“特殊健康人群”能否接种疫苗由谁定？

Core Viewpoint - The article discusses the extension of the graded referral model from disease treatment to disease prevention, emphasizing the role of clinical doctors in improving vaccine coverage among vulnerable populations and rebuilding trust in immunization [3]. Group 1: Vaccine Prescription and Assessment Clinics - The National Center for Disease Control and Prevention has recently supported the concept of "vaccine prescriptions," marking the first time this has been included in a policy document [3]. - Various regions, including Beijing, Shanghai, Guangdong, and Jiangsu, have initiated special assessment clinics for vulnerable populations to integrate clinical diagnosis with disease prevention [6][7]. - These assessment clinics primarily target children with special health conditions, providing medical vaccination advice and appropriate vaccine arrangements [6][7]. Group 2: Challenges in Vaccine Administration - There are significant challenges in the vaccine administration process, including the need for patients to undergo multiple consultations and tests before receiving vaccinations, which can deter them from proceeding [6][11]. - The lack of clinical guidelines for many diseases leads to hesitance among doctors to recommend vaccinations, as they fear potential legal repercussions from adverse reactions [10][11]. - The "first kilometer" and "last mile" issues highlight the logistical difficulties in the vaccine administration process, including the time and cost burdens on patients and the potential lack of recognition of assessment reports by community hospitals [11][12]. Group 3: Special Health Populations - Special health populations, such as children with cancer or organ transplant recipients, are at higher risk for severe outcomes from diseases like influenza, necessitating prioritized vaccination [9]. - The article notes that while some diseases are not listed as contraindications for vaccination, they also lack clear clinical treatment guidelines, complicating the decision-making process for healthcare providers [10]. - The need for multidisciplinary consultation platforms is emphasized to ensure comprehensive evaluations for patients with multiple health issues [11].