{"id":7484,"date":"2020-09-06T21:27:25","date_gmt":"2020-09-06T18:27:25","guid":{"rendered":"http:\/\/blog.ulubat.org\/?p=7484"},"modified":"2020-09-12T21:57:25","modified_gmt":"2020-09-12T18:57:25","slug":"covid-19-mucadelesi-asilar","status":"publish","type":"post","link":"https:\/\/blog.ulubat.org\/index.php\/genel\/covid-19-mucadelesi-asilar\/","title":{"rendered":"COVID-19 M\u00dcCADELES\u0130: A\u015eILAR"},"content":{"rendered":"\n<p>11 Mart 2020 tarihinde (1) D\u00fcnya Sa\u011fl\u0131k \u00d6rg\u00fct\u00fc taraf\u0131ndan \u2018pandemi\u2019 \u015feklinde s\u0131n\u0131fland\u0131r\u0131lan COVID-19 salg\u0131n\u0131, hayat\u0131m\u0131z\u0131n neredeyse her alan\u0131nda bir\u00e7ok s\u0131k\u0131nt\u0131ya yol a\u00e7m\u0131\u015f, hayat\u0131m\u0131zda de\u011fi\u015fikliklerin yap\u0131lmas\u0131n\u0131 zorunlu k\u0131lm\u0131\u015ft\u0131r. Bir\u00e7ok yerde vir\u00fcs\u00fcn yay\u0131l\u0131m\u0131n\u0131 kontrol edebilmek i\u00e7in insanlar aras\u0131ndaki temas azalt\u0131larak \u00f6nlemler al\u0131nm\u0131\u015ft\u0131r. Hastane kapasiteleri zorlanm\u0131\u015f (2) ve sa\u011fl\u0131k \u00e7al\u0131\u015fanlar\u0131 \u00e7ok zor \u015fartlarda \u00e7al\u0131\u015fmak durumunda kalm\u0131\u015ft\u0131r. Salg\u0131n\u0131n gidi\u015fat\u0131n\u0131 yava\u015flatacak, daha huzurlu bir zamana ula\u015fabilmemizi sa\u011flayacak en \u00f6nemli ara\u00e7lardan birinin de bu vir\u00fcse kar\u015f\u0131 geli\u015ftirilen a\u015f\u0131lar\u0131n olaca\u011f\u0131 d\u00fc\u015f\u00fcn\u00fclmektedir. 28 A\u011fustos 2020 tarihi itibariyle 33 tane a\u015f\u0131 klinik de\u011ferlendirme s\u00fcrecinde bulunmaktad\u0131r (3) ve bu a\u015f\u0131lar\u0131n yayg\u0131n kullan\u0131m\u0131na y\u00f6nelik ara\u015ft\u0131rmalar y\u00fcr\u00fct\u00fclmektedir. Bu a\u015f\u0131n\u0131n veya a\u015f\u0131lar\u0131n bulunmas\u0131na ve uygulaman\u0131n sa\u011flanmas\u0131na duyulan ihtiya\u00e7; Amerika\u2019da oldu\u011fu gibi h\u0131zland\u0131r\u0131lm\u0131\u015f ara\u015ft\u0131rma-geli\u015ftirme programlar\u0131n\u0131 (4) ve bu \u00e7al\u0131\u015fmalara ayr\u0131lan b\u00fcy\u00fck bir b\u00fct\u00e7eye duyulan ihtiyac\u0131 (5) da beraberinde getirmi\u015ftir. Peki, \u00fczerinde \u00e7al\u0131\u015f\u0131lan a\u015f\u0131lar\u0131n teknolojisi neye dayanmaktad\u0131r? \u2018mRNA\u2019 a\u015f\u0131s\u0131 dedi\u011fimiz \u015fey nedir? \u2018A\u015f\u0131 yar\u0131\u015f\u0131\u2019nda en \u00f6nde olan adaylar hangileri? Bu yaz\u0131da bu sorulara cevap bulmaya \u00e7al\u0131\u015faca\u011f\u0131z.&nbsp;<br><\/p>\n\n\n\n<h3><strong>A\u015eI GEL\u0130\u015eT\u0130RME S\u00dcREC\u0130<\/strong><br><\/h3>\n\n\n\n<p>\u0130lk olarak \u015fu anda SARS-CoV-2\u2019ye kar\u015f\u0131 geli\u015ftirilmekte olan a\u015f\u0131 adaylar\u0131n\u0131 ve a\u015f\u0131lar\u0131n kullan\u0131ma al\u0131nmadan \u00f6nce test edilmeleri gereken a\u015famalar\u0131 g\u00f6zden ge\u00e7irelim. \u00d6ncelikle bu konuda \u015funu g\u00f6z \u00f6n\u00fcnde bulundurmal\u0131y\u0131z: A\u015f\u0131 geli\u015ftirme s\u00fcreci \u00e7ok karma\u015f\u0131k ve bir s\u00fcr\u00fc de\u011fi\u015fkenin de\u011ferlendirilmesini i\u00e7eren bir ara\u015ft\u0131rmad\u0131r (6). Bir a\u015f\u0131 aday\u0131n\u0131n gerekli b\u00fct\u00fcn testlerden ge\u00e7mesi, a\u015f\u0131n\u0131n g\u00fcvenli ve faydal\u0131 oldu\u011funun ispatlanmas\u0131 normal \u015fartlarda ortalama 10-15 y\u0131l s\u00fcrmektedir (7). Ancak COVID-19 i\u00e7in \u00fcretilecek g\u00fcvenli ve etkili bir a\u015f\u0131n\u0131n pandeminin kontrol alt\u0131na al\u0131nmas\u0131ndaki en \u00f6nemli fakt\u00f6rlerden biri olaca\u011f\u0131 d\u00fc\u015f\u00fcn\u00fcld\u00fc\u011f\u00fc i\u00e7in (8) bu konudaki \u00e7al\u0131\u015fmalar da h\u0131z kazanm\u0131\u015ft\u0131r.&nbsp;<br><\/p>\n\n\n\n<p>\u0130la\u00e7 ara\u015ft\u0131rmalar\u0131nda genelde takip edilen s\u00fcre\u00e7 ise 5 a\u015famada \u00f6zetlenebilir:<\/p>\n\n\n\n<ul><li>Faz 0: Preklinik \u00e7al\u0131\u015fmalar\u0131 (9) i\u00e7erir.&nbsp; Ara\u015ft\u0131rmalar hedefledikleri antijeni ve uygun teknolojiyi se\u00e7erler, bunun \u00fczerinden in vitro ve in vivo deneyler y\u00fcr\u00fct\u00fcl\u00fcr (7).<\/li><li>Faz 1: Bu s\u00fcrecin as\u0131l amac\u0131 a\u015f\u0131n\u0131n g\u00fcvenilirli\u011finin test etmektir (9). 20-80 insanda (7) a\u015f\u0131 test edilir. Faz 1\u2019de ayn\u0131 zamanda a\u015f\u0131n\u0131n yaratt\u0131\u011f\u0131 ba\u011f\u0131\u015f\u0131kl\u0131k cevab\u0131n\u0131n t\u00fcr\u00fc ve boyutu da g\u00f6zlemlenir.<\/li><li>Faz 2: Bu a\u015famada optimum doz ve doz aral\u0131klar\u0131 hesaplan\u0131r (9). Faz 1\u2019den farkl\u0131 olarak bu a\u015famada birka\u00e7 y\u00fcz g\u00f6n\u00fcll\u00fcye ihtiya\u00e7 vard\u0131r (7).<\/li><li>Faz 3: Faz 1 ve Faz 2\u2019de ba\u015far\u0131l\u0131 oldu\u011fu kan\u0131tlanan a\u015f\u0131lar bu a\u015famaya ge\u00e7er ve daha b\u00fcy\u00fck bir pop\u00fclasyonda denenir. Plasebo kontroll\u00fc ara\u015ft\u0131rmalarla g\u00fcvenilirli\u011fi ve etkinli\u011fi detayl\u0131ca incelenir (9).<\/li><li>Faz 4: \u0130lk 3 a\u015famay\u0131 ge\u00e7en ila\u00e7lar ruhsat al\u0131p sat\u0131\u015fa sunulabilir. \u0130la\u00e7 pazara sunulduktan sonra yap\u0131lan her ara\u015ft\u0131rma Faz 4\u2019e girmektedir (9) ve bu s\u00fcre\u00e7te a\u015f\u0131n\u0131n g\u00fcvenilirli\u011fi devaml\u0131 olarak test edilmelidir (7). Bu d\u00f6nemde yap\u0131lan ara\u015ft\u0131rmalar, ilac\u0131n sonradan fark edilen yan etkilerini ve etkisinin uzun s\u00fcreli olup olmad\u0131\u011f\u0131n\u0131 da test edebilir.<\/li><\/ul>\n\n\n\n<figure class=\"wp-block-image\"><img src=\"https:\/\/lh6.googleusercontent.com\/Oxc9yvp7CPJCkPPWL-MjOmx3mHenR7MTlvfYOwG01vSN4kobV4ZPwrOKmlDpi-9B2pSVj5uJ4XAEVAx2f_vIT04KxItp1FWeMOJ7ZikOd7bmSrjCCjbGRQB0NGrEdMrqNN5k6c2o\" alt=\"\" \/><figcaption><strong>\u015eekil 1. Bir ila\u00e7\/a\u015f\u0131 geli\u015ftirme s\u00fcreci. <a href=\"https:\/\/www.ifpma.org\/wp-content\/uploads\/2019\/07\/IFPMA-ComplexJourney-2019_Stage-5_Web_High-Res.pdf\">https:\/\/www.ifpma.org\/wp-content\/uploads\/2019\/07\/IFPMA-ComplexJourney-2019_Stage-5_Web_High-Res.pdf<\/a>&nbsp;<\/strong><br><br><\/figcaption><\/figure>\n\n\n\n<h3><strong>SARS-CoV-2\u2019YE KAR\u015eI GEL\u0130\u015eT\u0130R\u0130LMEKTE OLAN A\u015eI ADAYLARI NELER?<\/strong><br><\/h3>\n\n\n\n<p>\u015eu anda potansiyeli y\u00fcksek oldu\u011fu d\u00fc\u015f\u00fcn\u00fclen a\u015f\u0131 t\u00fcrlerinden biri Moderna ve Amerika Alerji ve Bula\u015f\u0131c\u0131 Hastal\u0131k Enstit\u00fcs\u00fc (NIAID) i\u015fbirli\u011finde geli\u015ftirilmekte olan mRNA-1273 a\u015f\u0131s\u0131d\u0131r. mRNA-1273 a\u015f\u0131s\u0131 i\u00e7in ara\u015ft\u0131rmalar, Faz 3 a\u015famas\u0131na Temmuz ay\u0131 itibariyle ge\u00e7mi\u015ftir (10). mRNA\u2019dan \u00fcretilen a\u015f\u0131lar, asl\u0131nda \u015fimdiye kadar \u00e7ok s\u0131k kullan\u0131lmam\u0131\u015f, hala geli\u015fmekte olan bir a\u015f\u0131 t\u00fcr\u00fcd\u00fcr (11). Ancak Moderna \u015firketi, m\u00fchendislik ve t\u0131p alanlar\u0131ndaki birikimlerini birle\u015ftirerek COVID-19\u2019a kar\u015f\u0131 ba\u011f\u0131\u015f\u0131kl\u0131k yaratmay\u0131 ama\u00e7lamaktad\u0131r. A\u015f\u0131n\u0131n temeli, SARS-CoV-2\u2019nin y\u00fczey proteinine dayanmaktad\u0131r. \u0130nsan v\u00fccuduna verilen mRNA molek\u00fcl\u00fc, h\u00fccrelerde bu dizinin kodlad\u0131\u011f\u0131 proteinin \u00fcretilip ba\u011f\u0131\u015f\u0131kl\u0131k sisteminin bu proteini tan\u0131maya ba\u015flamas\u0131n\u0131 sa\u011flayacakt\u0131r (12). B\u00f6ylece a\u015f\u0131lanan bir insan\u0131n, COVID-19 bula\u015ft\u0131rabilen biriyle temas kurdu\u011funda bile hasta olmayaca\u011f\u0131 d\u00fc\u015f\u00fcn\u00fclmektedir \u00e7\u00fcnk\u00fc v\u00fccut zaten bu antijeni tan\u0131maktad\u0131r. Moderna, a\u015f\u0131lar\u0131n\u0131 2 doz halinde uygulamay\u0131 planlamaktad\u0131r (13). New England Journal of Medicine\u2019de yay\u0131nlanan bulgular\u0131na (14) g\u00f6re de \u015fimdiye kadarki testlerde bireylerde ba\u011f\u0131\u015f\u0131kl\u0131k cevab\u0131 olu\u015fturmay\u0131 sa\u011fl\u0131kl\u0131 bir \u015fekilde ba\u015farm\u0131\u015ft\u0131r. Ancak, a\u015f\u0131 geli\u015ftirme s\u00fcreci COVID-19 pandemisinin ciddiyetinden dolay\u0131 h\u0131zland\u0131r\u0131lmas\u0131 ve a\u015f\u0131 t\u00fcm denemeleri ge\u00e7se bile uzun vadeli etkilerinin uygulanmadan \u00f6nce tam olarak bilinemeyecek olmas\u0131, hala tart\u0131\u015fma ve endi\u015fe yaratan bir durumdur (15). Bu s\u0131k\u0131nt\u0131, \u015fu anda \u00fczerine \u00e7al\u0131\u015f\u0131lan ve COVID-19\u2019a kar\u015f\u0131 kullan\u0131m\u0131 planlanan di\u011fer ila\u00e7lar i\u00e7in ge\u00e7erlidir.&nbsp;<\/p>\n\n\n\n<figure class=\"wp-block-image\"><img src=\"https:\/\/lh4.googleusercontent.com\/-nFQYTM6z8pwEnUgg_TTQbZ71Asp8DPYg5iwnEeFvuHd7vXfKXmTMIARqGMSki4OPF_-IJiAILsKUX9yZmwR8xI7sCRPG2WXRO3Tt2qbnUuPhLNncNNXPIkt8acrVGSSXuB1aoDf\" alt=\"\" \/><figcaption><strong>\u015eekil 2. <a href=\"https:\/\/covid19.tabipacademy.com\/2020\/04\/14\/public-statement-for-collaboration-on-covid-19-vaccine-development\/\">https:\/\/covid19.tabipacademy.com\/2020\/04\/14\/public-statement-for-collaboration-on-covid-19-vaccine-development\/<\/a>&nbsp;<\/strong><br><br><\/figcaption><\/figure>\n\n\n\n<p>Tabii ki Moderna ve mRNA-1273, bilim insanlar\u0131na ve asl\u0131nda hepimize \u00fcmit veren tek a\u015f\u0131 aday\u0131 de\u011fildir. Oxford \u00dcniversitesi ve \u0130ngiltere-\u0130sve\u00e7 temelli AstraZeneca \u015firketi, Pfizer ve Biontech \u015firketleri, Johnson &amp; Johnson ve ba\u015fka \u00fclkelerden ba\u015fka kurumlar da \u00e7al\u0131\u015fmalar\u0131n\u0131 gece g\u00fcnd\u00fcz y\u00fcr\u00fctmektedir. Ancak bunlar\u0131n b\u00fcy\u00fck bir k\u0131sm\u0131 mRNA\u2019dan ba\u015fka yap\u0131lardan yararlanarak a\u015f\u0131 \u00fcretmeyi ama\u00e7lamaktad\u0131r. \u00d6rne\u011fin Sarah Gilbert liderli\u011finde Oxford \u00dcniversitesinde y\u00fcr\u00fct\u00fclmekte olan ve AZD1222 adl\u0131 a\u015f\u0131y\u0131 \u00fcretmeye y\u00f6nelik \u00e7al\u0131\u015fmalar (16) ChAdOx1 adl\u0131 ve \u015fempanzelerde enfeksiyona neden olan bir vir\u00fcsten t\u00fcretilip zay\u0131flat\u0131lm\u0131\u015f bir adenovir\u00fcs yap\u0131s\u0131yla SARS-CoV-2\u2019nin y\u00fczeyinde bulunan Spike (S) proteinini sentezletmeyi ama\u00e7lamaktad\u0131r (17). SARS-CoV-2, \u00fczerindeki Spike proteinini v\u00fccuttaki ACE2 resept\u00f6rlerine ba\u011flanmak i\u00e7in kullanmaktad\u0131r. Dolay\u0131s\u0131yla, farkl\u0131 bir mekanizma ile amac\u0131na ula\u015fsa bile AZD1222 a\u015f\u0131s\u0131 da Moderna\u2019n\u0131n \u00fczerine \u00e7al\u0131\u015ft\u0131\u011f\u0131 mRNA-1273 a\u015f\u0131s\u0131 ile ayn\u0131 prensiple, v\u00fccudun as\u0131l vir\u00fcsle kar\u015f\u0131la\u015fmas\u0131ndan \u00f6nce y\u00fczey proteinine tan\u0131\u015f\u0131kl\u0131k kazanmas\u0131n\u0131 sa\u011flayarak, ba\u011f\u0131\u015f\u0131kl\u0131k yaratmay\u0131 hedeflemektedir. 31 A\u011fustos tarihi itibariyle bu a\u015f\u0131n\u0131n da Faz 3 denemelerinin Amerika\u2019da ba\u015flat\u0131ld\u0131\u011f\u0131 duyurulmu\u015ftur (18). 20 Temmuz 2020\u2019de payla\u015f\u0131lan bulgulara g\u00f6re de a\u015f\u0131n\u0131n uygulanmas\u0131ndan bir ay sonra kat\u0131l\u0131mc\u0131lar\u0131n %95\u2019inde 4 katl\u0131k bir antikor art\u0131\u015f\u0131 oldu\u011fu g\u00f6zlemlenmi\u015ftir (17, 19). Bu a\u015f\u0131ya ek olarak, bir\u00e7ok bilim insan\u0131n\u0131n \u00fcmit ve heyecanla takip etti\u011fi bir di\u011fer ara\u015ft\u0131rma da Alman BioNTech \u015firketi ile Pfizer i\u015fbirli\u011finde geli\u015ftirilmekte ve y\u00fcr\u00fct\u00fclmekte olan BNT162 a\u015f\u0131 program\u0131d\u0131r (20). Program i\u00e7erisinde, her biri bir mRNA \u00e7e\u015fidi ve hedef antijenin farkl\u0131 bir kar\u0131\u015f\u0131m\u0131 olan en az 4 a\u015f\u0131 test edilmektedir (21). Bu aday a\u015f\u0131lardan Temmuz ay\u0131 sonunda Faz 2\/3 a\u015famas\u0131na ge\u00e7ileni, yine Spike proteinini kodlayan (22) ve mod-RNA denilen bir n\u00fckleik asit \u00e7e\u015fidi (21) ile ba\u011f\u0131\u015f\u0131kl\u0131k kazand\u0131rmay\u0131 hedeflemektedir.<br><\/p>\n\n\n\n<h3><strong>B\u0130Z\u0130 NELER BEKL\u0130YOR?<\/strong><br><\/h3>\n\n\n\n<p>Pandeminin getirdi\u011fi korku ve s\u0131k\u0131nt\u0131lar tabii ki bir a\u015f\u0131n\u0131n bulunmas\u0131yla tamamen sona ermeyecektir. Bu a\u015f\u0131n\u0131n do\u011fru bir \u015fekilde ve zaman\u0131 iyi kullanarak da\u011f\u0131t\u0131m\u0131n\u0131n yap\u0131lmas\u0131, daha sonra bunun etkilerinin izlenmesi gerekmektedir. Baz\u0131 uzmanlar taraf\u0131ndan a\u015f\u0131n\u0131n ilk da\u011f\u0131t\u0131m\u0131n\u0131n sa\u011fl\u0131k \u00e7al\u0131\u015fanlar\u0131na ve riskli gruplara yap\u0131lmas\u0131 \u00f6nerilmektedir (23). Ancak bu \u2018yar\u0131\u015fta\u2019 bir\u00e7ok \u00fclkenin ve kurumun yer almas\u0131 da \u00fclkeler aras\u0131ndaki a\u015f\u0131 \u00fcretimi-da\u011f\u0131t\u0131m\u0131 ili\u015fkisini tart\u0131\u015fma konusu haline getirmi\u015ftir. \u00c7o\u011fu \u00fclke, \u2018kendine ait\u2019 olarak de\u011ferlendirdi\u011fi ve \u00fcretimine ba\u015flad\u0131\u011f\u0131 a\u015f\u0131lar\u0131 \u00f6ncelikle kendi vatanda\u015flar\u0131na da\u011f\u0131tmay\u0131 ama\u00e7lamaktad\u0131r. Bu durum, \u2018a\u015f\u0131 milliyet\u00e7ili\u011fi\u2019 (vaccine nationalism) gibi kavramlar\u0131n konu\u015fulmas\u0131na yol a\u00e7m\u0131\u015ft\u0131r (24). COVID-19; s\u0131n\u0131r, \u0131rk, din, dil tan\u0131madan her \u00fclke ve insan i\u00e7in b\u00fcy\u00fck bir tehdit oldu\u011fundan ve geli\u015fmekte olan \u00fclkelerin de a\u015f\u0131ya eri\u015fiminin olmas\u0131n\u0131 sa\u011flanmak istendi\u011finden, D\u00fcnya Sa\u011fl\u0131k \u00d6rg\u00fct\u00fc b\u00fcnyesinde COVAX (Covid-19 Vaccine Global Access) (25) koalisyonu kurulmu\u015ftur. Bu \u015fekilde herkesin a\u015f\u0131ya ula\u015fabilmesi, \u00fclkelerin birbirlerine a\u015f\u0131ya eri\u015fimi art\u0131rabilmek i\u00e7in destek olmas\u0131, pandemiyi atlatman\u0131n maddi imkanlara ba\u011fl\u0131 olmamas\u0131 ama\u00e7lanmaktad\u0131r. Ancak bu ama\u00e7lara ra\u011fmen Amerika Birle\u015fik Devletleri ve Rusya gibi baz\u0131 \u00fclkeler kat\u0131lmamay\u0131 tercih etmi\u015ftir (26, 27). SARS-CoV-2\u2019ye kar\u015f\u0131 test edilmekte olan a\u015f\u0131 adaylar\u0131yla ve ara\u015ft\u0131rma s\u00fcreciyle ilgili olan bir di\u011fer tart\u0131\u015fma konusu da bu h\u0131zland\u0131r\u0131lm\u0131\u015f s\u00fcre\u00e7lerle a\u015f\u0131n\u0131n g\u00fcvenilirli\u011finden emin olup olunamamas\u0131d\u0131r. Halihaz\u0131rda b\u00fcy\u00fck bir halk sa\u011fl\u0131\u011f\u0131 tehditi olu\u015fturan a\u015f\u0131 kar\u015f\u0131tl\u0131\u011f\u0131, bu h\u0131zland\u0131r\u0131lm\u0131\u015f a\u015f\u0131 ara\u015ft\u0131rmalar\u0131yla g\u00fc\u00e7 kazanabilir ve uygulanacak olan a\u015f\u0131n\u0131n, g\u00fcvenli olsa bile, reddeden bireyler y\u00fcz\u00fcnden etkisi azalabilir (28). Ara\u015ft\u0131rmac\u0131lar ve sa\u011fl\u0131k politikac\u0131lar\u0131 taraf\u0131ndan bu teredd\u00fct\u00fcn temelsiz b\u0131rak\u0131lmas\u0131, denetlenmesi ve a\u015f\u0131lmas\u0131 i\u00e7in ad\u0131m at\u0131lmas\u0131 gerekmektedir.&nbsp;<\/p>\n\n\n\n<figure class=\"wp-block-image\"><img src=\"https:\/\/lh4.googleusercontent.com\/CsT-H_gj-Yk5hLQevQbzz3VOOa4J72671In8c6U1dzwXLztnC8p7d67VwGF7nJf8RlhIgFtA4ksuIjncnTkfMwssr53xw_vbCJa675GrSkcZxu2uBg7NETssF9kvMWT1JNvNMypl\" alt=\"\" \/><figcaption><strong>\u015eekil 3. <a href=\"https:\/\/www.pmlive.com\/pharma_news\/gavi_says_76_wealthy_countries_have_committed_to_covax_vaccine_facility_1348328\">https:\/\/www.pmlive.com\/pharma_news\/gavi_says_76_wealthy_countries_have_committed_to_covax_vaccine_facility_1348328<\/a> <\/strong><\/figcaption><\/figure>\n\n\n\n<p>COVID-19 pandemisinin kontrol al\u0131nmas\u0131nda en \u00f6nemli rol oynayacak geli\u015fmenin vir\u00fcse kar\u015f\u0131 bir a\u015f\u0131 geli\u015ftirilmesi ve \u00fcretilmesi oldu\u011fu tahmin edilmektedir. \u00dczerine \u00e7al\u0131\u015f\u0131lan a\u015f\u0131lar\u0131n ge\u00e7ti\u011fi a\u015famalar da bir an \u00f6nce kullan\u0131ma ge\u00e7irilmek i\u00e7in h\u0131zland\u0131r\u0131lm\u0131\u015ft\u0131r. Ancak bu pandemi hayat\u0131m\u0131z\u0131n neredeyse her alan\u0131nda belli s\u0131k\u0131nt\u0131lara ve de\u011fi\u015fikliklere yol a\u00e7t\u0131\u011f\u0131ndan bilimsel mucizeler bile muhtemelen \u2018normal\u2019e d\u00f6nmemizi hemen sa\u011flayamayacakt\u0131r. A\u015f\u0131n\u0131n \u00fcretiminin ve hakkaniyetli bir \u015fekilde da\u011f\u0131t\u0131m\u0131n\u0131n da planlanmas\u0131 ve belli stratejilerin d\u00fc\u015f\u00fcn\u00fclmesi gerekmektedir.<\/p>\n\n\n\n<h3><strong>KAYNAK\u00c7A<\/strong><\/h3>\n\n\n\n<ol><li>D\u00fcnya Sa\u011fl\u0131k \u00d6rg\u00fct\u00fc. (2020). <a href=\"https:\/\/www.euro.who.int\/en\/health-topics\/health-emergencies\/coronavirus-covid-19\">https:\/\/www.euro.who.int\/en\/health-topics\/health-emergencies\/coronavirus-covid-19<\/a>. Eri\u015fim tarihi: 26 A\u011fustos 2020.<\/li><li>Jessica Glenza, The Guardian. (2020). Over 40 Florida hospitals max out ICU capacity as Covid-19 cases surge across US. <a href=\"https:\/\/www.theguardian.com\/us-news\/2020\/jul\/10\/florida-coronavirus-cases-icu-beds-arizona-texas\">https:\/\/www.theguardian.com\/us-news\/2020\/jul\/10\/florida-coronavirus-cases-icu-beds-arizona-texas<\/a>. Eri\u015fim tarihi: 29 A\u011fustos 2020.<\/li><li>D\u00fcnya Sa\u011fl\u0131k \u00d6rg\u00fct\u00fc. (2020). Draft landscape of COVID-19 candidate vaccines. <a href=\"https:\/\/www.who.int\/publications\/m\/item\/draft-landscape-of-covid-19-candidate-vaccines\">https:\/\/www.who.int\/publications\/m\/item\/draft-landscape-of-covid-19-candidate-vaccines<\/a>. Eri\u015fim tarihi: 29 A\u011fustos 2020.<\/li><li>U.S. Department of Health and Human Services. (2020). Fact Sheet: Explaining Operation Warp Speed. <a href=\"https:\/\/www.hhs.gov\/about\/news\/2020\/06\/16\/fact-sheet-explaining-operation-warp-speed.html\">https:\/\/www.hhs.gov\/about\/news\/2020\/06\/16\/fact-sheet-explaining-operation-warp-speed.html<\/a>. Eri\u015fim tarihi: 29 A\u011fustos 2020.<\/li><li>The Indian Express. (2020). Experts say global push to develop COVID-19 vaccine requires big budget. <a href=\"https:\/\/indianexpress.com\/article\/world\/experts-say-global-push-to-develop-covid-19-vaccine-require-big-budget-6478487\/\">https:\/\/indianexpress.com\/article\/world\/experts-say-global-push-to-develop-covid-19-vaccine-require-big-budget-6478487\/<\/a>. Eri\u015fim tarihi: 29 A\u011fustos 2020.<\/li><li>History of Vaccines, The College of Physicians of Philadelphia. <a href=\"https:\/\/www.historyofvaccines.org\/content\/articles\/vaccine-development-testing-and-regulation\">https:\/\/www.historyofvaccines.org\/content\/articles\/vaccine-development-testing-and-regulation<\/a>. Eri\u015fim tarihi: 29 A\u011fustos 2020.<\/li><li>International Federation of Pharmaceutical Manufacturers &amp; Associations. (2019). The Complex Journey of a Vaccine. <a href=\"https:\/\/www.ifpma.org\/wp-content\/uploads\/2019\/07\/IFPMA-ComplexJourney-2019_FINAL.pdf\">https:\/\/www.ifpma.org\/wp-content\/uploads\/2019\/07\/IFPMA-ComplexJourney-2019_FINAL.pdf<\/a>. Eri\u015fim tarihi: 29 A\u011fustos 2020.<\/li><li>D\u00fcnya Sa\u011fl\u0131k \u00d6rg\u00fct\u00fc. (2020). Accelerating a safe and effective COVID-19 vaccine. <a href=\"https:\/\/www.who.int\/emergencies\/diseases\/novel-coronavirus-2019\/global-research-on-novel-coronavirus-2019-ncov\/accelerating-a-safe-and-effective-covid-19-vaccine\">https:\/\/www.who.int\/emergencies\/diseases\/novel-coronavirus-2019\/global-research-on-novel-coronavirus-2019-ncov\/accelerating-a-safe-and-effective-covid-19-vaccine<\/a>. Eri\u015fim tarihi: 29 A\u011fustos 2020.<\/li><li>\u00dcresin, Y. ve Terlemez, B. (2014). Faz 0, 1, 2, 3, 4 \u0130la\u00e7 Ara\u015ft\u0131rmalar\u0131 ve Belirte\u00e7ler. \u0130stanbul T\u0131p Fak\u00fcltesi. <a href=\"http:\/\/cdn.istanbul.edu.tr\/statics\/istanbultip.istanbul.edu.tr\/wp-content\/uploads\/2015\/02\/2.Faz0IIIIII-ilac%CC%A7-aras%CC%A7t%C4%B1rmalar%C4%B1-ve-biyobelirtec%CC%A7ler.pdf\">http:\/\/cdn.istanbul.edu.tr\/statics\/istanbultip.istanbul.edu.tr\/wp-content\/uploads\/2015\/02\/2.Faz0IIIIII-ilac%CC%A7-aras%CC%A7t%C4%B1rmalar%C4%B1-ve-biyobelirtec%CC%A7ler.pdf<\/a>. Eri\u015fim tarihi: 29 A\u011fustos 2020.<\/li><li>National Institutes of Health. (2020). Phase 3 clinical trial of investigational vaccine for COVID-19 begins. <a href=\"https:\/\/www.nih.gov\/news-events\/news-releases\/phase-3-clinical-trial-investigational-vaccine-covid-19-begins\">https:\/\/www.nih.gov\/news-events\/news-releases\/phase-3-clinical-trial-investigational-vaccine-covid-19-begins<\/a>. Eri\u015fim tarihi: 5 Eyl\u00fcl 2020.&nbsp;<\/li><li>Pardi, N., Hogan, M. J., Porter, F. W., &amp; Weissman, D. (2018). mRNA vaccines &#8211; a new era in vaccinology. <em>Nature reviews. Drug discovery<\/em>, <em>17<\/em>(4), 261\u2013279. <a href=\"https:\/\/doi.org\/10.1038\/nrd.2017.243\">https:\/\/doi.org\/10.1038\/nrd.2017.243<\/a>&nbsp;<\/li><li>European Pharmaceutical Review. (2020). Experimental COVID-19 vaccine mRNA-1273 is safe and elicits response. <a href=\"https:\/\/www.europeanpharmaceuticalreview.com\/news\/123650\/experimental-covid-19-vaccine-mrna-1273-is-safe-and-elicits-response\/\">https:\/\/www.europeanpharmaceuticalreview.com\/news\/123650\/experimental-covid-19-vaccine-mrna-1273-is-safe-and-elicits-response\/<\/a>. Eri\u015fim tarihi: 5 Eyl\u00fcl 2020.&nbsp;<\/li><li>U.S. National Library of Medicine, Clinical Trials. (2020). Safety and Immunogenicity Study of 2019-nCoV Vaccine (mRNA-1273) for Prophylaxis of SARS-CoV-2 Infection (COVID-19). <a href=\"https:\/\/clinicaltrials.gov\/ct2\/show\/NCT04283461\">https:\/\/clinicaltrials.gov\/ct2\/show\/NCT04283461<\/a>. Eri\u015fim tarihi: 5 Eyl\u00fcl 2020.&nbsp;<\/li><li>Jackson, L. et al. (2020). An mRNA Vaccine against SARS-CoV-2 \u2014 Preliminary Report. <em>NEJM<\/em>. <a href=\"https:\/\/doi.org\/10.1056\/NEJMoa2022483\">https:\/\/doi.org\/10.1056\/NEJMoa2022483<\/a>.&nbsp;&nbsp;<\/li><li>Zhang, S., <em>The Atlantic<\/em>. (2020). A Vaccine Reality Check. <a href=\"https:\/\/www.theatlantic.com\/health\/archive\/2020\/07\/covid-19-vaccine-reality-check\/614566\/\">https:\/\/www.theatlantic.com\/health\/archive\/2020\/07\/covid-19-vaccine-reality-check\/614566\/<\/a>. Eri\u015fim tarihi: 5 Eyl\u00fcl 2020.&nbsp;<\/li><li>The Independent. (2020). \u2018You just get on with it\u2019: The Oxford professor carrying the world\u2019s hopes of a coronavirus vaccine. <a href=\"https:\/\/www.independent.co.uk\/news\/health\/coronavirus-vaccine-oxford-latest-results-covid-19-sarah-gilbert-interview-trial-a9695161.html\">https:\/\/www.independent.co.uk\/news\/health\/coronavirus-vaccine-oxford-latest-results-covid-19-sarah-gilbert-interview-trial-a9695161.html<\/a>. Eri\u015fim tarihi 1 Eyl\u00fcl 2020..&nbsp;<\/li><li>AZD1222 SARS-CoV-2 Vaccine. (2020). <a href=\"https:\/\/www.precisionvaccinations.com\/vaccines\/azd1222-sars-cov-2-vaccine\">https:\/\/www.precisionvaccinations.com\/vaccines\/azd1222-sars-cov-2-vaccine<\/a>. Eri\u015fim tarihi 1 Eyl\u00fcl 2020.&nbsp;&nbsp;<\/li><li>National Institutes of Health. (2020). <a href=\"https:\/\/www.nih.gov\/news-events\/news-releases\/phase-3-clinical-testing-us-astrazeneca-covid-19-vaccine-candidate-begins\">https:\/\/www.nih.gov\/news-events\/news-releases\/phase-3-clinical-testing-us-astrazeneca-covid-19-vaccine-candidate-begins<\/a>. Eri\u015fim tarihi: 1 Eyl\u00fcl 2020.<\/li><li>Folegatti et al. (2020). Safety and immunogenicity of the ChAdOx1 nCoV-19 vaccine against SARS-CoV-2: a preliminary report of a phase 1\/2, single-blind, randomised controlled trial. Lancet; 396(10249): 467-478. <a href=\"https:\/\/doi.org\/10.1016\/S0140-6736(20)31604-4\">https:\/\/doi.org\/10.1016\/S0140-6736(20)31604<\/a>-4.&nbsp;&nbsp;<\/li><li>Pfizer. (2020). Pfizer and Biontech Choose Lead mRNA Vaccine Candidate Against Covid-19 and Commence Pivotal Phase 2\/3 Global Study. <a href=\"https:\/\/www.pfizer.com\/news\/press-release\/press-release-detail\/pfizer-and-biontech-choose-lead-mrna-vaccine-candidate-0\">https:\/\/www.pfizer.com\/news\/press-release\/press-release-detail\/pfizer-and-biontech-choose-lead-mrna-vaccine-candidate-0<\/a>. Eri\u015fim tarihi: 6 Eyl\u00fcl 2020.&nbsp;<\/li><li>Precision Vaccinations. (2020). BNT162 SARS-CoV-2 Vaccine. <a href=\"https:\/\/www.precisionvaccinations.com\/vaccines\/bnt162-sars-cov-2-vaccine\">https:\/\/www.precisionvaccinations.com\/vaccines\/bnt162-sars-cov-2-vaccine<\/a>. Eri\u015fim tarihi: 5 Eyl\u00fcl 2020.&nbsp;<\/li><li><a href=\"https:\/\/www.news-medical.net\/medical\/authors\/tomislav-mestrovic\">Me\u0161trovi\u0107,<\/a> T. (2020). Pfizer\/BioNTech COVID-19 vaccine candidate BNT162b2 profiled for large scale clinical trials. <a href=\"https:\/\/www.news-medical.net\/news\/20200823\/PfizerBioNTech-COVID-19-vaccine-candidate-BNT162b2-profiled-for-large-scale-clinical-trials.aspx\">https:\/\/www.news-medical.net\/news\/20200823\/PfizerBioNTech-COVID-19-vaccine-candidate-BNT162b2-profiled-for-large-scale-clinical-trials.aspx<\/a>. Eri\u015fim tarihi: 6 Eyl\u00fcl 2020.<\/li><li>Daley, J., <em>Scientific American. <\/em>(2020). How to Decide Who Should Get a COVID-19 Vaccine First. <a href=\"https:\/\/www.scientificamerican.com\/article\/how-to-decide-who-should-get-a-covid-19-vaccine-first\/\">https:\/\/www.scientificamerican.com\/article\/how-to-decide-who-should-get-a-covid-19-vaccine-first\/<\/a>. Eri\u015fim tarihi: 5 Eyl\u00fcl 2020.&nbsp;<\/li><li>Weintraub, R., Bitton, A., Rosenberg, M.; <em>Harvard Business Review. <\/em>The Danger of Vaccine Nationalism. <a href=\"https:\/\/hbr.org\/2020\/05\/the-danger-of-vaccine-nationalism\">https:\/\/hbr.org\/2020\/05\/the-danger-of-vaccine-nationalism<\/a>. Eri\u015fim tarihi: 5 Eyl\u00fcl 2020.&nbsp;<\/li><li>D\u00fcnya Sa\u011fl\u0131k \u00d6rg\u00fct\u00fc. (2020). 172 countries and multiple candidate vaccines engaged in COVID-19 vaccine Global Access Facility. <a href=\"https:\/\/www.who.int\/news-room\/detail\/24-08-2020-172-countries-and-multiple-candidate-vaccines-engaged-in-covid-19-vaccine-global-access-facility\">https:\/\/www.who.int\/news-room\/detail\/24-08-2020-172-countries-and-multiple-candidate-vaccines-engaged-in-covid-19-vaccine-global-access-facility<\/a>. Eri\u015fim tarihi: 4 Eyl\u00fcl 2020.<\/li><li>Rauhala, E., Abutaleb, Y.; <em>The Washington Post. <\/em>U.S. says it won\u2019t join WHO-linked effort to develop, distribute coronavirus vaccine. <a href=\"https:\/\/www.washingtonpost.com\/world\/coronavirus-vaccine-trump\/2020\/09\/01\/b44b42be-e965-11ea-bf44-0d31c85838a5_story.html\">https:\/\/www.washingtonpost.com\/world\/coronavirus-vaccine-trump\/2020\/09\/01\/b44b42be-e965-11ea-bf44-0d31c85838a5_story.html<\/a>. Eri\u015fim tarihi: 5 Eyl\u00fcl 2020.&nbsp;<\/li><li>Taylor, A. (2020). Why coronavirus vaccine nationalism is winning. <a href=\"https:\/\/www.washingtonpost.com\/world\/2020\/09\/03\/why-coronavirus-vaccine-nationalism-is-winning\/\">https:\/\/www.washingtonpost.com\/world\/2020\/09\/03\/why-coronavirus-vaccine-nationalism-is-winning\/<\/a>. Eri\u015fim tarihi: 6 Eyl\u00fcl 2020.<\/li><li>Bliss, K. ve Morrison, J.; <em>CSIS<\/em>. (2020). The Risks of Misinformation and Vaccine Hesitancy within the Covid-19 Crisis. <a href=\"https:\/\/www.csis.org\/analysis\/risks-misinformation-and-vaccine-hesitancy-within-covid-19-crisis\">https:\/\/www.csis.org\/analysis\/risks-misinformation-and-vaccine-hesitancy-within-covid-19-crisis<\/a>. Eri\u015fim tarihi: 5 Eyl\u00fcl 2020.&nbsp;&nbsp;<\/li><\/ol>\n","protected":false},"excerpt":{"rendered":"<p>11 Mart 2020 tarihinde (1) D\u00fcnya Sa\u011fl\u0131k \u00d6rg\u00fct\u00fc taraf\u0131ndan \u2018pandemi\u2019 \u015feklinde s\u0131n\u0131fland\u0131r\u0131lan COVID-19 salg\u0131n\u0131, hayat\u0131m\u0131z\u0131n neredeyse her alan\u0131nda bir\u00e7ok s\u0131k\u0131nt\u0131ya<\/p>\n","protected":false},"author":273,"featured_media":7485,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[1],"tags":[157,1072,1061,693,115,810,630,691,692],"acf":[],"views":1226,"_links":{"self":[{"href":"https:\/\/blog.ulubat.org\/index.php\/wp-json\/wp\/v2\/posts\/7484"}],"collection":[{"href":"https:\/\/blog.ulubat.org\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/blog.ulubat.org\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/blog.ulubat.org\/index.php\/wp-json\/wp\/v2\/users\/273"}],"replies":[{"embeddable":true,"href":"https:\/\/blog.ulubat.org\/index.php\/wp-json\/wp\/v2\/comments?post=7484"}],"version-history":[{"count":4,"href":"https:\/\/blog.ulubat.org\/index.php\/wp-json\/wp\/v2\/posts\/7484\/revisions"}],"predecessor-version":[{"id":7575,"href":"https:\/\/blog.ulubat.org\/index.php\/wp-json\/wp\/v2\/posts\/7484\/revisions\/7575"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/blog.ulubat.org\/index.php\/wp-json\/wp\/v2\/media\/7485"}],"wp:attachment":[{"href":"https:\/\/blog.ulubat.org\/index.php\/wp-json\/wp\/v2\/media?parent=7484"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/blog.ulubat.org\/index.php\/wp-json\/wp\/v2\/categories?post=7484"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/blog.ulubat.org\/index.php\/wp-json\/wp\/v2\/tags?post=7484"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}