Contraindications of the latest version of vaccination guide

Persons who are allergic to the active ingredients, inactive ingredients, and substances used in the production process of vaccines, or who have experienced severe allergies after receiving similar vaccines in the past; patients with uncontrolled severe neurological diseases (such as transverse myelitis, Guillain-Barré syndrome, demyelinating diseases, etc.); patients with severe chronic diseases who are having fever, acute illness, or acute exacerbation of chronic diseases; and pregnant women. Most of the remaining so-called "taboos" are vaccination deferrals or precautions that need to be assessed based on individual circumstances. There are no general requirements such as "10 categories of people must not be vaccinated" spread online.

When I was helping with popular science education at a community vaccination site a while ago, I encountered a lot of weird misunderstandings. The one who impressed me the most was a mother who brought her 3-year-old child who was mildly allergic to eggs to get a flu vaccine. She went to two vaccination sites before but was persuaded by volunteers at the door to go back, saying that she could not get vaccinated because of egg allergies, which made her cry. In fact, the ovalbumin content of the influenza vaccine currently on the market has been reduced to the ng level. As long as she does not suffer from severe allergic reactions such as laryngeal edema and anaphylactic shock after eating eggs, she can be vaccinated normally. The baby was observed by us for half an hour after the injection, and then left jumping away. Of course, we have to be fair here. Many grassroots vaccination sites are strictly stuck, not intentionally to cause trouble. After all, once a coincidental reaction occurs after vaccination, it is very troublesome to determine responsibility. For the sake of safety, requiring everyone to go to a general hospital to get an allergy assessment certificate is also a helpless move at the practical level. It is impossible to say who is right and who is wrong. If you encounter this kind of situation, ask more questions and don't make an argument.

In addition to the most common misunderstandings about allergies, vaccination questions from chronic disease groups also account for more than half of my daily consultations. Last month I met a 72-year-old man. His high blood pressure has been under stable control for more than ten years. But because of a post on the Internet that said "You can't get vaccinated for high blood pressure," he delayed getting a flu shot for half a year. During the flu pandemic last winter, he got pneumonia and was hospitalized for a week. The money he spent was enough to get flu shots for more than ten years. Now the guidelines clearly state that as long as the chronic disease is under stable control, such as hypertension stabilizing below 160/100mmHg after taking medication, diabetes fasting blood sugar stabilizing below 13.9mmol/L, and no other acute symptoms, normal vaccination can be performed. Of course, if you have recently taken antihypertensive medication and your blood sugar has been very high for two or three days in a row, it is not too late to wait for ten and a half months until the indicator stabilizes before taking the test. There is no need to fight for one or two days.

There is another category that people ask a lot, which is questions related to the nervous system. Last week, a girl in her 20s came over and asked if she could get the HPV vaccine after suffering from epilepsy as a child and not having a seizure in 10 years. She said that she had been rejected at other vaccination sites before. In fact, the only contraindications in the guidelines are "uncontrolled severe neurological diseases." Patients with epilepsy who have not had seizures for many years and are well-controlled can definitely be vaccinated. However, many vaccination sites are afraid of taking responsibility and will require you to provide a neurology evaluation certificate. In this case, just ask your attending doctor to issue a certificate of stable condition in advance to save you a wasted trip. A different professional opinion should be mentioned here: some neurologists do recommend that people with a history of neurological diseases be cautious about vaccination. Essentially, the risk considerations of the two parties are different. There is no absolute right or wrong. If you are really not sure, just ask two more doctors and weigh the pros and cons yourself.

Oh, by the way, there is another question that people often ask, which is the question of vaccination during pregnancy. It is now clear that the HPV vaccine cannot be given during pregnancy. If you find out you are pregnant after taking one shot, you can just give the remaining shots after the lactation period. There is no need to terminate the pregnancy because of the HPV vaccine. As for inactivated vaccines such as influenza and COVID-19, the guidelines say that you can get them if you have a high risk of exposure during pregnancy. However, many obstetricians and gynecologists will recommend avoiding them in the first trimester and making a decision based on your own situation in the second and third trimesters. At this time, just listen to your prenatal doctor and don’t worry about who is right online.

The rest of the taboos spread on the Internet, such as not taking vaccinations to prepare for pregnancy, not taking vaccinations after drinking alcohol, and not taking antibiotics after taking antibiotics, are basically rumors. Regardless of whether you are a man or a woman, there is no need to postpone your pregnancy preparation plan if you take any vaccine. Drinking one or two beers the day before is not uncomfortable at all and will not affect the vaccination at all. You can also take antibiotics as normal as long as you have no fever or acute infection symptoms. There is really no need to be overly nervous.

To be honest, the contraindications for vaccines are much looser now than they were ten years ago. After all, the safety of various vaccines has been verified in the real world with tens of billions of doses. Most of the so-called "cannot be used" are the result of excessive caution. If you are really not sure whether you can get vaccinated, go directly to the community vaccination center and ask. It will be more effective than reading ten outdated popular sciences online. When you go, remember to tell the truth about your medical history and the medicines you are taking. There is no need to hide or exaggerate. The doctor will give you the most appropriate advice.