Interpretation of vaccination guidelines for children and adolescents

There is no absolutely optimal universal vaccination plan. The bottom line is to give priority to vaccinations under the immunization plan (free). Vaccines outside the immunization plan (self-paid) can be selected on demand based on the family's economic conditions, the physical condition of the child, and the prevalence of local diseases. Special groups such as allergies and immune dysfunction require individualized assessment in advance. There is no need to blindly follow the vaccination list of Internet celebrities, and there is no need to forcibly postpone the vaccination time in order to collect "joint vaccines".

Last week, when I was attending a community vaccination clinic, I met a mother who came with a three-page printed guide. As soon as she sat down, she slapped the paper on the table and asked if she could give her baby a vaccination strictly according to the "golden vaccination schedule" online. She said that a day's delay would affect the antibody effect. In fact, this kind of anxiety is quite common. The most common inquiries I receive are "Is the self-funded vaccine a tax on IQ?" and "Will two injections at one time damage the immune system?" Various opinions are spread too much, but the most basic principles are covered up.

Let’s talk about the most familiar free vaccine first. This part is required by the state. Not only because the corresponding diseases have the highest epidemic risk and high fatality rate in severe cases, it is also the basis of public health policy. If you have not completed the vaccination, you will not even be able to pass the review for admission. There is really no need to discount it. I met an old man before who thought "my child won't get sick if he doesn't go out" and deliberately refused to vaccinate against measles. As a result, the neighbor's child downstairs brought the virus back from other places, and his own child had a fever for almost a week, and it was the child who suffered.

When it comes to self-funded vaccines, the controversy is indeed huge. I have seen two extremes. One is that as long as there are self-funded vaccines, all vaccines are given at one's own expense, regardless of whether the child needs it or not. Even niche vaccines with extremely low incidence rates have to be brought from abroad.； The other is that "it's better if it's free, and the hospital makes money for me if I pay for it myself" and doesn't touch it at all. In fact, both of these are a bit biased. When we in the public health department usually give advice to parents, we always say that self-paid seedlings are essentially a supplement to free seedlings. The reason why they are not included in the free list is mostly because of the high cost and the financial inability to cover them all. This does not mean that they are useless. For example, the pentavalent vaccine can combine the original 12 injections of DTP, polio, and Hib vaccines into 4 injections. This saves the child from 8 injections and reduces the risk of adverse reactions after 8 vaccinations. If the economy allows, it is indeed a more worry-free choice. ； However, if your family has a limited budget, the free single-vaccine vaccine will be completely effective. There is no absolute statement that "the self-paid vaccine is better than the free vaccine."

Oh, by the way, there are many children with allergies nowadays. Many parents immediately ask, "Should my child be allergic to milk? Should he not get vaccinated?" In the past, some parents did not even dare to get the flu vaccine because their children were allergic to eggs. In fact, the guidelines have been updated in recent years: except for children with a history of severe acute allergies to the vaccine ingredients themselves, most food Allergy and mild eczema will not affect vaccination. Even children with egg allergy have very low egg protein residues in current influenza vaccines. As long as they have not experienced shock or laryngeal edema due to egg allergy, they can be vaccinated normally. If you are really worried, just wait for 30 minutes and sit for a while. There is really no need to stop eating due to choking.

Regarding adverse reactions after vaccination, opinions on the Internet are even more polarized. Some people say that "fever means that the vaccine has taken effect. The higher the fever, the better the antibodies." Others say that "fever after vaccination means that the immunity is poor. Do not take it in the future." In fact, judging from clinical data, the incidence rate of general adverse reactions such as fever and local redness and swelling after vaccination is between 5% and 10%. It has nothing to do with the strength of the immunity. It is mainly related to the ingredients of the vaccine. For example, the probability of fever for vaccines with adjuvants is slightly higher than that for live attenuated vaccines. Generally, it will subside on its own in 24-48 hours. No special treatment is required. There is no need to take antipyretics in advance, and there is no need to refuse subsequent vaccinations just because you have a fever.

What impressed me the most was a parent I met last year. He believed the saying on the Internet that "too many vaccines at one time will collapse the immune system" and delayed the MMR vaccine that should have been given at 8 months old until 1 and a half years old. As a result, he got mumps just two weeks after the vaccination, and his face was swollen like a small bun. When he came for a follow-up examination, the parent regretted it. In fact, current childhood vaccines have been verified by tens of thousands of clinical trials. Vaccination with two or more vaccines at the same time will not increase the risk of adverse reactions, nor will it make the immune system "unbearable". On the contrary, delaying vaccination will expose children to disease risks for a longer period of time, which is not worth the gain.

In fact, in the final analysis, there is really no need to take a test for vaccination, and there is no need to worry about searching for guides everywhere. Before each vaccination, spend two minutes thinking about whether the child has had a fever, acute rash, or used hormones or immunosuppressants in the past week. Explain the child's allergic history and past medical history clearly to the vaccination doctor in advance. It is much more useful than comparing the timetables of 10 Internet celebrities for half a day. After all, vaccines are for protecting children's health, and the best ones are suitable for your children.