制度保障缺失，“特殊健康人群”能否接种疫苗由谁定？

Core Viewpoint - The article discusses the challenges and developments in the vaccination process for vulnerable populations in China, highlighting the introduction of "vaccine prescriptions" and specialized assessment clinics to improve vaccination rates among high-risk groups [1][2][4]. Group 1: Vaccination Challenges - There is a prevalent avoidance mentality among doctors due to a lack of institutional support, which affects their willingness to recommend vaccinations [5][8]. - Vulnerable groups, such as infants, pregnant women, and immunocompromised patients, face higher risks of severe illness from influenza, yet vaccination rates remain low due to safety concerns from both healthcare providers and parents [1][4]. - The complexity of the vaccination process, including the need for multiple consultations and tests, discourages patients from seeking vaccinations [3][9]. Group 2: Vaccine Prescription and Assessment Clinics - The National Health Commission has recently supported the concept of "vaccine prescriptions," allowing clinical doctors to prescribe vaccines for suitable populations [1][2]. - Specialized assessment clinics have been established in various regions to provide tailored vaccination advice for individuals with special health conditions, focusing on the types and doses of vaccines appropriate for them [3][4]. - These clinics primarily serve children with specific health issues, such as cancer or autoimmune diseases, and aim to bridge the gap between clinical treatment and disease prevention [3][4]. Group 3: Implementation and Operational Issues - The implementation of vaccine prescriptions and assessment clinics is still in its early stages, with a shortage of qualified doctors capable of making informed vaccination decisions for special populations [6][8]. - The "first mile" and "last mile" challenges in the vaccination process involve significant time and cost burdens on patients, as well as potential skepticism from community healthcare providers regarding assessments made by higher-level hospitals [9][11]. - There is a need for multi-disciplinary consultation platforms to address the complexities of vaccination for patients with multiple health issues, although these can be costly and time-consuming [9][11].