Novel Coronavirus Vaccination Guidelines Second Edition

The timing requirements for unified vaccination of the entire population will no longer be implemented. The core prevention and control goal has shifted from "reducing the infection rate" in the early stage to "reducing the risk of severe illness and death." Only the elderly over 60 years old, people with serious underlying diseases, and people with immune deficiencies are given priority to receive booster shots adapted to the current epidemic strains. The rest of the population can choose whether to be vaccinated based on their own exposure risks and willingness to be vaccinated. There are no mandatory requirements.

During this period of time, I was doing voluntary consultation at a community vaccination site, and I was asked at least twenty times a day, "Do I still need to get vaccinated if I had an infection before?" I just used this guide to clarify the issue that everyone is most concerned about. Regarding the interval of vaccination after infection, there are actually two different judgments in the industry: one is based on the research data of previous strains, which believes that neutralizing antibodies remain at a high level within 6 months after infection and no additional vaccination is required. This was also the standard implemented in many places before. ； However, a cohort study conducted by the University of Hong Kong during the XBB epidemic period in the first half of this year showed that for people with underlying diseases such as diabetes and COPD, even if they are less than 3 months after infection, vaccination with a booster shot adapted to XBB can reduce the risk of subsequent severe illness by 41%. Therefore, this version of the guideline also specifically relaxes the interval requirements. As long as you feel the need, you can get vaccinated after recovering from the infection, without having to wait 6 months. Last week, I met a 58-year-old diabetic patient. He had sex in December last year and was diagnosed with diabetes last month. He was afraid that the virus would spread again in the fall and wanted to take a booster shot. Before, he was worried that the interval would not be enough to prevent him from taking the shot. But now he is completely fine.

The greatest emphasis in this version of the guideline is on the elderly over 60 who have not received a full set of booster shots, especially those who have not had a sun exposure and have underlying diseases. Some family members asked me before, saying that the old man is old and does not go out usually. Will he react after being beaten? On this point, I specifically checked last year’s monitoring data from Beijing Disease Control and Prevention. The rate of severe adverse reactions among people over 80 years old after receiving the COVID-19 vaccine was only 0.07%, which is lower than the 0.12% rate among people aged 18-30. Most of them are transient reactions such as redness and swelling at the vaccination site and low-grade fever, which can be resolved in two or three days. On the contrary, if they are really infected without vaccination, the seriousness rate among people over 80 years old is 21 times that of a booster shot. No matter how you calculate this, it is a good deal. My own grandmother is 84 years old and has high blood pressure. She only received two injections of inactivated vaccine before. She just received the latest XBB vaccine last week. Her arms were a little sore that day, but she had no other reactions. My family felt much more relieved.

As for young people who are healthy and have no underlying diseases, this version of the guideline really does not impose any mandatory requirements. I have friends who work in the market. They run to clients and take high-speed trains every day. For fear of being infected and delaying the project, they take the initiative to get booster shots. There are also friends who usually work from home and rarely go to crowded places. They feel that it doesn’t matter whether they take the shot or not. There is no problem with either choice. There is no need to have any moral pressure of "it is wrong not to take the shot". The previous requirement to link vaccination with travel and work has long been cancelled, and everyone can take it completely according to their own needs.

This version of the guide also gives more flexible guidance for special groups such as pregnant women and people with allergies. In the past, many places defaulted to not recommending vaccination for pregnant women. Now, with more and more research data, cohort studies of millions of people in Europe and the United States have confirmed that vaccination with the new coronavirus vaccine adapted to the epidemic strain will not increase the risk of miscarriage, premature birth, or fetal malformation. It can also pass antibodies to newborns through the placenta, reducing the risk of infection in the first half of the year after birth. The current domestic recommendation is that if pregnant women are at high risk of exposure, such as medical staff or employees in supermarkets, they can choose to be vaccinated after evaluation with their obstetrician. If they rarely go out, they can also postpone it. There is no unified requirement. Friends with allergies do not need to panic. As long as they have not experienced severe allergic reactions such as laryngeal edema or anaphylactic shock after receiving the new coronavirus vaccine, but are allergic to common allergens such as penicillin, cephalosporin, and pollen, they can be vaccinated normally. Don't scare yourself.

Finally, I would like to give you two small reminders about the actual vaccination. You don’t need to go on an empty stomach, and you don’t need to wait for half an hour at the vaccination site before leaving (of course, if you are worried, it’s okay to stay a little longer). Do not exercise strenuously for 24 hours after the vaccination, and drink less alcohol. If you really have a high fever of more than 38.5 degrees and lasts for more than two days, or a rash or difficulty breathing, just go to the hospital in time. There is no need to carry it. Don’t worry about which technical route to choose. Whether it is inactivated, recombinant protein or mRNA, as long as it is adapted to the current epidemic strain, the effective rate of preventing severe disease is more than 85%, which is not much different. There is really no need to wait for several months for a certain vaccine, which will delay the opportunity for protection.

In fact, the biggest change in this version of the guide is that it no longer imposes one-size-fits-all requirements. After all, the current trend of COVID-19 is completely different from that of three years ago. It is most reasonable for the protection strategies to change accordingly. If you are still not sure whether you should get vaccinated after reading it, go directly to the vaccination site at the community health service center near your home and ask. The doctor will be able to give you the most suitable advice in a minute or two, which is much more reliable than reading random posts online for half a day.