ng t\u1eeb 10% \u0111\u1ebfn 60% \u0111\u1ed1i v\u1edbi tr\u1ebb b\u1ecb nhi\u1ec5m.<\/p>\n Vaccin u\u1ed1n v\u00e1n \u0111\u1ea7u ti\u00ean s\u1eed d\u1ee5ng \u0111\u1ed9c t\u1ed1 u\u1ed1n v\u00e1n h\u1ea5p ph\u1ee5 tr\u00ean mu\u1ed1i nh\u00f4m, \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng r\u1ed9ng r\u00e3i trong th\u1ebf chi\u1ebfn th\u1ee9 hai. \u0110\u1ebfn n\u0103m 1959, m\u1ed9t nghi\u00ean c\u1ee9u quan s\u00e1t \u0111\u00e3 cho th\u1ea5y ti\u00eam vaccin u\u1ed1n v\u00e1n cho thai ph\u1ee5 gi\u00fap b\u1ea3o v\u1ec7 g\u00e2n 95% tr\u1ebb s\u01a1 sinh kh\u1ecfi t\u1eed vong do u\u1ed1n v\u00e1n s\u01a1 sinh. Th\u1eed nghi\u1ec7m l\u00e2m s\u00e0ng ng\u1eabu nhi\u00ean \u0111\u1ea7u ti\u00ean cho th\u1ea5y kh\u00f4ng c\u00f3 tr\u01b0\u1eddng h\u1ee3p t\u1eed vong n\u00e0o do u\u1ed1n v\u00e1n s\u01a1 sinh \u1edf tr\u1ebb c\u00f3 m\u1eb9 \u0111\u01b0\u1ee3c ti\u00eam 2-3 li\u1ec1u vaccin, so v\u1edbi t\u1ef7 l\u1ec7 t\u1eed vong 7.8% \u1edf nh\u00f3m \u0111\u1ed1i ch\u1ee9ng. C\u00e1c nghi\u00ean c\u1ee9u sau \u0111\u00f3 c\u0169ng x\u00e1c nh\u1eadn r\u1eb1ng 2-3 li\u1ec1u vaccin u\u1ed1n v\u00e1n trong thai k\u1ef3 c\u00f3 hi\u1ec7u qu\u1ea3 b\u1ea3o v\u1ec7 l\u00ean \u0111\u1ebfn 98% v\u00e0 kh\u00f4ng l\u00e0m t\u0103ng nguy c\u01a1 bi\u1ebfn ch\u1ee9ng nghi\u00eam tr\u1ecdng cho m\u1eb9 ho\u1eb7c tr\u1ebb s\u01a1 sinh. N\u0103m 1988, kho\u1ea3ng 787.000 tr\u1ebb s\u01a1 sinh t\u1eed vong do u\u1ed1n v\u00e1n m\u1ed7i n\u0103m. Do \u0111\u00f3, n\u0103m 1989 H\u1ed9i \u0111\u1ed3ng Y t\u00ea Th\u1ebf gi\u1edbi \u0111\u00e3 \u0111\u1eb7t m\u1ee5c ti\u00eau gi\u1ea3m t\u1ef7 l\u1ec7 u\u1ed1n v\u00e1n s\u01a1 sinh xu\u1ed1ng d\u01b0\u1edbi 1 ca tr\u00ean 1.000 tr\u1ebb sinh s\u1ed1ng \u1edf m\u1ed7i qu\u1eadn\/huy\u1ec7n. \u0110\u1ebfn n\u0103m 2018, s\u1ed1 ca t\u1eed vong \u0111\u00e3 gi\u1ea3m c\u00f2n kho\u1ea3ng 25.000 ca, t\u1ee9c gi\u1ea3m 97% so v\u1edbi n\u0103m 1988, nh\u1edd m\u1edf r\u1ed9ng quy m\u00f4 ti\u00eam ch\u1ee7ng.<\/p>\n Ho g\u00e0 l\u00e0 m\u1ed9t b\u1ec7nh l\u00fd \u0111\u01b0\u1eddng h\u00f4 h\u1ea5p d\u1ec5 l\u00e2y nhi\u1ec5m, do vi khu\u1ea9n Bordetella pertussis g\u00e2y ra, \u0111\u1eb7c tr\u01b0ng b\u1edfi c\u00e1c c\u01a1n ho k\u1ecbch ph\u00e1t k\u00e8m theo ti\u1ebfng r\u00edt \u0111\u1eb7c tr\u01b0ng th\u00ec h\u00edt v\u00e0o. T\u1ea1i M\u1ef9, giai \u0111o\u1ea1n 1940-1948 s\u1ed1 ca t\u1eed vong do ho g\u00e0 \u1edf tr\u1ebb s\u01a1 sinh cao g\u1ea5p g\u1ea7n ba l\u1ea7n t\u1ed5ng s\u1ed1 ca t\u1eed vong do s\u1edfi, quai b\u1ecb, rubella, scarlet fever, b\u1ea1ch h\u1ea7u, b\u1ea1i li\u1ec7t v\u00e0 vi\u00eam m\u00e0ng n\u00e3o c\u1ed9ng l\u1ea1i. Ho g\u00e0 hi\u1ec7n v\u1eabn g\u00e2y 85.900 ca t\u1eed vong m\u1ed7i n\u0103m \u1edf tr\u1ebb s\u01a1 sinh tr\u00ean to\u00e0n c\u1ea7u, khi\u00ean \u0111\u00e2y tr\u1edf th\u00e0nh m\u1ed9t trong nh\u1eefng nguy\u00ean nh\u00e2n h\u00e0ng \u0111\u1ea7u g\u00e2y t\u1eed vong c\u00f3 th\u1ec3 ph\u00f2ng ng\u1eeba b\u1eb1ng vaccin.<\/p>\n Vaccin ho g\u00e0 to\u00e0n b\u00e0o \u0111\u00e3 \u0111\u01b0\u1ee3c ph\u00e1t tri\u1ec3n t\u1eeb n\u0103m 1914, v\u00e0 m\u1ed9t nghi\u00ean c\u1ee9u n\u0103m 1943 cho th\u1ea5y kh\u00e1ng th\u1ec3 c\u00f3 th\u1ec3 truy\u1ec1n qua nhau thai, mang l\u1ea1i m\u1ed9t ph\u1ea7n mi\u1ec5n d\u1ecbch cho tr\u1ebb s\u01a1 sinh khi m\u1eb9 \u0111\u01b0\u1ee3c ti\u00eam vaccin trong thai k\u1ef3. Tuy nhi\u00ean, ch\u01b0\u01a1ng tr\u00ecnh ti\u00eam vaccin ho g\u00e0 cho ph\u1ee5 n\u1eef mang thai kh\u00f4ng \u0111\u01b0\u1ee3c tri\u1ec3n khai ngay, m\u1ed9t ph\u1ea7n l\u00e0 do lo ng\u1ea1i v\u1ec1 t\u00e1c d\u1ee5ng ph\u1ee5 c\u1ee7a vaccin to\u00e0n b\u00e0o, v\u00e0 m\u1ed9t ph\u1ea7n v\u00ec ch\u01b0\u01a1ng tr\u00ecnh ti\u00eam ch\u1ee7ng cho tr\u1ebb s\u01a1 sinh khi \u0111\u00f3 \u0111\u00e3 \u0111\u1ea1t hi\u1ec7u qu\u1ea3 cao. \u0110\u1ebfn th\u1eadp ni\u00ean 1970-1980, vaccin ho g\u00e0 v\u00f4 b\u00e0o ra \u0111\u1eddi v\u1edbi \u0111\u1ed9 an to\u00e0n cao h\u01a1n. C\u00f9ng v\u1edbi s\u1ef1 b\u00f9ng ph\u00e1t tr\u1edf l\u1ea1i c\u1ee7a b\u1ec7nh ho g\u00e0 v\u00e0o \u0111\u1ea7u th\u1ebf k\u1ef7 XXI, \u0111i\u1ec1u n\u00e0y th\u00fac \u0111\u00e2y M\u1ef9 v\u00e0 Anh ch\u00ednh th\u1ee9c khuy\u1ebfn ngh\u1ecb ti\u00eam vaccin ho g\u00e0 trong thai k\u1ef3 v\u00e0o c\u00e1c n\u0103m 2010.<\/p>\n T\u1ea1i Anh, sau khi tri\u1ec3n khai ti\u00eam vaccin ho g\u00e0 trong thai k\u1ef3, s\u1ed1 ca m\u1eafc \u1edf tr\u1ebb d\u01b0\u1edbi 3 th\u00e1ng tu\u1ed5i gi\u1ea3m t\u1edbi 78%. Nhi\u1ec1u nghi\u00ean c\u1ee9u c\u0169ng ghi nh\u1eadn hi\u1ec7u qu\u1ea3 b\u1ea3o v\u1ec7 kh\u1ecfi nh\u1eadp vi\u1ec7n \u1edf tr\u1ebb d\u01b0\u1edbi 3 th\u00e1ng tu\u1ed5i dao \u0111\u1ed9ng t\u1eeb 66% \u0111\u1ebfn 94% m\u00e0 kh\u00f4ng l\u00e0m t\u0103ng nguy c\u01a1 tai bi\u1ebfn s\u1ea3n khoa ho\u1eb7c s\u01a1 sinh.<\/p>\n Khuy\u1ebfn ngh\u1ecb v\u1ec1 th\u1eddi \u0111i\u1ec3m v\u00e0 lo\u1ea1i vaccin \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng trong thai k\u1ef3 \u0111\u00e3 thay \u0111\u1ed5i k\u1ec3 t\u1eeb khi ch\u01b0\u01a1ng tr\u00ecnh ti\u00eam ph\u00f2ng ho g\u00e0 \u0111\u01b0\u1ee3c tri\u1ec3n khai. T\u1ea1i V\u01b0\u01a1ng qu\u1ed1c Anh, vaccin ho g\u00e0 ban \u0111\u1ea7u \u0111\u01b0\u1ee3c khuy\u1ebfn c\u00e1o ti\u00eam trong kho\u1ea3ng t\u1eeb 28 \u0111\u1ebfn 38 tu\u1ea7n c\u1ee7a thai k\u1ef3. Tuy nhi\u00ean, t\u1eeb n\u0103m 2016, kho\u1ea3ng th\u1eddi gian khuy\u1ebfn ngh\u1ecb \u0111\u00e3 \u0111\u01b0\u1ee3c m\u1edf r\u1ed9ng ra t\u1eeb 16 \u0111\u1ebfn 32 tu\u1ea7n. S\u1ef1 thay \u0111\u1ed5i n\u00e0y nh\u1eb1m t\u0103ng kh\u1ea3 n\u0103ng c\u00e1c thai ph\u1ee5 \u0111\u01b0\u1ee3c ti\u00eam ph\u00f2ng \u0111\u00fang th\u1eddi \u0111i\u1ec3m, \u0111\u1ed3ng th\u1eddi \u0111\u1ea3m b\u1ea3o r\u1eb1ng nh\u1eefng tr\u1ebb sinh non c\u0169ng c\u00f3 th\u1ec3 nh\u1eadn \u0111\u01b0\u1ee3c l\u1ee3i \u00edch t\u1eeb kh\u00e1ng th\u1ec3 m\u1eb9 truy\u1ec1n sang. M\u1ed9t nghi\u00ean c\u1ee9u v\u00e0o n\u0103m 2016 cho th\u1ea5y vi\u1ec7c ti\u00eam vaccin s\u1edbm h\u01a1n trong thai k\u1ef3 gi\u00fap t\u1ed1i \u01b0u h\u00f3a t\u1ef7 l\u1ec7 huy\u1ebft thanh d\u01b0\u01a1ng t\u00ednh v\u1edbi kh\u00e1ng nguy\u00ean ho g\u00e0 \u1edf tr\u1ebb s\u01a1 sinh, v\u00e0 \u0111\u00e2y l\u00e0 m\u1ed9t y\u1ebfu t\u1ed1 g\u00f3p ph\u1ea7n v\u00e0o s\u1ef1 thay \u0111\u1ed5i ch\u00ednh s\u00e1ch. Ngo\u00e0i ra, m\u1ed9t th\u1eed nghi\u1ec7m ng\u1eabu nhi\u00ean c\u00f3 \u0111\u1ed1i ch\u1ee9ng sau \u0111\u00f3 c\u0169ng cho th\u1ea5y r\u1eb1ng vi\u1ec7c ti\u00eam ph\u00f2ng v\u00e0o b\u1ea5t k\u1ef3 th\u1eddi \u0111i\u1ec3m n\u00e0o trong kho\u1ea3ng t\u1eeb 23 \u0111\u1ebfn 32 tu\u1ea7n \u0111\u1ec1u t\u1ea1o ra n\u1ed3ng \u0111\u1ed9 kh\u00e1ng th\u1ec3 t\u01b0\u01a1ng \u0111\u01b0\u01a1ng nhau \u1edf tr\u1ebb s\u01a1 sinh, c\u00e0ng c\u00f9ng c\u00f4 th\u00eam c\u01a1 s\u1edf cho ch\u00ednh s\u00e1ch ti\u00eam ph\u00f2ng s\u1edbm h\u01a1n trong thai k\u1ef3.<\/p>\n \u0110\u00e1p l\u1ea1i c\u00e1c ph\u00e1t hi\u1ec7n r\u1eb1ng vi\u1ec7c s\u1eed d\u1ee5ng vaccin ph\u1ed1i h\u1ee3p nhi\u1ec1u th\u00e0nh ph\u1ea7n bao g\u1ed3m b\u1ea1ch h\u1ea7u, u\u1ed1n v\u00e1n v\u00e0 ho g\u00e0 (DTaP), c\u00f3 ch\u1ee9a th\u00eam th\u00e0nh ph\u1ea7n vaccin b\u1ea1i li\u1ec7t b\u1ea5t ho\u1ea1t (IPV) – g\u1ecdi chung l\u00e0 DTaP\/IPV-trong thai k\u1ef3 c\u00f3 th\u1ec3 l\u00e0m gi\u1ea3m kh\u1ea3 n\u0103ng chuy\u1ec3n \u0111\u1ed5i huy\u1ebft thanh sau khi tr\u1ebb \u0111\u01b0\u1ee3c ch\u1ee7ng ng\u1eeba b\u1ea1i li\u1ec7t, k\u1ec3 t\u1eeb th\u00e1ng 7 n\u0103m 2024, t\u1ea1i V\u01b0\u01a1ng qu\u1ed1c Anh, c\u00e1c thai ph\u1ee5 \u0111\u00e3 \u0111\u01b0\u1ee3c khuy\u1ebfn c\u00e1o ti\u00eam lo\u1ea1i vaccin Tdap kh\u00f4ng ch\u1ee9a th\u00e0nh ph\u1ea7n IPV. Vi\u1ec7c ti\u00eam vaccin ho g\u00e0 trong thai k\u1ef3 c\u00f3 th\u1ec3 l\u00e0m c\u00f9n m\u00f2n (blunting) \u0111\u00e1p \u1ee9ng mi\u1ec5n d\u1ecbch c\u1ee7a tr\u1ebb sau khi ti\u00eam m\u0169i vaccin ho g\u00e0 \u0111\u1ea7u ti\u00ean, v\u00e0 hi\u1ec7u \u1ee9ng n\u00e0y \u0111\u1eb7c bi\u1ec7t r\u00f5 r\u1ec7t \u1edf tr\u1ebb \u0111\u01b0\u1ee3c ti\u00eam vaccin ho g\u00e0 d\u1ea1ng to\u00e0n b\u00e0o thay v\u00ec vaccin ho g\u00e0 v\u00f4 b\u00e0o trong ph\u00e1c \u0111\u1ed3 ti\u00eam ch\u1ee7ng. Tuy nhi\u00ean, c\u00e1c b\u1eb1ng ch\u1ee9ng d\u1ecbch t\u1ec5 h\u1ecdc hi\u1ec7n t\u1ea1i kh\u00f4ng cho th\u1ea5y c\u00f3 s\u1ef1 suy gi\u1ea3m mi\u1ec5n d\u1ecbch n\u00e0y \u1ea3nh h\u01b0\u1edfng r\u00f5 r\u1ec7t \u0111\u1ebfn hi\u1ec7u qu\u1ea3 b\u1ea3o v\u1ec7 tr\u00ean l\u00e2m s\u00e0ng, v\u00e0 l\u1ee3i \u00edch c\u1ee7a vi\u1ec7c ti\u00eam vaccin cho m\u1eb9 trong thai k\u1ef3 \u0111\u1ed1i v\u1edbi tr\u1ebb s\u01a1 sinh v\u01b0\u1ee3t tr\u1ed9i h\u01a1n nguy c\u01a1 ti\u1ec1m t\u00e0ng l\u00e0m gia t\u0103ng b\u1ec7nh \u1edf tr\u1ebb nh\u1ecf.<\/p>\n C\u00e1c lo\u1ea1i vaccin \u0111\u01b0\u1ee3c cung c\u1ea5p theo m\u00f9a \u0111\u01b0\u1ee3c k\u00fd hi\u1ec7u b\u1eb1ng (S), nh\u1eefng lo\u1ea1i vaccin \u0111\u01b0\u1ee3c cung c\u1ea5p khi c\u00f3 c\u00f4ng th\u1ee9c m\u1edbi nh\u1eb1m v\u00e0o bi\u1ebfn th\u1ec3 m\u1edbi \u0111\u01b0\u1ee3c k\u00fd hi\u1ec7u (NV), v\u00e0 c\u00e1c vaccin ch\u1ec9 \u0111\u01b0\u1ee3c cung c\u1ea5p cho nh\u1eefng tr\u1ebb s\u01a1 sinh c\u00f3 nguy c\u01a1 cao \u0111\u01b0\u1ee3c k\u00fd hi\u1ec7u b\u1eb1ng (HR). T\u1ea1i Anh, vaccin Covid-19 t\u1eebng \u0111\u01b0\u1ee3c tri\u1ec3n khai theo chi\u1ebfn d\u1ecbch ti\u00eam ch\u1ee7ng m\u00f9a v\u1ee5 cho \u0111\u1ebfn m\u00f9a Xu\u00e2n n\u0103m 2025, nh\u01b0ng c\u00e1c ph\u00e2n t\u00edch chi ph\u00ed \u2013 l\u1ee3i \u00edch hi\u1ec7n kh\u00f4ng c\u00f2n \u1ee7ng h\u1ed9 vi\u1ec7c ti\u1ebfp t\u1ee5c \u0111i\u1ec1u n\u00e0y. \u1ede Hoa K\u1ef3, vaccin c\u00fam th\u01b0\u1eddng \u0111\u01b0\u1ee3c ti\u00eam v\u00e0o m\u00f9a thu, nh\u01b0ng n\u1ebfu tam c\u00e1 nguy\u1ec7t th\u1ee9 ba r\u01a1i v\u00e0o m\u00f9a h\u00e8, c\u00f3 th\u1ec3 xem x\u00e9t ti\u00eam v\u00e0o m\u00f9a h\u00e8 \u0111\u1ec3 b\u1ea3o v\u1ec7 tr\u1ebb s\u01a1 sinh. T\u1ea1i \u1ea4n \u0110\u1ed9, m\u0169i ti\u00eam ph\u00f2ng u\u1ed1n v\u00e1n th\u1ee9 hai c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c k\u1ebft h\u1ee3p v\u1edbi m\u0169i nh\u1eafc l\u1ea1i Tdap.<\/p>\n Mang thai l\u00e0m t\u0103ng nguy c\u01a1 m\u1eafc b\u1ec7nh n\u1eb7ng vi\u00eam ph\u1ed5i do virus g\u00e2y ra. Do \u0111\u00f3, vaccin c\u00fam v\u00e0 vaccin Covid-19 \u0111\u01b0\u1ee3c khuy\u1ebfn c\u00e1o s\u1eed d\u1ee5ng \u0111\u1ec3 b\u1ea3o v\u1ec7 c\u1ea3 m\u1eb9 v\u00e0 thai nhi trong th\u1eddi k\u1ef3 mang thai. Ti\u00eam ph\u00f2ng trong thai k\u1ef3 c\u00f3 hi\u1ec7u qu\u1ea3 49% trong vi\u1ec7c ng\u0103n ng\u1eeba nhi\u1ec5m virus c\u00fam v\u00e0 94% hi\u1ec7u qu\u1ea3 trong vi\u1ec7c ng\u0103n ng\u1eeba nh\u1eadp vi\u1ec7n do Covid-19. C\u1ea3 hai lo\u1ea1i vaccin n\u00e0y \u0111\u1ec1u kh\u00f4ng li\u00ean quan \u0111\u1ebfn nguy c\u01a1 t\u0103ng c\u00e1c bi\u1ebfn ch\u1ee9ng chu sinh, m\u1ed9t s\u1ed1 nghi\u00ean c\u1ee9u th\u1eadm ch\u00ed c\u00f2n ghi nh\u1eadn t\u1ef7 l\u1ec7 sinh non v\u00e0 thai l\u01b0u gi\u1ea3m \u1edf c\u00e1c tr\u01b0\u1eddng h\u1ee3p \u0111\u00e3 ti\u00eam ph\u00f2ng, c\u00f3 th\u1ec3 l\u00e0 nh\u1edd vi\u1ec7c ng\u0103n ng\u1eeba c\u00e1c bi\u1ebfn ch\u1ee9ng do nhi\u1ec5m virus g\u00e2y ra. M\u1eb7c d\u00f9 m\u1ee5c ti\u00eau ch\u00ednh c\u1ee7a vi\u1ec7c ti\u00eam ph\u00f2ng l\u00e0 \u0111\u1ec3 b\u1ea3o v\u1ec7 thai ph\u1ee5 kh\u1ecfi b\u1ec7nh n\u1eb7ng trong thai k\u1ef3, nh\u01b0ng ng\u00e0y c\u00e0ng c\u00f3 nhi\u1ec1u nh\u1eadn th\u1ee9c r\u1eb1ng vi\u1ec7c b\u1ea3o v\u1ec7 tr\u1ebb s\u01a1 sinh c\u0169ng l\u00e0 m\u1ed9t l\u1ee3i \u00edch quan tr\u1ecdng.<\/p>\n C\u00e1c th\u1eed nghi\u1ec7m ng\u1eabu nhi\u00ean c\u00f3 \u0111\u1ed1i ch\u1ee9ng \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n t\u1ea1i c\u00e1c qu\u1ed1c gia thu nh\u1eadp th\u1ea5p \u0111\u00e3 nh\u1ea5t qu\u00e1n cho th\u1ea5y r\u1eb1ng ti\u00eam vaccin c\u00fam trong thai k\u1ef3 c\u00f3 hi\u1ec7u qu\u1ea3 56% trong vi\u1ec7c ng\u0103n ng\u1eeba nhi\u1ec5m virus c\u00fam \u0111\u00e3 \u0111\u01b0\u1ee3c x\u00e9t nghi\u1ec7m x\u00e1c nh\u1eadn \u1edf tr\u1ebb d\u01b0\u1edbi 2 th\u00e1ng tu\u1ed5i v\u00e0 hi\u1ec7u qu\u1ea3 35% \u1edf tr\u1ebb d\u01b0\u1edbi 6 th\u00e1ng tu\u1ed5i. T\u1ea1i c\u00e1c qu\u1ed1c gia thu nh\u1eadp cao, c\u00e1c nghi\u00ean c\u1ee9u quan s\u00e1t cho th\u1ea5y vi\u1ec7c ti\u00eam vaccin c\u00fam m\u00f9a trong thai k\u1ef3 c\u00f3 hi\u1ec7u qu\u1ea3 t\u1eeb 41% \u0111\u1ebfn 71% trong vi\u1ec7c ng\u0103n ng\u1eeba nhi\u1ec5m c\u00fam \u0111\u01b0\u1ee3c x\u00e9t nghi\u1ec7m x\u00e1c nh\u1eadn \u1edf tr\u1ebb s\u01a1 sinh, v\u00e0 hi\u1ec7u qu\u1ea3 t\u1eeb 39% \u0111\u1ebfn 92% trong vi\u1ec7c ng\u0103n ng\u1eeba nh\u1eadp vi\u1ec7n do c\u00fam. \u0110\u1ed1i v\u1edbi vaccin Covid-19, hi\u1ec7u qu\u1ea3 ti\u00eam trong thai k\u1ef3 dao \u0111\u1ed9ng t\u1eeb 21% \u0111\u1ebfn 84% trong vi\u1ec7c ng\u0103n ng\u1eeba nhi\u1ec5m covid \u1edf tr\u1ebb s\u01a1 sinh, v\u00e0 t\u1eeb 32% \u0111\u1ebfn 95% ng\u0103n ng\u1eeba nh\u1eadp vi\u1ec7n do Covid-19 \u1edf tr\u1ebb. C\u00e1c lo\u1ea1i vaccin \u0111\u01b0\u1ee3c \u0111i\u1ec1u ch\u1ec9nh ph\u00f9 h\u1ee3p v\u1edbi bi\u1ebfn th\u1ec3 virus \u0111ang l\u01b0u h\u00e0nh v\u00e0 \u0111\u01b0\u1ee3c ti\u00eam sau tu\u1ea7n 20 c\u1ee7a thai k\u1ef3 cho th\u1ea5y hi\u1ec7u qu\u1ea3 b\u1ea3o v\u1ec7 cao nh\u1ea5t.<\/p>\n Hi\u1ec7u qu\u1ea3 b\u1ea3o v\u1ec7 r\u00f5 r\u1ec7t n\u00e0y, c\u00f9ng v\u1edbi b\u1eb1ng ch\u1ee9ng cho th\u1ea5y tr\u1ebb s\u01a1 sinh \u0111\u1eb7c bi\u1ec7t d\u1ec5 b\u1ecb t\u1ed5n th\u01b0\u01a1ng b\u1edfi c\u00fam v\u00e0 covid-19, \u0111\u00e3 l\u00e0m d\u1ea5y l\u00ean l\u1eddi k\u00eau g\u1ecdi \u0111i\u1ec1u ch\u1ec9nh l\u1ecbch ti\u00eam ch\u1ee7ng nh\u1eb1m t\u1ed1i \u0111a h\u00f3a kh\u1ea3 n\u0103ng b\u1ea3o v\u1ec7 cho tr\u1ebb s\u01a1 sinh, thay v\u00ec ch\u1ec9 t\u1eadp trung v\u00e0o m\u1eb9 v\u00e0 thai nhi trong th\u1eddi k\u1ef3 mang thai. Vi\u1ec7c ti\u00eam vaccin c\u00fam trong thai k\u1ef3 hi\u1ec7n \u0111\u01b0\u1ee3c tri\u1ec3n khai r\u1ed9ng r\u00e3i d\u01b0\u1edbi h\u00ecnh th\u1ee9c chi\u1ebfn d\u1ecbch ti\u00eam ph\u00f2ng theo m\u00f9a, tr\u01b0\u1edbc c\u00e1c \u0111\u1ee3t d\u1ecbch virus c\u00fam \u0111\u01b0\u1ee3c d\u1ef1 \u0111o\u00e1n x\u1ea3y ra v\u00e0o m\u00f9a \u0111\u00f4ng. Vaccin covid-19 c\u0169ng t\u1eebng \u0111\u01b0\u1ee3c tri\u1ec3n khai t\u1ea1i Anh d\u01b0\u1edbi d\u1ea1ng chi\u1ebfn d\u1ecbch theo m\u00f9a (tr\u01b0\u1edbc m\u00f9a xu\u00e2n n\u0103m 2025) ho\u1eb7c t\u1ea1i M\u1ef9 khi c\u00f3 vaccin ph\u00f9 h\u1ee3p v\u1edbi bi\u00ean th\u00ea m\u1edbi. \u0110\u1ec3 t\u1ed1i \u01b0u h\u00f3a kh\u1ea3 n\u0103ng b\u1ea3o v\u1ec7 cho tr\u1ebb s\u01a1 sinh, c\u00e1c m\u0169i ti\u00eam nh\u1eafc l\u1ea1i c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c l\u00ean l\u1ecbch trong khung th\u1eddi gian t\u01b0\u01a1ng t\u1ef1 nh\u01b0 ti\u00eam ph\u00f2ng ho g\u00e0 trong thai k\u1ef3. Theo hi\u1ec3u bi\u1ebft hi\u1ec7n t\u1ea1i, v\u1eabn ch\u01b0a c\u00f3 k\u1ebf ho\u1ea1ch ch\u00ednh th\u1ee9c \u0111\u1ec3 th\u1ef1c hi\u1ec7n thay \u0111\u1ed5i n\u00e0y, tuy nhi\u00ean t\u1ea1i M\u1ef9 \u0111\u00e3 c\u00f3 khuy\u00ean c\u00e1o c\u1eadp nh\u1eadt r\u1eb1ng vi\u1ec7c ti\u00eam v\u00e0o m\u00f9a h\u00e8 trong tam c\u00e1 nguy\u1ec7t th\u1ee9 ba c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c c\u00e2n nh\u1eafc nh\u1eb1m t\u0103ng c\u01b0\u1eddng b\u1ea3o v\u1ec7 cho tr\u1ebb s\u01a1 sinh. C\u00f9ng v\u1edbi vi\u1ec7c c\u01a1 quan qu\u1ea3n l\u00fd d\u01b0\u1ee3c ph\u1ea9m t\u1ea1i \u00dac g\u1ea7n \u0111\u00e2y \u0111\u00e3 c\u1ea5p ph\u00e9p cho vaccin c\u00fam s\u1eed d\u1ee5ng trong thai k\u1ef3 v\u1edbi m\u1ee5c \u0111\u00edch b\u1ea3o v\u1ec7 tr\u1ebb s\u01a1 sinh, nh\u1eefng \u0111\u1ed9ng th\u00e1i n\u00e0y cho th\u1ea5y m\u1ed9t s\u1ed1 qu\u1ed1c gia c\u00f3 th\u1ec3 s\u1ebd c\u00e2n nh\u1eafc thay \u0111\u1ed5i chi\u1ebfn l\u01b0\u1ee3c ti\u00eam ch\u1ee7ng trong t\u01b0\u01a1ng lai g\u1ea7n.<\/p>\n Virus vi\u00eam gan B c\u00f3 th\u1ec3 g\u00e2y nhi\u1ec5m tr\u00f9ng c\u1ea5p t\u00ednh ho\u1eb7c m\u00e3n t\u00ednh, v\u00e0 c\u00f3 t\u1edbi 85-90% tr\u1ebb s\u01a1 sinh \u0111\u01b0\u1ee3c sinh ra t\u1eeb c\u00e1c b\u00e0 m\u1eb9 d\u01b0\u01a1ng t\u00ednh v\u1edbi kh\u00e1ng nguy\u00ean HBV s\u1ebd ph\u00e1t tri\u1ec3n t\u00ecnh tr\u1ea1ng nhi\u1ec5m tr\u00f9ng m\u1ea1n t\u00ednh, khi\u1ebfn c\u00e1c em c\u00f3 nguy c\u01a1 b\u1ecb x\u01a1 gan, suy gan v\u00e0 ung th\u01b0 gan. Do l\u00e2y truy\u1ec1n trong th\u1eddi k\u1ef3 chu sinh l\u00e0 m\u1ed9t trong nh\u1eefng con \u0111\u01b0\u1eddng ch\u00ednh l\u00e2y lan HBV tr\u00ean to\u00e0n c\u1ea7u, vi\u1ec7c ph\u00f2ng ng\u1eeba con \u0111\u01b0\u1eddng n\u00e0y l\u00e0 \u0111i\u1ec1u thi\u1ebft y\u00eau n\u00eau WHO mu\u1ed1n \u0111\u1ea1t \u0111\u01b0\u1ee3c m\u1ee5c ti\u00eau lo\u1ea1i tr\u1eeb HBV v\u00e0o n\u0103m 2030.<\/p>\n Hi\u1ec7n c\u00f3 r\u1ea5t \u00edt b\u1eb1ng ch\u1ee9ng cho th\u1ea5y vi\u1ec7c truy\u00ean kh\u00e1ng th\u1ec3 th\u1ee5 \u0111\u1ed9ng ch\u1ed1ng HBV qua nhau thai c\u00f3 th\u1ec3 b\u1ea3o v\u1ec7 tr\u1ebb s\u01a1 sinh kh\u1ecfi nhi\u1ec5m virus. Ng\u01b0\u1ee3c l\u1ea1i, vi\u1ec7c ti\u00eam vaccin HBV cho tr\u1ebb ngay sau sinh gi\u00fap gi\u1ea3m 73% nguy c\u01a1 nhi\u1ec5m HBV \u1edf tr\u1ebb s\u01a1 sinh. Khi k\u1ebft h\u1ee3p gi\u1eefa ti\u00eam vaccin HBV v\u00e0 mi\u1ec5n d\u1ecbch th\u1ee5 \u0111\u1ed9ng v\u1edbi globulin mi\u1ec5n d\u1ecbch ch\u1ed1ng l\u1ea1i HBV, hi\u1ec7u qu\u1ea3 b\u1ea3o v\u1ec7 t\u0103ng l\u00ean \u0111\u1ebfn 92%. Kh\u00f4ng c\u00f3 m\u1ed1i lo ng\u1ea1i n\u00e0o v\u1ec1 t\u00ednh an to\u00e0n c\u1ee7a vi\u1ec7c ti\u00eam vaccin HBV ngay sau sinh, c\u1ea3 trong th\u1eed nghi\u1ec7m l\u00e2m s\u00e0ng l\u1eabn trong d\u1eef li\u1ec7u theo d\u00f5i h\u1eadu ti\u00eam ch\u1ee7ng.<\/p>\n Do \u0111\u00f3, WHO khuy\u1ebfn ngh\u1ecb ti\u00eam vaccin HBV cho t\u1ea5t c\u1ea3 tr\u1ebb s\u01a1 sinh ngay sau sinh. G\u1ea7n nh\u01b0 t\u1ea5t c\u1ea3 c\u00e1c qu\u1ed1c gia \u1edf ch\u00e2u M\u1ef9 v\u00e0 ch\u00e2u \u00c1 \u0111\u00e3 \u00e1p d\u1ee5ng khuy\u1ebfn ngh\u1ecb n\u00e0y, trong khi nhi\u00eau qu\u1ed1c gia ch\u00e2u \u00c2u \u2013 bao g\u1ed3m c\u1ea3 V\u01b0\u01a1ng qu\u1ed1c Anh \u2013 l\u1ea1i th\u1ef1c hi\u1ec7n s\u00e0ng l\u1ecdc HBV trong thai k\u1ef3 v\u00e0 ch\u1ec9 ti\u00eam ch\u1ee7ng cho c\u00e1c tr\u1ebb s\u01a1 sinh c\u00f3 nguy c\u01a1, c\u00f2n ph\u1ea7n l\u1edbn tr\u1ebb kh\u00e1c s\u1ebd \u0111\u01b0\u1ee3c ti\u00eam vaccin c\u00f3 th\u00e0nh ph\u1ea7n HBV trong l\u1ecbch ti\u00eam ch\u1ee7ng \u0111\u1ecbnh k\u1ef3 sau sinh. Tuy nhi\u00ean, s\u1ef1 th\u00e0nh c\u00f4ng c\u1ee7a chi\u1ebfn l\u01b0\u1ee3c s\u00e0ng l\u1ecdc v\u00e0 ch\u1ecdn l\u1ecdc n\u00e0y ph\u1ee5 thu\u1ed9c r\u1ea5t l\u1edbn v\u00e0o kh\u1ea3 n\u0103ng ph\u00e1t hi\u1ec7n ph\u1ea7n l\u1edbn c\u00e1c ca nhi\u1ec5m HBV \u1edf ph\u1ee5 n\u1eef mang thai \u0111i\u1ec1u m\u00e0 ngay c\u1ea3 \u1edf c\u00e1c qu\u1ed1c gia c\u00f3 thu nh\u1eadp cao c\u0169ng kh\u00f4ng ph\u1ea3i l\u00fac n\u00e0o c\u0169ng th\u1ef1c hi\u1ec7n \u0111\u01b0\u1ee3c.<\/p>\n B\u1ec7nh lao v\u00e0 b\u1ec7nh b\u1ea1i li\u1ec7t l\u00e0 nh\u1eefng nguy\u00ean nh\u00e2n ch\u00ednh g\u00e2y t\u1eed vong \u1edf tr\u1ebb s\u01a1 sinh v\u00e0 tr\u1ebb nh\u1ecf t\u1ea1i c\u00e1c qu\u1ed1c gia n\u01a1i c\u00e1c b\u1ec7nh n\u00e0y v\u1eabn \u0111ang l\u01b0u h\u00e0nh. Do \u0111\u00f3, WHO khuy\u1ebfn ngh\u1ecb ch\u1ee7ng ng\u1eeba b\u1ea1i li\u1ec7t c\u00e0ng s\u1edbm c\u00e0ng t\u1ed1t sau sinh \u1edf Afghanistan v\u00e0 Pakistan, v\u00e0 ti\u00eam ph\u00f2ng lao \u1edf h\u1ea7u h\u1ebft c\u00e1c qu\u1ed1c gia thu\u1ed9c khu v\u1ef1c c\u1eadn Sahara, ch\u00e2u Phi, Nam \u00c1 v\u00e0 \u0110\u00f4ng Nam \u00c1. Hi\u1ec7n t\u1ea1i, vaccin duy nh\u1ea5t ph\u00f2ng lao l\u00e0 vaccin BCG. V\u00ec l\u00e0 vaccin s\u1ed1ng gi\u1ea3m \u0111\u1ed9c l\u1ef1c, BCG b\u1ecb ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh trong thai k\u1ef3, do \u0111\u00f3 chi\u1ebfn l\u01b0\u1ee3c ti\u00eam ph\u00f2ng lao trong thai k\u1ef3 hi\u1ec7n ch\u01b0a th\u1ec3 \u00e1p d\u1ee5ng.<\/p>\n M\u1ed7i li\u1ec1u vaccin BCG ti\u00eam cho tr\u1ebb s\u01a1 sinh c\u00f3 hi\u1ec7u qu\u1ea3 kho\u1ea3ng 80% trong vi\u1ec7c b\u1ea3o v\u1ec7 tr\u1ebb d\u01b0\u1edbi 5 tu\u1ed5i kh\u1ecfi t\u1eed vong do b\u1ec7nh lao. M\u1ed9t li\u1ec1u b\u1ed5 sung vaccin b\u1ea1i li\u1ec7t u\u1ed1ng ngay sau sinh c\u0169ng \u0111\u01b0\u1ee3c khuy\u1ebfn ngh\u1ecb, v\u00ec n\u00f3 gi\u00fap t\u0103ng t\u1ef7 l\u1ec7 chuy\u1ec3n \u0111\u1ed5i huy\u1ebft thanh sau khi ho\u00e0n th\u00e0nh ba li\u00eau trong l\u1ecbch ti\u00eam ch\u1ee7ng cho tr\u1ebb nh\u1ecf \u2013 v\u1ed1n kh\u00f4ng \u0111\u1ee7 \u0111\u1ec3 b\u1ea3o v\u1ec7 tr\u1ebb tr\u01b0\u1edbc b\u1ec7nh b\u1ea1i li\u1ec7t t\u1ea1i c\u00e1c khu v\u1ef1c l\u01b0u h\u00e0nh virus. V\u00ec c\u1ea3 vaccin BCG v\u00e0 vaccin b\u1ea1i li\u1ec7t u\u1ed1ng \u0111\u1ec1u l\u00e0 vaccin s\u1ed1ng gi\u1ea3m \u0111\u1ed9c l\u1ef1c, ch\u00fang c\u00f3 kh\u1ea3 n\u0103ng g\u00e2y b\u1ec7nh, \u0111\u1eb7c bi\u1ec7t \u1edf nh\u1eefng tr\u1ebb b\u1ecb suy gi\u1ea3m mi\u1ec5n d\u1ecbch. T\u1ea1i Anh, vaccin BCG ch\u1ec9 \u0111\u01b0\u1ee3c khuy\u1ebfn c\u00e1o ti\u00eam cho tr\u1ebb s\u01a1 sinh c\u00f3 nguy c\u01a1, v\u00e0 \u1edf c\u00e1c khu v\u1ef1c c\u00f3 ch\u01b0\u01a1ng tr\u00ecnh t\u1ea7m so\u00e1t suy gi\u1ea3m mi\u1ec5n d\u1ecbch k\u1ebft h\u1ee3p (SCID), vi\u1ec7c ti\u00eam BCG s\u1ebd \u0111\u01b0\u1ee3c tr\u00ec ho\u00e3n cho \u0111\u1ebfn khi c\u00f3 k\u1ebft qu\u1ea3 x\u00e9t nghi\u1ec7m.<\/p>\n Nguy c\u01a1 g\u00e2y h\u1ea1i ti\u00eam \u00e2n t\u1eeb vaccin BCG, c\u00f9ng v\u1edbi hi\u1ec7u qu\u1ea3 b\u1ea3o v\u1ec7 t\u01b0\u01a1ng \u0111\u1ed1i th\u1ea5p c\u1ee7a n\u00f3, khi\u1ebfn cho vi\u1ec7c ph\u00e1t tri\u1ec3n m\u1ed9t lo\u1ea1i vaccin lao m\u1edbi tr\u1edf th\u00e0nh \u01b0u ti\u00ean h\u00e0ng \u0111\u1ea7u. \u0110\u1ed1i v\u1edbi vaccin b\u1ea1i li\u1ec7t u\u1ed1ng, ch\u1ee7ng ng\u1eeba ngay sau sinh \u0111\u01b0\u1ee3c cho l\u00e0 gi\u00fap nguy c\u01a1 m\u1eafc b\u1ec7nh li\u00ean quan \u0111\u1ebfn vaccin, v\u00ec tr\u1ebb s\u01a1 sinh v\u1eabn c\u00f2n \u0111\u01b0\u1ee3c b\u1ea3o v\u1ec7 ph\u1ea7n n\u00e0o nh\u1edd kh\u00e1ng th\u1ec3 t\u1eeb m\u1eb9.<\/p>\n Virus h\u1ee3p b\u00e0o h\u00f4 h\u1ea5p (RSV) l\u00e0 nguy\u00ean nh\u00e2n h\u00e0ng \u0111\u1ea7u g\u00e2y nhi\u1ec5m tr\u00f9ng \u0111\u01b0\u1eddng h\u00f4 h\u1ea5p d\u01b0\u1edbi c\u1ea5p t\u00ednh \u1edf tr\u1ebb nh\u1ecf. Tr\u00ean to\u00e0n c\u1ea7u v\u00e0o n\u0103m 2019, \u01b0\u1edbc t\u00ednh c\u00f3 kho\u1ea3ng 33 tri\u1ec7u ca LRTI li\u00ean quan \u0111\u1ebfn RSV \u1edf tr\u1ebb d\u01b0\u1edbi 5 tu\u1ed5i, trong \u0111\u00f3 95% ca b\u1ec7nh v\u00e0 97% trong s\u1ed1 100.000 ca t\u1eed vong x\u1ea3y ra t\u1ea1i c\u00e1c qu\u1ed1c gia c\u00f3 thu nh\u1eadp th\u1ea5p v\u00e0 trung b\u00ecnh. \u1ede c\u00e1c qu\u1ed1c gia c\u00f3 thu nh\u1eadp cao, RSV l\u00e0 nguy\u00ean nh\u00e2n ch\u00ednh g\u00e2y nh\u1eadp vi\u1ec7n v\u00e0 l\u00e0 m\u1ed9t v\u1ea5n \u0111\u1ec1 l\u1edbn trong vi\u1ec7c s\u1eed d\u1ee5ng ngu\u1ed3n l\u1ef1c y t\u00ea. Tr\u1ebb s\u01a1 sinh nh\u1ecf tu\u1ed5i b\u1ecb \u1ea3nh h\u01b0\u1edfng n\u1eb7ng n\u1ec1 do b\u1ec7nh n\u1eb7ng, v\u1edbi t\u1ef7 l\u1ec7 nh\u1eadp vi\u1ec7n cao nh\u1ea5t r\u01a1i v\u00e0o nh\u00f3m tr\u1ebb t\u1eeb 28 ng\u00e0y \u0111\u1ebfn 3 th\u00e1ng tu\u1ed5i. Tr\u1ebb sinh non chi\u1ebfm kho\u1ea3ng 25% s\u1ed1 ca nh\u1eadp vi\u1ec7n do nhi\u1ec5m tr\u00f9ng \u0111\u01b0\u1eddng h\u00f4 h\u1ea5p d\u01b0\u1edbi li\u00ean quan \u0111\u1ebfn RSV.<\/p>\n V\u00ec v\u1eady, vi\u1ec7c ph\u00e1t tri\u1ec3n c\u00e1c chi\u1ebfn l\u01b0\u1ee3c ph\u00f2ng ng\u1eeba an to\u00e0n, hi\u1ec7u qu\u1ea3 v\u00e0 h\u1ee3p t\u00fai ti\u1ec1n \u0111\u1ec3 gi\u1ea3m t\u1ef7 l\u1ec7 b\u1ec7nh t\u1eadt v\u00e0 t\u1ef7 l\u1ec7 t\u1eed vong li\u00ean quan \u0111\u1ebfn RSV \u2013 bao g\u1ed3m c\u1ea3 \u1edf tr\u1ebb \u0111\u1ebb non \u2013 l\u00e0 m\u1ed9t v\u1ea5n \u0111\u1ec1 \u01b0u ti\u00ean to\u00e0n c\u1ea7u. G\u1ea7n \u0111\u00e2y, c\u00e1c chi\u1ebfn l\u01b0\u1ee3c nh\u01b0 ti\u00eam vaccin trong thai k\u1ef3 v\u00e0 ti\u00eam ph\u00f2ng ph\u1ed5 c\u1eadp cho tr\u1ebb s\u01a1 sinh b\u1eb1ng kh\u00e1ng th\u1ec3 \u0111\u01a1n d\u00f2ng c\u1ee7a RSV \u0111\u00e3 \u0111\u01b0\u1ee3c tri\u1ec3n khai. C\u1ea3 hai chi\u1ebfn l\u01b0\u1ee3c n\u00e0y \u0111\u1ec1u nh\u1eb1m b\u1ea3o v\u1ec7 tr\u1ebb s\u01a1 sinh v\u00e0 tr\u1ebb nh\u1ecf trong m\u00f9a RSV \u0111\u1ea7u ti\u00ean trong \u0111\u1eddi b\u1eb1ng c\u00e1ch tr\u00ec ho\u00e3n l\u00e2n nhi\u1ec5m RSV \u0111\u1ea7u ti\u00ean cho \u0111\u1ebfn khi tr\u1ebb l\u1edbn h\u01a1n \u2013 khi m\u00e0 th\u1eddi \u0111i\u1ec3m nguy c\u01a1 m\u1eafc b\u1ec7nh n\u1eb7ng th\u1ea5p h\u01a1n.<\/p>\n M\u1ed9t lo\u1ea1i vaccin s\u1eed d\u1ee5ng protein RSV prefusion F (RSV pre-F) v\u1eeba m\u1edbi \u0111\u01b0\u1ee3c ph\u00e1t tri\u1ec3n \u0111\u1ec1 ti\u00eam ph\u00f2ng trong thai k\u1ef3 v\u00e0 hi\u1ec7n \u0111\u00e3 \u0111\u01b0\u1ee3c c\u1ea5p ph\u00e9p s\u1eed d\u1ee5ng t\u1ea1i nhi\u1ec1u qu\u1ed1c gia d\u01b0\u1edbi t\u00ean th\u01b0\u01a1ng m\u1ea1i Abrysvo. Trong m\u1ed9t th\u1eed nghi\u1ec7m l\u00e2m s\u00e0ng pha III, lo\u1ea1i vaccin n\u00e0y cho th\u1ea5y hi\u1ec7u qu\u1ea3 81.8% trong ng\u0103n ng\u1eeba LRTI n\u1eb7ng li\u00ean quan \u0111\u1ebfn RSV \u1edf tr\u1ebb s\u01a1 sinh d\u01b0\u1edbi 90 ng\u00e0y tu\u1ed5i v\u00e0 69.4% \u1edf tr\u1ebb d\u01b0\u1edbi 180 ng\u00e0y tu\u1ed5i. Vi\u1ec7c ti\u00eam vaccin Abrysvo trong thai k\u1ef3 \u0111\u00e3 \u0111\u01b0\u1ee3c tri\u1ec3n khai nh\u01b0 m\u1ed9t ch\u01b0\u01a1ng tr\u00ecnh theo m\u00f9a t\u1ea1i Argentina v\u00e0 Hoa K\u1ef3 t\u1eeb n\u0103m 2023 v\u00e0 nh\u01b0 m\u1ed9t ch\u01b0\u01a1ng tr\u00ecnh quanh n\u0103m t\u1ea1i Anh t\u1eeb n\u0103m 2024. \u0110\u00e1ng l\u01b0u \u00fd, trong th\u1eed nghi\u1ec7m pha III c\u1ee7a Abrysvo c\u00f3 ghi nh\u1eadn s\u1ef1 ch\u00eanh l\u1ec7ch kh\u00f4ng c\u00f3 \u00fd ngh\u0129a th\u1ed1ng k\u00ea v\u1ec1 t\u1ef7 l\u1ec7 sinh non \u2013 nh\u01b0ng kh\u00f4ng l\u00e0m gia t\u0103ng t\u1ef7 l\u1ec7 t\u1eed vong li\u00ean quan \u2013 t\u1ea1i Nam Phi v\u00e0 Brazil, trong khi hi\u1ec7n t\u01b0\u1ee3ng n\u00e0y kh\u00f4ng x\u1ea3y ra \u1edf c\u00e1c qu\u1ed1c gia thu nh\u1eadp cao. D\u1ea5u hi\u1ec7u n\u00e0y \u0111\u00e3 \u0111\u01b0\u1ee3c \u0111\u00e1nh gi\u00e1 c\u00e2n tr\u1ecdng trong qu\u00e1 tr\u00ecnh c\u1ea5p ph\u00e9p, \u0111\u1eb7c bi\u1ec7t l\u00e0 trong b\u1ed1i c\u1ea3nh th\u1eed nghi\u1ec7m pha III kh\u00e1c v\u1ec1 vaccin RSV pre-F \u0111\u00e3 b\u1ecb d\u00f9ng v\u00e0o th\u00e1ng 2 n\u0103m 2022 do ghi nh\u1eadn s\u1ef1 kh\u00e1c bi\u1ec7t \u0111\u00e1ng k\u1ec3 v\u1ec1 t\u1ef7 l\u1ec7 sinh non gi\u1eefa nh\u00f3m ti\u00eam vaccin v\u00e0 nh\u00f3m d\u00f9ng gi\u1ea3 d\u01b0\u1ee3c. Hi\u1ec7n t\u01b0\u1ee3ng n\u00e0y ch\u1ee7 y\u1ebfu xu\u1ea5t hi\u1ec7n trong m\u1ed9t giai \u0111o\u1ea1n c\u1ee5 th\u1ec3 t\u1ea1i c\u00e1c qu\u1ed1c gia c\u00f3 thu nh\u1eadp th\u1ea5p v\u00e0 trung b\u00ecnh. D\u1ea5u hi\u1ec7u n\u00e0y c\u00f3 th\u1ec3 ph\u1ea3n \u00e1nh c\u00e1c \u0111\u1eb7c \u0111i\u1ec3m d\u1ecbch t\u1ec5 h\u1ecdc \u0111\u1eb7c tr\u01b0ng c\u1ee7a c\u00e1c khu v\u1ef1c thu nh\u1eadp th\u1ea5p, nh\u01b0ng s\u1ef1 kh\u00e1c bi\u1ec7t v\u1ec1 ti\u00eau chu\u1ea9n ch\u0103m s\u00f3c tr\u01b0\u1edbc sinh gi\u1eefa c\u00e1c \u0111\u1ecba \u0111i\u1ec3m nghi\u00ean c\u1ee9u c\u0169ng c\u00f3 th\u1ec3 l\u00e0 m\u1ed9t y\u1ebfu t\u1ed1 g\u00f3p ph\u1ea7n. Kho\u1ea3ng th\u1eddi gian gi\u1eefa ti\u00eam vaccin v\u00e0 sinh n\u1edf l\u00e0 t\u01b0\u01a1ng t\u1ef1 gi\u1eefa c\u00e1c nh\u00f3m, v\u00e0 kh\u00f4ng ghi nh\u1eadn s\u1ef1 ch\u00eanh l\u1ec7ch v\u1ec1 t\u1ef7 l\u1ec7 sinh non trong nh\u00f3m thai k\u1ef3 nguy c\u01a1 cao trong th\u1eed nghi\u1ec7m pha III.<\/p>\n Vi\u1ec7c kh\u00f4ng ghi nh\u1eadn t\u00edn hi\u1ec7u b\u1ea5t th\u01b0\u1eddng n\u00e0o \u1edf c\u00e1c qu\u1ed1c gia thu nh\u1eadp cao cho th\u1ea5y l\u1ee3i \u00edch c\u1ee7a vi\u1ec7c ti\u00eam vaccin RSV trong thai k\u1ef3 v\u01b0\u1ee3t tr\u1ed9i h\u01a1n r\u1ee7i ro \u1edf nh\u1eefng qu\u1ed1c gia n\u00e0y. Tuy nhi\u00ean, \u0111\u1ec3 \u0111\u1ea3m b\u1ea3o ni\u00eam tin v\u00e0o ch\u01b0\u01a1ng tr\u00ecnh ti\u00eam ch\u1ee7ng, t\u1ef7 l\u1ec7 sinh non \u0111ang \u0111\u01b0\u1ee3c theo d\u00f5i ch\u1eb7t ch\u1ebd. D\u1eef li\u1ec7u m\u1edbi t\u1eeb Hoa K\u1ef3 cho th\u1ea5y t\u1ef7 l\u1ec7 sinh non sau khi ti\u00eam vaccin RSV ph\u00f9 h\u1ee3p v\u1edbi t\u1ef7 l\u1ec7 sinh non tr\u01b0\u1edbc \u0111\u00f3. \u0110\u1ec3 gi\u1ea3m thi\u1ec3u nguy c\u01a1 ti\u1ec1m \u1ea9n c\u1ee7a vi\u1ec7c \u0111\u1ebb non, Hoa K\u1ef3 \u0111\u00e3 ch\u1ecdn ch\u1ec9 ti\u00eam vaccin RSV sau tu\u1ea7n thai th\u1ee9 32. Argentina c\u0169ng ti\u00eam t\u1eeb 32 tu\u1ea7n v\u00e0 \u1edf Anh l\u00e0 t\u1eeb 28 tu\u1ea7n. \u0110i\u1ec1u n\u00e0y c\u00f3 ngh\u0129a l\u00e0 nh\u1eefng tr\u1ebb sinh c\u1ef1c non \u2013 t\u1ee9c l\u00e0 sinh tr\u01b0\u1edbc th\u1eddi \u0111i\u1ec3m vaccin c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c ti\u00eam \u2013 s\u1ebd kh\u00f4ng nh\u1eadn \u0111\u01b0\u1ee3c kh\u00e1ng th\u1ec3 IgG \u0111\u1eb7c hi\u1ec7u RSV t\u1eeb m\u1eb9 truy\u1ec1n qua nhau thai, nh\u01b0ng v\u1eabn c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c h\u01b0\u1edfng l\u1ee3i t\u1eeb vi\u1ec7c gi\u00e1n \u0111o\u1ea1n l\u00e2y truy\u1ec1n RSV v\u00e0 kh\u00e1ng th\u1ec3 \u0111\u1eb7c hi\u1ec7u RSV truy\u1ec1n qua s\u1eefa m\u1eb9.<\/p>\n Vi\u1ec7c tri\u1ec3n khai ti\u00eam ch\u1ee7ng theo m\u00f9a \u1edf Hoa K\u1ef3 v\u00e0 Argentina c\u00f2n gi\u1edbi h\u1ea1n th\u00eam kh\u1ea3 n\u0103ng h\u01b0\u1edfng l\u1ee3i, v\u00ec nh\u1eefng thai ph\u1ee5 c\u00f3 thai ngo\u00e0i kho\u1ea3ng th\u1eddi gian \u0111\u01b0\u1ee3c ch\u1ec9 \u0111\u1ecbnh trong m\u00f9a s\u1ebd kh\u00f4ng \u0111\u01b0\u1ee3c \u0111\u1ec1 ngh\u1ecb ti\u00eam vaccin RSV. Hi\u1ec7n t\u1ea1i m\u1ed9t lo\u1ea1i vaccin mRNA (mRNA-1345, do Moderna ph\u00e1t tri\u1ec3n) m\u00e3 h\u00f3a protein pre-F \u0111\u00e3 \u0111\u01b0\u1ee3c \u1ed5n \u0111\u1ecbnh \u0111ang trong giai \u0111o\u1ea1n th\u1eed nghi\u1ec7m l\u00e2m s\u00e0ng pha III \u1edf thai ph\u1ee5 tr\u00ean to\u00e0n c\u1ea7u v\u00e0 v\u1eeba \u0111\u01b0\u1ee3c c\u1ea5p ph\u00e9p cho c\u00e1c ch\u1ec9 \u0111\u1ecbnh kh\u00e1c.<\/p>\n T\u1eeb nh\u1eefng n\u0103m 1990, vi\u1ec7c ti\u00eam h\u00e0ng th\u00e1ng palivizumab \u2013 m\u1ed9t kh\u00e1ng th\u1ec3 \u0111\u01a1n d\u00f2ng kh\u00e1ng protein F c\u1ee7a RSV – trong m\u00f9a RSV \u0111\u00e3 \u0111\u01b0\u1ee3c khuy\u1ebfn ngh\u1ecb cho nh\u1eefng tr\u1ebb s\u01a1 sinh c\u00f3 nguy c\u01a1 cao nh\u1ea5t m\u1eafc RSV b\u1ec7nh n\u1eb7ng t\u1ea1i c\u00e1c qu\u1ed1c gia thu nh\u1eadp cao. S\u1ef1 ra \u0111\u1eddi g\u1ea7n \u0111\u00e2y c\u1ee7a nirsevimab, m\u1ed9t kh\u00e1ng th\u1ec3 \u0111\u01a1n d\u00f2ng ch\u1ed1ng l\u1ea1i RSV c\u00f3 t\u00e1c d\u1ee5ng k\u00e9o d\u00e0i (v\u1edbi th\u1eddi gian b\u00e1n h\u1ee7y l\u00ean \u0111\u1ebfn 79 ng\u00e0y v\u00e0 ch\u1ec9 c\u1ea7n m\u1ed9t li\u1ec1u ti\u00eam b\u1eafp duy nh\u1ea5t), \u0111\u00e3 t\u1ea1o n\u00ean b\u01b0\u1edbc \u0111\u1ed9t ph\u00e1 v\u00e0 cho ph\u00e9p tri\u1ec3n khai r\u1ed9ng r\u00e3i mi\u1ec5n d\u1ecbch th\u1ee5 \u0111\u1ed9ng \u0111\u1ec3 b\u1ea3o v\u1ec7 tr\u1ebb s\u01a1 sinh t\u1ea1i ch\u00e2u \u00c2u v\u00e0 B\u1eafc M\u1ef9. Trong nghi\u00ean c\u1ee9u pha III, nirsevimab (hi\u1ec7n \u0111\u01b0\u1ee3c c\u1ea5p ph\u00e9p v\u1edbi t\u00ean th\u01b0\u01a1ng m\u1ea1i l\u00e0 Beyfortus) cho th\u1ea5y hi\u1ec7u qu\u1ea3 ph\u00f2ng LRTI li\u00ean quan \u0111\u1ebfn RSV c\u1ea7n ch\u0103m s\u00f3c y t\u00ea l\u00ean \u0111\u1ebfn 150 ng\u00e0y, 74.5% hi\u1ec7u qu\u1ea3 \u1edf tr\u1ebb \u0111\u1ee7 th\u00e1ng v\u00e0 tr\u1ebb non mu\u1ed9n (> 35 tu\u1ea7n thai), 70.1% hi\u1ec7u qu\u1ea3 \u1edf tr\u1ebb sinh non t\u1eeb 29 tu\u1ea7n \u0111\u1ebfn d\u01b0\u1edbi 35 tu\u1ea7n.<\/p>\n K\u1ec3 t\u1eeb khi \u0111\u01b0\u1ee3c c\u1ea5p ph\u00e9p v\u00e0 tri\u1ec3n khai, nirsevimab \u0111\u00e3 cho th\u1ea5y hi\u1ec7u qu\u1ea3 v\u01b0\u1ee3t tr\u1ed9i v\u1edbi \u0111\u1ed9 bao ph\u1ee7 \u1ea5n t\u01b0\u1ee3ng \u1edf nhi\u1ec1u qu\u1ed1c gia. T\u1ea1i T\u00e2y Ban Nha, sau khi ch\u01b0\u01a1ng tr\u00ecnh ti\u00eam ch\u1ee7ng ph\u1ed1 bi\u00ean cho tr\u1ebb s\u01a1 sinh \u0111\u01b0\u1ee3c \u00e1p d\u1ee5ng t\u1eeb th\u00e1ng 9\/2023, t\u1ef7 l\u1ec7 bao ph\u1ee7 \u0111\u1ea1t t\u1eeb 78.7% \u0111\u00ean 98.6% t\u1ea1i ba khu v\u1ef1c, v\u1edbi hi\u1ec7u qu\u1ea3 70.2% trong vi\u1ec7c ng\u0103n ng\u1eeba nh\u1eadp vi\u1ec7n do RSV-LRTI. C\u00e1c nghi\u00ean c\u1ee9u ti\u1ebfp theo t\u1ea1i khu v\u1ef1c Galicia (T\u00e2y Ban Nha) v\u00e0 Ph\u00e1p cho th\u1ea5y r\u1eb1ng c\u00e2n 25 \u0111\u1ebfn 39 tr\u1ebb s\u01a1 sinh \u0111\u01b0\u1ee3c mi\u1ec5n d\u1ecbch th\u1ee5 \u0111\u1ed9ng \u0111\u1ec3 ng\u0103n ng\u1eeba m\u1ed9t ca nh\u1eadp vi\u1ec7n v\u00ec RSV, th\u1ec3 hi\u1ec7n t\u00ednh hi\u1ec7u qu\u1ea3 v\u1ec1 m\u1eb7t chi ph\u00ed v\u00e0 t\u00e1c \u0111\u1ed9ng y t\u1ebf. T\u1ea1i Luxembourg, n\u0103m 2023 \u2013 n\u01a1i t\u1ef7 l\u1ec7 bao ph\u1ee7 \u0111\u1ea1t 84% – \u0111\u1ed9 tu\u1ed5i trung b\u00ecnh khi nh\u1eadp vi\u1ec7n v\u00ec RSV t\u0103ng t\u1eeb 7.8 l\u00ean 14.4 th\u00e1ng, trong khi th\u1eddi gian n\u1eb1m vi\u1ec7n \u1edf tr\u1ebb d\u01b0\u1edbi 6 th\u00e1ng gi\u1ea3m t\u1eeb 5.6 xu\u1ed1ng c\u00f2n 3.4 ng\u00e0y, cho th\u1ea5y b\u1ec7nh nh\u1eb9 h\u01a1n. T\u1ea1i Ph\u00e1p, d\u1eef li\u1ec7u th\u1ef1c t\u1ebf ti\u1ebfp t\u1ee5c x\u00e1c nh\u1eadn k\u1ebft qu\u1ea3 th\u1eed nghi\u1ec7m l\u00e2m s\u00e0ng pha III, v\u1edbi hi\u1ec7u qu\u1ea3 75.9% trong vi\u1ec7c gi\u1ea3m ca n\u1eb7ng c\u00e2n h\u1ed3i s\u1ee9c. Trong khi \u0111\u00f3, t\u1ea1i M\u1ef9, t\u1ef7 l\u1ec7 bao ph\u1ee7 trong m\u1ea1ng l\u01b0\u1edbi gi\u00e1m s\u00e1t vaccin ch\u1ec9 \u0111\u1ea1t 4-12% nh\u01b0ng trong s\u1ed1 tr\u1ebb \u0111\u00e3 ti\u00eam, hi\u1ec7u qu\u1ea3 ng\u0103n ng\u1eeba nh\u1eadp vi\u1ec7n do RSV v\u1eabn r\u1ea5t cao, \u0111\u1ea1t 90%. \u0110i\u1ec1u n\u00e0y cho th\u1ea5y ti\u1ec1m n\u0103ng l\u1edbn c\u1ee7a nirsevimab n\u00eau \u0111\u01b0\u1ee3c tri\u1ec3n khai r\u1ed9ng r\u00e3i h\u01a1n t\u1ea1i c\u00e1c qu\u1ed1c gia c\u00f3 t\u1ef7 l\u1ec7 bao ph\u1ee7 c\u00f2n th\u1ea5p.<\/p>\n Vi\u1ec7c s\u1eed d\u1ee5ng kh\u00e1ng th\u1ec3 \u0111\u01a1n d\u00f2ng ch\u1ed1ng l\u1ea1i RSV cho tr\u1ebb s\u01a1 sinh l\u00e0 m\u1ed9t chi\u1ebfn l\u01b0\u1ee3c r\u1ea5t h\u1ea5p d\u1eabn nh\u1eb1m b\u1ea3o v\u1ec7 tr\u1ebb trong 6 th\u00e1ng \u0111\u1ea7u \u0111\u1eddi, \u0111\u1eb7c bi\u1ec7t l\u00e0 \u1edf nh\u1eefng nh\u00f3m d\u00e2n c\u01b0 c\u00f2n do d\u1ef1 v\u1edbi ti\u00eam ch\u1ee7ng khi mang thai. Tuy nhi\u00ean, t\u1ea1i h\u1ea7u h\u1ebft c\u00e1c qu\u1ed1c gia, l\u1ef1a ch\u1ecdn kh\u00f4ng thu\u1ed9c v\u1ec1 gia \u0111\u00ecnh m\u00e0 \u0111\u01b0\u1ee3c quy\u1ebft \u0111\u1ecbnh \u1edf c\u1ea5p qu\u1ed1c gia, t\u00f9y theo chi\u1ebfn l\u01b0\u1ee3c y t\u1ebf c\u00f4ng c\u1ed9ng. Th\u00eam v\u00e0o \u0111\u00f3, chi ph\u00ed cao c\u1ee7a kh\u00e1ng th\u1ec3 \u0111\u01a1n d\u00f2ng hi\u1ec7n t\u1ea1i l\u00e0 r\u00e0o c\u1ea3n l\u1edbn khi\u00ean chi\u1ebfn l\u01b0\u1ee3c n\u00e0y ch\u01b0a th\u1ec3 tri\u1ec3n khai r\u1ed9ng r\u00e3i tr\u00ean to\u00e0n c\u1ea7u. Tuy nhi\u00ean, vi\u1ec7c c\u1ea5p ph\u00e9p th\u00eam c\u00e1c kh\u00e1ng th\u1ec3 \u0111\u01a1n d\u00f2ng RSV c\u00f3 t\u00e1c d\u1ee5ng k\u00e9o d\u00e0i s\u1ebd gi\u00fap c\u1ea3i thi\u1ec7n ngu\u1ed3n cung, t\u0103ng t\u00ednh b\u1ec1n v\u1eefng v\u00e0 c\u00f3 th\u1ec3 gi\u1ea3m chi ph\u00ed trong t\u01b0\u01a1ng lai. Trong s\u1ed1 n\u00e0y, clesrovimab, m\u1ed9t kh\u00e1ng th\u1ec3 nh\u1eb1m v\u00e0o v\u1ecb tr\u00ed kh\u00e1c tr\u00ean protein F c\u1ee7a RSV, hi\u1ec7n \u0111ang g\u1ea7n ho\u00e0n th\u00e0nh th\u1eed nghi\u1ec7m l\u00e2m s\u00e0ng pha III, m\u1edf ra tri\u1ec3n v\u1ecdng t\u0103ng c\u01b0\u1eddng kh\u1ea3 n\u0103ng ti\u1ebfp c\u1eadn mi\u1ec5n d\u1ecbch th\u1ee5 \u0111\u1ed9ng cho tr\u1ebb s\u01a1 sinh tr\u00ean to\u00e0n th\u1ebf gi\u1edbi.<\/p>\n Ng\u01b0\u1eddi d\u1ecbch: NTHN Xem v\u00e0 t\u1ea3i file PDF t\u1ea1i \u0111\u00e2y B\u1ec7nh truy\u1ec1n nhi\u1ec5m g\u00e2y ra nguy c\u01a1 \u0111\u1eb7c bi\u1ec7t \u0111\u1ed1i v\u1edbi tr\u1ebb s\u01a1 sinh, v\u00e0 hi\u1ec7n \u0111ang c\u00f3 nhu c\u1ea7u to\u00e0n c\u1ea7u v\u1ec1 vi\u1ec7c b\u1ea3o v\u1ec7 nh\u00f3m \u0111\u1ed1i t\u01b0\u1ee3ng d\u1ec5 t\u1ed5n th\u01b0\u01a1ng n\u00e0y. Do g\u1eb7p nhi\u1ec1u th\u00e1ch th\u1ee9c trong vi\u1ec7c ph\u00e1t tri\u1ec3n c\u00e1c lo\u1ea1i vaccin […]\n","protected":false},"author":1,"featured_media":134506,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[1],"tags":[],"class_list":["post-134453","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-y-te-suc-khoe"],"acf":[],"_links":{"self":[{"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/posts\/134453","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/comments?post=134453"}],"version-history":[{"count":8,"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/posts\/134453\/revisions"}],"predecessor-version":[{"id":134593,"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/posts\/134453\/revisions\/134593"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/media\/134506"}],"wp:attachment":[{"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/media?parent=134453"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/categories?post=134453"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/tags?post=134453"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}T\u1ed4NG QUAN<\/h2>\n
MI\u1ec4N D\u1ecaCH C\u1ee6A VACCIN TRONG MANG THAI<\/h2>\n
\u0110\u00e1p \u1ee9ng mi\u1ec5n d\u1ecbch c\u1ee7a ti\u00eam ch\u1ee7ng trong thai k\u1ef3<\/h3>\n
![\"Qu\u00e1](\"https:\/\/vnras.com\/drug\/wp-content\/uploads\/2025\/08\/tiem-vaccin-khi-mang-thai.jpg\" "\\"\\"")
S\u1ef1 truy\u1ec1n kh\u00e1ng th\u1ec3 qua nhau thai<\/h3>\n
C\u00e1c y\u1ebfu t\u1ed1 \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn th\u1eddi \u0111i\u1ec3m ti\u00eam vaccin trong thai k\u1ef3<\/h3>\n
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![\"H\u00ecnh](\"https:\/\/vnras.com\/drug\/wp-content\/uploads\/2025\/08\/tiem-vaccin-khi-mang-thai-1.jpg\" "\\"\\"")
Kh\u00e1ng th\u1ec3 trong s\u1eefa m\u1eb9<\/h3>\n
Ng\u1eaft chu\u1ed7i l\u00e2y truy\u1ec1n m\u1ea7m b\u1ec7nh th\u00f4ng qua ti\u00eam vaccin<\/h3>\n
CH\u01af\u01a0NG TR\u00ccNH TI\u00caM CH\u1ee6NG<\/h2>\n
Ti\u00eam vaccin u\u1ed1n v\u00e1n trong thai k\u1ef3<\/h3>\n
Ti\u00eam vaccin ho g\u00e0 trong thai k\u1ef3<\/h3>\n
![\"H\u00ecnh](\"https:\/\/vnras.com\/drug\/wp-content\/uploads\/2025\/08\/tiem-vaccin-khi-mang-thai-2.jpg\" "\\"\\"")
![\"Ti\u00eam](\"https:\/\/vnras.com\/drug\/wp-content\/uploads\/2025\/08\/tiem-vaccin-khi-mang-thai-3.jpg\" "\\"\\"")
Ti\u00eam vaccin c\u00fam v\u00e0 Covid-19 trong thai k\u1ef3<\/h3>\n
Ti\u00eam vaccin vi\u00eam gan B ngay sau sinh<\/h3>\n
Ti\u00eam ph\u00f2ng lao v\u00e0 b\u1ea1i li\u1ec7t \u1edf c\u00e1c khu v\u1ef1c l\u01b0u h\u00e0nh d\u1ecbch<\/h3>\n
C\u00e1c ch\u01b0\u01a1ng tr\u00ecnh m\u1edbi n\u1ed5i nh\u1eb1m b\u1ea3o v\u1ec7 ch\u1ed1ng l\u1ea1i RSV<\/h3>\n
Ti\u00eam vaccin RSV trong thai k\u1ef3<\/h3>\n
Mi\u1ec5n d\u1ecbch th\u1ee5 \u0111\u1ed9ng ch\u1ed1ng l\u1ea1i RSV ngay sau sinh<\/h3>\n
T\u00c0I LI\u1ec6U THAM KH\u1ea2O<\/h2>\n
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