Vaccination Guidelines for Children and Adolescents

Category I vaccines in the national immunization program must be vaccinated as required. Category II vaccines in non-immunization programs should be selected based on the child's physical condition, family economic conditions, and local disease prevalence. Special groups with congenital diseases, immune deficiencies, and severe allergies must first undergo professional evaluation before deciding on a vaccination plan. There is no "universal vaccination list" that applies to all children, and there is no need to blindly follow the vaccination combinations recommended by Internet celebrities.

Last week, I was sitting in the vaccination clinic of the community health service center in my jurisdiction. I met a mother who was pregnant with her second child. She was holding three "optimal vaccination guides" from Xiaohongshu and Maternity and Infant Group. She was squatting in the waiting area and was in tears - the eldest child was about to go to kindergarten. In kindergarten, strategy A said that the five-drug vaccine is an IQ tax and it is better to save money by taking it separately. Strategy B said that not giving the five-drug vaccine would make the child suffer more. Strategy C also listed more than ten kinds of must-do second-class vaccines, which cost more than 20,000. She couldn't make up her mind and didn't even dare to get a number.

In fact, many parents focus on "which expensive seedlings to choose", but ignore the type of seedlings that don't need to be entangled the least. These free vaccines included in the national immunization program are the "safety bottom line" verified by decades of domestic clinical data. They cover infectious diseases with extremely high fatality and disability rates, such as hepatitis B, tuberculosis, and poliomyelitis. As long as the child does not have clear contraindications for vaccination - such as being severely allergic to vaccine components, in the febrile stage of acute infection, or suffering from uncontrolled severe neurological diseases - do not delay vaccination. The longer you delay, the higher the risk of exposure to the virus. Two years ago, I met a parent whose elder was a hepatitis B virus carrier. He was afraid that the vaccine would harm the baby, so he deliberately postponed the third hepatitis B injection until he was one and a half years old. As a result, when the child was six months old, he lived with his elders for half a month and was accidentally infected. Although he did not develop into chronic hepatitis B in the end, it frightened the family.

When it comes to the controversy over Category II seedlings, there are actually two mainstream views in the industry. There is nothing right or wrong, they just have different starting points. One is the "high-incidence first" group, which believes that there is no need to pursue expensive or new ones. It is enough to first cover the diseases that are popular in the local area and are easy for children to get, such as influenza, 13-valent pneumonia, hand, foot and mouth, chickenpox, and HPV. They are all the hardest hit areas for cluster transmission in childcare institutions and schools, and are the most cost-effective. My best friend’s baby just started a small class last fall. She thought it was too troublesome to get the flu vaccine every year, so she didn’t make an appointment. As a result, half of the children in the class in November had a fever above 39 degrees. Her baby had a fever for four days, and also developed otitis media. She made an appointment for her baby as soon as the vaccination season came a while ago, saying that it was worth spending hundreds of dollars to change the baby to avoid suffering. The other is the "experience first" group, who are more willing to choose combined vaccines, such as five-combination and four-combination vaccines, which can combine more than a dozen vaccines into four or five injections. The baby will be less painful and parents will not need to frequently ask for leave to go to the hospital. Many parents are worried that combined vaccines will not be unsafe if they contain too many ingredients? The safety and effectiveness data of all combination vaccines currently on the market in China are not statistically different from those of single vaccines administered separately, but the production process is more complex and the price is higher. It is completely a matter of choice. There is no need to diss each other. It is too extreme to say "those who choose combination will pay IQ tax" or "those who do not use combination are irresponsible".

As for children with a history of allergies, immune deficiencies, and congenital diseases, the assessment criteria of different doctors may differ. For example, some doctors believe that eczema cannot be vaccinated in the acute stage, while others think that as long as there is no severe eczema at the vaccination site and the child is in stable condition, vaccination can be done. In this case, don’t get hung up on Baidu and just go directly to a doctor who specializes in pediatric immunization for an individualized assessment. I once had a child who was severely allergic to dust mites. The parents checked online and found that the allergic constitution could not be vaccinated against leprosy. They delayed the child until he was in elementary school and had to be screened for admission. Almost all of the antibodies before the test were negative, which is equivalent to not being protected in the past few years, but it is even more dangerous.

Many parents panic when they see their child has a fever after vaccination and the vaccination site is red and swollen, thinking that there is something wrong with the vaccine. In fact, as long as the body temperature does not exceed 38.5°C, the child is in a normal mental state, can eat and play, it is a normal immune response, just physically cool down at home and drink more water. If the fever lasts for more than 24 hours, a severe rash, difficulty breathing, and then go to the hospital in time, there is really no need to go to the emergency room at night even if there is a slight reaction, and adults and children will suffer.

In fact, there is no 100% perfect option for raising a baby. The same goes for vaccination. You don’t need to follow other people’s strategies mechanically, and you don’t need to be anxious after listening to what others say. It’s enough to ask more reliable specialists and choose based on your baby’s physical condition and family’s financial conditions. After all, our original intention of vaccination is to give the baby an extra layer of protection, right?