Summary of vaccination guidelines for children and adolescents

Vaccinations for children and adolescents are divided into two categories: "Immunization program vaccines (free and required)" and "non-immunization program vaccines (optional at own expense)". The former is a required item when entering kindergarten. If there are no special contraindications, it must be completed according to the procedures.； The latter gives priority to the five categories of influenza, pneumococcal, HPV, chickenpox, and rotavirus. Special groups such as allergies and immune deficiencies need to consult a pediatrician/immunologist in advance before vaccination. The overall benefits are much higher than the risk of adverse reactions.

Last week I met a mother of her second child at a community vaccination clinic. She was squatting in a corner with a crumpled vaccination book and was sweating anxiously. She said that her eldest daughter had missed a DPT booster shot and was about to go to elementary school, so she was afraid of being stuck in her admission qualifications. In fact, this kind of worry is quite common. Many parents usually don’t pay attention to the vaccination booklet and only panic when it’s time to use it. The vaccination program is determined by the country based on the domestic disease epidemic situation and the characteristics of children's immune development. Generally speaking, as long as there are no contraindications such as severe allergies, immune deficiencies, and acute disease attacks, try to take the vaccine according to the appointment time. Postponing it for a week or two is not a big problem, but delaying it for too long not only brings the risk of infection, but also requires a replacement certificate or revaccination during the verification of admission to kindergarten, which is quite troublesome.

Oh, by the way, regarding the issue of "can children get vaccinated if they have a slight runny nose?", there are indeed two different views in the industry: one is the evidence-based group, which believes that as long as there is no fever and the mental state is normal, mild colds and eczema will not affect vaccination, and there is no need to postpone it.； The other group is the conservative group, which recommends waiting for symptoms to completely subside for 3 days before taking the vaccine to avoid unclear coupling reactions. Parents can actually choose based on their own situation. If there are no infectious diseases circulating around them recently, it doesn't matter if they wait for two days. If it is during the period of high incidence of influenza and hand, foot and mouth, and the child is in good condition, he can definitely get vaccinated.

After getting the required vaccinations, many parents start to wonder whether to pay for the vaccinations at their own expense. Some parents around me even think that the self-paid vaccinations are an "IQ tax" and a project for the hospital to make a profit. It is really unnecessary. Let’s just talk about the data. Surveillance data from the Chinese Center for Disease Control and Prevention in 2023 shows that the influenza-related hospitalization rate for children under 5 years old is three times that of ordinary adults. Influenza vaccination can reduce the risk of severe illness by 60%. One vaccine only costs more than 100 yuan. If a child really gets the flu and is hospitalized once, it will cost thousands of yuan at least, and he will suffer.

When it comes to self-funded vaccines, the controversy surrounding the HPV vaccine cannot be avoided. A father asked me before if he said he was a boy, so he didn’t need to get HPV shots? Mainstream guidelines at home and abroad do recommend that both men and women aged 9 and above can be vaccinated to prevent genital warts, oropharyngeal cancer and other related diseases. However, some experts in the public health field have pointed out that although the domestic supply of HPV vaccine is already sufficient than in previous years, the input-output ratio of giving priority to women's vaccination is higher. Boys can choose if their family conditions permit, and there is no need to worry if they do not take the vaccine for the time being. This is really a matter of abundance and frugality.

One more thing, children with allergies or immune deficiencies should not be taken directly to the vaccination station to try their luck. I met a child who was severely allergic to eggs before. The parents did not dare to give him a flu vaccine for fear of something happening. Later, he went to the immunology department for an evaluation and chose a cell-cultured inactivated flu vaccine. After the vaccination, there was no problem at all. Nowadays, many vaccines have versions for special constitutions. It is much more reliable to ask your child's health care practitioner or immunologist for an evaluation in advance than to make blind guesses on your own.

Don’t deify vaccines either. A parent came to me before and said that his child still got chickenpox despite being vaccinated. Is there something wrong with the vaccine? In fact, the protection rate of the chickenpox vaccine is about 85%, which does not prevent 100% infection. However, even if you get sick after taking the vaccine, the symptoms will be much milder. His child had seven or eight rashes at that time, and the fever subsided after a day. Among the children in the same class who were not vaccinated, the most developed more than 200 rashes, stayed in the hospital for a week, and left scars on their faces. The difference is actually very obvious in comparison. There are also some comments on the Internet that "too many vaccines will destroy children's immunity." Currently, there are research data on millions of samples around the world. There is no evidence that vaccination according to the program will damage the immune system. Of course, there are a few objections, but from the perspective of evidence-based medicine, the benefits of vaccination far outweigh the potential risks.

Oh, by the way, don’t believe those old almanacs about the precautions after vaccination. You can’t take a bath for 24 hours, and you can’t eat eggs and seafood. As long as the vaccination site is not ulcerated, it is perfectly fine to take a shower, and the child can eat non-allergenic foods normally. If you have a low fever after vaccination and are in good spirits, physical cooling will do. If the temperature exceeds 38.5°C, take antipyretics according to the dose. If you develop a large rash, difficulty breathing, or feel listless, don't hesitate to go to the hospital directly.

In fact, to put it bluntly, vaccination is like protecting your child's health. Don't miss out on the must-buy "compulsory traffic insurance" (immunization program vaccines), and choose the cost-effective "commercial insurance" (high-priority self-paid vaccines) as needed. You don't need to follow the trend of others and don't take anything, and don't take any chances. What is best for your child is the best.