Latest version of vaccination guide

High-risk groups (the elderly, immunocompromised people, patients with chronic diseases, and young children) are given priority to receive key vaccines such as influenza, pneumonia, herpes zoster, and COVID-19. General healthy people choose according to their needs based on their own exposure risks. There is no need to blindly follow the trend of vaccination. All decisions must be based on personal physical status.

I said this at least twenty times at the community vaccination site last week - or Uncle Zhang, who has just retired, clutching his mobile phone and asking if it is true that the new crown vaccine needs to be given every year on the Internet.； Or a mother who has just given birth is holding her six-month-old baby in her arms, wondering whether to get hand, foot and mouth and flu vaccines at the same time.

Regarding the vaccination of the new coronavirus vaccine booster shot, there are currently two different guidance opinions in the industry: The WHO's updated guidance this year recommends that high-risk groups such as the elderly over 60 years old, immunocompromised people, pregnant women, etc., receive an updated version of the vaccine against the current epidemic strain every 6-12 months.； Many domestic front-line clinical infectious diseases doctors believe that if ordinary healthy adults have a history of infection or have received booster shots in the past 12 months and do not have the need to frequently visit high-risk places, they do not need additional vaccinations for the time being. It is more reasonable to leave resources to high-risk groups who need them more. Both views are supported by large sample data. There is no absolute right or wrong. Everyone can choose according to their actual situation.

The most frequently asked question recently is the update of children's vaccines. Previously, everyone only knew about the EV71 single vaccine for hand, foot and mouth vaccination. This year, the bivalent hand, foot and mouth vaccine has been fully rolled out. It also covers EV71 and CV-A16, the two strains that are most likely to cause severe hand, foot and mouth, and has a wider range of protection. I generally recommend that parents give priority to this vaccine. Also, after the applicable age for the HPV vaccine was relaxed, girls in their twenties and thirties come every day to ask if they can get the nine-price vaccine. In fact, the nine-price vaccine has now been extended to 9-45 years old, and there is no need to stick to the 26-year-old line. However, I have to mention here that many public health experts have been recommending that if you can’t get the nine-price vaccine, don’t wait. The bivalent HPV vaccine already covers the most dangerous types 16 and 18, and can prevent more than 90% of cervical cancer. Early vaccination and early protection are much more cost-effective than waiting three to five years to get the nine-price vaccine.

The vaccination priorities of the elderly have also been adjusted this year. Before, everyone only remembered to vaccinate against influenza, 23-valent pneumonia, and COVID-19. Now the shingles vaccine has been placed in an equally important position as the first three. I met a 64-year-old aunt last year. She thought the shingles vaccine was too expensive at over 1,000 yuan per shot and was reluctant to take it. She got shingles at the end of the year and was so painful that she couldn't sleep all night. Postherpetic neuralgia lasted for more than three months. She spent nearly 20,000 yuan and suffered a serious crime. Later, she came to the vaccination site to ask if she could get a replacement shot. There are two types of herpes zoster vaccines. One is a live attenuated vaccine that requires one injection. It is suitable for the elderly who are relatively healthy and do not have severe immune deficiencies. The other is a recombinant protein vaccine that requires two injections. It is safer for immunosuppressed people and the elderly with unstable underlying diseases.

There is another question that everyone has asked: I am allergic, can I not get any vaccines? Really not, only those with a history of severe allergies to the components of a certain vaccine (such as adjuvants, egg components in some chicken embryo-prepared influenza vaccines) are contraindicated in vaccination. Ordinary pollen allergies, dust mite allergies, and penicillin allergies are not affected. Last week, a girl who was allergic to mango asked if she could get the HPV vaccine. Of course she could, but there is no mango ingredient in the vaccine.

As for the flu vaccine that everyone struggles with every autumn and winter, there is no unified mandatory requirement. One school of thought believes that influenza strains mutate every year, and annual vaccination can provide the best protection, especially if there are elderly and children at home. It is best to vaccinate the whole family. ； Another school of thought believes that young people with good physical fitness who rarely go to crowded and closed places can also play every other year, and there is no need to join in the fun every year. Either way is fine, it just depends on your needs.

In fact, after doing vaccination work for so many years, my deepest feeling is that there is never a one-size-fits-all standard answer to vaccination. No matter how many guides you read online, it is not as reliable as taking your past medical records to a community vaccination site near your home and spending three to five minutes asking the doctor on duty - after all, everyone has different underlying diseases, immune status, and exposure risks. A plan that works for others may not be suitable for you. If you are really not sure, just ask a few more questions, there is nothing embarrassing.