Vaccination Guidelines 2nd Edition

Ordinary healthy people can be vaccinated in strict accordance with the national immunization plan procedures. There is no need to blindly re-vacculate unnecessary booster shots, and there is no need to be overly entangled with differences in vaccine technical routes and manufacturers.； For special groups of people with allergies, low immune function, the elderly/combined with serious underlying diseases, they can minimize vaccination risks and maximize protection benefits by first completing a pre-vaccination risk assessment and then selecting suitable vaccines.

This version of the guideline was updated based on clinical vaccination data from the past three years, adverse reaction monitoring reports from the Centers for Disease Control and Prevention, and practical experience from thousands of outpatient consultations. The biggest difference from the first version is that there are not so many "one size fits all" requirements. After all, everyone's physical condition is very different, and rigidly applying unified standards can easily lead to problems.

Last week, a 62-year-old aunt came to the outpatient clinic with three respiratory vaccine leaflets from different manufacturers in her pocket. She said that after watching the video and listening to "experts" saying that each technical route must be vaccinated once to prevent this year's influenza and mycoplasma, all of them must be vaccinated on the same day. In fact, this is also a point of great controversy in the industry: one school of thought supports the mixed administration of vaccines with different technical routes, believing that it can induce broader cross-immunity. There are small-scale overseas research data showing that the neutralizing antibody titer against mutant strains can be 20%-30% higher when mixed. ； But the basis of the other school is more solid - monitoring data from the domestic Centers for Disease Control and Prevention in the past year show that after healthy people complete basic immunization, the incidence of adverse reactions increases by 17% for each unnecessary booster dose, but the marginal gain of protection against common epidemic strains decreases by more than 70%. To put it bluntly, "the benefits are not much, but the probability of suffering is higher." Both statements are supported by data. If you travel frequently and need to come into contact with a large number of people on a daily basis, there is no problem in choosing a mixed game. If you rarely go out and have allergies, you really can't join in the fun.

Many people deliberately fast before coming for vaccination, saying they are afraid of affecting the effectiveness of the vaccine. Last month, I met a 22-year-old girl who didn't eat in the morning and came to get the nine-price HPV shot. She fainted just two minutes after the injection, and her face was as white as paper. It took half an hour to recover. In fact, except for a few special cases where antibodies need to be tested, it is enough to eat and drink normally before vaccination, and do not drink and stay up late. Fasting will increase the probability of needle fainting. Some people went to a hot spring to take a bath on the day after the injection. The next day, the needle hole was swollen as big as a coin. They came over to ask if there was something wrong with the vaccine. In fact, it was because the needle hole had not healed and had been exposed to dirty water. Applying potato chips for two days was enough. There was no need to worry.

If you are immunocompromised, such as having had an organ transplant, taking glucocorticoids for a long time, or having an autoimmune disease, then you really cannot follow the standards of ordinary people. Not long ago, there was a 38-year-old patient with lupus erythematosus who had been taking prednisone for almost a year. Before, she did not dare to take the herpes zoster vaccine for fear of inducing disease activity. After we evaluated her immune indicators, we chose a vaccine based on the recombinant protein route. After the vaccination, she was followed up for two months. It did not induce lupus activity, and the antibody seroconversion rate was 32% higher than that of patients of the same type who received inactivated vaccines. To be honest here, it is not that the inactivated vaccine is not good. On the contrary, the inactivated vaccine is actually safer. It is just that for people with low immunity, the ability to induce immune response is weaker. Which one to choose, be sure to let the doctor evaluate your situation before making a decision. Don’t make a decision just by looking up a few words on the Internet.

Another controversial question that is asked the most is: Should we wait for the nine-price HPV vaccine? Many young girls start lining up for the nine-price offer as soon as they turn 20, and when they reach 26 and still haven’t made it, they come over and ask if they want to continue waiting. Now there are two voices in the industry: one is that the 9-price cover covers many serotypes and can prevent 90% of cervical cancer. It is definitely best to wait. ； The other is that the protection rate of the two-price and four-price vaccines against the most dangerous types 16 and 18 is exactly the same as that of the nine-price vaccine, which can already cover 84.5% of the risk of cervical cancer. If you are almost 26 years old or have had sexual intercourse, it is better to take the second-price vaccine first to protect yourself early. It will be no problem to catch up with the nine-price vaccine when your age is extended. My general advice to the girls I consult is: get vaccinated whenever you have an appointment. It is better to get vaccinated first than anything else. There is really no need to wait for several years to cover a few more low-risk subtypes, but it will increase the risk of infection.

In fact, this guide has been revised over and over again, but the core is still the same - don't be anxious, and don't follow blindly. The first-class vaccines required by the national immunization plan are the most cost-effective and necessary vaccines that have been proven for decades. They must be administered on time. ； Just choose the second-category vaccine based on your needs and physical condition. If you are really not sure, just go to the community vaccination clinic near your home and ask a few questions. Our doctors are willing to tell you, which is much more reliable than reading three hours of fragmented "popular science".