Can people under the age of 18 get the third dose of COVID-19? Who can't get the COVID-19 booster shot

On March 29, the National Health Commission issued the first version of COVID-19 Vaccination Technical Guidelines, proposing that people under the age of 18 should not be recommended to receive COVID-19 Vaccine for the time being! What are the specific precautions? Attached vaccination guide!

I. People under 18 years old are not recommended to be vaccinated with COVID-19 vaccine! What are the specific precautions?

On March 29, the National Health Commission issued the first version of COVID-19 Vaccination Technical Guidelines, which proposed that people under the age of 18 should not be recommended to receive COVID-19 Vaccine.

It is reported that based on the clinical trial research data of the approved vaccines in China and the epidemiological characteristics of COVID-19, the COVID-19 Vaccine Working Group of the Chinese Center for Disease Control and Prevention has drafted a technical guide for COVID-19 vaccination, which was reviewed and approved by the National Advisory Committee of Immunization Planning Experts. The SEP guidelines suggest vaccination for individuals aged 60 and above; People who have been infected with COVID-19 in the past can receive one dose of vaccine six months later; People under 18 years old are not recommended to be vaccinated with COVID-19 vaccine; The interval between other vaccines and COVID-19 vaccine should be more than 14 days; Women do not need to delay their pregnancy plans solely due to vaccination; It is recommended for lactating women to continue breastfeeding after vaccination.

II. Technical Guidelines for COVID-19 Vaccination (the first version)

At present, COVID-19 vaccines from five manufacturers in China have been approved for conditional marketing or emergency use. The interim analysis results of the phase III clinical trials of three inactivated vaccines and adenovirus vector vaccines approved for marketing conditionally showed that the protective efficacy of the vaccines met the requirements of the Guiding Principles for Clinical Evaluation of novel coronavirus Vaccines for Prevention (Trial) issued by the State Drug Administration, and also met the index requirements recommended in the World Health Organization's COVID-19 Vaccine Target Product Characteristics. The monitoring data of suspected abnormal reactions after large-scale vaccination of key population in clinical trials, emergency use stage and early stage show that COVID-19 vaccine is safe. The phase II clinical trial results of the recombinant COVID-19 vaccine (CHO cell) approved for emergency use showed good immunogenicity and safety.

Based on the clinical trial research data of the approved vaccines in China and the epidemiological characteristics of COVID-19, the COVID-19 Vaccine Working Group of the Chinese Center for Disease Control and Prevention drafted this guideline, which was reviewed and approved by the National Advisory Committee of Experts on Immunization Planning.

This guide is for health departments at all levels and disease control institutions to guide vaccination units to carry out COVID-19 vaccination.?

(1) Vaccine types

1. Inactivated vaccines.

The three conditionally approved COVID-19 inactivated vaccine products were produced by Sinopharm Sinopharm Beijing Institute of Biological Products Co., Ltd. (Beijing Institute), Wuhan Institute of Biological Products Co., Ltd. (Wuhan Institute) and Beijing Kexing Zhongwei Biologics Technology Co., Ltd. (Kexing Zhongwei). The principle is to use African green monkey kidney (Vero) cells for virus culture and amplification, followed by beta testing; Propionine is used to inactivate the virus, retain antigen components to induce immune response in the body, and aluminum hydroxide adjuvant is added to enhance immunogenicity.

2. Adenovirus vector vaccine.

The adenovirus vector vaccine conditionally approved for listing is the recombinant COVID-19 vaccine (type 5 adenovirus vector) produced by Concino Biological Co., Ltd. (Concino). The principle is to recombine the spike glycoprotein (S protein) gene of COVID-19 into the replication defective human adenovirus type 5 gene, and the recombinant adenovirus expresses the S protein antigen of COVID-19 in vivo to induce the immune response of the body.

3. Recombinant subunit vaccine.

The recombinant subunit vaccine approved for emergency use is the recombinant COVID-19 vaccine (CHO cell) produced by Anhui Zhifeilong Kema Biological Pharmaceutical Co., Ltd. (Zhifeilong Kema). The principle is to recombine the receptor binding region (RBD) gene of S protein of COVID-19 into the gene of Chinese hamster ovary (CHO) cells, express it in vitro to form RBD dimer, and add aluminum hydroxide adjuvant to improve immunogenicity.

(II) Recommended Immunization Program

1. Target audience.

People aged 18 and above.

2. Vaccination doses and intervals.

2.1 Two doses of inactivated COVID-19 vaccine (Vero cell) [SEP]; The recommended interval for vaccination between two doses is 3 weeks, and the second dose should be completed as early as possible within 8 weeks.

2.2 One dose of recombinant COVID-19 vaccine (adenovirus type 5 vector) [SEP].

2.3 Three doses of recombinant COVID-19 vaccine (CHO cells) [SEP]; The recommended interval for vaccination between adjacent doses is 4 weeks. The second dose should be completed within 8 weeks after the first dose, and the third dose should be completed within 6 months after the first dose.

3. Vaccination route and site

recommends intramuscular injection into the deltoid muscle of the upper arm.

(III) Other related matters

1. Delayed planting and replanting.

For those who have not completed the vaccination of 2 or 3 doses of the vaccine according to the procedure, it is recommended to vaccinate as soon as possible. The immune program does not need to be restarted, and the corresponding dose can be completed by re planting.

For those who have completed two doses of inactivated COVID-19 vaccine within 14 days, one dose of inactivated vaccine should be added as soon as possible three weeks after the second dose. For those who have completed two doses of inactivated COVID-19 vaccine inoculation within 14-21 days, there is no need to reseed.

2. Strengthen immunity.

Currently, it is not recommended to strengthen immunity.

3. Administer at the same time as other vaccines.

It is currently not recommended to receive it simultaneously with other vaccines. The interval between other vaccines and COVID-19 vaccine should be more than 14 days. When rabies vaccine, tetanus vaccine and immunoglobulin need to be vaccinated due to animal injury, trauma and other reasons, the vaccination interval with COVID-19 vaccine may not be considered.

4. Replacement of different vaccine products. At present, it is recommended to use the same vaccine product for vaccination. In case of special circumstances such as the inability to continue supplying vaccines or vaccination of recipients in different locations, and the inability to complete vaccination with the same vaccine product, vaccination can be completed using vaccine products from other manufacturers of the same type.

5. COVID-19 infection and antibody screening.

It is not necessary to carry out nucleic acid and antibody detection of COVID-19 before vaccination; It is not recommended to conduct routine antibody testing as a basis for the success or failure of immunization after vaccination.?

6. Vaccination contraindications.

Common vaccine contraindications include: (1) those who are allergic to the active ingredients, any non active ingredients, substances used in the production process, or those who have previously been allergic to similar vaccines; (2) Individuals who have experienced severe allergic reactions to vaccines in the past (such as acute allergic reactions, angioedema, respiratory distress, etc.); (3) Individuals with uncontrolled epilepsy and other severe neurological disorders (such as transverse myelitis, Guillain Barr é syndrome, demyelinating diseases, etc.); (4) Individuals with fever, acute illness, acute exacerbation of chronic illness, or uncontrolled severe chronic illness; (5) Pregnant women.

For the population with contraindications or caution for vaccination listed in the instructions, please refer to the following specific population vaccination recommendations.

(IV) Vaccination recommendations for specific populations

1. People aged 60 and above.

People aged 60 years and above are people with high risk of severe disease and death after COVID-19 infection. At present, the number of people included in the phase III clinical trials of four conditionally approved COVID-19 vaccines is limited, and there is no data on the protective effect of vaccines on this population. However, phase I/II clinical research data shows that the safety of vaccination in this population is good. Compared with the 18-59 age group, the titer of neutralizing antibodies after vaccination is slightly lower, but the positive conversion rate of neutralizing antibodies is similar. This suggests that vaccines can also have a certain protective effect on people over 60 years old, and it is recommended to be vaccinated.?

2. People under 18 years old.

Currently, there is no clinical trial data available for vaccines used in this population, and it is not recommended to vaccinate individuals under the age of 18.

3. Chronic patient population.

Chronic patients are those with high risk of severe disease and death after COVID-19 infection. The group of chronic patients with stable health and good drug control is not considered as the contraindication group for COVID-19 vaccination, and vaccination is recommended.

4. Women of childbearing age and lactation.

If you are pregnant after vaccination or vaccinated in the case of unknown pregnancy, based on the understanding of the safety of the above vaccines, it is not recommended to take special medical measures (such as termination of pregnancy) only for the purpose of COVID-19 vaccination, and it is recommended to do a good job in pregnancy inspection and follow-up. For women with a pregnancy preparation plan, it is not necessary to delay the pregnancy plan just because of the COVID-19 vaccination.

Although there is no clinical research data on the impact of COVID-19 vaccination on lactating infants among lactating women at present, based on the understanding of vaccine safety, it is recommended to vaccinate lactating women (such as medical personnel) at high risk of COVID-19 infection. Considering the importance of breast-feeding for infant nutrition and health, and referring to international practices, it is recommended to continue breast-feeding after breast-feeding women are vaccinated with COVID-19 vaccine.

5. People with impaired immune function.

The population with impaired immune function is the population with high risk of severe disease and death after COVID-19 infection. At present, there is no data on the safety and effectiveness of the COVID-19 vaccine for this population (such as patients with malignant tumors, nephrotic syndrome, AIDS), and people infected with human immunodeficiency virus (HIV). The immune response and protective effect of this population after vaccination may decrease. For inactivated vaccines and recombinant subunit vaccines, it is recommended to administer them based on the safety characteristics of similar vaccines in the past; For adenovirus vector vaccines, although the vector virus used is replication defective, there is no safety data for the use of similar vaccines in the past. It is recommended that individuals be fully informed and weigh the benefits over the risks before administering.

6. Previous COVID-19 patients or infected persons.

The existing research data shows that the re infection of COVID-19 is rare within 6 months after infection. People who have been infected with COVID-19 virus in the past (patients or asymptomatic infected people) can be given one dose after 6 months on the basis of full notification.

(V) Other matters

With the approval of more COVID-19 vaccines, the continuous improvement of vaccine clinical research data, and the increase of post marketing monitoring and evaluation data of vaccines, this guide will be updated in due course according to the needs of epidemic prevention and control situation.