• Clinical and Experimental Vaccine Research
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• 제12권4호
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• pp.313-318
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• 2023

Purpose: Globally, 25 million children were either unvaccinated or under-vaccinated in year 2021. Among them, India had the highest number of children unvaccinated. Studies have shown impact of coronavirus disease 2019 (COVID-19) pandemic on routine health-care services. Present study aimed to estimate the impact of COVID-19 on utilization of routine immunization services during years 2020 and 2021 in tertiary-care facility. Materials and Methods: Record based descriptive analytic study was conducted at pediatric tertiary-care hospital, Jaipur. Data of children vaccinated as per the National Immunization Schedule for the period January 2019 to December 2021 were retrieved from the immunization records. Doses administered were assessed as a proxy measure of vaccine coverage. The vaccination trends of 2020 and 2021 were compared assuming base year 2019. Unpaired t-test of significance and Pearson correlation was used for correlation analysis. Results: There was significant drop in the vaccine counts after emergence of COVID-19 pandemic. In year 2020 and 2021, mean monthly vaccine count was 2,190±715.1 and 2,305±393.2, respectively, in which maximum drop was in April 2020 (-79.12%) and May 2021 (-57.16%) when it was compared with matched month of base year. There was negative correlation between percent change in vaccine count and COVID-19 cases in 2020 (r=-0.057, p=0.861) and 2021 (r=-0.827, p=0.001) as compared to year 2019. Conclusion: Study concludes that there was a significant gap in utilization of routine immunization services during the COVID-19 pandemic. This necessitates planning and management of routine immunization services in-case of future pandemics to avoid resurgence of vaccine-preventable diseases in the Rajasthan.

• Asian Pacific Journal of Cancer Prevention
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• 제13권3호
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• pp.897-900
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• 2012

Cervical cancer resulting from prior infection with human papillomavirus (HPV) is a significant public health threat against young Japanese women. A national immunization plan to vaccinate 13~16 year old female students against HPV infection has been started in Japan since 2010, and may reach almost full coverage by the end of 2012. Older age females who may already be sexually active are not targeted by this plan but should follow safer sex practices as well as periodic screening of the cervix cytology to reduce their risk of developing cervical cancer. HPV vaccination alone does not offer full protection either, because only some HPV types are covered by the vaccines and the long-term efficacy of the vaccines has not been determined yet. Therefore, we did a survey at an international university in Japan to study the knowledge and attitude of female college students towards prevention of cervical cancer, to examine the age when they start sexual activity and other related attributes that may influence the risk of cervical cancer. We discuss the results of our survey and what they imply for the possible impact of an HPV immunization plan on the risk of cervical cancer in Japan, and conclude by an emphasis on the need to increase awareness among Japanese female adolescents and to enhance the cervical screening rates among older females who are already sexually active.

• Clinical and Experimental Pediatrics
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• 제55권12호
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• pp.455-461
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• 2012

Following the Five Year Measles Elimination Program, measles has been declared eliminated from the Republic of Korea since 2006. However, there remain challenges related to the surveillance of measles in the postelimination phase. Even though the routine surveillance system has revealed a gradual decrease in the number of reported cases since 2002, 4 resurgences have occurred, notably due to outbreaks. Because vaccine-modified measles is becoming widespread due to high vaccination coverage, conducting laboratory confirmation in each case becomes important. Moreover, susceptible individuals with measles have been identified through seroprevalence studies. Lastly, the efforts to improve the timeliness of measles reporting have led to the establishment of an active laboratory-based surveillance network, which has shortened the interval between diagnosis and notification. In these circumstances, searching for more sensitive and effective surveillance measures is important for maintaining the elimination status and preventing future outbreaks of measles in Korea.

• 보건행정학회지
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• 제19권3호
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• pp.71-91
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• 2009

To assess comparatively the administrative behavior of vaccination and satisfaction of physicians by the provision method according to the National Expanded Programme on Immunization (NEPI) between 2005 and 2006 Demonstration Project in Korea. A questionnaire was performed at 582 and 64 physicians in Daegu metropolitan city and Gunpo city on 2005 (a response rate of 39.3%, 45.3%, respectively). Also, we sampled 31, 56, and 28 physicians in Gangneung city, Yangsan city, and Yeongi county on 2006 (a response rate of 35.5%, 98.2%, and 60.7%, respectively). We analyzed these data set using descriptive analysis and $\chi^2$-test through SPSS for Windows (12.0). Most question categories in Daegu metropolitan city and Gunpo city on 2005 were higher than those in the 2006 Demonstration Project regions. These were 'preparing and signing informed consent to vaccination', 'doing physical examination before periodic immunization', 'searching past shot history and inputting the current shot record through the immunization registry management program by physician', 'filing a medical record', 'satisfying the impact of 2005 and 2006 Demonstration Project and achieving the expectation of this Project', and 'improving the immunization coverage rate', et al. In conclusion, we show that the attitudes and practices of physician should be more sensitive to free vaccination services by private clinics and hospitals than public health centers. In the near future, the government must consider the opinion of physicians in implementing the NEPI by the affordable method of the public-private dynamics.

• Biomolecules & Therapeutics
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• 제31권3호
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• pp.350-358
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• 2023

Hand-foot-and-mouth disease (HFMD) is a viral infectious disease that occurs in children under 5 years of age. Its main causes are coxsackievirus (CV) and enterovirus (EV). Since there are no efficient therapeutics for HFMD, vaccines are effective in preventing the disease. To develop broad coverage against CV and EV, the development of a bivalent vaccine form is needed. The Mongolian gerbil is an efficient and suitable animal model of EV71 C4a and CVA16 infection used to investigate vaccine efficacy following direct immunization. In this study, Mongolian gerbils were immunized with a bivalent inactivated EV71 C4a and inactivated CVA16 vaccine to test their effectiveness against viral infection. Bivalent vaccine immunization resulted in increased Ag-specific IgG antibody production; specifically, EV71 C4a-specific IgG was increased with medium and high doses and CVA16-specific IgG was increased with all doses of immunization. When gene expression of T cell-biased cytokines was analysed, Th1, Th2, and Th17 responses were found to be highly activated in the high-dose immunization group. Moreover, bivalent vaccine immunization mitigated paralytic signs and increased the survival rate following lethal viral challenges. When the viral RNA content was determined from various organs, all three doses of bivalent vaccine immunization were found to significantly decrease viral amplification. Upon histologic examination, EV71 C4a and CVA16 induced tissue damage to the heart and muscle. However, bivalent vaccine immunization alleviated this in a dose-dependent manner. These results suggest that the bivalent inactivated EV71 C4a/CVA16 vaccine could be a safe and effective candidate HFMD vaccine.

• Clinical and Experimental Pediatrics
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• 제53권5호
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• pp.623-628
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• 2010

The mumps virus is a single-stranded, non-segmented, negative-sense RNA virus belonging to the $Paramyxoviridae$ family. Mumps is characterized by bilateral or unilateral swelling of the parotid gland. Aseptic meningitis is a common complication, and orchitis is also common in adolescents and adult men. Diagnosis is based on clinical findings, but because of high vaccination coverage, clinical findings alone are not sufficient for diagnosis, and laboratory confirmation is needed. Mumps is preventable by vaccination, but despite high vaccination coverage, epidemics occur in several countries, including Korea. Many hypotheses are suggested for these phenomena. In this review, we investigate the reason for the epidemics, optimal methods of diagnosis, and surveillance of immunization status for the prevention of future epidemics.

• Journal of Preventive Medicine and Public Health
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• 제55권6호
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• pp.559-567
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• 2022

Objectives: This study aimed to assess the effect of complete coverage and content of available antenatal care (ANC) on the incidence of low birth weight (LBW) in 4 countries belonging to the Association of Southeast Asian Nations (ASEAN). Methods: Measures of complete coverage and content of ANC services included the frequency of ANC visits and the seven service components (blood pressure measurement, iron supplementation, tetanus toxoid immunization, explanations of pregnancy complications, urine sample test, blood sample test, and weight measurement). The complete coverage and content of ANC services were assessed as high if more than 4 ANC visits and all seven components were delivered. Multivariable logistic regression with complex survey designs was conducted using Demographic Health Survey data from the 4 ASEAN countries in question from 2014 to 2017. Results: The proportion of LBW infants was higher in the Philippines (13.8%) than in Indonesia (6.7%), Cambodia (6.7%), or Myanmar (7.5%). Poor ANC services were associated with a 1.30 times higher incidence of LBW than a high level of complete coverage and content of ANC services (adjusted odds ratio [aOR], 1.30; 95% confidence interval [CI], 1.11 to 1.52). In addition, the risk of LBW was higher in the Philippines than in other countries (aOR, 2.25; 95% CI, 2.01 to 2.51) after adjusting for mothers' demographic/socioeconomic factors, health behaviors, and other factors. Conclusions: In sum, complete coverage and content of ANC services were significantly associated with the incidence of LBW in Indonesia, Cambodia, and Myanmar. The Philippines did not show statistically significant results for this relationship, but had a higher risk of LBW with poor ANC.

• Journal of Preventive Medicine and Public Health
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• 제41권3호
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• pp.153-158
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• 2008

Objectives : This study describes a plan that was designed to prevent a measles outbreak that showed a changed outbreak pattern. This study is based on the epidemiological investigation of a measles outbreak in a preschool in Incheon, Korea, 2006. Methods : The subjects were 152 students at a preschool where a measles outbreak occurred. A questionnaire survey was conducted and serological testing for measles-specific IgM was preformed. Results : Of the fifteen confirmed, identified cases, eleven patients had been vaccinated with one dose, one patient had received two doses and three patients were unvaccinated. The three unvaccinated cases consisted of one 5-year-old child, one 3-year-old child and one 16-month-old infant. For the cases with one dose of the vaccination, there were 11 cases, which consisted of six 5-year-old children, two 4-year-old children, two 3-year-old children and one 2-year-old child. The case with two doses of the vaccination was one 4-year-old child. The attack rate of measles was 100% in the 0-dose group, 11.2% in the 1-dose group and 2.0% in the 2-dose group. The vaccine's efficacy was 88.8% in the 1-dose group and 98.0% in the 2-dose group. The vaccine effectiveness for the 2-dose group was higher than that of the 1-dose group. Conclusions : High coverage with a 2-dose vaccination should be maintained, and the vaccination should be given at the suitable time to prevent a measles outbreak with a changed outbreak pattern.

• Pediatric Infection and Vaccine
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• 제25권3호
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• pp.141-147
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• 2018

목적: 임신 중 tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis (Tdap) 접종의 효과 및 안전성에도 불구하고, 아직 국내 임신 중 Tdap 접종률은 낮다. 이에 저자들은 임신 중 Tdap 접종에 대한 임부들의 인식, 태도 및 행동에 대한 조사를 하였다. 방법: 본 연구는 서울 및 경기 소재 대학병원 산부인과를 방문한 임부를 대상으로 개별적인 설문지를 통해 임신 중 Tdap 접종에 대한 인식, 태도 및 행동을 수집한 단면 설문조사다. 결과: 총 184명의 임부들이 설문지 작성을 완료하였다. 이 중 158명(86%)의 임부들은 의사로부터 백일해 및 Tdap 백신에 대한 정보를 안내 받지 못했고, 166명(90%)의 임부들은 임신 중 Tdap 접종의 필요성을 알지 못했다. 현 임신기간 중 Tdap 접종을 하지 않을 것이라고 답한 임부 중 7%만이 백일해 및 백신에 대한 이해를 묻는 5문항 중 3문항 이상 올바르게 답하였다. 로지스틱 회귀분석에서 의사의 추천(adjusted odds ratio [OR], 236.2; 95% confidence interval [CI], 12.6-4,432), 백신이 효과적이라는 믿음(adjusted OR, 40.21; 95% CI, 2.35-687.7), 백신이 안전하다는 믿음(adjusted OR, 19.83; 95% CI, 1.54-255.9) 등이 Tdap 접종을 결정하는데 유의하게 중요한 요인이었다. 결론: 대부분의 임부들이 Tdap 접종에 대하여 적절하게 안내를 받지 못하거나, 추천받지 못하는 것으로 보인다. 임부들의 Tdap 접종률을 향상시키는 데에 의료기관 종사자에 의해 제공되는 정보가 매우 중요하다.

• Pediatric Infection and Vaccine
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• 제24권1호
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• pp.7-15
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• 2017

목적: 예방접종 정책과 프로그램 수립에 있어 청소년의 인플루엔자 백신접종률은 중요한 정보를 제공한다. 본 연구는 국내 청소년의 인플루엔자 예방접종률을 파악하고 이에 영향을 미치는 요인을 파악하고자 하였다. 방법: 2007년부터 2012년 그리고 2014년에 시행된 제4-6기 국민건강영양조사에 참여한 만 12-18세 청소년 중 인플루엔자 백신 예방접종 여부에 유, 무를 응답한 5,213명을 대상으로 건강설문 자료를 활용하여 분석하였다. 결과: 연구 대상자의 인플루엔자 예방접종률은 23.2% (범위, 21.1%-24.7%)였다. 연구 대상자들 중, 초등학생인 경우(odds ratio [OR], 1.706; 95% confidence interval [CI], 1.526-1.906)와 주관적 건강 인식에서 건강 인식이 좋을수록(OR, 1.192; 95% CI, 1.057-1.344) 더 높은 접종률을 보였다. 음주를 하지 않고(OR, 1.769; 95% CI, 1.474-2.122) 흡연 경험이 없는 청소년(OR, 1.459; 95% CI, 1.144-1.860)에서 접종률이 높았고, 폐렴으로 의사에게 진단받은 경험이 있는 경우(OR, 1.469; 95% CI, 1.076-2.006) 접종을 많이 하는 것으로 확인되었다. 결론: 국내 청소년 중 예방접종률이 낮은 집단인 중, 고등학생과 주관적으로 건강상태가 나쁘다고 생각하는 그룹 및 음주, 흡연을 하는 청소년들을 대상으로 한 적극적인 예방접종 홍보 정책이 요구된다.