Interpretation of vaccination guidelines for children and adolescents

There is no "perfect vaccination schedule" for everyone. It is enough to follow three core principles - give priority to vaccinations in the immunization plan (free) in the prescribed time sequence, match non-immunization plan (self-paid) vaccines on demand, and conduct professional vaccination assessment first for special health conditions. There is no need to follow the strategies of Internet celebrities, and there is no need to be overly anxious about adverse reactions.

Maybe many parents are still confused when they first read this sentence. After all, there are all kinds of vaccination strategies on the Internet. Sometimes they say "these 5 self-paid vaccines must be vaccinated", and sometimes they say "too many vaccinations for children will damage their immunity." I have been doing vaccination consulting in community disease control for 7 years, and I have encountered many cases of fraud. Let's explain each of them clearly.

Let’s first talk about the most familiar free vaccine, which is the mandatory immunization program vaccine required by the country. In fact, there is no controversy in the entire academic community. All vaccination times and doses have been verified by decades of large-scale population data, and the protection is set for the most susceptible age groups of children. Last week, I met a mother who used a parenting blogger’s guide and asked if she could delay the BCG vaccine until she is half a year old. She said she was worried that the injection would be too painful for her newborn baby. In fact, it was completely unnecessary. The BCG vaccine targets severe tuberculosis, which is highly prevalent in infants and young children. The protection is provided by vaccination within 24 hours of birth. The rate is the highest. Monitoring data from the Chinese Center for Disease Control and Prevention in 2023 shows that children who complete the immunization program vaccinations in the prescribed time sequence have a 62% lower risk of infectious disease infection than those who delay vaccination. Therefore, don’t put off free vaccines, and go as early as possible as scheduled.

The most controversial thing is actually the self-funded non-immunization program vaccines. Now the academic circle is basically divided into two schools of thought: One group is experts in the field of public health. It is generally recommended that as long as the family's finances allow, priority should be given to all the cost-effective vaccines such as 13-valent pneumonia, pentavirus, hand, foot and mouth, rotavirus, influenza, and chickenpox. After all, if a child is hospitalized for severe pneumonia, it will cost at least 5,000 to 6,000 yuan, and there may be sequelae. However, all these types of vaccines only cost more than 2,000 yuan, and the input-output ratio is very high.； The other group is that of pediatric clinical doctors, whose views are more individualized. For example, children with allergies, frequent eczema relapses, or children with low immunity who have recently suffered from acute diseases do not need to rush to get all the self-funded vaccines at the age of 1 month. They can appropriately stagger the peak, such as 1-2 weeks apart from free vaccines, to avoid the risk of superimposed adverse reactions. Last year, I met a parent who made appointments for three self-funded vaccinations for influenza, hand, foot and mouth, and chickenpox on the same day for his 5-year-old child. That night, the child had a fever of 39.7°C. Although it was a normal vaccine reaction and did not require special treatment, the adult stayed up for two nights and the child also suffered. In fact, the vaccinations can be taken separately. There is no need to rush for that time. Here is a truth that many institutions will not say: self-funded vaccines are definitely better than free ones. For example, the Japanese encephalitis vaccine. The free live attenuated vaccine only requires 2 doses, and the protection rate can reach more than 90%. It is not much different from the self-funded inactivated vaccine. However, children with immune deficiencies and congenitally low immunity are more suitable to choose inactivated vaccines. Don’t be fooled into spending money randomly.

What many parents struggle with most is the question of "can I vaccinate my child if he or she is feeling unwell?" Domestic and foreign guidelines do differ in this regard: Guidelines from European and American countries generally believe that as long as the child does not have a fever and is in a normal mental state, even if the child has a clear nose or mild eczema, the child can be vaccinated normally.； Domestic previous requirements were conservative, and it was generally recommended to slow down. However, the latest "Vaccination Guidelines for Children and Adolescents" released in 2024 has adjusted the relevant requirements. Common colds, physiological diarrhea, mild eczema, and newborns after jaundice subsides will not affect normal vaccination. There is no need to wait for all symptoms to disappear, but it will increase the risk of children being exposed to the virus. Last week, a grandma brought her grandson to get the leprosy vaccine. She said that her child had a runny nose for two days, and she delayed coming for half a month. As a result, she happened to come into contact with a child who had measles in the community. Fortunately, she was not infected, otherwise the gain would not be worth the loss. The most frequently asked question is "Can I get the flu vaccine if I'm allergic to eggs?" The latest guidelines have made it clear that everyone can get the flu vaccine normally, regardless of whether they have a mild egg allergy or a history of severe anaphylactic shock. The egg protein content of the current flu vaccine is so low that it can be ignored. However, children with severe allergies must be kept under observation for 30 minutes after vaccination. Don't rush home after the vaccination.

After doing vaccination consultation for so many years, my biggest feeling is that many parents’ anxiety is actually unnecessary: ​​either they have to get all the vaccines, and they squeeze in the dates, for fear that if they miss one type of vaccine, their children will get sick.； Or they don’t dare to take any vaccine, for fear of adverse reactions and affecting the child’s immunity. You must know that the vaccine has gone through tens of thousands of clinical trials before it is put on the market. The incidence of serious adverse reactions is less than one in a million, which is lower than the probability of being hit by a falling object when you go shopping with your child. Most of the adverse reactions are low-grade fever and redness and swelling at the vaccination site, which will disappear on their own in two or three days. There is really no need to worry too much.

Oh, by the way, if your child has special health conditions, such as congenital diseases, immune deficiencies, or has had serious adverse reactions to previous vaccinations, and you are not sure whether he can be vaccinated, just take your child's medical records and physical examination report to the community vaccination clinic to find a doctor for an evaluation. It takes 10 minutes, which is much more useful than reading 100 Internet celebrity tips.