Latest version of vaccination guide

There are no compulsory vaccination requirements, and the overall policy is "risk stratification, on-demand vaccination". Currently, high-risk groups are given priority to receive four types of vaccines - split influenza vaccine, 13-valent/23-valent pneumococcal vaccine, recombinant herpes zoster vaccine, and COVID-19 vaccine containing XBB variant components. Ordinary healthy people can voluntarily choose according to their own exposure risks and physical conditions.

Recently, a lot of people have come to the vaccination site for consultation. After all, the information on the Internet is too complicated. Some people say that "all vaccines must be fully vaccinated to be safe", and other people say that "vaccination will damage immunity." I have been working in a community public health post for three years and have seen many situations, so I will give you some real facts. Last week, a 68-year-old Aunt Zhang came in with three contradictory public account articles. One moment she said that the pneumonia vaccine was useless for the elderly, and the other moment she said that the fourth shot of the new coronavirus should be taken quickly, she asked me who I listened to. In fact, there is no unified answer to this matter. Let me tell you two real things that happened last year.

One is Uncle Wang, who lives in Building 3 of our community. He is 62 years old. His high blood pressure is very stable. He usually climbs Xiangshan Mountain faster than a young man. Last autumn, we called him to inform him to get the flu and pneumonia vaccines. He laughed directly on the phone: "I am in such good health, why do I do that? Don't waste resources." ”As a result, he was infected with the flu at the peak of the flu in December. He had a fever that turned into pneumonia for 3 days and was hospitalized for 11 days. He spent 19,000 yuan. After paying for medical insurance, he paid more than 8,000 yuan. The first thing he did after he was discharged was to go to the vaccination site and get two injections. He said, "This more than 8,000 yuan is enough for ten rounds of vaccination. It's a waste." There is also an Internet operation girl who was born in 1995. She often stays up late to catch up on projects. Last year, she heard that her colleague had shingles and was so painful that she could not even type on the keyboard. She came here to ask if she could get it. At that time, there was an old man nearby who advised her: "The probability of young people getting this disease is low, and it's a waste of time." "Money", she still took the shot. This spring, three people in her department got herpes zoster, and the least one had to take seven days off. Nothing happened to her. The last time she came to get the flu vaccine, she told us, "It's more than a thousand dollars spent, otherwise the pain will delay the KPI."

There are actually two points of controversy for everyone: one is "whether it is necessary to get so many vaccines", and the other is "who must get vaccinated." To be honest, there is no completely unified conclusion in the academic community. One school of thought believes that vaccines are the most cost-effective means of prevention, especially for serious diseases and sequelae that can be avoided through vaccines. If possible, vaccinate them. ； The other group believes that healthy young people with normal immune function have extremely low infection and severe disease rates for many diseases, and there is no need for additional vaccinations to increase the burden on the body. Both views are supported by clinical data, and there is no absolute right or wrong.

The current guidance from the National Center for Disease Control and Prevention is actually very flexible. If you belong to a high-risk group - that is, over 60 years old, have underlying diseases such as diabetes/hypertension/COPD, have low immune function, are pregnant, and are practitioners who often come into contact with large numbers of people, such as medical care/transportation/supermarkets - it is still recommended to give priority to the four types of vaccines mentioned above, especially influenza and pneumonia vaccines. Vaccination in September and October every year can just cover the high incidence period of autumn and winter, and the protection can be maintained for a whole year. If you are a young person who has a regular schedule, rarely goes to crowded places, and is in good physical condition, you can make your own choice. If you are afraid of getting shingles and delaying your work, you can take it. If you feel you can handle it, you don’t have to take it. No one will force you.

Speaking of which, I have to mention the COVID-19 vaccine that everyone is most concerned about. There is indeed a lot of noise in the academic community now. Some epidemiological experts recommend that high-risk groups be vaccinated once a year, just like influenza. After all, the virus mutates too quickly and the antibodies decay quickly.； Another group of clinical experts believe that the antibodies produced by the general population after infection or vaccination can last for at least half a year, and the risk of severe illness is extremely low, so there is no need to be vaccinated every year. The current official guidance is not one-size-fits-all: high-risk groups can receive vaccines containing XBB mutant strains 6 months after their last vaccination or infection. The general population can voluntarily do so and does not need to follow suit.

There is another reminder that I repeatedly tell people who receive vaccinations, and this is based on real experience: Don’t believe the rumors on the Internet that “you need to fast and stop cold medicine before vaccination”. As long as you are not in the acute onset period (such as fever, allergy attack, unstable control of underlying diseases), you can get vaccinated. Staying for observation for 30 minutes after vaccination is really not a formality. Last month, a young man was mildly allergic to the excipients in the vaccine. He broke out in hives just 10 minutes after sitting. He was given loratadine on the spot and it disappeared in half an hour. If he had left early and only found out when he got home, he might have been in a panic. In addition, it is normal to have a low fever and arm pain for one or two days after vaccination. Just drink more hot water and rest more. There is no need to take antipyretics. If the fever exceeds 38.5 degrees for more than two days, just go to the hospital.

In fact, there is really no need to be anxious about getting vaccinated, and there is no need to listen to the extreme comments on the Internet. Either "vaccination is harmful" or "if you don't get vaccinated, you will be irresponsible to yourself." These are too extreme. Just like whether you should bring an umbrella when it rains, you usually go out a lot and take it with you if you are afraid of getting wet. You usually stay at home and don’t go out. It’s okay if you don’t bring it. If you are really not sure, take 10 minutes to go to the vaccination site at the community health service center near your home and ask. The doctors who treat you will know the latest policies, which is much more useful than reading contradictory information online for two hours.