Today (April 25) marks the 36th National Child Vaccination Day.
The importance of vaccination is not unfamiliar to everyone. However, after the baby is born, there are too many types of vaccines to be vaccinated.
Why are some vaccines free and some self-funded? Is there any difference? Is it necessary to get a vaccine at your own expense?
In fact, we often say "type II vaccines" and "self-funded vaccines", referring to "non-immune program vaccines".
Immunization programme vaccines are provided free of charge by the government to citizens, and citizens should receive vaccines in accordance with government regulations. In accordance with the provisions of the Vaccine Administration Law of the People's Republic of China, residents living in China enjoy the right to receive vaccines from the immunization programme in accordance with the law and fulfill the obligation to receive vaccines from the immunization programme.
Non-immunization programme vaccines are vaccines given on a "voluntary, self-funded" basis. According to the epidemic of the disease and the supply of vaccines in various places, local governments with the capacity will also consider including some non-immunization program vaccines into the immunization program vaccines, and the government will purchase vaccines at the expense of the government and provide them to residents free of charge.
Subject to economic conditions, the baby is partially self-funded to provide more comprehensive protection for the baby [1].
In this article, we will talk about the "self-funded" vaccine.
Today, according to the severity of the corresponding disease, incidence, timing of vaccination and other factors, we have selected 7 vaccines for you that also cost money to give your children. Here are the detailed instructions.
(If you don't want to see a detailed description of a single vaccine, you can drop it down to the end of the article.) The age of each vaccination & time of dose and other important points, we have compiled into a table so that you can save directly to your mobile phone. ）
1. 13-valent pneumococcal polysaccharide conjugate vaccine (PCV 13): it is necessary to play, it is recommended to give as early as possible
The World Health Organization (WHO) recommends the inclusion of pneumococcal conjugate vaccine (PCV) in the global childhood immunization programme [2].
On the mainland, pneumococcal disease is the leading cause of death in children under 5 years of age [3].
Moreover, pneumococcal infection may not only cause pneumonia, but also severe invasive meningitis, sepsis and other diseases, as well as common diseases such as sinusitis and otitis media.
Vaccination against pneumococcal can greatly reduce the incidence of pneumonia in children under 5 years of age. Therefore, it is very necessary to vaccinate your baby against pneumococcal.
Vaccination procedure
The recommended procedure is 1 dose at the baby's 2, 4, and 6 months of age, and 1 dose of immunization enhancement at 12 to 15 months of age.
If vaccination is not possible in accordance with the recommended procedure, revaccination should be given as soon as possible according to the following principles:
Start the vaccination at 1.5 to 6 months of age: a total of 4 doses, the interval between the 1st to 3rd dose is 1 to 2 months, the 1 dose is strengthened at 12 to 15 months of age, and the interval between the booster and the 3rd dose is ≥ 8 weeks.
Start the vaccination at 7 to 11 months of age: a total of 3 doses, the interval between the 1st and 2nd doses is 1 to 2 months, the dose is strengthened at 12 to 15 months of age, and the interval between the booster dose and the third dose is ≥ 8 weeks.
Vaccination begins at 1 to 2 years of age: a total of 2 doses are given at an interval of ≥ 2 months.
≥ start at the age of 2: 1 dose is enough.
Although the number of doses required for vaccination decreases with age, the earlier you are vaccinated, the sooner you receive protection, so early vaccination is recommended [2].
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2. Hib vaccine (Haemophilus influenzae type b vaccine) & 5 & 4: 1.5 months to 5 years old
Haemophilus influenzae type b vaccine, referred to as Hib vaccine, mainly prevents a series of diseases caused by Haemophilus influenzae type b infection, such as meningitis, pneumonia, laryngitis, sepsis, etc.
The World Health Organization (WHO) recommends that the Hib conjugate vaccine be included in all routine infant immunization schedules [4].
It is recommended to start with 2 months of age, 1 dose of the basic needle per month for a total of 3 doses, and 1 dose of strengthening at 18 months of age.
If vaccination is not possible in accordance with the recommended procedure, revaccination should be given as soon as possible according to the following principles:
Start of vaccination at 2 to 6 months of age: a total of 4 doses, the interval between the 1st to 3rd dose is 1 to 2 months, the 1st dose is strengthened at 18 months of age, and the interval between the booster dose and the 3rd dose is ≥ 8 weeks.
Start the vaccination at 7 to 11 months of age: a total of 3 doses, the interval between the 1st to 2 doses is 1 to 2 months, the 1st dose is strengthened at 12 months of age, and the interval between the booster dose and the 3rd dose is ≥ 8 weeks.
Start vaccinating ≥ 1 year of age: 1 dose is sufficient.
Of course, the Hib vaccine can be replaced by a five-vaccine or a quad-vaccine.
The penta vaccine can prevent 5 diseases, instead of polio vaccine, DTP vaccine, Haemophilus influenzae type b vaccine (self-funded), a total of 4 doses.
Compared with the usual separate vaccination, the five-dose vaccine can be given 8 doses less, reducing the risk of pain and adverse reactions caused by the baby's vaccination, as well as the risk of cross-infection in the hospital.
If the quintile vaccine is out of stock, or if the quintile vaccine is too expensive, it can also be replaced by the "quintile vaccine + polio vaccine" program.
Although this program has 4 more doses than the quintuple vaccine, it can also be given 4 fewer doses than the conventional separate vaccination.
Quad vaccines can prevent 4 diseases, instead of DTP vaccine, Haemophilus influenzae type b vaccine (at your own expense).
3. Influenza vaccine: once a year for people over 6 months of age
Influenza is a high incidence in autumn and winter, the baby's immunity is poor, easy to infect with influenza, and even cause serious complications such as viral pneumonia or mixed pneumonia, and vaccination can play a role in protecting the body [5].
At present, the influenza vaccines approved for marketing in mainland China include: trivalent inactivated influenza vaccine (IIV3, 6 months of age to 35 months of age) and quadrivalent inactivated influenza vaccine (IIV4, ≥ 3 years old people).
If your child is over 6 months old, it's best to get a flu shot every year. Even during the influenza epidemic season or even during the peak of influenza onset, you should try to get vaccinated for protection.
Children younger than 6 months of age can be vaccinated without the flu vaccine. Therefore, all family members should be vaccinated against influenza, establish a family protection circle, indirectly protect the child, and avoid bringing the virus home to spread to the baby.
4. EV71 Hand,Foot-and-Mouth Vaccine (EV71 Vaccine): 6 months to 5 years old
The Chinese Centers for Disease Control and Prevention encourages children to complete the vaccination process before the age of 1 year, and the earlier children aged 1 year and older, the better [6].
HFMD is characterized by a high incidence, and although most of the symptoms are mild, they are also severe, and severe diseases can lead to death.
According to statistics: more than 70% of severe cases and more than 90% of hand-foot-and-mouth disease deaths are related to EV71 (enterovirus type 71) infection.
Vaccination with EV71 can effectively reduce the incidence of severe disease and death of hand-foot-and-mouth disease.
Vaccination does not mean that the baby will not suffer from hand-foot-and-mouth disease. However, the main cause of hand-foot-and-mouth disease in mainland children is enterovirus type 71, so the EV71 hand-foot-and-mouth disease vaccine still has a certain protective effect on babies.
Inoculation method
A total of 2 doses, it is recommended to start at 6 months of age, the interval ≥ 1 month, even if there is no vaccination at 6 months of age, 2 doses should be completed before the age of 6 years, and THE EV71 vaccine is not recommended for children over 5 years old.
5. Chickenpox vaccine: 1 dose starting at 12 months of age, it is recommended to strengthen 1 dose after 4 years of age
Chickenpox is a highly contagious disease of the respiratory tract, mainly transmitted by droplets, so it is very easy to erupt in groups, especially in places where babies are highly concentrated, such as nursery schools and kindergartens, which require more attention [7].
The Chinese Center for Disease Control and Prevention recommends that children receive one dose of the varicella vaccine before entering kindergarten [8].
Getting the chickenpox vaccine protects your baby. Even if you still get chickenpox after vaccination, the symptoms will be very mild.
Inoculation method
A total of 2 doses are given, and it is generally recommended to give 1 dose each at 12 to 15 months of age and 4 to 6 years old.
In some areas, there may be different procedures according to the local epidemic situation and epidemic prevention needs, but as long as the chickenpox vaccine is given according to local requirements, it is safe and effective.
6. Oral rotavirus vaccine: start at 2 months of age
Rotavirus is the leading cause of severe dehydrated diarrhoea in children under 5 years of age worldwide, and rotavirus infectious diarrhea is the second leading cause of emergency and mortality (in addition to respiratory infections) in infants and young children.
THE WHO strongly recommends that rotavirus vaccine be included in national immunization programmes [9].
There are currently 2 main rotavirus vaccines available:
Monovalent Rotalix vaccine: 2 months of age or older, 1 dose per year, up to 4 doses.
5-valent Rottenq: it is recommended that one dose each at 2 months, 4 months and 6 months old, and the first dose can be taken orally at the earliest 1.5 months of age.
7. Human papillomavirus (HPV vaccine): Girls over 9 years of age are vaccinated as soon as possible
Because the last shot of the free vaccine is given when the child is about 6 years old, many parents mistakenly think that after the age of 6, the child does not need any more vaccinations.
In fact, for girls over the age of 6, in addition to the flu vaccine, it is also very important to get the HPV vaccine in time!
HpV vaccine can prevent cervical cancer, vulvar cancer, cancer and other diseases caused by HPV virus infection. The vaccine needs to be arranged at the age of 9, and the earlier the vaccination, the better [10].
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In addition to the above, the out-of-pocket vaccines also include the following types, which you can also choose to be vaccinated according to your child's situation:
Hepatitis A inactivated vaccine: 18 months of age to replace live attenuated hepatitis A vaccine, more immunogenic, longer protection time, can be 1 dose at 12 months of age and 1 dose of 18 months of age.
Japanese encephalitis inactivated vaccine: an alternative to the live attenuated japanese encephalitis vaccine, suitable for children with contraindications to live vaccine, requiring 4 doses.
Bivalent flow brain conjugate vaccine: replaces the group A flow brain polysaccharide vaccine from 6 months of age, which provides more comprehensive protection and better effect of inducing immune memory.
Quadrivalent flow brain polysaccharide vaccine: replaces bivalent flow brain polysaccharide vaccines for 3 and 6 years of age for more comprehensive protection.
23-valent pneumonia polysaccharide vaccine: for high-risk children, such as functional or anatomical asplenia, cochlear transplantation, etc.
Of course, parents may have a lot of questions about vaccinations:
In the first 6 months of the child's birth, when the vaccine is intensive, when it is really impossible to finish, which ones are preferred?
After the first dose, the vaccine is out of stock, can I change to another vaccine?
If you still want to read it, feel free to like this article or click "Watching", or leave the question you want to ask in the message area.
Remember to follow Tencent Medical Code for the latest vaccination information and more health knowledge.
Scientific Audit:
Wang Cuiling
Chief Physician of the Department of Pediatrics, Beijing Friendship Hospital
Jiang Shiqiang
Director of the Department of Immunization Planning, Shenzhen Nanshan District Center for Disease Control and Prevention
bibliography
[1] National Immunization Program Vaccine For Children Immunization Procedures and Descriptions (2016 Edition)[J].Chinese Journal of Virology,2017,7(02):81-86.
[2] World Health Organization (WHO), WHO Position Paper on Pneumococcal Vaccine (2012)[EB/OL].https://www.who.int/immunization/position_papers/WHO_PP_pneumococcal_2012_ZH.pdf, 2012.
Expert consensus on immunoprophylaxis of pneumococcal diseases (2020 edition)[J].Chinese Journal of Vaccines and Immunology,2021,27(01):1-47.
[4] World Health Organization (WHO). Who's Position Paper on Haemophilus influenzae type b vaccination [EB/OL].https://www.who.int/immunization/documents/summary_haemophilus_influenza_type_b_Chinese.pdf?ua=1,2013-7.
Chinese Center for Disease Control and Prevention. Technical Guidelines for Influenza Vaccination in China (2020-2021)[EB/OL].http://www.chinacdc.cn/jkzt/crb/bl/lxxgm/jszl_2251/202009/W020200911453959167308.pdf,2020-9.
Chinese Center for Disease Control and Prevention. Technical guidelines for the use of inactivated enterovirus 71 vaccine [EB/OL].http://www.chinacdc.cn/jkzt/crb/bl/grxfxb/jszl_2265/201810/P020181010391205885510.pdf,2016-5.
[7] WHO Position Bulletin on Varicella and Shingles Vaccine[EB/OL].https:/www.who.int/wer/2014/wer8925.pdf?ua=1,2014-6.
Chinese Center for Disease Control and Prevention. Chickenpox vaccine [EB/OL].http://www.chinacdc.cn/jkzt/ymyjz/ymlbgd/201211/t20121130_72490.html,2012-11.
[9] World Health Organization (WHO). Rotavirus Vaccine Position Paper [EB/OL].https://www.who.int/immunization/Rotavirus_Chinese.pdf, 2007-8.
World Health Organization. Position paper on HPV vaccine [EB/OL].https://www.who.int/immunization/policy/position_papers/PP_HPV_Chinese_Oct2014.pdf, 2014-10.
Editors: Emgrand, Zhao Yanan, Ye Zhengxing
Proofreading: Wu Yihe | Typesetting: Li Yongmin
Operation: Han Ningning | Coordinator: Zhao Yanan