Latest vaccination guidelines for children and adolescents

First, the polio vaccination procedure has been adjusted from "1 dose of inactivated + 3 doses of oral attenuated virus" to "2 doses of inactivated + 2 doses of oral attenuated virus" to further reduce the risk of vaccination in children with immune abnormalities.； Second, the coverage age for catch-up vaccination of measles, mumps and rubella vaccine has been relaxed from 14 to 18 years old. Teenagers who have missed the vaccination can go to community vaccination points to catch up for free. ； Third, for the first time, the public health priorities of non-immunization program vaccines for people aged 3-17 years are clarified. From high to low priority, they are influenza vaccine, pneumococcal vaccine, HPV vaccine, and chickenpox vaccine.

I recently helped with vaccination education at a community health service center. The most asked question from parents in the past half month was the adjustment of polio procedures. In the old procedure, the first dose was inactivated, and the next three doses were oral live attenuated vaccines. A very small number of children with congenital immune deficiencies may have cases of vaccine-related paralysis. Now the first two doses are replaced with inactivated vaccines, which is equivalent to reducing this extremely low risk to an almost negligible level. It is too friendly for children with allergies and weak immunity. However, many parents have asked if half of the vaccinations according to the old procedure need to be re-vaccinated. The official has already made it clear that those who have completed the full course of vaccination do not need to re-vacculate. Those who have not completed the vaccination can continue according to the new procedure and do not need to start all over again.

The question of whether to take non-immunization scheduled vaccines has been a controversial topic among parents for several years. One group believes that "free vaccines are necessary vaccines recognized by the state, and those that charge are to earn IQ taxes." The other group wishes that all available vaccines should be provided to children. In fact, the priority given in this guide has been made very clear: it is not that other non-immunization program vaccines are useless, but from the perspective of public health cost and severe disease protection effect, the top ones are the most cost-effective. Take the flu vaccine as an example. Of the 12 children with severe influenza admitted to our pediatric clinic last winter, 10 did not receive the flu vaccine for that year. There was also a 6-year-old boy who had a fever and convulsions and was hospitalized for a week. Parents always thought that "the flu is just a bad cold, and you can get it if you get it, and it is a waste of money." However, even if you are still infected after vaccination, the risk of severe illness can be reduced by 90%, and the duration of fever can be shortened by at least two or three days, so the child will suffer less.

The HPV vaccine is even more controversial. Last week, I met a grandma who stopped her 10-year-old granddaughter from getting vaccinated. She said that there was a rumor in the community that "vaccinating with this vaccine will affect future fertility." She read the official guidelines and the WHO's public statement and was still dubious. It wasn't until I went back to ask a distant relative who is a pediatrician that she took her granddaughter to get the first two-price shot this week. There are indeed two voices: one group believes that the golden period for vaccination is between the ages of 9 and 14. The level of antibodies in this age group is twice that of those after 18 years old. It is most important to protect the most important high-risk subtypes with the second price first. There is no need to wait for the ninth price. ； The other group feels that the nine-price system covers many subtypes, and would rather wait a few more years before adopting the nine-price system. In fact, there is no absolute right or wrong, but from the perspective of medical advice, it is best not to wait until the age of 15 to get the 9th price. If you really want to get the 9th price, you can take the 2nd price first. You can also make up for it later if conditions permit.

Many parents always use "the child has been feeling a little unwell recently" as a reason to postpone vaccination. In fact, many taboos are outdated and old concepts. For example, if you only have a runny nose, a slight cough, no fever, and your mental state is normal, you can be vaccinated normally. ； There is also the previous rumor that "you cannot get the flu vaccine if you are allergic to eggs." Today's flu vaccines are made by cracking chicken embryos. The egg protein content is so low that it is negligible. There is no need to do an allergy test in advance. Children with egg allergies can also get the vaccine. Last week, the little boy who suffered from flu convulsions was slightly allergic to eggs. He had been struggling for three years not to take the flu vaccine. This time, he had no reaction at all. Mom patted her thigh and said she wouldn't have delayed it if she had known better.

If a child has underlying diseases such as asthma, epilepsy, or congenital immune deficiency, there is no need to give up vaccination directly. He or she can first seek an evaluation from a doctor at the vaccination clinic. For example, children with a history of febrile convulsions can be vaccinated against meningococcal meningitis and Japanese encephalitis normally as long as they have not had a seizure for more than six months and have no other neurological abnormalities. Of course, different doctors may have different judgments. Some doctors may be more conservative and suggest a few more months of observation. If you are unsure, just ask two more doctors from regular hospitals. Don’t get stuck on one person’s opinion for a long time.

Having worked as a child prevention educator for almost five years, my biggest feeling is that there is never an absolute standard answer when it comes to vaccines. You don’t have to listen to others who say, “It’s the vaccine’s fault if a child gets a fever after taking a certain vaccine.” You don’t have to blindly follow others’ vaccinations based on self-paid vaccines. Check more official information from the National Administration of Disease Control and Prevention, and ask regular medical staff if you have questions. This is much more reliable than the various rumors you hear in community groups or short videos. After all, children's health always depends on facts.