Lecture on vaccination guidelines for children and adolescents

As long as there are no clear contraindications to vaccination, all Class I vaccines in the national immunization program must be vaccinated according to the procedure. If you miss it, you must make up for it quickly, otherwise you will not even be able to pass the enrollment verification.； There are no mandatory requirements for the second-category vaccines in non-immunization programs. Just choose one based on your family’s financial situation, your child’s physical condition, and the daily environmental risks. All vaccination decisions will always follow the priority of “child’s individual health status > official guidelines > online rumors.” Don’t be swayed by the endless noise on the Internet.

Some people may think that this is too general. When it comes to choosing vaccines at the vaccination clinic, they still feel confused? I was on duty at a community vaccination site last week, and I met a mother holding her cell phone and talking to the nurse, saying that she had seen a video online saying that the live attenuated vaccine was unsafe, and that she had to replace the scheduled attenuated Japanese encephalitis vaccine with the inactivated vaccine at her own expense. She said that her neighbor's baby had an attenuated vaccine last month and had a fever for two days, and she was afraid that her own baby would suffer too.

In fact, there is no absolutely unified standard answer in the industry regarding how to choose between attenuated and inactivated vaccines. The mainstream recommendation of the disease control system is that children in good health should give priority to live attenuated vaccines. The induced immune response lasts longer and the overall protection rate is slightly higher. It is also a Category 1 vaccine that is free and has a good price/performance ratio. ； However, many doctors in pediatric clinics will recommend that children with allergies, recent use of immunosuppressants, or innate immunity defects choose inactivated vaccines, which have low activity and a lower probability of adverse reactions. Both views are valid. No one is right or wrong. The key point is to first find out the physical condition of your own child, rather than relying on words and phrases on the Internet as a standard.

Speaking of adverse reactions, this should be the most anxious point for all parents. My own niece received the quadrivalent influenza vaccine last year and her fever reached 38.7°C that night. My sister called me crying in the middle of the night, wondering if the vaccine was damaged. As a result, she put an anti-pyretic patch on her and gave her more water. The next morning she was bouncing around and wanted to eat strawberries. In fact, the current incidence rate of serious abnormal reactions to children's vaccines in China is only about three per million, which is lower than the probability of being hit by a falling ornament when you take your child to the mall to play. Most of them are transient reactions such as localized redness and swelling, low-grade fever, and slight fatigue, which will subside on their own in a day or two. There is really no need to not vaccinate the child because of fear of reactions. The risk of contracting the corresponding infectious disease is much greater than the adverse reactions of the vaccine.

Oh, by the way, parents are also particularly concerned about whether allergies can be vaccinated. The old version of the vaccination guidelines did require that children with egg allergies not get the flu vaccine, and those with milk protein allergies should not get the measles vaccine. However, the updated national guidelines after 2020 have removed these taboos, and they can get them as long as they are not in the acute stage of allergy. However, I would like to remind everyone that in order to avoid risks, many staff at grassroots vaccination sites will still stick to the old regulations. In this case, don’t argue with others. Either bring your child’s previous allergen report to the special vaccination clinic of the higher-level hospital for evaluation, or follow the requirements of the vaccination site to postpone or change the vaccine. There is no need to conflict over this matter, and everyone will act in accordance with the rules and regulations.

Let’s talk about how to choose the second type of seedlings that everyone asks the most. My own advice to relatives and friends is never to make a list and ask them to buy everything. After all, no one’s money comes from the strong wind, and buying them all is indeed a lot of money. Generally speaking, I would recommend that if financial conditions permit, give priority to the hand, foot and mouth vaccine, HPV vaccine, 13-valent pneumococcal vaccine, and influenza vaccine. The remaining chickenpox, whorls, and herpes zoster depend on the situation. For example, if your child goes to the indoor playground every day and crawls around with a bunch of children, then it is best to get chickenpox and whorls. If he usually stays at home and rarely goes to crowded and closed places, you can consider it again. Oh, yes, don’t think that the HPV vaccine is only for girls. Getting the HPV vaccine for boys can not only prevent genital warts and laryngeal papillomas, but also reduce the risk of infection in future partners. Now the industry is actively promoting vaccination for boys, but many parents are not aware of it yet.

Finally, let me tell you two pitfalls that are easy to step into. They are the most common problems I encounter every day. Don't believe in the saying that "vaccination is wasted if the vaccine is delayed." If your child has a cold, fever, or rash, you can wait for a week to get better before taking the vaccine again. Delaying it for one or two months or even half a year will not affect the final immune effect. Don't force your sick child to vaccinate, as it may easily induce adverse reactions. Also, being asked to stay under observation for 30 minutes after the injection is really not a formality. Last month, I met a child who developed acute urticaria 15 minutes after the MMR injection. Fortunately, he was in the outpatient clinic and was immediately given anti-allergy medicine, which disappeared in a few minutes. If you leave early, it will be too late if something goes wrong on the way.

What I’m talking about today is just a general reference. When it comes time for your child to be vaccinated, you must truthfully tell the vaccination doctor about your child’s past medical history, allergies, whether he has been sick in the past week and what medicine he has taken. This is more useful than watching 100 popular science videos. If you have any questions, you can raise your hands and ask them now.