The invention of vaccines is a landmark in human history, and in our fight against disease, vaccination is the most economical, safe and effective means of controlling and even eliminating infectious diseases.
Vaccines vaccinated on the mainland fall into two categories: the first is the vaccine that the government provides free of charge to citizens (immunization programme vaccine), and the second type of vaccine refers to other vaccines that are voluntarily administered by citizens at their own expense (non-immunization programme vaccines).
Relevant literature shows that in recent years, the vaccination rate of children routinely reported by the national immunization program has exceeded 95%, and the total proportion of children vaccinated by non-immunization programs has been 61.42%.
At what age should the vaccine be given to the childhood immunization programme? What diseases can these vaccines prevent? Which children cannot get these vaccines? What should I do if I can't get vaccinated in time due to epidemic prevention and control?
Age at which the vaccine is given
In March last year, the National Health Commission issued the "National Immunization Program Vaccine Children Immunization Procedures and Instructions (2021 Edition)", which pointed out that when children reach the age of vaccination of the corresponding dose of vaccine, they should be vaccinated as soon as possible.
At birth
Hepatitis B vaccine is given in the first dose to prevent viral hepatitis B
BCG vaccination to prevent tuberculosis (mainly tuberculous meningitis, miliary tuberculosis, etc.)
January
Hepatitis B vaccine is given in the 2nd dose
February
Polio inactivated vaccine 1st dose to prevent polio (commonly known as polio)
March
Inactivated polio vaccine given 2nd dose
DTP vaccine The first dose is used to prevent whooping cough, diphtheria and tetanus
April
3rd dose of live attenuated polio vaccine for the prevention of polio
Dtptonitis vaccinated in the 2nd dose
May
Dtptonide vaccine is given in the 3rd dose
June
Hepatitis B vaccine is given in the 3rd dose
Group A fluencephalosaccharide vaccine is given in the first dose to prevent meningococcal meningitis
August
The first dose of the mempic wind vaccine is given to prevent measles, rubella and mumps
Vaccinated with live attenuated Japanese encephalitis the first dose to prevent Japanese encephalitis
Inactivated Japanese encephalitis vaccine 1st and 2nd doses are given to prevent Japanese encephalitis
(Note: There are two vaccines to prevent Japanese encephalitis, the two-dose vaccination procedure is used when choosing the live attenuated Japanese encephalitis vaccine; the four-dose vaccination procedure is used when selecting the Japanese inactivated vaccine; and the first and second doses of the Japanese inactivated vaccine are 7-10 days apart.) ）
September
Group A cerebral polysaccharide vaccine is given in the 2nd dose
August
Vaccinated with DTP 4
Vaccination against measles is given in the 2nd dose
Live attenuated vaccine against hepatitis A is given in the first dose to prevent viral hepatitis A
Hepatitis A inactivated vaccine is given in the first dose to prevent viral hepatitis A
(Note: There are two vaccines for the prevention of viral hepatitis A, and the one-dose vaccination procedure is used when selecting live attenuated hepatitis A vaccination, and the two-dose vaccination procedure is used when selecting hepatitis A inactivated vaccination.) ）
2 years old
Vaccinated with live attenuated Japanese encephalitis vaccine 2nd dose
Inactivated Japanese encephalitis vaccine is given in the 3rd dose
Hepatitis A inactivated vaccine is given in the 2nd dose
3 years old
Vaccinated with group A C cerebral polysaccharide vaccine 3rd dose to prevent meningococcal meningitis
4 years old
Vaccination of live attenuated polio vaccine 4th dose
6 years old
Vaccinated with dtutria vaccine 5th dose to prevent whooping cough, diphtheria and tetanus
Inactivated Japanese encephalitis vaccine is given in the 4th dose
Group A C cerebral polysaccharide vaccine is given in the 4th dose
(Source: National Health Commission)
The age of vaccination in the immunization schedule refers to the minimum age at which the dose of vaccine can be administered, and the age range for children reaching the age range of the corresponding dose of vaccine is:
1. The first dose of hepatitis B vaccine: completed within 24 hours after birth.
2. BCG: less than 3 months of age to complete.
(Bcgware vaccination scars / Source: Wikipedia)
3. The 3rd dose of hepatitis B vaccine, the 3rd dose of polio vaccine, the 3rd dose of DTP vaccine, the 1st dose of measles vaccine, the 1st dose of Japanese attenuated live vaccine or the 2nd dose of Japanese encephalitis inactivated vaccine: less than 12 months of age to complete.
4. A group flow cerebral polysaccharide vaccine 2nd dose: less than 18 months of age to complete.
5. The second dose of measles vaccine, the first dose of hepatitis A live attenuated vaccine or hepatitis A inactivated vaccine, the fourth dose of dtphotadecan vaccine: less than 24 months of age to complete.
6. The second dose of Japanese encephalitis live attenuated vaccine or the third dose of Japanese encephalitis inactivated vaccine, the second dose of hepatitis A inactivated vaccine: less than 3 years old to complete.
7. The first dose of A group C cerebral polysaccharide vaccine: less than 4 years old to complete.
8. The 4th dose of polio vaccine: less than 5 years of age to complete.
9. Dtptony mildew vaccine, group A C cerebral polysaccharide vaccine 2nd dose, Japanese encephalitis inactivated vaccine 4th dose: less than 7 years old to complete.
If the child has not completed vaccination in the above age range, he can consult the relevant doctor and carry out the revaccination as soon as possible according to the general principles of re-vaccination and the specific re-vaccination requirements of each vaccine.
Which children cannot be vaccinated?
Although children should be vaccinated as soon as possible after they reach the age of the corresponding vaccine, some children are sometimes unable to receive these vaccines because of their special health status.
Allergic constitution
It is only said that "allergic constitution" is actually too general, such as pollen allergy, dust mite allergy, etc., which have little to do with the composition of the vaccine, and are generally not used as contraindications to vaccination.
However, if the vaccine is severely allergic to a known vaccine component or if laryngeal edema, anaphylactic shock, and other systemic severe anaphylaxis have occurred as a result of vaccination, the vaccine cannot be continued.
Children born to mothers infected by human immunodeficiency virus (HIV).
There are three types of HIV infection status for children born to HIV-infected mothers: (1) HIV-infected children, (2) children with unknown HIV status, and (3) hiv-infected children. A diagnosis of whether the child is HIV-infected, symptomatic, or immunosuppressed is issued by a medical institution.
Infants born to HIV-infected mothers younger than 18 months of age do not need to be screened for HIV antibodies prior to vaccination, and are given according to children whose HIV status is unknown
1. Children born to HIV-infected mothers are temporarily vaccinated with BCG vaccine after birth, and then revaccinated when it is confirmed that the child is not infected with HIV; when the child is confirmed to be infected with HIV, bcgy vaccine vaccination is not granted.
2. Children born to HIV-infected mothers who are diagnosed with AIDS-related symptoms or immunosuppressive symptoms by medical institutions will not be vaccinated with measles components; if there are no AIDS-related symptoms, they can be vaccinated with measles components.
3. Children born to HIV-infected mothers can be vaccinated with hepatitis B vaccine, DTP vaccine, A-group cerebral polysaccharide vaccine, A-group C-cerebral polysaccharide vaccine and dtphotose vaccine in accordance with immunization procedures.
4. Children born to HIV-infected mothers will not be vaccinated with Japanese encephalitis live attenuated vaccine, hepatitis A live attenuated vaccine, and live attenuated polio vaccine unless it has been clearly not infected with HIV, and can be vaccinated with Japanese encephalitis inactivated vaccine, hepatitis A inactivated vaccine, and polio inactivated vaccine in accordance with immunization procedures.
5. Children born to non-HIV-infected mothers do not need to be routinely screened for HIV before vaccination. If there are other exposure risks, and HIV infection is confirmed, follow the schedule for vaccination recommendations for HIV-infected children.
(Source: National Health Commission)
In addition to HIV-infected people, other immunodeficient or children who are receiving systemic immunosuppressive therapy can receive inactivated vaccines, and in principle, live attenuated vaccines are not given (except for patients with complement deficiencies).
Premature and low birth weight infants
Premature infants (gestational age less than 37 weeks) and/or low birth weight (birth weight less than 2500 g), are vaccinated according to the actual age of birth if medically assessed to be stable and in a state of continued recovery (severe infections, metabolic diseases, acute kidney disease, liver disease, cardiovascular disease, and neurological and respiratory diseases that do not require ongoing treatment).
(Source: Figureworm Creative)
How to arrange vaccinations under the COVID-19 pandemic?
Today, the situation of the new crown epidemic in some parts of the country is grim, and some places have been closed for a long time, and many parents are worried that they will miss their children's immunization time.
In this regard, the Qinghai Health Commission issued the "Reference Guidelines for Vaccination During the Novel Coronavirus Pneumonia Epidemic in Qinghai Province", which pointed out:
1. Obstetric vaccination units that carry out midwifery services should continue to provide newborns with the first dose of hepatitis B vaccine and BCG vaccination.
2. The second dose and the third dose of hepatitis B vaccine for newborns born to hepatitis B surface antigen-positive mothers, the vaccination unit should give the baby as timely as possible.
3. Vaccines for post-exposure immunization, such as rabies vaccine and tetanus vaccine, should go to the vaccination clinic in time according to the vaccination procedure or choose a medical institution with a small number of outpatient clinics to open canine injuries nearby.
Recommendations for postponing vaccination in immunization programmes during the epidemic are as follows:
(1) Hepatitis B vaccine: It is recommended that newborns born to non-hepatitis B surface antigen-positive mothers complete three doses of vaccination before the age of 12 months, with each dose interval of at least 28 days, and vaccinations over 12 months of age are equally effective.
(ii) Polio vaccine and DTP vaccine: it is recommended to complete three doses of basic immunization according to the immunization program procedure, but it is effective to complete three doses at any time before 12 months of age, and the interval between each dose is at least 28 days.
(3) Serogroup A cerebral polysaccharide vaccine: it is recommended that it is best to complete according to the immunization program procedure, but it is effective to complete two doses at any time before 12 months of age, with an interval of 3 months between each dose.
(iv) Leprosy vaccine/leprosy vaccine: it is recommended that it is best to complete it according to the immunization programme procedure, but it is effective to complete a dose at any time before the age of 12 months.
(5) Japanese encephalitis vaccine and hepatitis A vaccine: It is recommended that it is best to complete it in accordance with the immunization program procedure, but it is effective to complete a dose of vaccination at any time before the age of 24 months.
In short, if the children are healthy and the epidemic conditions permit, in principle, they should be vaccinated according to the immunization procedure.
Non-immunization programme vaccines (e.g., seasonal influenza vaccine, live attenuated chickenpox vaccine, inactivated enterovirus type 71 vaccine, etc.) are important supplements to immunization programme vaccines and can be given selectively when economic conditions permit and actual needs.
Vaccines can not only protect the susceptible, but also form a herd immunity barrier, when the vaccination rate reaches a certain level, even if there is a source of infection invading, because most people have been vaccinated, they have been immunized, the transmission chain of infectious diseases is blocked, the scope of transmission is limited, and the spread and spread of infectious diseases can be reduced.
Audit experts for this issue
Edit: Dr. Spring Rain
bibliography:
[1].Expert consensus on informed notification of vaccination (Part 1)[J].Chinese Journal of Vaccines and Immunology,2021,27(02):121-151.
Liu Zhaoqiu,Bai Yunhua,Zheng Dongyi. Introduction and application recommendations for vaccines and non-immunization programmes in mainland China[J].Chinese Journal of Pediatrics,2020,58(06):524-526.
[3] Notice of the Disease Control and Prevention Administration, National Health Commission on Printing and Distributing the Immunization Procedures and Instructions for Vaccine Children of the National Immunization Program (2021 Edition), 2021-03-12, http://www.nhc.gov.cn/jkj/s3581/202103/590a8c7915054aa682a8d2ae8199e222.shtml
[4] The Notice of the Qinghai Health Commission and the Office of the Qinghai Provincial Health Commission on Printing and Distributing the "Reference Guidelines for Vaccination During the Novel Coronavirus Pneumonia Epidemic in Qinghai Province" https://wsjkw.qinghai.gov.cn/zwgk/xxgkml/jbyfkz/2020/02/12/1581495983344.html