Regulations on pre-vaccination screening for children for non-hospital facilities in Vietnam

Regulations on pre-vaccination screening for children for non-hospital facilities in Vietnam (Internet image)

On March 27, 2023, the Ministry of Health of Vietnam issued Decision 1575/QD-BYT promulgating guidelines for pre-vaccination screening for children.

Specifically, the Ministry of Health of Vietnam provides guidelines for pre-vaccination screening for children at non-hospital facilities as follows:

Pre-vaccination screening for children 1 month of age and older in Vietnam

According to Decision 1575/QD-BYT, the pre-vaccination screening for children aged 1 month and older at non-hospital facilities is regulated as follows:

(1) Contraindications:

- There is a history of anaphylaxis grade III or higher after the previous vaccination (with the same ingredients).

- In case of history of intussusception: contraindicated with the Rotavirus vaccine.

- In case of congenital immunodeficiency: contraindicated with the OPV vaccine. 

- Other contraindications according to the manufacturer's instructions for each vaccine.

(2) Cases of postponement:

- There is a history of grade II anaphylaxis after the previous vaccination (with the same ingredients): transfer to the hospital for screening and vaccination.

- There is a state of organ dysfunction (such as respiratory failure, circulatory failure, heart failure, kidney failure, liver failure, impaired consciousness, etc.). Vaccinate when the child's health is stable.

- Suffering from acute diseases, infectious diseases. Vaccinate when the child's health is stable.

- Fever ≥ 38°C or hypothermia ≤ 35.5°C (underarm temperature measurement). Vaccinate when the child's temperature is stable.

- Immunodeficiency: Children suspected of having or having congenital immunodeficiency of an unspecified degree or suffering from severe immunodeficiency: postpone vaccination with live attenuated vaccines and transfer to hospital screening.

Immunization when children are diagnosed with non-severe immunodeficiency, except for the oral polio vaccine (OPV) (Appendix VII).

- Children who have just received immunoglobulin products within 3 months (except for hepatitis B antisera): temporarily suspend vaccination with live attenuated vaccines.

Immunize the child when he is 3 months old from the last day of using the product.

- Children who are being treated or have just finished a course of systemic corticosteroid therapy (oral/injection) with high doses (equivalent to prednisone 2 mg/kg/day), chemotherapy (alkylation drugs, anti-metabolites, TNF-α inhibitors, IL-1 inhibitors, or other monoclonal antibodies that target immune cells...), and radiation therapy within 14 days: Postponing vaccination with live attenuated vaccines.

Immunization for children begins 14 days after the end of corticosteroid, chemotherapy, and radiation therapy.

- Children weighing less than 2000g: transfer to the hospital for screening and vaccination. When the child's weight is 2000 g or more, screening and vaccination are performed at vaccination facilities outside the hospital.

- There is a history of increasing reactions after previous vaccinations of the same vaccine (e.g., the first time there was no swelling, the next time there was diffuse swelling at the injection site...): transfer to the hospital for screening and vaccination.

- Having congenital or chronic diseases of the heart, lungs, digestive system, urinary system, or blood, unstable cancer: transfer to the hospital for screening.

Vaccinate when the child's condition is stable.

- Other cases of suspension of vaccination according to the manufacturer's instructions for each type of vaccine.

Pre-vaccination screening for children under 1 month old in Vietnam

In the period of children under 1 month of age when screening, it is necessary to pay attention to the gestational age at birth, adjusted gestational age, weight, and organ functions; acute illness, suspected immunodeficiency disease, HIV exposure...

Specifically, in Clause 2, Section II of the Guidelines issued together with Decision 1575/QD-BYT, some specific contraindications and suspension situations are as follows:

- Contraindications: According to the manufacturer's instructions for each vaccine.

- Cases of postponement include:

+ There is a state of organ dysfunction (such as respiratory failure, circulatory failure, heart failure, kidney failure, liver failure, impaired consciousness, etc.). Vaccinate when the child's health is stable.

+ Suffering from acute diseases, infectious diseases. Vaccinate when the child's health is stable.

Fever ≥ 38°C or hypothermia ≤ 35.5°C (underarm temperature measurement). Vaccinate when the child's temperature is stable.

+ Children weighing less than 2000g: transfer to the hospital for screening and vaccination.

+ Suspected to have or have congenital immunodeficiency of an undetermined degree or severe immunodeficiency: postpone the vaccination against TB (BCG) and transfer to the hospital for screening.

Immunization when children are immunocompromised not severely. Indication for injectable inactivated polio vaccine (IPV) as an alternative to oral attenuated live polio vaccine (OPV).

See also Appendix VII on indications, contraindications, and postponement of immunization for children with congenital immunodeficiency.

+ Premature babies with gestational age < 34 weeks postpone vaccination against TB (BCG). Vaccinate when the baby is 34 weeks old (adjusted gestational age).

+ Premature babies with gestational age < 34 weeks: If the mother has HBsAg (-), postpone the neonatal hepatitis B vaccination, vaccinate when the baby is full 34 weeks old (adjusted gestational age).

If the mother has HBsAg (+) or is not tested, transfer her to the hospital for screening and vaccination.

+ Children who have just received immunoglobulin products in infancy (except for hepatitis B antisera): postpone vaccination with live attenuated vaccines.

Immunize the child when he is 3 months old from the last day of using the product.

+ Having congenital or chronic diseases of the heart, lungs, digestive system, urinary system, blood, nerves, or an unstable cancer: transfer to the hospital for screening and vaccination.

+ Other cases of suspension of vaccination are allowed according to the manufacturer's instructions for each type of vaccine.

More details can be found in Decision 1575/QD-BYT effective from the date of signing.

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