Earticle

본 연구의 목적은 대학생의 A형간염 지식, 예방접종 실태, 예방행위를 파악하고 지식과 행위와 관련이 있는 지 파악하여 예방 교육 프로그램을 개발하고자 시도되었다. 연구 대상은 U대학 1-4학년에 재학중인 학생이며, 임 상 실습 전 필수로 예방접종을 실시하는 간호학과 3, 4학년 학생을 제외한 219명을 편의 표집하였다. 자료분석은 SPSS 18.0 WIN을 이용하여 빈도, 백분율, t-test, ANOVA, Pearson correlation으로 분석하였다. 연구결과 A형 간염 지식은 성별, 전공, 한 달 용돈, 3개월 이내 HAV 교육경험, 본인의 항체 보유, HAV 감염 여부, 가족 중 HAV 감염력이 있는 경우와 A형간염 예방행위는 거주형태에서 유의한 차이를 나타냈다. 그리고 A형간염 지식과 예방행 위는 유의한 상관관계가 나타나지 않았다. 본 연구를 통해 대학생의 A형간염 접종률을 높이기 위해서는 예방접종 의 필요성과 성인기 예방접종에 대한 홍보가 필요하며, 습관화된 예방행위가 이루어질 수 있는 프로그램 개발이 필요하다.

The purpose of this study was to develop a prevention education program by grasping the knowledge of hepatitis A, Immunization and prevention behavior of university students. The subject of the study was questionnaire for 219 students, excluding the 3rd and 4th graders of the Department of Nursing. Collected data were analyzed by frequency, percentage, t-test, ANOVA, Pearson correlation using SPSS 18.0. As a result of the study, knowledge of hepatitis A was determined by gender, major, allowance for a month, HAV education experience within 3 months, personal antibody retention, HAV hepatitis, and cases of HAV infection among family members, hepatitis A prevention behavior showed a significant difference in the type of residence. In order to increase the hepatitis A vaccination rate of university students through this study, the need for vaccination and promotion of adult vaccination is necessary, and the development of a program that enables habitual preventive behaviors is needed.

The Pharmaceutical Affairs Act and the Infectious Disease Control and Prevention Act currently restrict pharmacists in South Korea to vaccine storage, distribution and counseling roles, which were limiting the opportunity to meet surging demand during the COVID-19 pandemic. In response, the inaugural Pharmacy-Based Immunization Delivery certificate training program was initiated in July 2023 in South Korea, marking a significant step for equipping pharmacists as vaccinators once national regulations evolve. Globally, pharmacy communities have confronted numerous challenges, including regulatory restrictions, professional conflicts, competency gaps, and low public trust and awareness. Nevertheless, evidence shows pharmacy-based vaccination programs significantly improved immunization rates, prevented infectious diseases, reduced vaccine hesitancy, and minimized post-immunization adverse reactions. According to the International Pharmaceutical Federation’s 2024 report, 56 of 120 surveyed countries now offer pharmacy-based vaccination services, 44 grant pharmacists direct vaccine-administration rights, and 26 authorize pharmacist prescribing privileges. Learning from these international precedents, this review proposes a coordinated, stepwise strategy for South Korea. Key recommendations include that pharmacy bodies and stakeholders should establish a multi-stakeholder forum to unite government agencies, medical associations, and legislators on shared policy objectives, while engaging the public to build awareness and trust. In addition, pharmacy professions should adopt a phased authorization approach, initiating with pilot program implementation, followed by rigorous evaluation and legislative endorsement, which enable pharmacists to demonstrate that the expanded scope of practice can safely and effectively improve national immunization efforts.

예방접종이 20세기의 질병퇴치에 가장 효과적인 보건정책이었음은 주지의 사실이다. 그러나 경제적 관점에서 예방접종의 장기적 효과에 대해서는 잘 알려져 있지 않다. 본 연구에서는 미국의 IPUMS의 1980년, 1990년 그리고 2000년 센서스 데이터와 1960년대 초부터 1980년대 말까지 제정된 주별 예방접종 관련 법안 제정 시기 데이터를 활용하여 예방접종의 효과가 성인기 소득에 미치는 효과를 살펴보았다. 분석 결과 예방접종 의무 조항이 있는 주에서 태어난 경우 성인기 소득을 1% 정도 증가시키는 것을 알 수 있었다. 이러한 사실은 예방 접종률을 높이는 정책의 개발과 효과적인 예방접종 지원정책이 노동시장에서의 생산성 향상에 긍정적인 효과를 줄 수 있음을 시사한다.

Although vaccination has been known as one of the most effective public health policies for improving children’s health throughout the twentieth century, the long-term economic effect of vaccination is less explored. This paper examines the effect of vaccination in early life on income in adult, exploiting the 1980-2000 IPUMS data sets and the legislation history of US school immunization law. One of the main findings shows that those who lived at age 5 in the states where school immunization law was implemented had about 1% higher income in adult than those who lived in the states where school immunization was not enforced. The result suggests that the policies of promoting vaccination may have a longer-term effect on economic productivity.

본 연구는 의료인 권장예방접종에 대한 간호대학생의 건강신념 요인을 검토하고, 예방접종 의도에 건강신 념 요인이 미치는 영향을 파악하기 위해 시도되었다. 연구대상자는 간호대학생 260명이었고, 자료는 설문지를 통 해 수집되었고, SPSS 23.0 프로그램의 t-test, ANOVA, 피어슨 상관계수 및 위계적 다중회귀를 사용하여 분석하 였다. 간호대학생의 권장예방접종 의도에 영향을 미치는 요인에 대한 회귀모형은 유의하였고(F=13.35, p<.001), 주요 영향 변인은 행동의 계기, 자기효능감, 지각된 유익성, 학년 순으로 나타났으며, 모형의 설명력은 36.4% 이었 다. 본 연구를 통해 임상실습 중 감염예방을 위한 예방접종의 효과를 강조하고 간호대학생 대상의 의료인 권장예 방접종 의도를 향상시킬수 있는 프로그램을 개발하고 적용할 필요가 있음을 확인하였다.

The purpose of this study was to find the influential factors of nursing students’ behavioral intention of Recommended Immunizations for Healthcare Personnel(RIHP). The survey was performed on 260 nursing students. Data were collected using a structured questionnaires and analyzed using t-test, ANOVA, Pearson correlation coefficient, and hierarchical regression with SPSS 23.0 program. Results of this study revealed that the influential factors on the behavioral intention of RIHP were the cues to action, self-efficacy, perceived benefits and senior grade. And the explanation power of the regression model appeared as being 36.4%(F=13.35, p<.001). Based on the study findings, further development and application of specific programs to improve nursing students’ intention of RIHP in consideration of grade, to emphasize benefits of immunization, are needed to prevent infection in clinical practice.

청소년의 인플루엔자 예방접종은 지역사회의 인플루엔자 확산 방지에 중요하다. 따라서 본 연구에서는 국민건강영양조사 제 6기 자료를 이용하여 청소년의 인플루엔자 예방접종에 영향을 미치는 개인 요인과 부모 요인 을 알아보고자 하였다. 연구대상은 만 12-18세 청소년 1,020명과 그 어머니 884명, 아버지 557명이었다. 분석을 위 해 Rao-Scott x2, 다중회귀분석을 실시하였다. 청소년의 인플루엔자 예방접종률은 26.2%로 매우 낮았고, 청소년의 연령이 적을수록, 최근 2주간 몸이 불편했던 경험과 폐렴 과거력이 있으며, 자동차 앞좌석 안전벨트를 착용하는 경 우 인플루엔자 예방접종률이 높았다. 또한 부모의 연령이 적을수록, 부모 본인이 인플루엔자 예방접종을 한 경우 청소년의 인플루엔자 예방접종률이 높았다. 우리나라 청소년의 인플루엔자 예방접종을 확대하기 위해서는 미디어와 의료인들은 청소년과 부모에게 인플루엔자 예방접종에 대한 교육이나 홍보를 통해 인플루엔자 예방접종에 관한 인 식을 개선하고 다양한 융합적 중재를 제공해야 한다.

Influenza vaccination in adolescents is crucial to prevent the influenza expansion. The aim of this study was to investigate the difference of personal factors and parental factors affected influenza vaccination coverage. Study data on 12-18 years old adolescents and their parents were obtained from the 6th Korea National Health and Nutrition Examination Survey. Rao-Scott Chi-square test and multivariate logistic regression were used for the analysis. The percentage of influenza vaccination coverage in adolescents was low (26.2%). The personal factors influencing influenza vaccination were age, discomfort within two weeks, history of pneumonia, and wearing safety belt in adolescents, and the parental factors were age and influenza vaccination. In order to increase the influenza vaccination coverage for adolescents, media and healthcare professionals should provide education to adolescents and their parents about influenza vaccination.

Purpose: Immunization is one of the simplest and most effective approaches for protecting the health of children from preventable infectious disease. This study assessed the immunization statuses of children presenting to childcare centers in Korea and compared the sociodemographic factors of children with age-appropriate immunization for DTaP4 with those with delayed immunization for DTaP4. Method: A national mail survey was used to collect data on the children's immunization history and sociodemographic information. A total of 248 mothers returned completed questionnaires for their children. Results: The overall immunization coverage for HepB, a series of DTaP and polio and varicella was above 95%. However, the percentage of age-appropriate immunizations of vaccines ranged from 45.3% to 69.0% depending on the vaccines. Only the age of the child was a significant factor for delayed immunization for DTaP4. Conclusion: To fully protect children from vaccine- preventable disease, childcare providers can play a role in monitoring the immunization statuses of children in their care centers to ensure that they all receive all childhood immunizations on time.

Purpose: This study investigated the factors associated with Adverse Event Following Immunization (AEFI) for Coronavirus Disease 2019 (COVID-19) in selected areas in Indonesia. Methods: We used a cross-sectional approach with a correlational research design; a total of 2,730 samples were collected using accidental sampling. The instrument was an online questionnaire. The AEFI questionnaire was a modified version of the survey instrument of the Ministry of Health, Republic of Indonesia. x2 and Fisher's exact tests were used for statistical analysis. Results: The most common AEFI were pain at the injection site (81.2%), drowsiness (77.2%), hunger (77.0%), headache (70.3%), and weakness (58.4%). Bivariate testing revealed that gender, age, disease history, vaccine type, and anxiety had statistically significant relationships with the incidence of weakness, pain at the injection site, and headache (p<.050). Age and vaccine type were significantly related to the incidence of fever, swelling at the injection site, and hunger. Gender, vaccine type, and anxiety were found to have statistically significant relationships with the incidence of nausea. Vaccine type and anxiety were significantly related to vomiting. Conclusion: The study found that gender, age, history of disease, vaccine type, and level of anxiety were associated with several adverse events following COVID-19 immunization. These findings provide data to nurses and other health workers to help them offer additional interventions to prevent or reduce adverse events in at-risk groups following COVID-19 vaccination.

The present study was aimed to investigate the molecular mechanisms of active immunization against GnRH by focusing on effects of active immunization against GnRH on hypothalamic-pituitary-testicular axis. Adult male rats (n=36) were randomly and equally allocated into three groups: control (no treatment), surgically castrated, or immunized against 50 ug D-Lys6-GnRH-tandem-dimer peptide conjugated to ovalbumin in Specol adjuvant at 12 weeks of age (with a booster 8 weeks later). Blood samples (for antibody titers and hormone concentrations) were collected at 2-week intervals until rats were killed at 20 weeks of age. At decapitation, testes weight /volume and pituitary weight were recorded. Hypothalamus, pituitary and testis were collected to detect the mRNA expressions of reproduction-related genes with real-time fluorescence quantitative PCR, and the hypothalamus and testes were excised for tissue GnRH detection and morphological observation, respectively. Compared to intact controls, immunocastration reduced (p<0.05) serum concentrations of testosterone, LH and FSH, and the GnRH content in the median eminence, reduced the weight of the hypohysis (p<0.01), and induced testicular atrophy (suppression of spermatogenesis). Furthermore, mRNA expression of GnRH in the hypothalamus, GnRH receptor, LH-β and FSH-β in the pituitary, LH receptor and FSH receptor in the testes, and genes in sex steroid feedback loops (androgen receptor (AR), kisspeptin encoded gene (Kiss-1) and kisspeptin receptor (GPR54) in the hypothalamus were decreased in immunocastrated rats compared to intact controls (p<0.05). Similarly, surgical castration reduced GnRH in the median eminence as well as mRNA expression of GnRH, AR, Kiss-1 and GPR54 in the hypothalamus (p<0.05). These results suggest that active immunization against GnRH reduces GnRH synthesis in the hypothalamus by decreasing androgen-androgen receptor-Kisspeptin-GPR54 signaling pathways and causes dysfunction of the pituitarytesticular axis. Both the loss of GnRH synthesis and dysfunction of the pituitary- testicular axis seem to be mechanisms underlying immunocastration.

Purpose: HPV vaccination is important for the prevention of cervical cancer and genital warts and it is recommended that females be vaccinated against HPV before having sexual contact. Although the national HPV immunization has recently started in Korea, the vaccination rate is still not high. This is a relevant study attempting to investigate the factors affecting the vaccination status of female adolescents in the target age groups focusing on mothers' knowledge and health beliefs of HPV vaccines. Methods: Participants were 206 mothers who had daughters at the target age for the national HPV vaccination program living in a metropolitan city. Data were collected using a self-reported questionnaire about HPV knowledge and health beliefs of HPV vaccines, consisting of perceived susceptibility seriousness, benefits, barriers, and cues to action. Results: The participants’ knowledge of HPV was significantly correlated with the overall health beliefs. The factors influencing mothers regarding the HPV vaccination status of their adolescent daughters were found to be perceived barriers, advice on vaccination from medical staff, and perceived benefits. Conclusion: There is a need to organize subject-specific education programs focusing on correcting misinformation about the side effects and benefits of HPV vaccines. When operating education programs, it is recommended that participants include both students and their parents, that various approaches be implemented such as formal health classes, home correspondence and online education, and that medical personnel be also involved as education providers.

Purpose: The present study examines the current influenza immunization rate among kidney transplant patients in an effort to identify the factors influencing their decisions pertaining to the immunization. Methods :Participants in the study included 150 adults over the age of 64 years who visited a General Surgery Department in Korea on April 2015, who had had a kidney transplant at least two years prior to the visit. We compared the characteristics of transplant patients who were immunized against those of the patients who had not been immunized. Results: The average age of the participants was 48.5±9.6 years, consisting of 87 males (58.0%) and 63 females (42.0%). The average post-surgery period was 91.0±59.0 months. Between September and December 2014, the immunization rate among these participants was 61.3%. Factors which influenced the participant’s decision to get immunized in 2014 and drove up the immunization rate were: previous immunization in 2013 (OR=24.57, CI= 8.79-68.70, p<.001), marital status (OR=3.33, CI 1.05-10.56, p=.041), and awareness (OR=1.58, CI=0.99-2.52, p=.056). Conslusion: The current study found that the previous year’s immunization record, marital status, and awareness increased the rate of immunization among the participants.

Purpose: To explore the barriers and solutions of immunization programs for children among vulnerable classes in the position of service providers in public health centers. Method: Data were collected through focus group interviews with 3 groups (17 providers), and were analyzed according to the analytic method of Morgan (1998) and Krueger (1998). Results: The following five categories were identified: difficulties in obtaining a list of children among vulnerable classes, difficulties in first contact with them, difficulties in up-to-date immunization, various difficulties according to the types of vulnerable family and suggestions of solution. These results indicated that there are many difficulties in providing expanded immunization service for children among vulnerable classes in terms of manpower, cooperation of departments in public health centers and linkages between health and welfare. Finally, the characteristics of the types of vulnerable family need to be elucidated. Conclusion: To increase immunization rates among children of vulnerable classes, policies need to be prepared at the public health organization itself and the linkages between health and welfare and need for hiring additional personnel.

-Factors Influencing Children's Immunization

우리나라에서 예방접종에 대한 비용지원은 국가예방접종사업을 통해 이루어진다. 국가예방접종사업은 2006년 법률안 개정을 통해 민간의료기관에 대한 위탁시행 근거를 마련하고, 2014년부터 어린이 필수예방접종에 대해 무료접종을 도입하면서 현재와 같은 제도가 만들어졌다. 정부가 계속해서 국가예방접종사업을 확대하고 있지만, 지원하는 대상을 확대해야 한다는 요구가 이어지고 있다. 본 연구는 우리나라의 예방접종에 대한 비용을 지원하는 제도인 국가예방접종사업의 현황과 법적 지원체계를 검토 분석하여, 그 개선방안을 제시하고자 하였다. 우선 필수예방접종 대상 감염병에 대한 접종 권고 대상(백신 포함)과 국가예방접종에 따른 비용지원 대상이 어떻게 차이가 있는지를 질병관리청이 제공하는 예방접종 안내, 지침, 보도자료 등을 통해 분석하였다. 또한 현행법령에 규정된 예방접종 관련 조문을 분석하여 접종 권고와 비용지원 대상자의 차이를 만들어내는 법 체계상의 문제를 확인하고자 하였다. 마지막으로 17대 국회 이후 발의된 의원 발의안과 발의안에 대한 상임위 검토보고서를 분석하여 개선 방향에 대한 시사점을 찾고자 하였다. 연구 결과, 필수예방접종 권고 대상과 국가예방접종 관리사업의 비용지원 대상 사이에 세 가지 유형의 불일치가 발생하고 있음을 확인하였다. 또한 국가예방접종사업에 대한 직접적인 법적 근거가 없으며, 예방접종에 대한 비용지원을 다르게 할 법적 근거가 없음을 확인하였다. 17대부터 21대(현재)까지 27건의 예방접종 비용지원 확대 개정 발의안 중 필수예방접종 대상 감염병 종류를 확대 7건만 법안에 반영되고, 접종 대상(자) 확대는 모두 폐기되었는데, 이는 정부가 접종 대상(자) 확대는 우선순위 연구와 예산 상황을 고려해 점진적 확대라는 정책 방향을 추진하기 때문으로 추정하였다. 비용지원 제도의 문제를 해소하기 위해 몇 가지 입법적 개선방안을 제안하였다. 우선 예방접종 권고 대상과 비용지원 대상의 불일치를 해소하기 위해 국가예방접종사업을 법에 직접 명시하는 방안과 국가예방접종 대상이 아닌 대상(자)을 지원하기 위해 국민건강보험을 활용한다면 국민건강보험법에 별도의 근거 조항을 두어야 함을 제시하였다. 두 번째로 국민건강보험법에 코로나19와 같은 팬데믹 시기의 대규모 예방접종에 대해 건강보험이 지원할 수 있는 근거를 만들어야 함을 제기하였다. 마지막으로 감염병예방법에서 ‘실시대상․시기 및 주의사항’과 위임을 법에 명시할 것을 제안하였다

The National Immunization Program in Korea, initiated in 2006 and later revised in 2014, functions as the primary avenue for providing vaccinations through collaboration with public and private healthcare sectors. Despite ongoing efforts to expand its reach, there’s a growing demand for broader inclusivity within the program’s support parameters. This study conducts a comprehensive analysis of the program’s current operational landscape, evaluating its legal foundation and proposing crucial enhancements to fortify its effectiveness. A examination comparing vaccination recommendations with funding targets revealed inherent discrepancies. These disparities underscore a significant absence of direct legal grounding and pose challenges due to inconsistencies in financial support allocation. Extensive scrutiny of legislative endeavors across multiple assemblies unveiled a limited integration of bills aimed at extending the breadth of immunization targets. The underlying reasons for this deficiency often trace back to policy directives and budgetary constraints that shape decision-making processes. This essay presents a strategic blueprint for legislative improvements, aiming to bridge existing gaps within the support framework. This deliberate step seeks to rectify the discrepancies between vaccination recommendations and the allocation of financial resources. Additionally, the proposition advocates for the creation of separate clauses within the National Health Insurance Act to extend coverage to individuals falling outside the current scope of the national immunization ambit. Moreover, there’s a pressing need to fortify the National Health Insurance Act by introducing provisions geared towards facilitating mass vaccination during pandemics, exemplified by the tumultuous challenges posed by the COVID-19 outbreak. Lastly, this essay proposes refining the delegation aspects within the Infectious Disease Prevention Act, necessitating explicit guidelines regarding ‘who, when, and precautions’ associated with such delegations.

Background: 8,000 children in North Korea died before they reached the 1 year after births in 2013. The high mortality rate of children under five years of age is mainly caused by infectious diseases and malnutrition. The need for national pediatric immunization and supply of vaccines will be vital when the abrupt reunification occurs. Objective: The purpose of this study is to scrutinize the pediatric immunization coverage of North Korea. Additionally it is to estimate the amount and the costs needed to vaccinate. Methods: The target population is the children of North Korea. The method is based on a pre-survey and an interview of North Korea defectors. The target interviewees searched for are as follows; doctors, teachers, and others. The interview includes questions on mortality rates and immunization coverage. The analysis is largely based on the statements of the health care providers within the selected group. Results: The interviewees are 8; 7 female and 1 male. The birth years range from 1956 to 1982. 3 out of 8 are former health care providers; a doctor, a pharmacist, and a nurse. The morbidity rate of infectious diseases exceeds the data from WHO. The immunization coverage is nearly 0% after 1980s. In order to ensure the welfare of North Korean children, at least 8,234,000 vaccine doses, requiring over 105 million U.S. dollars, are needed. Conclusion: The morbidity rate of infectious disease in North Korea is conspicuous. The preparation for supply and expenditure of vaccines is vital.

Objective: To gather inputs from clinical experts on selecting and prioritizing research topics, to address unmet vaccine safety needs. Methods: A questionnaire containing 15 vaccine safety assessment research proposals was sent to 28 vaccine experts chosen from various domestic medical association boards, and the rationale for each of the proposals was provided by presenting the following information: 1) a brief summary of the clinical safety studies on the vaccine, conducted by the Clinical Immunization Safety Assessment (CISA) project group, supervised by the United States Center for Disease Control (U.S. CDC), and 2) a summary of recently published studies that address vaccine safety issues. The experts were instructed to select and rank 5 topics in the order of preference, and the preference score for each proposed topic was calculated by assigning points on a scale of 1 to 5. Results: All 28 experts responded to the questionnaire, and the following topics were selected according to their calculated preference scores: 1) Human papillomavirus vaccine safety profile in the Korean female adolescents; 2) A signal detection of adverse events following Influenza vaccination: comparison between the US and South Korea; 3) Incidence of anaphylaxis following National Immunization Program vaccines between 2008 and 2017; 4) Safety of quadrivalent influenza vaccines compared to trivalent influenza vaccines; and 5) Pneumococcal vaccine safety profile in the general population. Conclusion: Five research topics addressing vaccine safety were selected, for which well-constructed research protocols need to be promptly developed to address current unmet vaccine safety needs in South Korea.

Inspired by the biological immune system against outside invasion in nature, this paper propose a network security strategy using Agent technology. The Agents with independent behavior capacity are set for resisting network intrusion using their spontaneous coordinate organization. Based on the comparisons of existing immunization strategies, such as target immune, acquaintance immune and random immunity, it is found that the importance of nodes in network are influenced by interaction between nodes, degree of nodes, information flow, and other factors. If the nodes are more important, they have a greater influence over the whole network. When important nodes are infected by virus, there will be a higher probability of spreading of hazard information. Therefore, this paper proposes a network security model using Agent technology, where important nodes are implanted with relationship immunization strategy. Experimental results show when the network suffered from random or malicious attacks, relationship immunization strategy is more effective than others existing methods.

This report includes the recommended immunization schedule table for children and adolescents based on the 8th (2015) and revised 7th (2012) Immunization Guidelines released by the Committee on Infectious Diseases of the Korean Pediatric Society (KPS). Notable revised recommendations include: reorganization of the immunization table with a list of vaccines on the vertical axis and the corresponding age on the horizontal axis; reflecting the inclusion of Haemophilus influenzae type b vaccine, pneumococcal conjugate vaccine, and hepatitis A vaccine into the National Immunization Program since 2012; addition of general recommendations for 2 new Japanese encephalitis (JE) vaccines and their interchangeability with existing JE vaccines; addition of general recommendations for quadrivalent meningococcal conjugate vaccines and scope of the recommended targets for vaccination; and emphasizing catch-up immunization of Tdap vaccine. Detailed recommendations for each vaccine may be obtained from the full KPS 8th Immunization Guidelines.