Original text of the second edition of vaccination guidelines

Clearly include past infection history into the vaccination priority assessment dimension, clarify the four priority vaccination dosage forms for those over 60 years old and those with underlying medical conditions, and clearly cancel the mandatory interval requirements for booster vaccination for those aged 18-59 without underlying medical conditions. The remaining general provisions maintain an overlap of more than 90% with the first version.

I helped out at a community vaccination site near my home last week. The bulletin board on the left hand side of the entrance posted a pink summary of the new version of the guidelines. The fonts are two sizes larger than the old version, because I am afraid that the elderly with presbyopia cannot see it clearly. The most common question I get is whether elderly people with underlying diseases can take vaccinations. Last Wednesday, an aunt who has suffered from type 2 diabetes for 12 years came with last month’s blood sugar report and said that the first edition of the guidelines required that fasting blood sugar should be stable below 7 before taking vaccinations. She has been fluctuating around 8 recently. She didn't dare to come, so I pointed her to the clauses in the new guidelines: as long as she is not in the acute attack stage of ketoacidosis, hyperosmolar coma, etc., slight fluctuations in blood sugar are not contraindications for vaccination. My aunt finished her vaccination that day and stayed for observation. When she left, she said that she no longer had to worry about whether she could go square dancing.

When it comes to the scale of adjustment, there is actually no consensus within the academic community. Those who support relaxing restrictions are mostly front-line disease control personnel. They say that due to the previous six-month interval between booster shots, many people who frequently travel for business and come into contact with overseas items have already passed their peak antibody period, and the risk of being infected by new strains of the virus is ridiculously high. The relaxation is equivalent to giving high-risk groups more room for flexible choices. Some experts in the clinical immunology department have reservations, saying that there is currently insufficient large-sample data to prove that frequent vaccination in a short period of time will not induce immune tolerance. It is still recommended that the general population, if they do not have a high risk of exposure, should try to give boosters every 4-6 months without rushing.

To give an example that impressed me deeply, last Tuesday a young man who worked in cross-border logistics hurriedly rushed in and said that he was going to Europe to participate in an exhibition the next day. Yangkang was more than 2 months old. Previous popular science said that it would take 6 months for Yangkang to be strengthened. He was afraid that he would be infected with a new strain abroad, so he came here to try his luck. It happened that the new version of the guidelines had been released, clarifying that people with previous infections can receive booster shots after 3 months. He made an appointment with the recombinant protein vaccine on the spot. When he left for observation, he clutched the vaccination certificate and said, "There is no need to panic now."

Oh, by the way, I was asked before about whether vaccinations can be taken during pregnancy and lactation. This version directly gives the answer: men and women during pregnancy do not need to delay pregnancy preparation plans because of vaccination. Breastfeeding women can also be vaccinated normally. There is no need to interrupt breastfeeding after vaccination. Many people used to ask the old popular science from two years ago, but now there is no need to explain it again and again. Penicillin allergy, egg allergy, and cephalosporin allergy, which were previously listed on the caution list, have all been removed from the contraindications this time. As long as you are not clearly allergic to the aluminum adjuvant and other ingredients in the vaccine, you can be vaccinated normally. I counted them when I helped organize the notice. The new version has 7 fewer contraindications than the old version. Recently, more than half of the people have come to issue contraindication certificates.

Not all questions have clear answers. For example, whether teenagers aged 12 to 17 should get a fourth shot. The guide only states "it is recommended to self-assess based on exposure risk" and does not make a mandatory recommendation. The community disease control officials here suggested that children living in middle schools and high schools should be vaccinated. After all, the crowds are dense and one infected person can easily spread to the whole class. However, the infectious disease doctor at the Children's Hospital has a different view. He said that the immune response of teenagers is already strong, and the antibody level within six months after Yangkang is about 30% higher than that of adults. If there is no high risk of exposure, there is no need to vaccinate. Both sides of the statement are supported by data. In fact, parents can choose based on the actual situation of their children, and do not have to listen to one side.

There is also a vague area that is not yet unified: people with immune deficiencies and people taking immunosuppressants for a long time. The guideline only says "it is recommended to consult the attending physician to appropriately increase the number of vaccination doses." It does not recommend specific intervals and dosage forms. Now the implementation standards of different hospitals are also different. Some recommend one additional dose every 2 months, and some still follow the interval of the general population. In this case, it is best not to make a random decision based on the guideline. It is more reliable to find an attending physician who has been following up on your condition for evaluation.

Anyway, all regular vaccination sites have now posted the core summary of the new version of the guideline in a prominent position. If you are unsure, ask the medical staff at the front desk directly. It is much more reliable than searching for third-party popular science on the Internet. After all, everyone’s physical condition and exposure risk are different, and a plan that works for others may not be suitable for you.