Vaccination Guidelines for Children and Adolescents

Priority is given to completing the full course of vaccination with the first-category vaccines in the national immunization plan. The second-category vaccines are voluntarily selected on demand based on the child's health status, family economic situation, and local disease prevalence. There is no standard answer of "must vaccinate them all" or "don't vaccinate if possible". All vaccination decisions must be made on an individualized basis.

Last week, I was helping with popular science Q&A at a community vaccination clinic in Haidian. I met the mother of a second-grade baby. She carried a printed "Influencer Vaccination List" of more than 20 pages in her bag. One moment she asked if 10 types of second-category vaccines would be enough, and the other moment she worried that the baby's immune system would be overwhelmed by too many doses. I encounter this kind of dilemma almost every day.

Let’s talk about the most uncontroversial thing first: the state’s free Category 1 vaccines are really a must. Don’t believe the online conspiracy theory that “Category 1 vaccines are compulsorily harvested”. The vaccines included in our country’s immunization program have been verified by the population for decades, and they all prevent diseases that once caused extremely high rates of death and disability. When you were a child, you might have seen an elder suffering from polio, but now you hardly see one on the road, right? This is the result of the popularization of polio vaccine, and the vaccination record of the first-class vaccine is directly linked to the enrollment in kindergarten. If you miss it, you will have to make up for it when you register. There is no need to delay things.

When it comes to the second-category seedlings that everyone is most confused about, the parents I have met are basically divided into two groups. No one is right or wrong, but the logic of choice is different. One group is the "cost-effective first" approach often promoted by veteran doctors who have worked in the community prevention and protection department for decades, giving priority to categories with high prevention and high risk of severe disease: For example, the influenza vaccine is a hot search every autumn and winter. Every year, I receive dozens of calls from parents saying that their children have fevers and convulsions. Children under 5 years old are three times more likely to develop severe pneumonia and encephalitis after getting influenza than adults. This is really recommended to be vaccinated every year. ； There is also a 13-valent pneumococcal vaccine, which targets the pathogenic bacteria that children under 5 years old are most susceptible to. Severe cases can cause meningitis and sepsis. If you can afford it, try to get it. ； There is also the HPV vaccine. Now many provinces have begun to vaccinate junior high school girls free of charge. Regardless of male or female, those aged 9 to 14 can get the best protection effect. The benefits of these are recognized to be the highest. The other group is the "cautious evaluation group". Most of them are parents who have children with allergies and underlying diseases. For example, if the child has a severe egg allergy, the influenza vaccine cultured in chicken embryos must be carefully selected. Children with immune deficiencies cannot just take the live attenuated vaccine. They must seek evaluation from a doctor in the pediatric immunology department. In such cases, you cannot blindly follow the trend. Oh, yes, some experts in the public health field have also mentioned that for families with average economic conditions, there is no need to pursue rare disease vaccines that cost thousands per unit and prevent only a few hundred cases of disease per year in China. It is much more cost-effective to spend money on the high-yield categories mentioned above.

Don’t blindly believe in the “preparations you must make before vaccination” list on the Internet. I have seen many parents give their children antiviral drugs in advance to “prevent reactions”. This is completely blind and may affect the effectiveness of the vaccine. Normally, as long as there is no high fever, severe cough or diarrhea one week before vaccination, and the chronic disease is not in the acute attack stage, you can get vaccinated. Staying under observation for 30 minutes after vaccination is really not a formality. Last year, a child developed large-area urticaria 15 minutes after vaccination. The clinic gave him anti-allergic medicine on the spot. If the attack happened on the way home, the parents would be so panicked that something might happen. As for low-grade fever and arm redness and swelling after treatment, these are normal immune reactions. Physical cooling is enough. If the fever exceeds 38.5, take antipyretics and you don’t have to rush to the emergency room. Oh, by the way, many parents still ask, "Will the vaccine be ineffective if I delay it?" ”Not at all, as long as the interval between vaccinations is enough, all the previous vaccinations will count, and there is no need to re-vaccinate from the beginning. Don't be anxious because your child had a cold before and delayed the vaccination.

There is also the rumor that "vaccines cause autism" that has been circulating for almost 20 years. The earliest fake paper has been retracted long ago. The WHO and the Chinese Center for Disease Control and Prevention have conducted tracking studies on millions of samples. There is no correlation at all. Don't delay your child's vaccination because of such nonsense. Of course, if your child has had a severe allergic reaction to a certain vaccine before, there is no need to directly reject all vaccines of the same type. First, find out which component of the vaccine you are allergic to, and just switch to a manufacturer's batch that does not contain that component. For example, if you are allergic to streptomycin, you can avoid BCG batches containing streptomycin.

In fact, to put it bluntly, vaccination is like installing anti-virus software on a child’s immune system. The more installed, the better, nor is it best to run naked without installing anything. The one that is suitable for your child is the right one. When you are unsure, don’t blindly search for fragmented information on the Internet. Instead, ask a doctor in the community prevention department, or ask a doctor in the pediatric immunology department for an evaluation, which is much more effective than reading the Little Red Book for three days and three nights.