병원에서 사용된 백신양으로 평가한 예방접종 실태

김정수,백용수,정문현,이진수,오경선 대한감염학회 2008 Infection and Chemotherapy Vol.40 No.3

Background:Studies on immunization in Korea mainly focus to the coverage rates in recipients. The attitudes of health-care providers regarding immunization are rarely evaluated. Therefore, to assess the pattern of vaccine administration by health-care personnel, the vaccine consumption in a university hospital was investigated. Materials and Methods:The vaccine consumption in a university hospital during 2 months (September and October) in 2 years (2002 and 2007) was evaluated. September is representative of months when influenza vaccine is not available, whereas October is representative of months when influenza vaccine is available. These monthly data were summarized by departments and vaccines. Results:Vaccine consumption over the 5-year period increased primarily because of the increased use of the influenza and tetanus-diphtheria (Td) vaccines in adults. In 2007, the most frequently administered vaccine during the influenza season was the influenza vaccine, followed by the Td vaccine. In the same year, the Td vaccine was the most frequently administered vaccine during the non-influenza season. Compared to 2002, there was a marked increase in the use of the hepatitis A virus (7-fold), Japanese encephalitis (6-fold), and pneumococcal polysaccharide (3-fold) vaccines in 2007; the Td, meningococcal, and pneumococcal protein-conjugated vaccines were not available in 2002. In adults, pneumococcal vaccination was increasingly prescribed concomitant with the increased influenza vaccination; a similar trend was not observed in children. The use of vaccines in most departments was confined to the influenza vaccine, and the majority of Td vaccine was consumed in the emergency department. As compared to the internal medicine and family medicine departments, fewer vaccines were prescribed by the neurology, surgical, and minor specialty departments, especially in the non-influenza season. Conclusion:Although vaccine consumption increased during the 5-year period, the increase was attributed to the increased consumption of the influenza vaccine. Promotion and education regarding the use of non-influenza vaccines are needed. 배 경:국내에서 백신 사용은 접종을 받은 사람에서만 조사가 되었고, 예방접종 제공자에서 조사가 적었다. 앞으로 백신 접종률을 높이기 위해서는 접종자에 대한 연구도 있어야 하며, 병원 단위에서 백신 사용 양상을 알기 위해 대학병원에서 백신 사용량을 조사하였다. 재료 및 방법:2002년과 2007년의 9월과 10월에 약제부에서 사용된 백신 양을 조사하였다. 9월은 인플루엔자 백신이 없는 달을 대표하는 달이고 10월은 인플루엔자 예방접종이 가능한 달을 대표한 것이다. 월별 백신 소모량을 과별, 백신별로 정리를 하였다. 결 과:2002년에 비해 2007년에는 백신 사용량이 1.6배 증가했으며, 인플루엔자 백신과 Td의 사용 증가가 주요 이유였다. 인플루엔자 백신 접종 시기에는 인플루엔자 백신 사용량이 제일 많았고, 두 번째 많이 사용되는 백신은 2002년에는 B형 간염 백신이었고 2007년에는 Td였다. 성인에서는 인플루엔자 백신 사용과 함께 폐렴사슬알균 백신 사용량이 늘었지만 소아에서는 이런 경향이 보이지 않았다. 인플루엔자 백신 접종 시기인 10월에는 소아과에서 사용보다 비소아과에서 백신 사용량이 더 많았다. 과별로 보면 대부분 과에서 인플루엔자 백신이 주로 사용되었고, 응급실에서는 Td만이 사용되었다. 신경과와 재활의학과, 외과계열, 소수과에서 사용이 적었다. 결 론:예방접종이 5년 사이 증가하였으나 인플루엔자 백신에 국한된 양상을 보였다. 인플루엔자 백신과 파상풍-디프테리아 백신뿐만 아니라 다른 백신에 대한 홍보가 필요하다.

Efficient induction of cell-mediated immunity to varicella-zoster virus glycoprotein E co-lyophilized with a cationic liposome-based adjuvant in mice

Wui, Seo Ri,Kim, Kwang Sung,Ryu, Ji In,Ko, Ara,Do, Hien Thi Thu,Lee, Yeon Jung,Kim, Hark Jun,Lim, Soo Jeong,Park, Shin Ae,Cho, Yang Je,Kim, Chang-Gyeom,Lee, Na Gyong Elsevier 2019 Vaccine Vol.37 No.15

<P><B>Abstract</B></P> <P>Varicella zoster virus (VZV) is a neurotropic and lymphotropic alpha herpesvirus that causes varicella and herpes zoster (HZ). At a primary infection, VZV causes varicella in young children. Reactivation of latent VZV in sensory ganglia causes painful HZ in elderly people, occasionally leading to a serious complication, postherpetic neuralgia (PHN). A live attenuated VZV vaccine, the first vaccine licensed for the prevention of HZ and PHN is not very effective, while a recombinant subunit vaccine provides higher and longer protection against HZ. In the present study, we developed a new adjuvant system CIA09A, which is composed of cationic liposomes, the Toll-like receptor 4 (TLR4) agonist de-<I>O</I>-acylated lipooligosaccharide, and <I>Quillaja</I> saponin fraction QS-21. We then determined its adjuvant activity for recombinant VZV glycoprotein E (gE) in mice. Co-lyophilization of the liposomal adjuvant formulation with gE did not abolish the immune-stimulating activity. In fact, the CIA09A-adjuvanted gE vaccine was highly effective in eliciting both humoral and cellular immune responses to the recombinant gE protein and VZV in a VZV-primed mouse model. Furthermore, the frequency of gE-specific polyfunctional CD4<SUP>+</SUP> T cells expressing interferon (IFN)-γ, tumor necrosis factor (TNF)-α, and interleukin (IL)-2 was significantly increased in mice immunized with the adjuvanted vaccine. These data indicate that co-lyophilization of protein antigens with CIA09A enables development of a liposome-adjuvanted vaccine in a single vial to induce strong cell-mediated immunity required for vaccine efficacy. Thus, the CIA09A-adjuvanted gE vaccine warrants further development as a new prophylactic vaccine against HZ.</P> <P><B>Highlights</B></P> <P> <UL> <LI> We determined the adjuvanticity of CIA09A (cationic liposomes with a TLR4 ligand and QS-21) for VZV gE. </LI> <LI> Co-lyophilization of CIA09A with gE did not abolish the immune-stimulating activity for VZV gE. </LI> <LI> The CIA09A-adjuvanted gE vaccine effectively elicited humoral and CMI responses to gE and VZV. </LI> <LI> The adjuvanted vaccine induced gE-specific CD4<SUP>+</SUP> T cells expressing IFN-γ, TNF-α, and IL-2. </LI> <LI> Co-lyophilization of VZV gE with CIA09A enables manufacture of a subunit vaccine in a single vial. </LI> </UL> </P>

Barriers to measles mumps rubella vaccine acceptance in the three southern border provinces of Thailand

Sirithammaphan Uraiwan,Chaisang Ubontip,Pongrattanamarn Kwanjit 대한백신학회 2023 Clinical and Experimental Vaccine Research Vol.12 No.4

Purpose: This qualitative study utilizing phenomenological methodology aimed to depict parental measles mumps rubella (MMR) vaccine acceptance through the work experiences of health personnel. Materials and Methods: Twenty-two public health workers working as vaccination providers in the three southern border provinces of Thailand were recruited. In-depth, face-to-face, semi-structured interviews were conducted. Data were analyzed using thematic analysis. Results: Four main themes emerged: (1) religious beliefs, (2) personal disagreements, (3) fear and mistrust regarding potential vaccine side effects, and (4) misperceptions about the potential severity of measles. Four subthemes were identified: (1) haram (prohibited), (2) the will of Allah, (3) spousal disagreement, and (4) disagreement from a religious leader. The results of this study indicated that perceived religious prohibition was the most important reason for refusing to vaccinate among Muslim parents. Vaccine-hesitant parents were concerned that the vaccine might contain gelatin derived from pig products. Also, halal certification of the vaccine was required from Muslim parents to ensure that vaccine has been approved for Muslims. Meanwhile, a lack of knowledge and positive attitudes concerning immunizations of vaccine-hesitant parents were also found as predominant reasons for incomplete childhood immunizations in the deep south of Thailand. Conclusion: Health education and engagement by religious leaders to endorse the vaccination and bridge the gap between religious beliefs and vaccine acceptance is needed to overcome this issue. This study findings could be effectively applied to improve vaccination uptake in a Muslim majority context.

Live-attenuated tetravalent dengue vaccines: The needs and challenges of post-licensure evaluation of vaccine safety and effectiveness

Wichmann, Ole,Vannice, Kirsten,Asturias, Edwin J.,de Albuquerque Luna, Expedito José,Longini, Ira,Lopez, Anna Lena,Smith, Peter G.,Tissera, Hasitha,Yoon, In-Kyu,Hombach, Joachim Elsevier 2017 Vaccine Vol.35 No.42

<P><B>Abstract</B></P> <P>Since December 2015, the first dengue vaccine has been licensed in several Asian and Latin American countries for protection against disease from all four dengue virus serotypes. While the vaccine demonstrated an overall good safety and efficacy profile in clinical trials, some key research questions remain which make risk-benefit-assessment for some populations difficult. As for any new vaccine, several questions, such as very rare adverse events following immunization, duration of vaccine-induced protection and effectiveness when used in public health programs, will be addressed by post-licensure studies and by data from national surveillance systems after the vaccine has been introduced. However, the complexity of dengue epidemiology, pathogenesis and population immunity, as well as some characteristics of the currently licensed vaccine, and potentially also future, live-attenuated dengue vaccines, poses a challenge for evaluation through existing monitoring systems, especially in low and middle-income countries. Most notable are the different efficacies of the currently licensed vaccine by dengue serostatus at time of first vaccination and by dengue virus serotype, as well as the increased risk of dengue hospitalization among young vaccinated children observed three years after the start of vaccination in one of the trials. Currently, it is unknown if the last phenomenon is restricted to younger ages or could affect also seronegative individuals aged 9years and older, who are included in the group for whom the vaccine has been licensed. In this paper, we summarize scientific and methodological considerations for public health surveillance and targeted post-licensure studies to address some key research questions related to live-attenuated dengue vaccines. Countries intending to introduce a dengue vaccine should assess their capacities to monitor and evaluate the vaccine’s effectiveness and safety and, where appropriate and possible, enhance their surveillance systems accordingly. Targeted studies are needed, especially to better understand the effects of vaccinating seronegative individuals.</P>

Evaluation of the protective effects of a nanogel-based vaccine against rabbit hepatitis E virus

Park, Byung-Joo,Ahn, Hee-Seop,Han, Sang-Hoon,Go, Hyeon-Jeong,Lee, Joong-Bok,Park, Seung-Yong,Song, Chang-Seon,Lee, Sang-Won,Paik, Hyun-Jong,Choi, Yang-Kyu,Choi, In-Soo Elsevier Ltd. 2019 Vaccine Vol.37 No.40

<P><B>Abstract</B></P> <P>Infection with hepatitis E virus (HEV) has raised serious public health concerns worldwide. In this study, a nanogel-based vaccine encapsulating the capsid protein of rabbit HEV was developed and its protective efficacy was compared with a subunit vaccine. A total of 23 rabbits were divided into 5 groups: (1) negative control (n = 4), (2) positive control (n = 4), (3) nanogel control (n = 5), (4) nanogel vaccine (n = 5), and (5) subunit vaccine (n = 5). Rabbits were vaccinated two times, at weeks 0 and 1, with nanogel and subunit vaccines, respectively, and challenged with rabbit HEV at week 4. By week 11, rabbits vaccinated with the nanogel vaccine produced higher antibodies than those vaccinated with the subunit vaccine. Fecal viral shedding and viremia were identified in rabbits of the positive and nanogel control groups at weeks 6–10. However, there was no viral shedding and viremia in rabbits immunized with both the nanogel and subunit vaccines. Alanine aminotransferase and aspartate aminotransferase levels were not elevated in any rabbit. However, histopathological examination revealed much less hepatic inflammation in rabbits of the nanogel vaccine group compared to the positive and nanogel control groups. Significant increases in IL-12 and IFN–γlevels were identified from rabbits immunized with the nanogel vaccine. Collectively, these results indicate that the newly developed nanogel vaccine induced sufficient immunity leading to complete protection from HEV infection in rabbits. Application of this vaccine should be considered as a preventive measure against HEV infection in other animal species and humans.</P> <P><B>Highlights</B></P> <P> <UL> <LI> A nanogel vaccine encapsulating rabbit HEV capsid protein was developed. </LI> <LI> The nanogel vaccine induced anti-HEV antibodies, IL-12, and IFN-γ. </LI> <LI> The nanogel vaccine completely protected rabbits from HEV infection. </LI> </UL> </P>

병원에서 사용된 백신양으로 평간한 예방접종 실태

김정수,백용수,정문현,이진수,오경선 대한감염학회 2008 감염과 화학요법 Vol.40 No.3

Background : Studies on immunization in Korea mainly focus to the coverage rates in recipients. The attitudes of health-care providers regarding immunization are rarely evaluated. Therefore, to assess the pattern of vaccine administration by health-care personnel, the vaccine consumption in a university hospital was investigated. Materials and Methods : The vaccine consumption in a university hospital during 2 months (September and October) in 2 years (2002 and 2007) was evaluated. September is representative of months when influenza vaccine is not available, whereas October is representative of months when influenza vaccine is available. These monthly data were summarized by departments and vaccines. Results : Vaccine consumption over the 5-year period increased primarily because of the increased use of the influenza and tetanus-diphtheria (Td) vaccines in adults. In 2007, the most frequently administered vaccine during the influenza season was the influenza vaccine, followed by the Td vaccine. In the same year, the Td vaccine was the most frequently administered vaccine during the non-influenza season. Compared to 2002, there was a marked increase in the use of the hepatitis A virus (7-fo1d), Japanese encephalitis (6-fo1d), and pneumococcal polysaccharide (3-fold) Vaccines in 2007; the Td, meningococcal, and pneumococcal protein-conjugated vaccines were not available in 2002. In adults, pneumococcal vaccination was increasingly prescribed concomitant with the increased influenza vaccination: a similar trend was not observed in children. The use of vaccines in most departments was confined to the influenza vaccine, and the majority of Td vaccine was consumed in the emergency department. As compared to the internal medicine and family medicine departments, fewer vaccines were prescribed by the neurology, surgical, and minor specialty departments, especially in the non-influenza season. Conclusion : Although vaccine consumption increased during the 5-year period, the increase was attributed to the increased consumption of the influenza vaccine. Promotion and education regarding the use of non-influenza vaccines are needed. 배경 : 국내에서 백신 사용은 접종을 받은 사람에서만 조사가 되었고, 예방접종 제공자에서 조사가 적었다. 앞으로 백신 접종률을 높이기 위해서는 접종자에 대한 연구도 있어야 하며, 병원 단위에서 백신 사용 양상을 알기 위해 대학병원에서 백신 사용량을 조사하였다. 재료 및 방법 :2002년과 2007년의 9월과 10월에 약제부에서 사용된 백신 양을 조사하였다. 9월은 인플루엔자 백신이 없는 달을 대표하는 달이고 10월은 인플루엔자 예방 접종이 가능한 달을 대표한 것이다. 월별 백신 소모량을 과별, 백신별로 정리를 하였다. 결과 : 2002년에 비해 2007년에는 백신 사용량이 1.6배 증가했으며, 인플루엔자 백신과 Td의 사용 증가가 주요 이유였다. 인플루엔자 백신 접종 시기에는 인플루엔자 백신 사용량이 제일 많았고, 두 번째 많이 사용되는 백신은 2002년에는 B형 간염 백신이었고 2007년에는 Td였다. 성인에 서는 인플루엔자 백신 사용과 함께 폐렴사슬알균 백신 사용량이 늘었지만 소아에서는 이런 경향이 보이지 않았다. 인플루엔자 백신 접종 시기인 10월에는 소아과에서 사용보다 비소아과에서 백신 사용량이 더 많았다. 과별로 보면 대부분 과에서 인플루엔자 백신이 주로 사용되었고, 응급실에서는 Td만이 사용되었다. 신경과와 재활의학과, 외과계열, 소수과에서 사용이 적었다. 결론 : 예방접종이 5년 사이 증가하였으나 인플루엔자 백신에 국한된 양상을 보였다. 인플루엔자 백신과 파상풍-디프테리아 백신뿐만 아니라 다른 백신에 대한 홍보가 필요하다.

백신 전달기술 개발 동향과 과제

정형일(Hyungil Jung),김정동(Jung Dong Kim),김미루(Mi-roo Kim),마니타 당골(Manita Dangol) 한국생물공학회 2010 KSBB Journal Vol.25 No.6

Vaccine is a protective clinical measure capable of persuading immune system against infectious agents. Vaccine can be categorized as live attenuated and inactivated. Live attenuated vaccines activate immunity similar to natural infection by replicating living organisms whereas inactivated vaccines are either whole cell vaccines, eliciting immune response by killed organisms,or subunit vaccines, stimulating immunity by non-replicating sub cellular parts. The components of vaccine play a critical role in deciding the immune response mediated by the vaccine. The innate immune responds against the antigen component. Adjuvants represent an importantcomponent of vaccine for enhancing the immunogenicity of the antigens. Subunit vaccines with isolated fractions of killed and recombinant antigens are mostly co-administered with adjuvants. The delivery system of the vaccine is another essential component to ensurethat vaccine is delivered to the right target with right dosage form. Furthermore, vaccine delivery system ensures that the desired immune response is achieved by manipulating the optimal interaction of vaccine and adjuvantwith the immune cell. The aforementioned components along with routes of administration of vaccine are the key elements of a successful vaccination procedure. Vaccines can be administered either orally or by parenteral routes. Many groups had made remarkable efforts for the development of new vaccine and delivery system. The emergence of new vaccine delivery system may lead to pursue the immunization goals with better clinical practices.

Addressing Vaccine Hesitancy Among Immigrant Communities in Canada

Jinny Choi,Sangwook Michael Woo 한국공공가치학회 2022 공공가치연구 Vol.3 No.1

The digital communication era has given rise to quick and convenient access to information. With vaccine disinformation and anti-vaccine rhetoric becoming increasingly prevalent across social media, the need to improve vaccine literacy at a population level has become urgent. Immigrant communities face unique challenges that hinder their access to credible and coherent sources of vaccine-related information, potentially leading to reliance on disinformative sources of information. Additionally, factors such as language barriers, social exclusions, and the amplification of anti-vaccine narratives across social media culminate the perfect milieu for vaccine hesitant attitudes to propagate within immigrant communities. By identifying the determinants behind the adoption of anti-vaccine narratives among immigrant communities in Canada, strategies to counter vaccine hesitancy can be optimized to improve health education and vaccine literacy within immigrant communities.

외국의 백신 능동적 감시 시스템 소개

정나영 ( Na-young Jeong ),박상신 ( Sangshin Park ),임은선 ( Eunsun Lim ),최남경 ( Nam-kyong Choi ) 한국보건정보통계학회(구 한국보건통계학회) 2019 한국보건정보통계학회지 Vol.44 No.4

Vaccines require higher safety standards than most other medicinal products because they are given to healthy individuals, including infants, children, and elderly. Despite various activities by national agencies, public concern about vaccine safety often arises. Post-marketing activities for vaccine safety can be broadly classified into passive and active surveillances. Many countries as well as Korea operate passive vaccine safety surveillance systems that report adverse events related to vaccines. However, the active surveillance systems operate only in several countries, such as the United States of America (USA), Europe, Canada and Australia. In the US, Vaccine Safety Datalink (VSD) and Post-Licensure Rapid Immunization Safety Monitoring (PRISM) were developed in 1990 and 2009 respectively for monitoring vaccine actively. In the case of Europe, the Vaccine Adverse Event Surveillance and Communication (VAESCO) consortium was launched in 2008. After the end of VAESCO, the Accelerated Development of VAccine beNefit-risk Collaboration in Europe (ADVANCE) was organized to establish a vaccine benefit-risk monitoring framework in 2013. Canada has been operating a vaccine active monitoring system known as the Canadian Immunization Monitoring Program, ACTive (IMPACT) since 1991. The objective of this review was to describe and compare background, databases, and analysis systems of various vaccine active surveillance systems in the US, Europe, and Canada. We described the examples of studies on the safety of influenza A (H1N1) vaccines carried out in each system. This review could help provide directions for the future development of the ideal active vaccine safety surveillance system in Korea.

A forecast of typhoid conjugate vaccine introduction and demand in typhoid endemic low- and middle-income countries to support vaccine introduction policy and decisions

Mogasale, Vittal,Ramani, Enusa,Park, Il Yeon,Lee, Jung Seok TaylorFrancis 2017 Human Vaccines & Immunotherapeutics Vol.13 No.9

<P><B>ABSTRACT</B></P><P>A Typhoid Conjugate Vaccine (TCV) is expected to acquire WHO prequalification soon, which will pave the way for its use in many low- and middle-income countries where typhoid fever is endemic. Thus it is critical to forecast future vaccine demand to ensure supply meets demand, and to facilitate vaccine policy and introduction planning. We forecasted introduction dates for countries based on specific criteria and estimated vaccine demand by year for defined vaccination strategies in 2 scenarios: rapid vaccine introduction and slow vaccine introduction. In the rapid introduction scenario, we forecasted 17 countries and India introducing TCV in the first 5 y of the vaccine's availability while in the slow introduction scenario we forecasted 4 countries and India introducing TCV in the same time period. If the vaccine is targeting infants in high-risk populations as a routine single dose, the vaccine demand peaks around 40 million doses per year under the rapid introduction scenario. Similarly, if the vaccine is targeting infants in the general population as a routine single dose, the vaccine demand increases to 160 million doses per year under the rapid introduction scenario. The demand forecast projected here is an upper bound estimate of vaccine demand, where actual demand depends on various factors such as country priorities, actual vaccine introduction, vaccination strategies, Gavi financing, costs, and overall product profile. Considering the potential role of TCV in typhoid control globally; manufacturers, policymakers, donors and financing bodies should work together to ensure vaccine access through sufficient production capacity, early WHO prequalification of the vaccine, continued Gavi financing and supportive policy.</P>