Is vaccination for the elderly effective and safe? An article explains →

Four questions about vaccination for the elderly: a survey report from the front line of epidemic prevention and control

90.37% is the current proportion of people in the country who have completed the full course of vaccination with the new coronavirus vaccine; 86.6% and 66.4% are the proportions of people aged 60 and above and over 80 years old who have completed the full course of vaccination respectively.

With the weakening of the pathogenicity of Omicron, the popularization of vaccination, and the accumulation of prevention and control experience, my country's epidemic prevention and control faces new situations and new tasks.

The State Council Joint Prevention and Control Mechanism Comprehensive Group optimized the implementation of the "New Ten Measures" for epidemic prevention and control, and proposed to accelerate the promotion of COVID-19 vaccination for the elderly. The Central Economic Work Conference just held also proposed that epidemic prevention and control measures should be optimized according to the current situation, and various measures for epidemic prevention and control in the new stage should be implemented conscientiously, with a focus on the prevention and control of the elderly and those with underlying diseases, and efforts should be made to protect their health and prevent severe illness.

Why is it important to emphasize the necessity of vaccination for the elderly? Does vaccination work? Is vaccination safe? The reporter conducted an investigation at the front line of epidemic prevention and control.

How necessary is it? The defense line of the elderly group is relatively weak

Li Cuiwen, 78, lives in a remote village in a central province. Her children are all in the city, and they usually bring her rice, flour and oil. She grows vegetables in her own fields, and goes to the town to attend the market once a month.

"I don't see many outsiders." Li Cuiwen and her husband have not yet received the new coronavirus vaccine. "Is it because everyone else has received the vaccine? Even if we don't get it, we can't be infected?"

Li Cuiwen is not the only one who has similar doubts. In this regard, Xia Gang, director of the Health and Immunization Department of the National Center for Disease Control and Prevention, said that a considerable number of disabled or semi-disabled elderly people in my country live at home for a long time and rarely go out, but they may still be infected when accompanied by relatives or when relatives visit.

Compared with previous strains of the novel coronavirus, the pathogenicity of Omicron is weakening, but its infectiousness has become stronger. The extremely fast transmission speed multiplied by my country's huge population base means that even if the severity and mortality rates are already very low, the number of people at risk cannot be underestimated.

During the epidemic in Shanghai from March to June this year, compared with those who were not vaccinated, the risk of death for people aged 60 and above who completed booster immunization was reduced by 98.08%, and the risk of death for people aged 80 and above who completed booster immunization was reduced by 95.83%.

At a press conference of the State Council's Joint Prevention and Control Mechanism held recently, Xia Gang introduced that according to research, if elderly people over 80 years old do not receive any dose of vaccine, the risk of death after being infected with the new coronavirus is about 14.7%; if they receive one dose of vaccine, the risk of death drops to 7.16%; if they receive three doses of vaccine, the risk of death drops to 1.5%.

"I strongly call for accelerating the vaccination, especially focusing on strengthening vaccination for vulnerable groups such as the elderly," said Zhong Nanshan, an academician of the Chinese Academy of Engineering.

How effective is it? Survey data shows that it can significantly reduce the risk of severe illness

In Chongqing, an 84-year-old recovered patient named Zhang told reporters that he suffered from multiple underlying diseases such as hypertension and diabetes. He completed the third dose of vaccination in July this year. He was infected with the new coronavirus in November. After treatment, his condition was quickly under effective control and he has now been discharged from the hospital.

"Research at home and abroad has confirmed that vaccination has a good effect in preventing severe illness and death." Xia Gang said that the elderly are more likely to develop severe illness or even die after being infected with the new coronavirus, and they will benefit the most from vaccination with the new coronavirus vaccine.

At its peak, Beijing Ditan Hospital admitted more than 100 COVID-19 patients over the age of 80. Chen Xiaoyou, deputy director of the hospital, said that the vaccination rate of these elderly patients is generally low, and the incidence of severe illness after illness is relatively high, especially when COVID-19 is combined with underlying diseases, causing more severe illness.

Ding Zhen, director of the respiratory and critical care medicine department of Hefei Binhu Hospital, a designated hospital for the treatment of COVID-19 in Hefei, told reporters: "For some elderly people with underlying diseases such as hypertension and diabetes, the new coronavirus infection may aggravate the inflammatory response in the body, aggravate the underlying disease, and even cause multiple organ failure in severe cases."

Ding Zhen introduced that based on their clinical treatment observations, the possibility of worsening of the condition of vaccinated elderly people is relatively smaller, and the time required for the nucleic acid test to turn negative is shorter.

In October 2022, The Lancet Infectious Diseases published a study based on a real-world vaccinated population by a research team from the School of Public Health, Li Ka Shing Faculty of Medicine, University of Hong Kong. The study showed that the effectiveness of preventing severe illness in elderly people over 60 years old after two doses of domestic inactivated vaccines was about 70%, and after the third dose of booster immunization, the effectiveness of preventing severe illness reached more than 95%.

Safety geometry - clarify vaccination contraindications to ensure maximum safety

In recent days, in Huanghuagang Street, Yuexiu District, Guangzhou, the number of elderly people who actively consulted and made appointments for vaccination has exceeded 300 per day, a significant increase compared to usual.

Uncle Yu and Aunt Ye, who live in Nongben Community, had concerns about vaccination due to underlying diseases. After many door-to-door promotions by community workers and volunteers, Aunt Ye was vaccinated under the health monitoring of the doctor and had no adverse reactions. The next day, Uncle Yu also completed the vaccination. "Now I know that my previous concerns were unnecessary."

The reporter found in many places that the enthusiasm of the elderly for vaccination has increased significantly recently, but some elderly people are still worried about the safety of the vaccine. Many elderly people told the reporter that they are mainly worried about "adverse reactions after vaccination due to their age and underlying diseases."

**"Chronic diseases such as diabetes and hypertension are not absolute contraindications to the new coronavirus vaccination. As long as these chronic diseases are well controlled and in a stable period, the new coronavirus vaccine can be administered." **Zheng Zhongwei, director of the Science and Technology Development Center of the National Health Commission and leader of the vaccine research and development task force of the scientific research team of the State Council's joint prevention and control mechanism, said.

According to the situation of vaccine development and vaccination practice, the Joint Prevention and Control Mechanism of the State Council has clarified the vaccination contraindications for the elderly in the "Work Plan for Strengthening COVID-19 Vaccination for the Elderly", including four types of situations where vaccination cannot be given or postponed. At the same time, local health departments should implement the "four-have" requirements of vaccination units having emergency first aid personnel stationed at a general hospital above level 2, emergency equipment and medicines, 120 ambulances on duty on site, and a green channel for treatment at a general hospital above level 2 to ensure vaccination safety.

Carry out training on determining vaccination contraindications at each level to guide medical personnel to scientifically determine vaccination contraindications; draw well-known doctors from various specialties to form a vaccination advisory expert group to patiently answer various consulting questions... Many places are refining the work of answering questions and resolving doubts to eliminate the elderly's concerns about vaccination to the greatest extent possible.

How convenient is it? The “last 100 meters” is being opened up

Every Tuesday, Thursday and Saturday afternoon, the "Medical Cavalry Team" of Pingguoyuan Street, Shijingshan District, Beijing, goes door-to-door for vaccination. The "Medical Cavalry Team" consists of 5 to 6 people from the street, community workers and medical staff, who are divided into two groups to go door-to-door for vaccination, and each group can visit about 12 households.

"We first conduct a health assessment at home, asking the elderly whether they have any underlying diseases and looking at their medical history to confirm whether they are suitable for vaccination." Luo Yan, one of the medical staff of the "Medical Light Cavalry Team" and a member of the Medical Department of Beijing Rehabilitation Hospital affiliated to Capital Medical University, said, "After the assessment, we further communicate with the family members, and after the family members agree, they sign the informed consent form and get vaccinated."

Similar situations have occurred in many places recently. Jinbi Yayuan Community in Baiyun District, Guangzhou City, opened a special COVID-19 vaccination for seniors over 60 years old. Ms. Liu, 63, suffers from rheumatoid arthritis. Medical staff asked her about her various physical indicators in detail, and after assessing that she met the vaccination requirements, they guided her to receive the third dose of the vaccine.

Li Zizhen, director of the vaccination office of the community health service center of Dongcheng Sub-district Office in Jieshou City, Anhui Province, told reporters that recently, 20 to 30 elderly people come to get the new coronavirus vaccine every day, and the consultation calls are from morning to night. The local area has set up a mobile door-to-door vaccination service team equipped with emergency equipment and medicines to provide door-to-door services at any time.

Green channels, temporary vaccination points, mobile vaccination vehicles, etc. are set up for the elderly; medical personnel with rich diagnosis and treatment experience are selected to form vaccination teams, carrying common equipment and medicines needed during the post-vaccination observation period, and providing door-to-door vaccination services for disabled and semi-disabled elderly people... Many places are optimizing various convenience measures as required to open up the "last 100 meters" for vaccination for the elderly.

For the 267 million elderly people over 60 years old nationwide, every 1 percentage point increase in the vaccination rate means that more than 2 million more people will have built a barrier against severe illness and death. "The Spring Festival is coming soon, and now the vaccine generally takes effect in half a month, which is very helpful for us to prevent large-scale transmission during the Spring Festival when people go home and migrate in large numbers," said Zhong Nanshan.

Source: Xinhua News Agency