2021 version of vaccination guide

Priority should be given to ensuring that people in highly exposed occupations, the elderly over 60 years old, and people with underlying diseases at high risk of severe illness complete basic immunizations. People over 18 years old who have no contraindications to vaccination should all be vaccinated. Vaccines from different technical routes cannot be mixed unless there are special circumstances. Staying for observation for 30 minutes after vaccination is a safety rule that must be observed.

I worked as a volunteer at the vaccination site of the street community health service center for more than three months in the spring and summer of 2021. I wrinkled the edges of this thin booklet. To be honest, it is far from the cold official document uploaded on the Internet. Behind every detail is the newly released clinical data at the time and the practical experience of hundreds of thousands of vaccinations.

At that time, the most common question asked by uncles and aunts was not how effective the vaccine was, but "I have diabetes/high blood pressure/cold legs, can I get vaccinated?" ”In fact, the taboos in the guidelines are not very strict: as long as you have no history of allergies to the active ingredients of the vaccine or substances used in the production process, are not experiencing fever, acute illness, or uncontrolled chronic diseases, even if you have high blood pressure and have been taking medicine all year round, as long as your blood pressure is stable below 140/90, and your fasting blood sugar for diabetes is stable below 13.9, you can get it. I was particularly impressed by a 92-year-old man who was accompanied by three generations of his family. His high blood pressure has been controlled very steadily after taking medication for 30 years. When he signed the informed consent form, his handwriting was neater than that of a young man. After the treatment, he stayed for half an hour for observation without any problems. Later, he specially sent a calligraphy calligraphy of "Benevolence and Benevolence" written by himself to our vaccination site.

Oh, by the way, there were many people who asked if they could choose any vaccine. Some people heard on the Internet that mixed vaccines are more effective, so they came over to ask if they could get inactivated vaccines for the first shot and adenovirus for the second shot. In fact, there were different voices in the academic circles at that time: One group was from Europe and the United States who conducted small sample studies, saying that the antibody level induced by heterologous vaccination was 3-5 times higher than that of homologous vaccination, and supported the use of mixed vaccinations when the vaccine was insufficient. ； The other group is that the country did not have enough clinical data on mixed vaccination among local people at that time, and rashly letting go may increase the risk of adverse reactions. Therefore, the 2021 version of the guideline finally clearly requires that the basic immunity stage must be vaccinated with the same technical route - to put it bluntly, it is like buying a high-speed rail ticket to go to Beijing. The procedures for the three types of vaccines at that time were also clearly divided: 2 doses of inactivated vaccine, 3 to 8 weeks apart ； Adenovirus vector vaccine only requires one dose, and is suitable for people who are in a hurry to travel abroad on business ； The recombinant subunit vaccine requires 3 doses, with an interval of more than 4 weeks between each dose. The adverse reaction rate is the lowest among the three categories. Many little girls who are afraid of pain deliberately choose this vaccine.

There was actually a lot of controversy at the time as to whether people with immune deficiencies could be vaccinated. Some experts believe that such people are more than ten times more likely to become seriously ill after infection than ordinary people. As long as there are no contraindications, they should be given priority for vaccination. ； Some experts also pointed out that the immune response level of this group of people is low, and the antibody positive conversion rate after vaccination may be only 30% of that of healthy people, which is not cost-effective. It is better to give the vaccine to healthy people who can produce sufficient antibodies first. In the end, the guideline still provided a compromise plan: as long as there are no clear contraindications, people with low immune function can be vaccinated, and if there is a follow-up policy for booster shots, they can be given priority. At that time, I met an uncle who had had a kidney transplant for three years. He came here for three consultations and finally received an inactivated vaccine. After a follow-up visit, he said he had no discomfort. Although the antibodies were a little lower than ordinary people, he still had a layer of protection.

Oh, by the way, there were a lot of outrageous misunderstandings at that time. Some people asked if you can eat spicy food, eat seafood, and take a bath after being vaccinated. In fact, the guide did not mention these dietary and lifestyle taboos at all. Unless you are allergic to seafood and peppers, or the injection site is prone to infection when exposed to water, you should do whatever you want. The only thing you have to be careful about is not to drink too much. I met a young man who had just received the vaccine in the morning. He went out with friends to drink ten bottles of beer in the evening. The next day, his fever reached 38 degrees Celsius. He rushed over in a panic and asked if there was something wrong with the vaccine. After a long investigation, it was found that there was an inflammatory reaction induced by alcohol, which made us laugh and cry. Some people think that there is no need to wear a mask after being vaccinated. The guideline specifically emphasizes it several times. The core role of the vaccine is to reduce the risk of severe illness and death, not to prevent 100% infection. The masks should be worn and the disinfection should be done. After all, the Delta strain spread quickly at that time, and one person who was positive could infect eight or nine people. There was no need to be careless.

Looking back at the 2021 version of the guidelines now, they are actually the most practical "vaccination instructions" during the special period at that time. There are not so many fancy words. The core of all the rules is to help everyone get the greatest protection with the lowest risk. Later guidelines have been adjusted based on new strains and new clinical data, but the 2021 version of this rolled-edge booklet has always been different to me - behind it are the blue tents that filled the streets that summer, people queuing up to wear masks, and everyone's hope that the epidemic will pass soon. It's quite nostalgic to say that.