11. What are the contraindications for vaccination?
A: At present, there are contraindications to any vaccination except rabies vaccine. The usual contraindications are those who are suffering from serious organ diseases, especially those in active stage; Acute infectious diseases are fever; Children with immune deficiency can’t be vaccinated with live vaccine because they are allergic to vaccine ingredients. When there are clear contraindications, it is really impossible to vaccinate, and vaccination should be carried out after the vaccinated object is ill.
12. Can vaccination guarantee that you will not get sick?
A: All vaccines have a certain protection rate, but due to the individual differences of the recipients, a few people will not have a protective effect after vaccination, and they may still get sick. Another case is the coupled disease. If the recipient happens to be in the incubation period of the disease targeted by the vaccine at the time of vaccination, the disease will still occur after vaccination without protective effect.
13. How to compensate for the abnormal reaction of vaccination?
A: Vaccination is a public health measure. While protecting the health of the vast majority of people, very few people bear the risk of abnormal reactions. Taking full account of the rights and interests of the recipients, the Regulations on the Administration of Vaccine Circulation and Vaccination stipulates that those who have suffered serious damage due to abnormal reactions shall be given one-time compensation, and the specific compensation measures shall be formulated by the people’s governments of provinces, autonomous regions and municipalities directly under the Central Government. The compensation expenses for abnormal reactions caused by Class I vaccines shall be arranged by the provincial finance, and those caused by Class II vaccines (self-funded vaccination) shall be borne by the production enterprises.
Abnormal reaction is inevitable because of the inherent characteristics of the vaccine itself; The occurrence of abnormal reaction is a small probability event; It is neither caused by vaccine quality problems nor by implementation errors, and no one is at fault. Through vaccination, an immune barry is established to protect that recipient and the people around the recipient. Therefore, it is not compensation to give certain economic compensation to the recipients.
14. Do you need routine screening before vaccination?
A: The contraindications of each vaccine are different and have their own special contraindications. General contraindications can only be judged by inquiry or simple physical examination, and it is impossible to screen all contraindications, and the screening cost is expensive; Routine screening of all contraindications before vaccination is not recommended internationally.
15. What will be the impact of public doubts about vaccine safety?
A: If the public’s confidence in vaccines and vaccination declines, it may lead parents of children to refuse to vaccinate their children. Without vaccination, the vaccination rate of the population will decrease, the immune barrier of the population will decrease, and the corresponding infectious diseases may break out.
For example, in Nigeria in August, 2003, some people claimed that polio vaccine (OPV) was unsafe and would lead to infertility of children in adulthood. This has led to the cessation of polio vaccination in two northern Nigerian States, and the proportion of polio vaccination in other States has also dropped significantly. As a result, polio broke out in northern Nigeria. The outbreak eventually paralyzed thousands of children in Nigeria and spread the disease to 19 other polio-free countries. Many children had to face the tragedy of lifelong disability, which could have been avoided by vaccination. In addition, countries such as Japan and Britain have also resisted vaccination because of the dissemination of false information about vaccination. The consequence is that there is an immune gap and a loophole in the immune barrier of the population, which leads to the outbreak of vaccines against infectious diseases.
16. What problems should parents pay attention to before children are vaccinated?
A: Parents should take their children to qualified vaccination clinics recognized by government departments for vaccination. Before vaccination, they should truthfully provide the vaccinators with the health status of the recipients so that the staff can judge whether they can be vaccinated. Parents should pay special attention to whether their children have acute diseases, allergies, immune insufficiency, nervous system diseases, etc., and cooperate with vaccination under the guidance of vaccinators. For example, before the newborn is vaccinated, parents need to cooperate with the vaccinators, do a good job in inquiring about the newborn’s health status and general health examination, and provide the newborn’s health status, including whether it is full-term delivery at birth, birth weight, newborn birth score, congenital birth defects, whether it is suffering from a certain disease, etc., so that the vaccinators can correctly grasp the contraindications of vaccination and decide whether to vaccinate. If you find anything suspicious after vaccination, you should immediately consult the vaccination staff and seek medical treatment if necessary, so as to get timely and correct treatment.
17. Under what circumstances are children not suitable for vaccination?
A: Acute disease: If parents find that their children have a fever, especially those with a fever above 37.6℃, or children with other obvious symptoms at the same time, they should suspend vaccination. After the child recovers and nursed back to health for a period of time, he will be vaccinated. In addition, if the child is in the onset or recovery period of an acute disease, or in the acute attack period of a chronic disease, the vaccination should be postponed until the child recovers.
Allergic constitution: individual children have allergic constitution, which is easily ignored by parents. Children with allergic constitution may occasionally cause allergic reactions after vaccination, resulting in adverse reactions. The so-called allergic constitution refers to children’s repeated contact with a certain substance, which is prone to allergic reactions and corresponding symptoms, among which allergic skin rash is the most common. If it is found that allergic reactions have occurred in the past, vaccination should be stopped.
Immune insufficiency: It is generally believed that children’s immune insufficiency is not only worse than that of healthy people after vaccination, but also easy to cause adverse reactions, especially when vaccinated with live vaccines. Serious immune insufficiency includes immune deficiency (such as agammaglobulinemia/hypogammaglobulinemia), leukemia, lymphoma, malignant tumor and so on. If children are prone to recurrent bacterial or viral infections, often accompanied by symptoms such as fever, rash and lymphadenopathy after infection, the possibility of immune insufficiency should be suspected, and special care should be taken when vaccinating.
Nervous system diseases: It is dangerous for people with nervous system diseases to get some vaccines, so it has been confirmed that children with nervous system diseases, such as epilepsy, encephalopathy, hysteria, encephalitis sequela, convulsions or convulsions, should be carefully vaccinated under the guidance of doctors.
18. What is the probability of coupling disease during vaccination?
A: Take children’s coupled illness as an example. According to the survey of health service demand in China, the two-week prevalence rate of children aged 0-4 years old is 17.4%. Therefore, even if the vaccination is safe, about 17 children out of every 100 vaccinated children will suffer from other diseases in the next two weeks. Although the diseases have nothing to do with vaccination, they are easily misunderstood as abnormal reactions to vaccination because the time is closely related to vaccination. Take the coupled death of newborns vaccinated with hepatitis B vaccine as an example. The mortality rate of newborns (0-28 days) in China is 10.7‰, and the number of children born every year in China is about 16 million. Based on this calculation, about 170,000 newborns die every year in China, which means about 466 newborns die every day. According to the regulations of China’s hepatitis B vaccine immunization program, hepatitis B vaccine should be vaccinated within 24 hours after children are born. Based on the national vaccination rate of the first dose of hepatitis B vaccine in time (within 24 hours after birth) of 75%, about 350 newborn deaths are vaccinated every day, that is, there may be 350 cases of coupled deaths in newborns vaccinated with hepatitis B vaccine every day in China.
19. How do we classify vaccines in vaccination management in China?
A: According to the Regulations on the Administration of Vaccine Circulation and Vaccination promulgated by the State Council in 2005, vaccines are divided into two categories in China.
The first category of vaccines refers to vaccines provided by the government to citizens free of charge, which citizens should receive in accordance with government regulations, including vaccines determined by the national immunization plan, vaccines added by the people’s governments of provinces, autonomous regions and municipalities directly under the Central Government in the implementation of the national immunization plan, and vaccines used for emergency vaccination or mass vaccination organized by the people’s governments at or above the county level or their health authorities. The second category of vaccines refers to other vaccines that are inoculated by citizens at their own expense and voluntarily.
Incorporating the second type of vaccine into the first type of vaccine mainly considers the degree of harm to public health caused by diseases that can be prevented by the vaccine, the effect and safety of the vaccine, the production and supply capacity of domestic vaccines and the financial burden of the government. The first kind of vaccines are generally used to prevent common infectious diseases that seriously endanger children’s health, infectious diseases with relatively high morbidity and mortality in China, and diseases that are generally included in immunization programs in other countries and diseases that are eliminated or controlled globally.
20. What are the management requirements for vaccination services?
A: The Regulations on the Administration of Vaccine Circulation and Vaccination promulgated by the State Council in 2005 stipulates that the medical and health institutions designated by the health authorities of the people’s governments at the county level in accordance with the regulations shall undertake the vaccination work. Vaccination units are required to have a medical institution’s practice license, a practicing physician, a practicing assistant physician, a nurse or a rural doctor who has passed the vaccination professional training organized by the health department of the people’s government at the county level and passed the examination, and a cold storage facility, equipment and a cold storage system that meet the standards for vaccine storage and transportation management.
In order to standardize the vaccination management, the former Ministry of Health promulgated the Code for Vaccination Work, together with the State Food and Drug Administration, promulgated the Code for the Management of Vaccine Storage and Transportation, and also formulated a series of rules and regulations, which set clear technical requirements for vaccine planning, warehousing management, cold chain management and vaccination services. According to local needs, local health administrative departments have formulated corresponding working rules and organized daily work assessment.
Cdc centers at all levels are responsible for technical guidance of vaccination and immunization planning, and undertake the monitoring and control of vaccines against diseases, formulation of vaccine demand plan of national immunization planning, management and maintenance of cold chain, distribution and guidance of vaccines, monitoring of suspected abnormal reactions to vaccination, monitoring of vaccination rate, personnel training and social publicity and mobilization. Grass-roots vaccination units are responsible for the vaccine and cold chain management of their own units, establish vaccination certificates and vaccination cards for school-age children, and provide vaccination services in accordance with the immunization procedures formulated by the state.
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