The latest vaccination guide in 2020

There is no adjustment to the vaccination procedure for the first-class vaccine in the immunization plan. Those who have delayed vaccination only need to make up the remaining doses without re-vaccination; the second-class vaccine can be voluntarily vaccinated according to the epidemic risk and their own needs; the new crown vaccine, which was still in the phase III clinical trial stage at that time, is not open to the general public, and only emergency vaccination is carried out for people with high risk of exposure. There is no official guidance plan for universal vaccination of the entire population.

I worked in the vaccination clinic of the community health service center throughout 2020. I received up to 27 consultation calls a day, half of which were asking whether I could make an appointment for the COVID-19 vaccine, and most of the rest were asking whether my children's routine vaccines, which had been delayed for several months, were okay. At that time, the epidemic had just broken out, and everyone's attention to vaccines was more than an order of magnitude higher than in previous years. Many questions that no one cared about before were asked over and over again during that period.

As for the new coronavirus vaccine at that time, there was actually no unified statement in the industry. One group is conservative and believes that the Phase III clinical data has not been completely unblinded and the long-term tracking data of adverse reactions is insufficient. Except for people who must be exposed to high-risk environments, there is no need for ordinary people to make the trip and it will not be too late to wait until the data is fully available. The other group prefers flexible response. For example, international students and staff working abroad who need to travel abroad in an emergency can apply for vaccination as long as they meet the admission criteria for emergency vaccination. After all, the risk of infection abroad is much higher than at home. The first emergency vaccinator I came into contact with at that time was Brother Wang, who was doing import cold chain loading and unloading in the jurisdiction. After the first injection in November, he had a slight fever. He was so frightened that he sent me a voice message all night. I told him that this was a normal immune response, and just drink more warm water and rest for two days. Later, his fever subsided the next day, and he even made a short video of himself moving goods to let me know that he was safe.

After talking about the new crown vaccine, let’s talk about the conventional vaccines that everyone is more familiar with. In the first half of 2020, many communities were under lockdown, and many parents were afraid to take their children out to get vaccinated. When the lockdown was lifted in April or May, the re-vaccination numbers were sold out within ten minutes of being released. A mother brought her half-year-old baby to get vaccinated against COVID-19. The first injection that was originally scheduled to be 2 months old was postponed to 6 months old. As soon as she walked in, her eyes were red and she asked if all the previous vaccinations were in vain. In fact, the guidance at the time was very clear: No matter how long the delay is for the first-class vaccine, all the unvaccinated doses are needed. There is no need to start the vaccination again, and it will have almost no impact on the final protective effect.

About the vaccination of Class II vaccines, there was considerable controversy at the time. For example, for the HPV vaccine, some gynecologists suggest that as long as they are of the right age, especially women who are about to reach the upper limit of 26-year-old nine-price vaccination, they should try to find ways to make an appointment for vaccination. After all, if you are overage, you will not be able to get the nine-price vaccine again. Although the epidemic has infection risks, it is still smaller than the risk of long-term infection with HPV. Some prevention and control personnel believe that if you rarely go out and do not have high-risk exposure risks, you can wait until the epidemic has stabilized before taking the vaccine. There is no need to risk cross-infection in the hospital to join in the fun. There was also the influenza vaccine back then. The National Health Commission recommended that key groups be vaccinated. As a result, the supply was once in short supply. At that time, we also recommended that the elderly who usually do not go out much at home and the young people who work from home should try to give the vaccine to high-risk groups such as school-going children and medical staff. This can be regarded as a special agreement in a special period.

The process of getting vaccinated at that time was not the same as it is now. You had to make an appointment on the official account one day in advance. You had to scan the health code and take your temperature on site. You were not allowed to take off your mask during the whole process of vaccination. Everyone sat far apart for a 30-minute observation period. Even the elderly who used to gather together to chat about home affairs did not dare to get close. If you have a cold or fever, or have been to a medium- to high-risk area within 14 days, you must postpone vaccination. This is a unified requirement whether it is a regular vaccine or the emergency new crown vaccine at that time.

Looking back at this 2020 guideline, it actually bears a heavy temporary imprint from the early stages of the epidemic. Many of the regulations may seem a bit unfamiliar now, but at that stage of mixed information, it did help many people clarify their thinking. In fact, vaccination guidelines have never been dead. Whether it is 2020 or now, the core principle is always the "risk-benefit balance" - which vaccine to vaccinate and when to vaccinate, essentially depends on which is higher, the risk of infection you face or the benefits of vaccination. There is never a standard answer that suits everyone.