• Health Policy and Management
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• v.19 no.3
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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.

• Clinical and Experimental Pediatrics
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• v.55 no.12
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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.

• Clinical and Experimental Vaccine Research
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• v.12 no.4
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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.

• Pediatric Infection and Vaccine
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• v.19 no.1
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• pp.1-11
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• 2012

Purpose : Although influenza is regarded as one of the major causes of morbidity and mortality in children with cancer, the actual vaccine coverage remains poor. We conducted evaluation of immunogenicity and safety of influenza vaccine in children with cancer. Methods : In this study, 25 children with cancer who received influenza vaccine (SK influenza IX vaccine$^{(R)}$) at the Korea Cancer Center Hospital between October and December 2009 were analyzed. Blood samples of patients were collected twice (at the beginning of this study and at 30th day after vaccination) and their antibody titers were measured using the hemagglutination-inhibition (HI) assay. Immunogenicity of the influenza vaccine was assessed by seroprotection rate on days 0 and 30, seroconversion rate on day 30, and mean fold increase (MFI) of geometric mean titer (GMT) of HI between days 0 and 30. Results : Any of the subjects in our study did not experienced serious adverse events after influenza vaccination. Seroprotection rates were 68% for H1N1, 40% for H3N2, and 36% for B. Seroconversion rates were 12% for H1N1, 16% for H3N2, and 20% for B. MFIs were 0.9 for H1N1, 1.2 for H3N2, and 1.8 for B. Conclusion : In the study, we found a limited protective immune response to influenza vaccine, among subjects with cancer. However, some subjects showed seroconversion, and there were no severe adverse events among all subjects, supporting the recommendation of annual influenza vaccination in children with cancer.

• Health Policy and Management
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• v.14 no.2
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• pp.34-57
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• 2004

Universal health insurance normally requires a basic benefit package, whose design intersects with almost all other aspects of the health insurance debate. Despite its central importance, basic benefit package has not received the analysis it deserves in Korea. The issue of how to decide which health services should be delivered and to whom has been a matter for consistent policy debate. Many industrialized countries observed in this study have been dealing explicitly or implicitly with the basic benefit package. The methods vary from having a specific positive list of services (Bismarkian countries) to the use of guidelines (Beveridgian countries). The purpose of this paper is to form the underlying principles and process for determining what is included or left out by getting accurate and representative responses from health-related personnel. Mail survey is used. Economic burden for treatment, seriousness of disease and urgency of treatment are ranked at the first three priorities. Services that had been suspended because of financial crisis in health insurance scheme in 2001 were selected as items which should firstly be expanded into coverage. Diagnostic test against heart disease and vaccination were also selected as items which should additionally belong to the list of covered services.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.3
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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.

• Tuberculosis and Respiratory Diseases
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• v.65 no.4
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• pp.269-276
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• 2008

Background: Although the prevalence of tuberculosis infections (PTBI) is one of the basic epidemiologic indices, no survey has been carried out since 1995 because the nation-wide tuberculosis prevalence survey was changed to a surveillance system. Subjects without a BCG scar are examined in a tuberculin survey. However, it is very difficult to select these subjects under high vaccination coverage. It is important to evaluate the impact of BCG vaccinations on the tuberculin response and estimate the PTBI regardless of the BCG vaccination status. Methods: A nation-wide, school-based cross-sectional tuberculin survey was carried out among first graders in elementary school in 2006. A total of 5,148 children in 40 schools were selected by quota sampling. Tuberculin testing with 0.1 ml of two tuberculin units of PPD RT23 was carried out on 4,018 children. The maximum transverse diameter of induration was measured 48 to 72 hours later. The presence of a BCG scar was checked separately. Results: There were no BCG scars in 6.3% of the subjects. The mean induration size of tuberculin testing was $3.7{\pm}4.4mm$, which included 1,882 (46.8%) subjects with an induration size of 0 mm. The PTBI was 10.9% (439 subjects) using a cut-off point of ${\geq}10mm$ (conventional method). The annual risk of tuberculosis infections (ARTI) was 1.9% when the mean age of the subjects was assumed to be 6 years. There was no difference in the PTBI according to the presence or absence of a BCG scar [11.2% vs 7.6% (OR: 1.54, 95% CI: 0.98~2.43)]. Using a mirror image technique with 16 mm as the cut-off point, the PTBI and ARTI had decreased to 2.4% and 0.4% respectively. Conclusion: PTBI and ARTI, as estimated by conventional methods, appear to be high among BCG vaccinated children. A mirror image technique is more suitable for estimating the indices in a country with an intermediate burden of tuberculosis than the conventional method.

• Pediatric Infection and Vaccine
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• v.20 no.3
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• pp.147-160
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• 2013

Purpose: Although the overall incidence of hepatitis A in Korea has been decreasing recently, the adolescents born before the introduction of the hepatitis A vaccine remain to be highly vulnerable to outbreak. This study examines the unvaccinated adolescents' and their parents' knowledge and health beliefs toward hepatitis A vaccination. Methods: Healthy adolescents aged 13-19 years old who had no previous history of hepatitis A vaccine and hepatitis A infection, and their parents or legal guardians were the subjects of the study. The survey was conducted using a structured questionnaire based on the Health Belief Model, and examined the subjects' demographics, knowledge, and health beliefs (i.e., perceived susceptibility, severity, benefits, and barriers). Results: We included 157 adolescents and their parents/guardians (mean age: $16.0{\pm}1.6$ and $45.6{\pm}4.7$ years, respectively). The average knowledge item score for adolescents and parents was $6.4{\pm}3.7$ and $7.3{\pm}3.4$ (out of 18), respectively. Similarly, average Health Belief Model item scores were: susceptibility, $5.6{\pm}1.6$ and $5.9{\pm}1.7$ (range: 2-10); severity, $16.3{\pm}4.1$ and $18.3{\pm}3.6$ (range:5-25); benefits, $19.7{\pm}3.3$ and $20.6{\pm}2.1$ (range:5-25); and barriers, $41.3{\pm}8.9$ and $39.0{\pm}9.1$ (range:7-85). The major reason for not undergoing hepatitis A vaccination was lack of knowledge about its importance. Conclusions: Refresher health lectures about hepatitis A and the vaccine are needed by both the adolescents and their parents. Furthermore, the inclusion of hepatitis A vaccine in the national immunization program should be considered to reduce the risk of hepatitis A outbreak and to raise the vaccination coverage among the adolescents in Korea.

• Pediatric Infection and Vaccine
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• v.18 no.1
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• pp.68-79
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• 2011

Purpose : This post-marketing surveillance study (NCT00750360) assessed the safety and reactogenicity of an inactivated, trivalent split-virion influenza vaccine licensed for use in the Korea since 2002. Methods : Eight hundred and eighty three subjects aged 6 months received a single dose of the ${\geq}$ vaccine; an additional dose was administered to those aged <9 years and unprimed with an influenza vaccine. Four hundred and eleven subjects used diary cards to record safety information; this report presents data from these subjects. Incidence of solicited local, general and unsolicited adverse events (4-days and 21-days post-vaccination follow-up periods, respectively) were recorded. Serious adverse events (SAEs) were recorded throughout the study period. Results : Injection site pain (subjects aged <6 years: 12.6% of subjects, ${\geq}$6 years: 34.7%), fever (<6 years: 1.3%) and myalgia (${\geq}$6 years: 13.9%) were the most frequently recorded solicited local and general adverse events. Grade 3 solicited adverse events were reported by ${\leq}$4.0% subjects. No vaccine-related SAEs were recorded (KFDA criteria). Conclusion : Considering the vaccine's well-established immunogenicity and its favourable safety and reactogenicity profile across all age groups and its high coverage rate in Korea, it may be recommended as a candidate to facilitate annual seasonal influenza vaccination for all ages as part of the Korean National Immunization Program.

• Pediatric Infection and Vaccine
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• v.31 no.1
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• pp.1-11
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• 2024

Despite improvements in vaccine coverage, a resurgence of measles has been reported, especially in the infant and adult populations in recent years. We conducted a systematic review of seroprevalence studies conducted in the Western Pacific Region (WPR) to provide insights into seropositivity trends in different countries. This systematic review aimed to collect data from all available measles seroprevalence studies to characterize the differences in population immunity against measles in different countries. We searched the online databases PubMed and Embase to identify: 1) observational studies that investigated seroprevalence in all age groups, and 2) results reported as antibody levels. The following variables were extracted from different study arms: paper identification (title, first author, publication year), inclusion and exclusion criteria, study site, age of subjects, number of subjects, country/area, population, methods, and seropositivity (%). The search yielded a total of 69 studies included in the review. Among the 1-6-year-old group, seropositivity remained relatively high, at 81-100% in China, 86-94% in Korea, and 77-91% in Australia. In adolescents aged 7-18-years old, seropositivity was relatively constant in China and Australia over time; however, a decreasing trend was noted in Korea in 2011 (66%), 2014 (69%), and 2014 (50%) in this age group. A similar downward trend was observed among Korean adults aged 19-39 years in 2011 (74%), 2019 (71%), and 2019 (64%). Children are likely to be protected by universal vaccination programs in WPR countries and regions. However, susceptible individuals with waned immunity may be present among the adult population.