What is the first edition of the vaccination guide?

The "First Edition of the Vaccination Guidelines" that everyone asks about every day mostly refers to the "New Coronavirus Vaccination Technical Guidelines (First Edition)" issued by the National Health Commission on December 19, 2020. It is also the first nationally unified normative guidance document on COVID-19 vaccination issued by my country after the outbreak of the COVID-19.

At that time, the first batch of domestic COVID-19 inactivated vaccines had just received conditional marketing qualifications, and various regions were about to start vaccinating high-exposure groups such as cold chain logistics, customs, and medical care. Previously, various regions either referred to vaccine instructions from different manufacturers, or only had temporary local regulations. Inconsistent standards caused many misunderstandings. When I was helping with street disease control, I just happened to catch up with the release of this guideline. The day before, some residents came in with vaccination notices from other places. They said that they had been taking medicine for diabetes for a long time. Why did the foreigners say that they could get local medicine but said no? This made us on the front line very entangled. As soon as the guideline came out, these disputes were straightened out. It was clarified that diabetes can be vaccinated routinely if fasting blood sugar is controlled below 13.9mmol/L, and that men and women preparing for pregnancy do not need to postpone their pregnancy plans due to vaccination, and lactating women can also be vaccinated. These issues were of greatest concern to the public at the time, which was equivalent to giving reassurance to front-line vaccinators and residents.

Of course, if we do not specifically refer to the COVID-19 project, my country also released the first version of the "National Immunization Program Vaccine Childhood Immunization Procedures and Instructions" in 2005, which is a guide for children's vaccination of free vaccines such as hepatitis B and BCG. However, it has been adjusted and updated on a small scale based on new clinical data over the years, and the general public rarely specifically mentions the "first version".

Speaking of which, the first version of the COVID-19 guideline is not perfect. When it was first released, there were many different opinions: some clinicians felt that the vaccination recommendations for people with abnormal immune function such as lupus erythematosus and AIDS were too vague. They only said that "vaccination is recommended after evaluation", and it was not clear whether the dosage of vaccination should be adjusted or whether follow-up should be carried out. To supplement the detection of antibodies, staff at grassroots vaccination sites in remote areas reported that the emergency response requirements for severe allergic reactions in the guide did not have supporting equipment standards, and they did not know how to adapt to local conditions in extreme situations. This feedback was later incorporated into several revised versions after 2021.

Looking back now, this first version of the guideline is more like a crutch to explore the road. After all, there was not much experience in large-scale COVID-19 vaccination in the world at that time, and many terms were determined by stepping on stones and crossing the river. However, the "three checks and seven-on-one verification" vaccination process it established, the basic logic of contraindication determination, and the rigid requirement of observing for 30 minutes after vaccination are still in use to this day, which can be regarded as laying a solid foundation for the subsequent universal vaccination work.