Novel coronavirus vaccination expert consensus (latest release in 2021)

Recently, we were led by the expert group of New Coronavirus inactivated vaccine vaccinated by the Concordia Hospital of Tongji Medical College of Huazhong University of Science and Technology and the emergency physician branch of the Wuhan Medical Association, and organized multidisciplinary experts to discuss and modify them repeatedly

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The expert consensus on vaccination of New Coronavirus inactivated vaccine was jointly prepared (2021 Edition)

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The purpose is to provide reference for all relevant units in vaccination and medical security work, help sort out relevant problems in practice, continuously optimize and improve the process, and complete vaccination security work better and safer

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The consensus was launched online in the Medical Herald on July 21, 2021

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Consensus point 1

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Classification of sars-cov-2 vaccine at present, more than 200 kinds of sars-cov-2 candidate vaccines are being developed in the world

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According to its technical route, they can be divided into six categories: inactivated vaccine, virus like particle, protein subunit vaccine, virus vector vaccine, nucleic acid vaccine and live attenuated vaccine, of which more than 60 are in clinical stage

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At present, there are 5 manufacturers of New Coronavirus vaccine approved for sale or emergency use in China

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It consists of 3 inactivated vaccines, 1 adenovirus vector vaccines and 1 recombinant COVID-19 vaccines

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The inactivated vaccines developed by China Pharmaceutical Group Corporation and Kexing holding Biotechnology Co., Ltd

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were included in the WHO emergency use list on May 7 and June 1, 2021 respectively

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Two

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COVID-19 vaccination medical support scheme and process 1

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Location of inoculation sites: inoculation points should be located in places where transportation is convenient and population is relatively concentrated

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It can be set up by fixed housing in community health service stations and school clinic, and temporary vaccination sites can also be set according to the needs of the mission

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Vaccination sites shall be spacious, bright, sanitary and tidy, and do a good job in disinfection, ventilation and other daily work

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The inoculation points shall be marked with eye-catching signs, and the work flow shall be marked

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They shall be divided according to the functions of seed waiting, pre diagnosis, inoculation, indwelling observation and so on

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In addition, the vaccination site shall be equipped with cold chain facilities and equipment for storing vaccines and injection equipment, drugs and instruments suitable for the number of recipients, reasonably set up sewage disposal room, and make vaccination records

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2

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Selection criteria for medical security personnel at vaccination sites: it is recommended to select medical personnel with intermediate or above professional titles to participate in the medical security of sars-cov-2 vaccination, and conduct pre job training for medical personnel to participate in medical treatment security

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Only those who pass the training can participate in medical security

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The medical staff who are required to participate in the protection must master the indications, contraindications and possible abnormal reactions of the novel coronavirus virus inoculation, and be familiar with the emergency treatment processes of all acute abnormal reactions, especially the acute emergency treatment measures such as acute severe allergy and sudden cardiac arrest

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3

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Basic configuration of inoculation point emergency response room: the inoculation point emergency response room shall be close to the observation area of the inoculation point, with eye-catching signs, and equipped with corresponding first-aid equipment (such as rescue bed, oxygen equipment, etc.) and drugs

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The basic equipment must be equipped with sphygmomanometer, blood oxygen saturation monitor, stethoscope, simple respirator and defibrillator; Adrenaline injection and glucocorticoid injection (hydrocortisone or dexamethasone, etc.) must be provided for the drug

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It is recommended to provide 0.9% sodium chloride injection, glucose injection and antihistamines   H1 receptor antagonists (injectable and oral dosage forms), short acting  β 2 receptor agonists (inhaled)   Norepinephrine injection and diazepam injection

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Fixed first aid points and ambulances shall be equipped

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4

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Preliminary screening and early warning of recipients: the guidelines clearly point out that the applicable objects of vaccination in the emergence stage are people aged 18 and above

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The usual COVID-19 vaccination taboos include: (1) allergy to the active ingredients of the vaccine, any inactive ingredient, substances used in the production process, or those who had previously been inoculated with similar vaccines

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② Those who have had severe allergic reaction to vaccine in the past (such as acute allergic reaction, angioneuroedema, dyspnea, etc.); ③ People with uncontrolled epilepsy and other serious nervous system diseases (such as transverse myelitis, Guillain Barre syndrome, demyelinating disease, etc.); ④ Fever, or acute disease, or acute attack of chronic disease, or uncontrolled severe chronic disease; ⑤ Pregnant women

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Detailed suggestions are also given for some people who are taboo or cautious in vaccination listed in the manual: ① vaccination is recommended for people over 60 years old; ② Vaccination is not recommended for persons under the age of 18; (3) health status is stable

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Chronic patients with good drug control are not recommended for vaccination against COVID-19

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(4) women of childbearing age do not recommend that special medical measures (such as termination of pregnancy) or delayed pregnancy plan be taken only for vaccination against COVID-19, and breastfeeding women should be breastfed after vaccination with COVID-19 vaccine

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(5) the immunocompromised population is a high-risk group with high risk of death after infection with COVID-19

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Vaccination against inactivated vaccine and recombinant subunit vaccine is recommended

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6

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Patients with novel coronavirus pneumonia infection (patients or asymptomatic infections) could receive 1 doses after 6 months of disease rehabilitation

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5

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Emergency response process for adverse reactions: before vaccination, the target population shall make an appointment by time through the appointment vaccination platform, and arrange the vaccination time in a reasonable and orderly manner; Vaccination of collective units shall be negotiated by collective units and vaccination units, and thorough registration shall be carried out

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The specific process is shown in the figure below

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Three

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The common adverse reactions and treatment of COVID-19 vaccine, 1 of the general adverse reactions and most of the adverse reactions reported after inoculation of COVID-19 vaccine were mild or moderate

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The total response of very few vaccinations lasted more than 7d

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The most common systemic adverse reactions are: fever, nausea, vomiting, headache, chest tightness, dizziness, muscle soreness, cough, sore throat, runny nose, fatigue, anorexia and diarrhea

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The symptoms are mild and self limiting

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They are dose-related and most of them occur after the first vaccination

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They can be treated symptomatically, but these reactions generally do not affect patients to vaccinate the same vaccine again

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2, adverse reactions and treatment (1) skin system: the common reactions of skin system after inoculation of COVID-19 vaccine include local abnormal reaction and allergy

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① Local reaction at the vaccination site: erythema, pain, swelling, induration and pruritus may appear at the injection site

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These symptoms may begin a few hours or even the next day after the injection

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These local symptoms are mild and self limiting

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Generally, they do not need special treatment and can be observed

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If the pain is severe, local cold compress or oral painkillers can be used

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If itching, oral anti allergic drugs can be taken

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② Allergy: Anaphylaxis is relatively rare

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The anaphylaxis of the confirmed vaccine is usually related to excipients or inactive ingredients, which usually occurs several minutes to one hour after vaccination

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Therefore, it must be observed on site for 30 minutes after vaccination

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Occasionally, some patients develop a small amount of urticaria or mild angioedema a few hours or days after vaccination, which is generally a normal immune response to immunization and does not need additional evaluation and treatment

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After vaccination with COVID-19, 10d should also observe the presence of viral herpes and other unusual skin rashes

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In case of abnormal rash, go to the dermatology clinic for treatment in time( 2) digestive system: the current literature reports that the common digestive system reactions after inoculation of the novel coronavirus virus vaccine include nausea, diarrhea, nausea and vomiting, and abdominal pain is rare.

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