Release news| some areas to suspend child vaccination, experts: appropriate postponement will not affect the effect

Recently, Ms. Chen, who lives in Hushuguan Town, Suzhou High-tech Zone, asked the surging news "epidemic service platform" for help: the child is almost 6 months old, but since February this year, due to the sporadic and repeated epidemics, the local outpatient clinic has suspended or made an appointment for vaccination, and the third dose of the five vaccines has been delayed by nearly 2 months. She is concerned that the protective effect of vaccines will be affected by delayed vaccination, and she is more worried that the delay in vaccination of one vaccine will lead to the postponement of other vaccinations, affecting the healthy growth of children.

There are nearly 200 "bao mamas" in the same community in a WeChat group where Ms. Chen belongs, and everyone has similar anxieties.

For the above situation, the staff of the community health service center of Hushuguan Town said that due to the signs of positive cases in the Hushuguan Town area, outpatient clinics and emergency medical services have been temporarily closed, but special outpatient clinics have been opened separately. However, the clinic is mainly for vaccines with special vaccination time limits (such as newborns born of hepatitis B surface antigen-positive or unknown mothers, premature babies and other special newborns), as well as other vaccines that require emergency immunization for epidemic prevention and control.

The staff member said that the vast majority of children's vaccines can be re-injected. Vaccination recovery arrangements can be made by paying attention to the "Suzhou Vaccination" public account appointment platform, or consulting the local community health service center.

According to the latest situation of the prevention and control of the new crown pneumonia epidemic in Suzhou, from 0:00 to 15:00 on April 12, there were 31 new cases of positive infection in the city, involving 7 county-level cities (districts), showing a multi-point sporadic situation and the risk of local spread.

The relevant staff of the Suzhou Municipal Center for Disease Control and Prevention told the surging news that the outpatient service for newborn vaccination is currently decided by the disease control and epidemic prevention departments of various districts, the health commission and other parties to decide whether to carry out, and some areas have been suspended. However, the staff member stressed that in cases where the national immunization programme procedure has special vaccination time limits, the districts will address them through different avenues.

Mainland vaccines are divided into immunization programme vaccines and non-immunization programme vaccines. Immunization programme vaccines are a type of vaccine that is provided free of charge by the state to citizens, such as hepatitis B vaccine, BCG vaccine, measles vaccine, etc. Non-immunization program vaccines are the second type of self-funded vaccines, which are commonly used in clinical practices such as rabies vaccine, influenza vaccine, 23-valent pneumococcal polysaccharide vaccine, polio inactivated vaccine, Japanese encephalitis inactivated vaccine, varicella attenuated vaccine, oral rotavirus live attenuated vaccine, etc.

Combination vaccines belong to the second class of vaccines, which can reduce the number of vaccinations while also preventing polio, whooping cough and other diseases. In the case of the five-dose vaccine, there are 4 injections in total. In general, infants can be vaccinated by appointment at 1 month of age, and at 2, 3, 4 months of age or 3, 4 or 5 months of age, a total of 3 basic injections are given, with each dose at least 28 days apart. Wait until 18 to 24 months of age, and then receive a booster injection.

Yu Wenzhou, chief physician of the Immunization Program of the Chinese Center for Disease Control and Prevention, previously said that there are two kinds of delayed vaccination for children: one is that in the case of vaccination has not yet begun, vaccination can be done according to the conventional procedure, and there is no impact on the production of antagonists; the other is that it has begun to be vaccinated, but there are not enough doses, and the remaining doses can be restored after vaccination, and the impact is not large.

Wang Nianrong, director of the Child Health Department of Chongqing Maternal and Child Health Hospital, explained to the surging news that the delay in vaccination of most vaccines in the short term will not bring about the incidence or even epidemic of preventable diseases of these vaccines. Delayed vaccination only delays the time for human immune memory cells to produce a large number of antibodies to the re-vaccination vaccine, but the protective efficiency and safety of the re-vaccination vaccine are not statistically significant compared with the vaccines given according to the conventional immunization procedure. Therefore, simply avoid delaying vaccination indefinitely to protect your child's health.

She said any vaccine has a fixed immunization dose, injection schedule and interval requirements. According to the "Technical Scheme for Delayed Vaccination and Resuscitation of Vaccines" promulgated by the state, the re-vaccination of the vaccine after the delay also needs to comply with the requirements of "early, full interval, priority to ensure the vaccine of the immunization program, and pay special attention to the prevention and control of highly contagious diseases" to carry out re-vaccination.

On March 16, 2020, the Chinese Center for Disease Control and Prevention issued the Notice on Printing and Distributing the Technical Plan for Late Vaccination and Re-vaccination of Vaccines for the Prevention and Control of the Novel Coronavirus Pneumonia Epidemic, which is accompanied by a technical plan for late vaccination of vaccines, which details the priority order of different vaccines under the two types of vaccines. The programme mentions -

Hepatitis B vaccine, BCG vaccine, polio vaccine, measles-containing vaccine, DTP vaccine, Japanese encephalitis vaccine, brain flu vaccine, hepatitis A vaccine and other immunization program vaccines need priority re-vaccination, and postponed non-immunization program vaccines are also recommended to be revaccinated in time, and immunization program vaccines and non-immunization program vaccines can be vaccinated at the same time.

Those who have not completed the doses specified in the national immunization program only need to revaccinate the incomplete doses and do not need to restart the full vaccination.

•Those who have not been vaccinated against a national immunization programme should be revaccinated according to their age at the time, in accordance with the immunization procedures for the vaccine, as well as the type of vaccine, the interval between vaccinations and the number of doses specified in the principles of vaccination.

Priority is given to ensuring the timely completion of the full vaccination of the national immunization program vaccine, and when it is impossible to use the same manufacturer's vaccine to complete the whole process of vaccination, it can use different manufacturers' vaccines to complete the follow-up vaccination.

Wang Nianrong said that in order to complete the vaccination as soon as possible, different vaccines can be used at the same time, or multi-linked or multivalent combination vaccines can be used. For the case of multiple vaccines at the same time, she explained that after a large number of clinical data studies, multiple vaccines are generally not immune interference or increase the risk of adverse reactions, but it should be noted that simultaneous vaccination needs to be carried out in different parts. In contrast, the lack of relevant clinical research data for the second type of vaccine, whether it can be vaccinated at the same time, need to provide the latest evidence to determine, "although from the principle of vaccination, the second type of vaccine generally does not increase the risk of adverse reactions, can be vaccinated at the same time." ”

Pentavalent vaccine or thirteen-valent pneumonia vaccine is divided into two stages: basic immunization and booster immunization. In general, the body can produce enough antibodies to play a preventive role in infancy 1 month after the basic immunization, and enhanced immunity can stimulate the body to produce more antibodies, and the whole process will continue to play a preventive role. However, during the COVID-19 epidemic, basic immunization or booster immunization may be delayed, and the age of re-vaccination may exceed the applicable age, and some scholars recommend completing basic immunization as soon as possible within six months after the resumption of immunization, and completing booster immunization within 3 months to ensure the preventive effect.

Wang Nianrong also pointed out that during the new crown epidemic, some vaccination sites will be temporarily closed, and infants and young children in this jurisdiction will also be required to move around at home and wear masks when going out, under such a premise, infants and young children are difficult to contact the source of infection, relatively safe, and mothers do not have to panic too much. "However, from the perspective of preventing diseases and establishing an immune barrier, it is still recommended to promote vaccination and replanting as soon as possible." She said.