The “epidemic” song successfully cultivated good “seeds”!

Author: Wang Lin, Chief Physician, Children's Hospital, Capital Institute of Pediatrics

Vice Chairman of the Children's Health Branch of the Chinese Association of Preventive Medicine

Reviewer: Dong Jian, Chief Physician, Zhongshan Hospital, Fudan University

Vice Chairman of the Science Popularization Branch of the Chinese Medical Association

Many parents are struggling over whether or not to give their children vaccines at their own expense. They can't even tell the difference between self-paid vaccines and free vaccines.

Currently, the vaccines available are divided into Class I and Class II vaccines. Class I vaccines are free, while Class II vaccines are at one’s own expense.

There are two types of self-paid vaccines. One type is those that can replace domestic vaccines, such as imported hepatitis B vaccine and imported hepatitis A vaccine. The other type is those that cannot be replaced, which are some new vaccines, such as varicella vaccine, pneumonia vaccine, influenza vaccine, rotavirus vaccine, quadruple vaccine, etc.

The choice between imported vaccines and domestic vaccines, or between Class I vaccines and Class II vaccines is voluntary. If you can afford it financially and are willing to choose imported vaccines or pay for vaccines at your own expense, you can make your own choice based on your own situation. Of course, you can also consult a professional doctor for advice.

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Under what circumstances would a doctor recommend some inactivated vaccines at one's own expense for a baby?

Children cannot be vaccinated with some live vaccines, mainly children with low immune function, or when they use some immune preparations or blood products. In this case, we may make some recommendations to parents based on the situation.

For example, oral polio vaccine is not recommended for children with low immune function. Instead, it is recommended that they be vaccinated with inactivated pentavalent vaccine. Some children may not be able to receive some live vaccines, such as live Japanese encephalitis vaccine, after liver transplantation. Instead, it is recommended that they be vaccinated with inactivated Japanese encephalitis vaccine.

In addition to these, are there any other vaccines that are not included in the immunization plan, such as chickenpox vaccine, flu vaccine, pneumonia vaccine, rotavirus vaccine, etc., which are paid for by the child? Is there anything that needs to be paid attention to?

1. Is it necessary to give children the chickenpox vaccine?

Chickenpox is caused by the herpes virus and is a contagious disease. It is highly contagious in childcare institutions. Some children develop scars due to local itching and scratching, or scabs from chickenpox.

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Although the varicella vaccine is a Class II vaccine, it is a must for children before they go to kindergarten in most cities and regions in my country. It is basically mandatory, and it is recommended to vaccinate children if conditions permit.

The first dose of varicella vaccine is given at 1.5 years old, and a booster dose is given at 4 years old, for a total of two doses.

Varicella vaccine is a live attenuated vaccine, and its side effects are relatively greater than those of inactivated vaccines. Common systemic adverse reactions include fever, irritability, etc. Local adverse reactions may cause local redness, swelling, and nodules.

In particularly rare cases, such as children with low immune function, since the varicella vaccine is a live vaccine, they may get small chickenpox after vaccination, with fever and varicella-like herpes all over the body. At this time, they need to be treated according to chickenpox.

Parents should pay attention to local protection. Chickenpox itself is itchy. Try to take good care of your children and don't let them scratch. At the same time, use iodine tincture for local disinfection to prevent further spread of the virus.

Varicella is a self-limiting disease. Parents do not need to worry too much if small amounts of chickenpox appear. It will slowly scab over after about 10-14 days. If necessary, seek medical attention in a timely manner and treat the symptoms to help the baby through this period.

2. Do children need flu vaccines?

Every winter is the season for influenza outbreaks. From a medical point of view, we recommend giving children influenza vaccines. Even if the vaccine is not necessarily the strain of the bacteria that is prevalent every year, there is still cross-immunity, which can provide a certain degree of protection for the baby.

The current influenza vaccine can only be given to babies over 6 months old, and the vaccination period is from October of each year to January of the following year.

Infants under 3 years old are given two doses with a one-month interval between them; children over 3 years old are given one dose. Whether to give one or two doses depends mainly on age. The dose for a single dose for children under 3 years old is 0.25 mL, so two doses are needed. The dose for a single dose for children over 3 years old is 0.5 mL, so one dose is enough.

What should I pay attention to when giving my baby the flu vaccine?

First of all, we need to check if there are any contraindications. For the flu vaccine, the main thing is to see if the baby has symptoms of a cold. During the incubation period of a cold, there will be obvious side effects after the flu vaccine. So before giving your baby the flu vaccine, you must first check if there are any possible infections.

Before vaccination, first give the baby a physical examination to see if the throat is red and swollen, whether the body temperature is abnormal, etc. Secondly, it is recommended to give the baby a hot bath before vaccination, because it is not recommended to take a bath within 24 hours after vaccination.

There are several main adverse reactions to influenza vaccination, including systemic adverse reactions such as fever, irritability, etc.; local adverse reactions, such as children feeling local discomfort, local itching or tenderness; and less commonly, flu-like symptoms such as runny nose, tears, etc.

If the body temperature exceeds 38.5℃, take antipyretics. If the body temperature is not very high, it is recommended that you drink more water. Generally, the condition will improve significantly after two or three days.

Observe for 2-3 days after vaccination. If the child does not have any particularly serious condition, it means that the child has passed this period relatively safely.

3. What is rotavirus vaccine? Is it necessary to get it?

Rotavirus vaccine is mainly used to prevent severe diarrhea caused by rotavirus infection in infants and young children, which usually occurs in autumn and is called autumn diarrhea.

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Rotavirus vaccine is an oral live attenuated vaccine. Parents are advised to choose vaccination based on their own and their children's physical conditions.

Domestic rotavirus vaccine is given once a year starting from 6 months of age.

The imported rotavirus vaccine entered the Chinese market after the Spring Festival in 2019. It is administered starting 6 weeks after birth, with one dose given between 6 weeks and 2 months of age, one dose every 2 months, and the third dose given between 5.5 and 6 months of age.

What are the contraindications for rotavirus vaccination?

First, the baby cannot have an intestinal infection, whether it is a bacterial or viral infection. Second, the baby cannot have a weakened immune function because it is a live attenuated vaccine. Other contraindications to vaccination are not much different from those of conventional vaccines.

What should I pay attention to before getting rotavirus vaccine?

Since the rotavirus vaccine is an oral vaccine, it is not recommended for children to breastfeed or eat anything within half an hour before vaccination. If they eat within half an hour and then take the rotavirus vaccine orally, it can easily cause vomiting and the rotavirus vaccine will be vomited out, which will not achieve effective protection.

After the vaccination, the child needs to be observed in the hospital for half an hour. It is also recommended not to give the child anything within half an hour to prevent vomiting.

The common adverse reactions of rotavirus vaccine are mainly systemic reactions, such as fever. Some children may develop minor rotavirus infections, diarrhea or vomiting.

Fever is mainly treated symptomatically, and antipyretic drugs are given when necessary. If intestinal adverse reactions occur, they can be observed first if they are not serious. If they are more serious, symptomatic treatment is required, and fluids should be replenished in time to reduce vomiting.

4. Do children need pneumonia vaccinations?

Pneumonia vaccine is a vaccine made for early pneumococcal infection in babies, and it can play a very effective role in preventing pneumococcal infection.

For young infants, severe pneumococcal infection can cause very serious consequences, such as encephalitis, meningitis or purulent infection, purulent meningitis, and some children may also develop otitis media.

Therefore, pneumonia vaccination is very important for young babies.

Babies under 2 years old are mainly given the 13-valent pneumococcal conjugate vaccine. The 7-valent and 13-valent refer to the number of antigens. The 7-valent was the original product, which was later upgraded to 13-valent. Now all vaccines used are the 13-valent pneumococcal polysaccharide conjugate vaccine.

Babies should receive one dose of vaccine from 6 weeks to 2 months of age, and then once every month. Three doses should be given before 1 year old, and one booster dose should be given after 1 year old. All vaccinations must be completed before 15 months of age.

Another type is the 23-valent pneumococcal vaccine, which is mainly suitable for infants and young children over 2 years old. The production process of the 23-valent polysaccharide vaccine is different from that of the 13-valent polysaccharide conjugate vaccine. It is a polysaccharide vaccine that can be vaccinated with one injection.