请双击下面的英文字幕来播放视频。
00:00
Transcriber: Ivana Korom
Reviewer: Krystian Aparta
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翻译人员: Wanting Zhong
校对人员: Yolanda Zhang
00:12
It is hard to overstate
the beneficial effects of immunization.
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免疫接种的益处
再怎么强调也不为过。
00:18
According to the US
Centers for Disease Control,
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根据美国疾病控制与预防中心的数据,
00:22
US children born over the last 20 years --
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过去 20 年内出生的美国小孩——
00:25
for those children, vaccines will prevent
greater than 322 million illnesses,
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对他们来说,疫苗能预防
超过 3.22 亿起病例、
00:31
greater than 21 million hospitalizations
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超过 2100 万例住院,
00:34
and greater than 730,000 deaths,
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以及超过 73 万例死亡,
00:37
with the societal cost savings
of nearly 1.4 trillion dollars.
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并节省近 1 万 4 千亿美元的社会开支。
00:43
Those are big numbers.
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这些都是巨额数字。
00:44
But let's zoom in
and look at a particular example.
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但让我们来具体看看一个实例。
00:47
Vaccines have nearly eliminated
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疫苗已近乎根除了
00:50
a bacterial infection
called Haemophilus influenzae.
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一种叫做流感嗜血杆菌的细菌感染。
00:53
This bacterium
used to infect young infants
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在过去,这种细菌
会感染年幼的婴儿,
00:56
causing bloodstream infections,
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导致血流感染、
00:58
pneumonia, meningitis, death
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肺炎、脑膜炎、死亡
01:01
or permanent disability.
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或者终身残疾。
01:03
As a young pediatrician,
I saw a few cases.
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当我还是一名年轻的儿科医生时,
我曾见过几个案例。
01:07
You folks probably have never
heard of this disease,
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大家可能从未听过这种疾病,
01:10
because vaccines have been so effective.
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因为疫苗的效果非常好。
01:12
You could see in the graph on the right
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从右边的图表里可以看出,
01:14
that since the introduction of vaccines,
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自从引入了疫苗,
01:17
the incidence of Haemophilus
bacterial infections
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流感嗜血杆菌感染的病例
01:19
has plummeted like a rock,
and it's nearly vanished.
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呈断崖式骤降,并已几乎绝迹了。
01:24
So vaccines are generally a success story.
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因此疫苗一般来说非常成功,
01:26
But we also face challenges.
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但我们也面临着挑战。
01:29
For one, for most vaccines,
we need to give multiple doses
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首先,大多数疫苗需要多次接种
01:33
to achieve or maintain protection.
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才能获得或维持免疫。
01:36
The scientific community is working
on developing single-shot vaccines.
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科学界正在努力开发
只需单次接种的疫苗。
01:41
Imagine being able to get only one
influenza shot your whole life
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试想一下,一辈子
只需要打一次流感疫苗,
01:44
and not having to get
a seasonal flu vaccine.
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再也不用去打季节性流感疫苗了。
01:48
Certain microbes
are difficult to immunize against.
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某些微生物导致的感染比较难预防。
01:51
A classic example is human
immunodeficiency virus, or HIV.
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一个经典例子就是人类免疫缺陷病毒,
即艾滋病毒(HIV)。
01:56
The need is urgent,
progress is being made;
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该疾病对疫苗的需求十分紧迫,
在研发方面也有所进展;
01:59
we're not there yet.
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但还没有成功。
02:01
Another critical element
in vaccine research right now
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目前的疫苗研究中,
另一个至关重要的要素
02:05
is optimizing vaccines
for the most vulnerable among us,
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是为易感人群优化疫苗,
02:08
the very young and the elderly.
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也就是婴幼儿和老年人。
02:10
And this is an active area of research.
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这是一个非常活跃的研究领域。
02:13
Finally, one of the biggest challenges
we unfortunately face right now
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然而令人遗憾的是,
我们最终面临的最大挑战之一
02:18
are anti-vax attitudes.
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是反对疫苗的态度。
02:20
In fact, it's alarming that over 100,000
infants and children in the United States
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事实上,非常令人担忧的是,
美国有超过 10 万名婴儿与儿童
02:27
have not received any vaccines,
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从未接种过任何疫苗,
02:29
and that number is growing.
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而这个数字还在增长。
02:31
In fact, the World Health
Organization, or WHO,
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事实上,世界卫生组织(WHO)
02:34
has declared anti-vax attitudes
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已经把反对疫苗的态度
02:37
as one of the 10 most important
threats to human health
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列为了当今世界上
对人类健康最重要的
02:41
in the world today.
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十大威胁之一。
02:43
This graphic illustrates
the spread of anti-vax sentiment
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这张图诠释了 2000 年至 2013 年期间
02:47
in the state of California,
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在加利福尼亚州
02:48
from the year 2000 to 2013,
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扩散的反疫苗情绪,
02:52
by looking at the percentage
of public kindergarten students
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显示的是公共幼儿园学生中
02:55
who claim the personal exemption
against immunization.
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要求个人疫苗豁免的百分比。
03:00
Anti-vax sentiment is on the rise,
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反疫苗情绪正在上升,
03:02
and it has very real consequences.
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这会带来非常现实的后果。
03:05
Many of you may be aware of the fact
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你们很多人可能都知道,
03:07
that we're seeing infections
that we thought we conquered long ago
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一些我们觉得很久以前
就已经消灭的传染病
03:10
coming back.
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又开始死灰复燃了。
03:11
Measles outbreaks have been reported
in multiple US states.
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美国多个州都报道
出现了麻疹疫情。
03:15
And many have forgotten,
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很多人已经遗忘了
这个严酷的事实:
03:16
but measles is very
infectious and dangerous.
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麻疹传染性极强,也很危险。
03:20
Just a few viral particles
can infect an individual.
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仅仅少量病毒颗粒
就能感染一个人。
03:24
And there have been even reports
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甚至曾有报道称,
03:26
at sporting events
and at an Olympic stadium
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在体育比赛现场、
在奥运会场馆内,
03:29
where the virus, through the air,
travels long distances
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麻疹病毒在空气中
传播了很远的距离,
03:31
and infects a vulnerable
person in the crowd.
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并感染了人群中
一位易感人员。
03:35
In fact, if I had
a measles cough right now,
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事实上,如果我的咳嗽中
带有麻疹病毒,
03:37
(Coughs)
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(咳嗽)
03:38
somebody in the back
of this auditorium could get infected.
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这个演讲厅后排的某个人
就可能会被传染。
03:43
And this has had
very real-world consequences.
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这一现象有着非常现实的后果。
03:47
Just a few months ago,
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仅仅几个月前,
03:48
an airline stewardess
contracted measles on a flight,
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一位空姐在航班上感染了麻疹,
03:52
the virus entered her brain
and caused encephalitis,
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病毒进入了她的脑部,
引起了脑炎,
03:55
and she died.
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导致她不幸去世。
03:56
So people are now dying
due to this anti-vax sentiment.
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现在人们正因为
这种反疫苗情绪而丧命。
04:01
I do want to take a few minutes
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我想花几分钟时间,
04:02
to address those
who don't believe in vaccines
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跟那些不相信疫苗、
抵制疫苗的人
04:05
and who resist vaccines.
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说几句话。
04:08
As a pediatrician who receives
my yearly flu vaccination,
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作为一名每年都接种
流感疫苗的儿科医生,
04:13
as a parent of three children
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作为根据推荐时间表
04:15
who have been vaccinated according
to the recommended schedule,
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接种疫苗的三个孩子的家长,
04:19
and as a pediatric infectious
disease consultant
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作为一名照顾过脑膜炎患儿的
04:22
who has taken care
of young children with meningitis
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儿科传染病顾问——
04:25
that would have been preventable
had their parents accepted immunization,
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要是家长愿意为孩子接种疫苗,
他们完全可以不受病痛之苦——
04:29
this is a personal matter to me.
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疫苗接种对于我个人
也有着非常重要的意义。
04:31
Let's take a look
at who is going to pay the price
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让我们看看,要是把社会中
疫苗接种的数量往回拨,
04:34
if we start dialing back the amount
of vaccination in our society.
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谁会为此付出代价。
04:38
This graph depicts, on the Y axis,
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这张图的纵轴显示的
04:41
the number of individuals
dying of infection in the world.
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是世界上因感染而死亡的人数。
04:44
And on the X axis,
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横轴则代表了
04:46
the age of the individuals who are dying.
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死者的年龄。
04:48
And as you can see,
it's very much a U-shaped distribution,
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可以看出,这是一个
明显的“U”型分布,
04:52
and it's particularly stark
in the very young ages.
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在婴幼儿年龄段,
感染风险非常高,
04:55
So vaccines shield
the very young from infection.
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而疫苗能保护婴幼儿免受感染。
05:00
And if we want to talk, my friends,
about what vaccines cause,
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各位,如果我们想谈谈
疫苗会导致的后果,
05:03
because there's a lot of speculation,
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因为有很多谣言——
05:05
unfounded speculation on the internet,
of what vaccines cause,
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网上对疫苗导致的后果
有很多毫无根据的流言——
05:09
vaccines cause adults, OK?
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疫苗只会“导致”你长大成人,好吧?
05:12
That's what they cause.
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这就是疫苗的后果。
05:13
And the other thing that they cause
is for elderly individuals to live longer.
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疫苗还能“导致”另一个后果,
那就是让老年人活得更长久。
05:18
Because they are shielded
against influenza
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因为它们能防护老年人
免受流感之恙,
05:21
and other killers of the elderly.
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还有其他对老年人来说
非常致命的疾病。
05:24
Now, let's talk a little bit
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那么,让我们再讲讲
05:25
about how we can improve
vaccines even further.
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如何进一步改良疫苗。
05:28
We can create vaccines that can immunize
the most vulnerable among us
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我们能研发出为最脆弱的人群
提供免疫保护的疫苗,
05:32
and perhaps even vaccines
that protect with single shots.
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或许甚至还能研发出
只需单次注射就能提供防护的疫苗。
05:36
Let me go over a little bit
of the immunology.
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让我简单介绍一下免疫学的原理。
05:38
In the top panel, what you see
is a simple vaccine.
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上面的图展示的
是一种简单的疫苗。
05:42
All vaccines contain
something called an antigen.
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所有疫苗都含有
一种叫做“抗原”的东西。
05:45
The antigen is like a piece
of a germ, of a microbe,
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抗原就像是一小块细菌,
一小块微生物,
05:48
that your body remembers, right?
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能让你的身体记住它。
05:50
It forms antibodies
and those antibodies can protect you.
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你的身体会产生抗体,
而这些抗体能保护你。
05:53
So those kind of vaccines
can induce an immune response,
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这种疫苗能引起免疫反应。
05:57
but as you see here,
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但像这里显示的这样,
05:58
that immune response
tends to go up and back down,
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免疫反应一般会先上升,随后回跌,
06:01
and you need to get another dose
and another dose
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于是你需要再接种一针又一针,
06:04
to maintain protection.
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才能获得免疫保护。
06:06
What can we do?
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我们能做些什么呢?
06:07
We and other scientists around the world
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我们和世界各地的科学家
06:10
are finding molecules
that can boost a vaccine response.
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都在寻找能增强疫苗反应的分子。
06:13
Those are called adjuvants,
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它们叫做 “佐剂(adjuvant)”,
06:15
from the Latin "adjuvare," to help or aid.
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来源于拉丁语的 “adjuvare”,
意为 “帮助”,或 “协助”。
06:18
Adjuvants are molecules
we might add to a vaccine
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我们能把佐剂这种分子
添加到疫苗中,
06:21
to get a stronger response.
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以增强免疫应答。
06:23
And in the presence of the adjuvant,
depicted here in red,
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在有佐剂,也就是图中的
红色星星的情况下,
06:26
you have a much more profound
activation of the white blood cells
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你的免疫系统中的白细胞
06:29
of your immune system,
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会被更强烈地激活,
06:31
and generate a much more
profound immune response,
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产生更加强烈的免疫反应,
06:33
with much higher antibody
levels, more rapidly,
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更快地产生更高的抗体浓度,
06:36
and that lasts a long time
for durable immunity.
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并会持续更长时间,
提供持久的免疫保护。
06:40
Interestingly, these adjuvants
have different effects
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有趣的是,这些佐剂
会根据个体的年龄
06:43
depending on the age or other demographic
factors of the individual.
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或者其他人口学因素
产生不同的效果。
06:47
Which brings me to the notion
of precision vaccines.
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这也就引出了“精准疫苗”的概念。
06:51
This is the idea that we will take
precision medicine --
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这个概念是说,
我们能将精准医学——
06:55
you know what precision
medicine is, right,
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各位知道什么是精准医学吧,
06:57
that's the idea that populations may vary
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就是指不同人群对某一特定药物
06:59
in their response
to a particular medicine --
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会产生不同反应——
07:02
and apply that to vaccines.
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并将其应用到疫苗上。
07:04
Right?
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对吧?
07:05
And here in Boston Children's Hospital
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在波士顿儿童医院这里,
07:08
at the Precision Vaccines
Program I direct,
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在我负责的精准疫苗项目中,
07:10
we have five approaches,
stepwise approaches we take,
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我们会通过五种逐步式的方法
07:14
to build precision vaccines
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为易感人群定制
07:15
that are tailored
to vulnerable populations.
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精准疫苗。
07:18
Number one,
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第一,
07:19
we need to understand
what the attitude of a given population is
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我们需要理解某个特定群体
07:22
towards a vaccine.
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对待疫苗的态度。
07:24
You could build the most
sophisticated vaccine in the world,
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你可以制作出世界上
最精良的疫苗,
07:26
but if nobody wants to take it,
you're going nowhere.
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但假如没有人愿意接种,
那还是徒劳。
07:29
Number two,
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第二,
07:30
we have to think
of the route of immunization.
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我们必须考虑
免疫接种的途径。
07:33
Most vaccines are intramuscular, or IM,
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大多数疫苗都是
通过肌肉注射接种的,
07:36
but there are others,
intranasal, oral and others.
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不过也有鼻内、口服等其它途径。
07:40
Then, as I just described to you,
vaccines have components.
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另外,就像我刚刚描述的那样,
疫苗有不同的组成成分。
07:43
All vaccines have an antigen,
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所有疫苗都含有抗原,
07:45
that's the part of the microbe
that your body remembers,
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也就是你的身体所记住的
微生物的一部分,
07:48
that you might make antibodies
or cell-mediated immunity against.
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你能对它产生抗体
或者细胞介导免疫反应。
07:52
And we might add an adjuvant,
as we talked about,
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此外,我还提到过,
我们可以添加佐剂,
07:54
to boost an immune response.
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以增强免疫反应。
07:55
But guess what?
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猜猜看怎么着?
07:57
There are many different
antigens to choose from
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我们可以从很多不同抗原
和很多不同佐剂中进行选择。
07:59
and many different adjuvants.
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08:00
How are we going to make that decision?
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我们该如何做出决定呢?
08:02
And the menu of these keeps growing.
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而这些成分的种类
还在不断增长。
08:04
So on our team,
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于是我们的团队
08:06
we've developed ways
to test vaccines outside the body --
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开发了在组织培养皿中,
即在体外测试疫苗的方法——
08:09
in Latin, that's "in vitro" --
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08:11
in a tissue culture dish.
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拉丁文叫做 “in vitro”。
08:12
So we use tissue engineering
with blood cells
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我们对血细胞进行组织工程学处理,
08:16
to immunize outside the body
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在体外接种疫苗,
08:18
and study the effect of the vaccine
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并研究疫苗对婴儿、
08:20
against, for example, infants
or elderly individuals or others.
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老年人或其他人群的效果。
08:25
And if you think about it,
this is critical,
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仔细想想就会发现
这一步至关重要,
08:27
because if you look at all the infections
we want to build vaccines against,
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因为如果考虑到我们想要
通过疫苗预防的所有传染病,
08:31
like Zika virus and Ebola virus
and HIV and others,
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比如寨卡病毒、埃博拉病毒、
艾滋病毒等等,
08:35
all the candidate antigens,
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所有待选病原体、
08:37
all the candidate adjuvants,
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所有待选佐剂、
08:39
all the different populations,
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所有不同人群,
08:41
it's going to be impossible to do
large, phase III clinical trials
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我们不可能对每一种组合都进行
08:44
for every combination.
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大型 Ⅲ 期临床试验。
08:46
This is where we think being able
to test vaccines outside the body
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因此我们认为,
在体外测试疫苗
08:50
can make a big difference
to accelerate vaccine development.
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能够大大加速疫苗的研发。
08:54
And finally, this whole effort
is to drive an immune response
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最后,所有这些努力
都是为了激活免疫反应,
08:57
that will protect against
that particular pathogen,
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针对某种特定病原体构筑防线,
09:00
getting antibodies and other cells
to defend the body.
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让抗体和其它细胞
为身体进行防御。
09:05
We are also using additional
innovative approaches
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我们还在使用其它创新的方法,
09:07
to bring the most cutting-edge science
to vaccine development.
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将最前沿的科技
引入疫苗研发中。
09:11
We're taking a deeper dive
as to how current vaccines protect.
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我们还在深入研究
目前的疫苗究竟如何提供防护。
09:15
We've formed an international consortium
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我们形成了一个国际联合会,
09:17
to study how hepatitis B vaccine
protects newborns
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研究乙肝疫苗如何保护新生儿
09:21
from hepatitis B infection.
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免遭乙肝病毒感染。
09:23
And to do this,
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为了实现这一目标,
09:24
we've developed a technique
called small sample, big data.
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我们开发了一项称为
“小样本,大数据”的技术。
09:28
We can get a tiny little drop
of baby blood before immunization,
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我们可以在接种疫苗之前以及之后
09:32
and take a tiny little drop
after immunization,
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各采集一小滴婴儿的血液样本,
09:35
and we can measure the inventory
of all the cells,
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然后我们就能测量那一小滴血里
09:38
and all the genes and all the molecules
in that drop of blood,
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所有的细胞、基因和分子,
09:41
and we can compare after the vaccine
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于是我们就能比较同一个婴儿
09:43
to before the vaccine in that same baby
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接种疫苗前后的数据,
09:46
and understand in a deep way
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从更深的层面理解
09:48
exactly how that successful
vaccine protects.
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那个成功的疫苗
究竟是如何提供保护的。
09:51
And those lessons we can use
to build the next vaccines in the future.
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然后我们就能将这些知识
应用到未来的疫苗研发中去。
09:56
So this diagram is really illustrating
a tiny drop of blood
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这张图展示了一小滴血
09:59
yielding huge amounts of information,
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蕴含了海量信息,
10:02
tens of thousands of analytes,
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成千上万种分析物,
10:04
and that hairball is meant to depict
the gene pathways that are turned on
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那边的“线团”描述的是
被启动的基因回路
10:08
and the molecular pathways
that are turned on.
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和被激活的分子通路。
10:11
So much more to come on that,
and very exciting science.
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这是一项十分激动人心的科学,
我们将迎来很多重大进展。
10:14
So we are partnering
with scientists around the world
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目前,我们在和
世界各地的科学家合作,
10:17
to bring all these new technologies
to invigorate vaccine development
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通过一个“精准疫苗网络”
来汇聚这些新科技
以推动疫苗研发。
10:21
in a Precision Vaccines network.
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10:23
We are going to advance
personalized vaccines
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我们将为了世界各地的易感人群
10:26
for vulnerable populations
around the world.
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推进个性化疫苗研究。
10:29
Our team includes scientists,
technical experts and physicians.
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我们的团队成员有科学家、
技术专家和医师。
10:33
And we're developing vaccines
against infectious diseases
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我们还在为百日咳
10:36
like pertussis, which is whooping cough.
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这样的传染病研发疫苗。
10:39
We have a whooping cough vaccine,
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我们已经有了百日咳疫苗,
10:41
but it requires multiple doses,
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但目前还需要多次接种,
10:43
and the immunity keeps dropping.
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而且免疫效果会持续下降。
10:44
We want to develop a single-shot
pertussis vaccine.
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我们想要研制一种只需
单次接种的百日咳疫苗。
10:47
We're working on a vaccine
for respiratory syncytial virus,
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我们也在研发一种预防
呼吸道合胞病毒的疫苗,
10:50
the number one cause of infant
hospitalization in the United States.
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在美国,这是导致
婴儿住院的头号原因。
10:54
A better vaccine against influenza,
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我们还在开发更好的流感疫苗,
10:56
and, of course, HIV.
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当然还有艾滋病疫苗。
10:59
We're also looking at vaccines
against cancer, allergy
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同时,我们也在研究
针对癌症和过敏的疫苗,
11:03
and, interestingly, opioid overdose.
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还有一个有意思的,
预防阿片类药物摄入过量的疫苗。
11:07
So, this is my final message to you.
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那么,最后我想对大家说:
11:11
Vaccines protect you and your loved ones
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疫苗能保护你、你心爱的人,
11:14
and the people around you.
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还有你身边的人们。
11:15
Not only do they protect you
against infection,
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它们不仅能保护你免受感染,
11:17
they prevent you
from spreading it to others.
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还能防止你把疾病传播给别人。
11:20
Get immunized.
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去接种疫苗吧。
11:21
Scientific progress is fragile
and can be lost.
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科学进步是脆弱的,
随时可能会遗失。
11:25
We must foster accurate
and respectful public dialogue.
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我们必须培养准确的、
互相尊重的公共对话。
11:29
And finally, we're on the verge
of great things,
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最后我要说的是,
我们正在迈入伟大的
11:31
a new era of vaccination.
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疫苗新时代,
11:33
We've just scratched the surface
of what can be accomplished.
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而目前还仅仅触及了冰山一角。
11:36
Please advocate for this research.
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请各位鼎力支持这类研究。
11:38
Thank you.
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谢谢。
11:40
(Applause)
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(掌声)
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