Over 90% of deaths in Shanghai are over 60 years old. Why is it difficult for the elderly to get vaccinated?

The 86-year-old was taking care of his paralyzed wife at home alone.

It was not until the outbreak of the local epidemic that the attitude of the elderly loosened

Persuading the elderly to get vaccinated, being rejected, and persuading repeatedly, such things are the norm in Lou Ying's work

Persuading the elderly to get vaccinated, being rejected, and persuading repeatedly, such things are the norm in Lou Ying's work

When the number of people did not meet the standard, Li Chu still received a notice of "let the medical staff work harder" in private chat and WeChat group

"Many doctors and nurses are now being pulled to support the shelters and do nucleic acid testing, and one-third of the people who remain have to maintain normal medical treatment

As of March 17, there are still 52 million elderly people in the country who have not completed the full course of vaccination

Lou Ying , a staff member who was scolded at both ends , kept receiving new requests for the new crown vaccination rate of the elderly at work

The two scolded staff go from house to house, and face-to-face communication has almost become a must for work now.

In addition, because he is located in a mountainous area, it is nearly a 30-minute drive from the vaccination site, and Zhou Chen needs to drive the elderly to transport the elderly.

Source: Visual China

Zhou Chen often encounters situations: elderly people or their families who cannot fully understand them prevaricate or even scold them when they mobilize , "An elderly person may be scared when he sees an injection scene after he arrives, his blood pressure soars to 140, and his daughter thinks we are The work is too simple and rude, and we forcibly tricked him into the vaccination site

Zhou Chen often encounters situations where elderly people or their families who cannot fully understand them prevaricate or even scold them when they mobilize.

"I'm used to being scolded at both ends.

Hesitant seniors: associations, misunderstandings, underlying diseases

Hesitant seniors: associations, misunderstandings, underlying diseases

Wang Huaqing, chief expert of the immunization program of the Chinese Center for Disease Control and Prevention, recently introduced that "from the analysis of the current monitoring results, the incidence of adverse reactions in the elderly over 60 years old is lower than that in other age groups

"Someone died from this vaccine, are you trying to harm me?" An old man asked Zhou Chen when he was rejecting it, which made him very helpless

Some reports focus on the incident of "death after vaccination", but do not pay attention to the explanation of the cause.

Panic about vaccines often forms a tight closed loop in the village.
"The elderly in the village like to get together and chat when they have nothing to do.
It won't take long for you to say a word to me, and the whole village will spread that the vaccine is not safe
.
"

Fears over vaccines often form tight closed loops in villages

Source: Visual China

Li Chu's hospital treats elderly people with underlying diseases as usual.
The difference is that now many elderly people and their family members tell her that "our discomfort is caused by vaccines.

" The answer that Li Chu can give is ambiguous.
"The doctor will explain to him that it is not necessarily because of the vaccine
.
" But to get a more definite answer, the doctor is only one part of the complex system, and the elderly also need to go through the process of "adverse reaction detection" declaration
.
"We will let the elderly go back to the local vaccination site to report, and then the site will report to the disease control, and the disease control will conduct an investigation
.
" Whether the elderly will report, and how the disease control will communicate with the elderly, Li Chu also does not know
.
Many elderly people are still stuck in the "association of the side effects of vaccines", thinking that as long as they have underlying diseases, it is better not to get vaccinated
.

But to get a more definite answer, the doctor is only one part of the complex system, and the elderly also need to go through the process of "adverse reaction detection" declaration
.

Professor Chen Guobing from the Institute of Geriatric Immunity of Jinan University said that "the elderly are in a situation of frailty and comorbidity.
They may be more sensitive, pay more attention to their own body abnormalities, and are more likely to associate them
.
"

Chang Rongshan, an expert in virology, suggested that "before taking the new crown vaccine, elderly friends also need to pay attention to what is a psychogenic reaction and what is a vaccine-coupling reaction.
Know yourself and the enemy, and have a purpose
.
" The misunderstanding of many elderly people about vaccines is that they expect to completely prevent infection.
The misunderstanding also includes a high degree of doubt about "is it really harmless to inject vaccines?
" In this regard, Zhou Chen said that the timing of door-to-door communication is very important.
"During the epidemic in Hong Kong, I heard that many elderly people have not been vaccinated and are very easy to get sick.
Some elderly people will cooperate with our work
.
" Some elderly people will refuse to have a small range of activities and are not easily infected with the new crown
.
Chang Rongshan said, "In the past two years, cities with a permanent population of 10 million and above have experienced large and small epidemics, and the proportion of elderly people over 60 years old is also high.
For example, the proportion of elderly people in Yangpu District, Shanghai has reached 30%.
The above
.
Within four months, the vaccination rate of the elderly is less than 70%
.
In such a big city, there is a risk of epidemics in the future
.
” Chen Guobing pointed out, “The elderly between 65 and 75 years old, we call it “vigor” The elderly”
.
If you want to go out to dance square dance or visit the great rivers and mountains of the motherland, there is actually a potential risk of new crown infection, so this group of people should be especially vaccinated
.
”

The misunderstanding of many elderly people about vaccines is that they expect to completely prevent infection.
The misunderstanding also includes a high degree of doubt about "is it really harmless to inject vaccines?
" In such a big city, there is a risk of epidemics in the future
.

Source: Visual China

How do older people need to establish correct cognition and how to assess risk? "Lack of adequate decision support from doctors" is one of the important factors for vaccine hesitancy in the elderly [1]
.
From a healthcare perspective, advising older adults on vaccinations is risky
.

Embarrassed medical care: "Who is the one who faints?" The concern of Liu Fang, who works in the prevention and protection department of a community hospital, is that "if some elderly people are very afraid, they may have psychological hints after the injection, feel uncomfortable everywhere, and then come to make trouble.
"
.
Her experience shows that although the outcome depends on "the hospital's ability to deal with it and the extent of the family's troubles, medical staff are generally asked to apologize"
.
So when she encounters nervous and repeatedly asking old people, she usually persuades them to stop fighting this time
.
At present, Liu Fang does not take the initiative to reach out to the elderly at work.
"The vaccination rate in our district has been completed, so it is not particularly necessary to go to places such as nursing homes for large-scale vaccination.
After all, if you faint, who is it?"
.
In such a situation, Liu Fang and other medical staff are still waiting for the operation of a clear responsibility definition rule to create a more secure working environment, "We also need protection at work, not just tasks and pressures constantly pressing every day.
to us"
.

Embarrassed medical staff: "Whoever faints" Her experience shows that although the outcome depends on "the hospital's ability to deal with it and the extent of the family's troubles, the medical staff will generally ask the medical staff to apologize
.
"

Source: Visual China

There are some situations that make doctors choose a more cautious attitude when it comes to counseling the elderly
.
Wang Runze, a doctor at the designated vaccine hospital, often encounters questions that are not clearly answered by the new crown vaccination guidelines when consulting with the elderly .
stable'?"
.
Although the location has released comparative standards and detailed contraindications based on past experience, there are still situations where he needs to add subjective judgments in reality
.
On the other hand, the preferred consultation object of the elderly is not necessarily a doctor in a designated hospital
.
Liu Fang often receives inquiries from elders, "They may trust me more and feel that I can give more detailed advice
.
" The actual situation is that Liu Fang also has many uncertainties, and as a relative, she will not draw conclusions easily
.

Wang Runze, a doctor at the designated vaccine hospital, often encounters questions that are not clearly answered by the new crown vaccination guidelines when consulting with the elderly recommendations"
.

Whether it is the protection of doctors, the judgment of contraindications, or the smooth flow of consultation channels, "the elderly who are not sure about the condition must consult a doctor before vaccination.
" This should be a consensus.
There are still many things in the real implementation.
Difficulties did not find solutions
.
One of the constraints on the reluctance of the elderly to get vaccinated is the inconvenience of travel, for which some areas have promoted door-to-door vaccination or pick-up services
.

For the door-to-door vaccination, Li Chu described the cost of time spent, "We will send a doctor and two nurses here.
In addition to the time spent on the road, it takes more than an hour for an elderly person to check before vaccination and observe after vaccination.
Not many people can be hit in a day
.
" and concerns about safety and security, "how to bring all the first aid equipment"
.

Home vaccination in Hong Kong

Source: Hong Kong Department of Health

On March 18, Zeng Yixin, deputy director of the National Health and Health Commission, said, "Inoculation units should arrange for medical staff who are familiar with the physical condition and disease diagnosis and treatment of the elderly to provide medical insurance.
On-site observation, especially preparations for emergency rescue
.
” Allocating manpower and improving security, Li Chu and others are still adjusting, adapting and exploring on the way to promote vaccination for the elderly
.
More than data: what else needs to be done to drive vaccination of older adults? "Vaccination rate" is a word that cannot be avoided in the promotion of vaccination of the elderly
.

More than data: what else needs to be done to drive vaccination of older adults?

In the high-pressure work environment, Li Chu gradually regarded it as a mechanized task.
"The doctor is too busy himself.
He will not take the initiative to communicate or not to fight.
It is enough to complete this rate
.
"

Liu Fang is in a first-tier city.
The elderly in the local community are more cooperative and do not need to publicize it.
The vaccination rate has exceeded expectations early, so they did not further investigate whether there are still elderly people who can be vaccinated
.
However, the vaccination rate in Zhou Chen's village has been slow to increase
.

At the same time, there are still many elderly people who do not believe the government's announcement that "vaccination has nothing to do with deaths"[1]
.

Under the influence of these factors, the promotion of vaccination for the elderly is difficult to promote
.
As of April 25, there were 190 deaths in Shanghai, including 16 cases aged 61-70, 38 cases aged 71-80, 79 cases aged 81-90, 46 cases aged 91-100, and 1 case aged 101 and above
.
Twelve of the deaths had been vaccinated against the new crown pneumonia virus, and the rest were not vaccinated against the new crown pneumonia virus
.

Up to now, more than 3.
6 million people aged 60 and above in Shanghai have been vaccinated with the new coronavirus vaccine, with a full-course vaccination rate of 62%, and more than 2.
2 million people have completed booster immunization, with a booster vaccination rate of 38%
.

At the end of February, only 28% of Hong Kong people over the age of 80 had received a second shot
.
The death rate of the elderly is much lower than that of Singapore in Hong Kong, which has reached 90%
.

In the fifth wave, data from Hong Kong showed that more than 95% of deaths were over the age of 60, and any three doses of the vaccine significantly reduced the risk of death, especially in older age groups
.

Source: Hong Kong SAR Government

As of March 17, among the elderly over 60 years old in China, there are still 52 million people who have not completed the full course of vaccination.
Among them, the proportions of people over 80 years old who have completed one dose of vaccination, full course basic immunization and booster immunization are 58.
8%, 50.
7% and 19.
7% respectively.
%
.