China Releases Covid-19 Vaccination Technical Guidelines

The official website of the National Health Commission issued the “New Coronavirus Vaccination Technical Guidelines (First Edition)” on the 29th. It is clear that existing research data shows that reinfection is rare within 6 months after the new coronavirus infection. People who have been infected with the new crown pneumonia virus (patients or asymptomatic infections) can receive one dose after 6 months on the basis of full notification. Details are as follows:

Technical Guidelines for New Coronavirus Vaccination (First Edition)

This guide is used by health departments and disease control agencies at all levels to guide vaccination units .

 Recommended immunization program

(1) Applicability

People who are 18 years old and above.

(2) Times and intervals of inoculation doses.

1. New coronavirus inactivated vaccine (Vero cells)

Inoculate 2 doses; the recommended interval between the 2 doses is ≥3 weeks, and the second dose should be completed as soon as possible within 8 weeks.

2. Recombinant new coronavirus vaccine (type 5 adenovirus vector)

Inoculate 1 dose.

3. Recombinant new coronavirus vaccine (CHO cell)

Inoculate 3 doses; the recommended interval between two 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) The route of vaccination .

Intramuscular injection in the deltoid muscle of the upper arm is recommended.

3. Other related matters

(1) Late planting and replanting.

For the two-dose or three-dose program, if the vaccination is not completed according to the program, it is recommended to replant as soon as possible. The immunization program does not need to be restarted, just complete the corresponding doses.

For those who have completed 2 doses of inactivated new coronavirus vaccination within 14 days, one dose of inactivated vaccine should be supplemented as soon as possible three weeks after the second dose of vaccination. For those who have completed 2 doses of inactivated new coronavirus vaccination within 14-21 days, there is no need to replant.

(2) Strengthen immunity.

Boost immunization is not recommended at this stage.

(3) Simultaneous vaccination with other vaccines.

It is not recommended to vaccinate with other vaccines at the same time. The interval between other vaccines and the new coronavirus vaccine should be greater than 14 days. When rabies vaccine, tetanus vaccine, and immunoglobulin are needed due to animal injuries, trauma, etc., the interval between vaccination with the new coronavirus vaccine may not be considered.

(4) Replacement of different vaccine products.

At this stage, it is recommended to use the same vaccine product to complete the vaccination. In special circumstances such as the inability to continue the supply of vaccines and the recipients are vaccinated in different places, and the same vaccine product cannot be used to complete the vaccination, the same type of vaccine products from other manufacturers can be used to complete the vaccination.

(5) New coronavirus infection and antibody screening.

There is no need to carry out new coronavirus nucleic acid and antibody testing before vaccination; routine antibody testing is not recommended as a basis for immunization success after vaccination. 

(6) Contraindications for vaccination.

Usual vaccination contraindications include: (1) Those who are allergic to the active ingredients of the vaccine, any inactive ingredients, substances used in the production process, or those who have had allergies during previous vaccination of the same type of vaccine; (2) A serious allergic reactions (such as acute allergic reactions, angioedema, dyspnea, etc.); (3) People with uncontrolled epilepsy and other serious neurological diseases (such as transverse myelitis, Guillain-Barre syndrome, demyelination) Sheath diseases, etc.); (4) Patients with fever, or suffering from acute diseases, or acute attacks of chronic diseases, or patients with uncontrolled severe chronic diseases; (5) Women during pregnancy.

This guide will refer to the following vaccination recommendations for specific populations 

4. Vaccination recommendations for specific populations

(1) People aged 60 and above.

People aged 60 and above are those at high risk of severe illness and death after being infected with the new coronavirus. At present, the number of phase III clinical trials of the 4 new coronavirus vaccines with conditional approval for marketing has been included in this population in a limited number, and there is no data on the protective efficacy of the vaccine in this population. However, the data of phase I/II clinical studies show that this population has good vaccination safety. Compared with the population of 18-59 years old, the neutralizing antibody titer after vaccination is slightly lower, but the positive conversion rate of neutralizing antibody is similar, suggesting that the vaccine is 60% People over the age of age will also have a certain protective effect, and vaccination is recommended. 

(2) People under 18 years old.

At present, the existing vaccines have not yet obtained clinical trial data for this population, and it is not recommended for people under 18 years of age to be vaccinated.

(3) People with chronic diseases.

People with chronic diseases are those who are severely ill and at high risk of death after being infected with the new coronavirus. People with stable health conditions and well-controlled chronic diseases are not considered contraindications for new coronavirus vaccination and are recommended to be vaccinated.

(4) Women of childbearing age and breastfeeding period.

If you get pregnant after vaccination or get the vaccine without knowing your 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) just because of the new coronavirus vaccine. It is recommended to do a pregnancy check and Follow up. For women who have a pregnancy plan, there is no need to delay the pregnancy plan just because of the new coronavirus vaccine.

Although there is currently no clinical research data on the impact of new coronavirus vaccines in breastfeeding women on breastfeeding infants, based on the understanding of the safety of the vaccine, it is recommended to vaccinate breastfeeding women (such as medical staff) who are at high risk of new coronavirus infections. . Considering the importance of breastfeeding to the nutrition and health of infants and young children, referring to internationally accepted practices, breastfeeding women are recommended to continue breastfeeding after being vaccinated against the new coronavirus.

(5) People with impaired immune function.

People with impaired immune function are those at high risk of severe illness and death after being infected with the new coronavirus. There is currently no data on the safety and effectiveness of the new coronavirus vaccine for the 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 group of people after vaccination may be reduced. For inactivated vaccines and recombinant subunit vaccines, based on the safety characteristics of previous vaccines of the same type, vaccination is recommended; for adenovirus vector vaccines, although the vector virus used is replication defective, there is no safety data for the use of the same type of vaccine in the past. It is recommended that after being fully informed, the individual weighs the benefits outweigh the risks and vaccinates.

(6) Past patients or infected persons with new coronary disease.

Existing research data shows that there are rare cases of re-infection within 6 months after the new coronavirus infection. People who have been infected with the new crown pneumonia virus (patients or asymptomatic infections) can receive one dose after 6 months on the basis of full notification.

5. Other matters

With the approval of more new coronavirus vaccines, the continuous improvement of vaccine clinical research data, and the increase in monitoring and evaluation data after the vaccine is marketed, this guide will be updated in due course according to the needs of the epidemic prevention and control situation.

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