[Public health and clinical care integration to improve immunization of children with special health care needs]

Immunization of children with special health care needs has always been one of the difficulties in community-level public health. In recent years the relevant consensus opinions on vaccination have been issued in China, but for a long time there is a lack of effective communication channels between disease prevention and clinical medical systems in China. Pediatricians play an unoccupied role in immunization, and community-level vaccinators face the difficulties including dilemma of disease identification, evidence-based evaluation and upward referral. These lead to the vaccination hesitancy, thus the multi-disciplinary management and three-level referral model of children with special health care needs should be improved urgently. It should strengthen the integration of public health and clinical care, with the active participation of pediatricians, to promote the immunization of children with special health care needs effectively.特殊健康状态儿童的疫苗接种一直是基层公共卫生工作的难点之一。尽管近年来各地出台了相关接种共识，但长期以来我国疾病预防和临床医疗两大系统之间缺乏相对有效的沟通渠道和交流机制，儿科医生在免疫接种工作中角色缺位，而基层接种人员面临疾病鉴别、科学评估和向上转诊等困境，导致疫苗接种犹豫问题凸显，特殊健康状态儿童的多学科管理和三级转诊模式亟待完善。需进一步加强医防融合，儿科医生积极参与，有效促进特殊健康状态儿童的疫苗接种。.