• 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.

• Health Policy and Management
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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

Purpose: Despite effectiveness and safety of maternal tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis (Tdap) vaccination, Tdap vaccination coverage during pregnancy remains quite low. We assessed the knowledge, attitude and practice on maternal Tdap vaccination among pregnant women. Methods: This study was a cross-sectional survey of pregnant women who visited tertiary obstetrics and gynecologic units in Seoul and Gyeonggi province of Korea. Individual questionnaires were administered to assess knowledge, attitude and practice on maternal immunization with Tdap. Results: The questionnaires were completed by 184 pregnant women; 158 (86%) had not received information from doctors about pertussis and Tdap, and 166 (90%) did not know the need for Tdap vaccination. Only 7% of pregnant women unlikely to receive Tdap vaccine during current pregnancy answered 3 or more of the 5 knowledge-based questions correctly. By logistic regression analysis, recommendation by doctor (adjusted odd ratio [OR], 236.2; 95% confidence interval [CI], 12.6-4,432), belief that the vaccine is effective (adjusted OR, 40.21; 95% CI, 2.35-687.7), and belief that the vaccine is safe (adjusted OR, 19.83; 95% CI, 1.54-255.9) were significantly important factors to respondents' intention to be vaccinated. Conclusions: Most pregnant women seem to be neither recommended nor adequately informed about Tdap vaccination. Information given by health care professionals is very important to increase Tdap coverage among pregnant women.

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

Purpose: Influenza vaccination coverage in adolescents is an important goal of informed vaccination policies and programs. This study aimed to estimate the influenza vaccination coverage rate and investigate the factors influencing influenza vaccination coverage in Korean adolescents. Methods: The study population consisted of 5,213 adolescents (aged 12 to 18 years) who participated in the Korea National Health and Nutrition Examination Survey from 2007 to 2014 (except for 2013). We analyzed influenza vaccination coverage in relation to the demographics, lifestyle, and medical characteristics of the participants. Results: The influenza vaccination coverage rate, during the study period, was 23.2% (range, 21.1% to 24.7%). Logistic regression analysis revealed that factors influencing influenza vaccination were elementary school age (odds ratio [OR], 1.706; 95% confidence interval [CI], 1.526 to 1.906), good self-rated health status (OR, 1.192; 95% CI, 1.057 to 1.344), a drinking status of non-drinker (OR, 1.769; 95% CI, 1.474 to 2.122), a smoking status of non-smoker (OR, 1.459; 95% CI, 1.144 to 1.860), and a past diagnosis of pneumonia (OR, 1.469; 95% CI, 1.076 to 2.006). Conclusions: Influenza vaccination coverage in Korean adolescents is relatively low. Special efforts are needed to increase vaccination coverage for adolescent groups with low vaccination rates including adolescent smokers and drinkers, middle and high school age adolescents, and adolescents with a poor self-rated health status.