Self-reported adverse events after 2 doses of COVID-19 vaccine in Korea

Kwon Yunhyung,황인섭,고미정,김형준,Kim Seontae,Seo Soon-Young,Cho Enhi,Yeon-Kyeng Lee 한국역학회 2023 Epidemiology and Health Vol.45 No.-

OBJECTIVES In Korea, a national coronavirus disease 2019 (COVID-19) vaccination program was implemented, including 4 vaccines against COVID-19. A text messaging-based survey, in addition to a passive adverse event reporting system, was launched to quickly report unusual symptoms post-vaccination. This study compared the frequency of adverse events after COVID-19 vaccination based on the vaccine type and the type of 2-dose regimen (homologous or heterologous). METHODS Self-reported adverse events were collected through a text-message survey for 7 days after each vaccination. This study included 50,950 vaccine recipients who responded to the survey at least once. Informed consent to receive surveys via text was obtained from the vaccine recipients on the date of first vaccination. RESULTS The recipients of mRNA vaccines reported local and systemic reactions 1.6 times to 2.8 times more frequently after dose 2 than after dose 1 (p<0.001), whereas ChAdOx1-S recipients reported significantly fewer local and systemic reactions after dose 2 than after dose 1 (p<0.001). Local and systemic reactions were approximately 2 times and 4 times more frequent for heterologous vaccination than for BNT162b2/BNT162b2 and ChAdOx1-S/ChAdOx1-S regimens, respectively. Young individuals, female, and those receiving heterologous vaccine regimens including ChAdOx1-S/BNT162b2 vaccines reported more adverse events than older participants, male, and those with homologous vaccine regimens. CONCLUSIONS Although a heterologous regimen, youth, and female sex were associated with a higher risk of adverse reactions after COVID-19 vaccination, no critical issues were noted. Active consideration of heterologous schedules based on the evidence of efficacy and safety appears desirable.

Main outcomes of the Sudden cardiac arrest survey 2006 to 2016

윤하정,Yunhyung Kwon,안주연,홍성옥,Young Taek Kim 대한응급의학회 2019 Clinical and Experimental Emergency Medicine Vol.6 No.2

In 2008, Korea CDC has introduced ‘Sudden Cardiac Arrest Survey’ to identify the incidence and survival of sudden cardiac arrests, in cooperation with National Fire Agency. Since then, it has been publishing sudden cardiac arrest statistics each year. The results from 2006 to 2016 are as follows. There are about 30,000 cases of sudden cardiac arrests occurring annually. Survival of the sudden cardiac arrest patients has increased 3.3 fold from 2.3% in 2006 to 7.6% in 2016. Rate of neurological recovery has increased 7 fold from 0.6% in 2006 to 4.2% in 2016. The rate of CPR performed by layperson and the rate of return of spontaneous circulation before hospital arrival, which are the two indices closely related to survival result, are both on the increasing trend. The sudden Cardiac Arrest survey has confirmed one positive and one negative aspect of the current status. On the positive side, there has been a nationwide improvement in sudden cardiac arrest survival, and on the negative side, the regional disparity widened. By feeding this statistical results back to the community, we hope to promote local community-based activities for the improved survival of cardiac arrest patients.

Delays in the diagnosis and treatment of tuberculosis during the COVID-19 outbreak in the Republic of Korea in 2020

Yang Jiyeon,Kwon Yunhyung,Kim Jaetae,장유진,한지연,김다애,Hye-Ran Jeong,박혜경,Shim Eunhye 질병관리본부 2021 Osong Public Health and Research Persptectives Vol.12 No.5

Objectives: We investigated the impact of the coronavirus disease 2019 (COVID-19) pandemic on tuberculosis (TB) management in the Republic of Korea (ROK).Methods: This retrospective cross-sectional study used nationwide ROK TB notification data (98,346 cases) from 2017 to 2020. The median time from the onset of TB symptoms to treatment initiation and the compliance rates with the required timing for notification and individual case investigations were measured and compared across periods and regions affected by the COVID-19 epidemic.Results: TB diagnosis during the COVID-19 pandemic was delayed. The median time to TB treatment initiation (25 days) in 2020 increased by 3 days compared to that of the previous 3 years (22 days) (p<0.0001). In the outbreak in Seoul, Incheon, and Gyeonggi province during August, the time to TB diagnosis was 4 days longer than in the previous 3 years (p=0.0303). In the outbreak in Daegu and Gyeongbuk province from February to March 2020, the compliance rate with the required timing for individual case investigations was 2.2%p points lower than in other areas in 2020 (p=0.0148). For public health centers, the rate was 13%p lower than in other areas (80.3% vs. 93.3%, p=0.0003).Conclusion: TB diagnoses during the COVID-19 pandemic in the ROK were delayed nationwide, especially for patients notified by public-private mix TB control hospitals. TB individual case investigations were delayed in regional COVID-19 outbreak areas (Daegu and Gyeongbuk province), especially in public health centers. Developing strategies to address this issue will be helpful for sustainable TB management during future outbreaks.

Safety monitoring of COVID-19 vaccines: February 26, 2021, To June 4, 2022, Republic of Korea

Yeon-Kyeng Lee,Yunhyung Kwon,Yesul Heo,Eun Kyoung Kim,Seung-Yun Kim,Hoon Cho,Seontae Kim,Mijeong Ko,Do Sang Lim,Soon-Young Seo,Enhi Cho 대한소아청소년과학회 2023 Clinical and Experimental Pediatrics (CEP) Vol.66 No.10

As of June 2022, 5 coronavirus disease 2019 (COVID-19)vaccine brands have been used in Korea’s national immunization program. The Korea Disease Control and PreventionAgency has enhanced vaccine safety monitoring through apassive web-based reporting system and active text messagebased monitoring. In this study, an enhanced safety monitoring system for COVID-19 vaccines is described and the frequencies and types of adverse events (AEs) associated with the5 COVID-19 vaccine brands were analyzed. AE reports fromthe web-based COVID-19 Vaccination Management Systemand text message-based reports from recipients were analyzed. AEs were classified as nonserious or serious (e.g., death oranaphylaxis). The AE reporting rates were calculated basedon the number of COVID-19 vaccine doses administered. Atotal of 125,107,883 doses were administered in Korea fromFebruary 26, 2021, to June 4, 2022. Among them, 471,068AEs were reported, of which 96.1% were nonserious and3.9% were serious. Among the 72,609 participants in thetext message-based AE monitoring process, a higher AErate of local and systemic reactions was reported for the 3rdversus 1st doses. A total of 874 cases of anaphylaxis (7.0 per1,000,000 doses), 4 cases of thrombocytopenia syndrome(TTS), 511 cases of myocarditis (4.1 per 1,000,000 doses),and 210 cases of pericarditis (1.7 per 1,000,000 doses)were confirmed. Six fatalities were causally associated withCOVID-19 vaccination (1 of TTS and 5 of myocarditis). Young adult age and female sex were related with a higherAE rate for COVID-19 vaccines. Most reported AEs werenonserious and of mild intensity.

FMH 충격위치에 변화에 따른 머리 상해치 영향 평가

박기옥(Giok Park),이윤형(Yunhyung Lee),범현균(Hyenkyun Beom),권오성(Osung Kwon) 한국자동차공학회 2005 한국자동차공학회 춘 추계 학술대회 논문집 Vol.2005 No.5_2

The FMVSS 201 regulation requires that the interior components in upper compartment of a passenger vehicle must satisfy Free Motion Headfoam (FMH) impact test with Head Injury Criterion (HIC) limit. Head Injury Criterion is influenced by many variables such as test velocity, FMH calibration performance, plan view angle, rotation angle and first contact position. In this paper, analytical research is carried out to find the effect of forehead impact zone and vertical approach angle in FMH Impact.

Safety monitoring of COVID-19 vaccination among adolescents aged 12 to 17 years old in the Republic of Korea

Seontae Kim,Insob Hwang,Mijeong Ko,Yunhyung Kwon,이연경 질병관리본부 2022 Osong Public Health and Research Persptectives Vol.13 No.3

Objectives: This study aimed to disseminate information on coronavirus disease 2019 (COVID-19) vaccine safety among adolescents aged 12 to 17 years in the Republic of Korea.Methods: Two databases were used to assess COVID-19 vaccine safety in adolescents aged 12 to 17 years who completed the primary Pfizer-BioNTech vaccination series. Adverse events reported to the web-based COVID-19 vaccination management system (CVMS) and collected in the text message-based system were analyzed.Results: From March 5, 2021 to February 13, 2022, 12,216 adverse events among 12- to 17-year-olds were reported to theCVMS, of which 97.1% were non-serious adverse events and 2.9% were serious adverse events, including 85 suspected cases of anaphylaxis, 74 suspected cases of myocarditis and/or pericarditis, and 2 deaths. From December 13, 2021 to January 26, 2022, 10,389 adolescents responded to a text message survey, and local/systemic adverse events were more common after dose 2 than after dose 1. The most commonly reported events following either vaccine dose were pain at the injection site, headache, fatigue/tiredness, and myalgia.Conclusion: The overall results are consistent with safety data reported in the United States and a controlled trial and serious adverse.events were rare among adolescents aged 12 to 17 years following COVID-19 vaccination.

Main results of the Korea National Hospital Discharge In-depth Injury Survey, 2004-2016

Sung Ok Hong,Boae Kim,Joongho Jo,Yunhyung Kwon,Yeon-Kyeng Lee,Youngtaek Kim 한국역학회 2020 Epidemiology and Health Vol.42 No.-

OBJECTIVES: The purpose of this study was to estimate the incidence of injuries and to identify their causes by classifying injuries according to various categories including age, sex, mechanism of injury, body parts injured, and place of injury. METHODS: This study used data from the Korea National Hospital Discharge In-depth Injury Survey (KNHDIS) from 2004 to 2016. The KNHDIS is conducted annually by the Korea Centers for Disease Control and Prevention, and its survey population includes all hospitalized patients discharged from medical institutions that have 100 or more beds, such as hospitals, general hospitals, and secondary community health centers. The number of injured cases is weighted and estimated using the mid-year estimated population of each year. RESULTS: The injury discharge rate steadily increased since 2004 (1,505 per 100,000 population in 2004, 2,007 per 100,000 population in 2016) and most injuries were unintentional (annual average of 94.7%). On average, during the 13-year study period, the injury rate for males was 1.5 times as high as for females. The 2 main causes of injury were consistently traffic accidents and falls. Notably, the rate of injuries resulting from falls rose by 1.7-fold from 463 to 792 per 100,000 people, and exceeded the rate of traffic accidents in 2016. CONCLUSIONS: The incidence of injuries steadily increased after the survey was first conducted, whereas mortality resulting from injuries mostly remained unchanged. This suggests that effective strategies and interventions should be reinforced to reduce unintentional injuries.

대전지역 폐암환자의 생존율과 이에 영향을 미치는 요인

이길회(Kil-Hoi Lee),권윤형(Yunhyung Kwon),이태용(Tae-Yong Lee) 한국역학회 2003 Epidemiology and Health Vol.25 No.2

Purpose: This study was carried out to investigate survival mte and the factors affecting survival among lung cancer patients who have been registered in Daejeon Cancer Registry from 1998 to 2000. Methods: Kaplan-Meier method and Cox proportional hazard model were used to evaluate the factors affecting survival of lung cancer patients. Results: Lung cancer was more common in men than women, with an ovemll sex ratio in Daejeon, Korea of roughly 3: 1. The incidence of lung cancer was 17.1 per 100,000 population in 1998, 21.4 in 1999, and 22.4 in 2000. Average age of incidence was 64.8 years old and 11.7% of study subjects having family history of lung cancer. Forty eight % of lung cancer was diagnosed as Stage III and 40.6% as Stage IV. Histologically, squamous cell carcinoma was 39.7% of all and most frequent, and then adenocarcinoma 25.5%, and small cell carcinoma 19.3%. 3-year survival rate of female was higher than that of males, and that of smoker was the lowest among groups according to the smoking level. Survival rate by age fell dramatically in group over 70 years. Lung cancer patients diagnosed as Stage III and Stage IV had a much lower survival rate than those diagnosed as Stage I or Ⅱ Stage, LDH and age were proved to be important variables that affect the mortality of lung cancer patients. Conclusion: We found that the stage at diagnosis was a critical factor that affected the survival of lung cancer patients from this study. So It is essential to develop early diagnosis of lung cancer and then it needs to evaluate the effectiveness of that.

Contact Investigations With a Single Tuberculin Skin Test on Infants Exposed to Tuberculosis in a Postpartum Care Center During the Neonatal Period

Choi Soo-Han,Oh Chi Eun,Lee Jungmin,Cho Yoon Young,Kwon Yunhyung,Kim Jieun,Lee Hyunju,Park Su Eun 대한의학회 2023 Journal of Korean medical science Vol.38 No.38

Background: Tuberculosis (TB) exposure in congregate settings related to neonates is a serious medical and social issue. TB exposure happens during the neonatal period, but contact investigations for exposed infants are usually conducted after the neonatal period. Generally, recommendations for screening and managing close contact are different for neonates and children. Thus, there are challenges in contact investigations. We aimed to report contact investigations with a single tuberculin skin test (TST) on infants exposed to infectious TB in a postpartum care center. Methods: The index case was a healthcare worker with active pulmonary TB: sputum acidfast bacilli smear negative, culture positive, and no cavitary lesion. All exposed infants underwent medical examinations and chest X-ray. After TB disease was ruled out, contacts received window period prophylaxis with isoniazid (INH) until three months after the last exposure. TST was performed only once after completing the prophylaxis. Results: A total of 288 infants were selected as high-priority contacts. At the initial contact investigation, the age of infants ranged from 8 to 114 days. None of these exposed infants had TB disease. The prevalence of latent TB infection (LTBI) was 25.3% (73/288; 95% confidence interval [CI], 20.7–30.7). There were no serious adverse events related to the window period prophylaxis or LTBI treatment with INH. During the 1-year follow-up period, no infants progressed to overt TB disease. The size of TST induration in infants vaccinated with percutaneous Bacillus Calmette-Guérin (BCG) vaccine was significantly larger than that of infants vaccinated with intradermal BCG vaccine (median, 8 mm vs. 5 mm; P = 0.002). In multiple logistic regression analysis, independent factors associated with TST positivity (≥ 10 mm induration) were male (adjusted odds ratio [aOR], 2.98; 95% CI, 1.6–5.64), percutaneous BCG vaccination (aOR, 3.30; 95% CI, 1.75–6.48), TST reading between 60 and 72 hours after injecting purified protein derivative (aOR, 2.87; 95% CI, 1.53–5.49), and INH prophylaxis more than four weeks (aOR, 0.49; 95% CI, 0.25–0.94). Conclusion: A single TST at three months after the last TB exposure with INH prophylaxis could be used as a main protocol in contact investigations for infants exposed to infectious TB during the neonatal period in congregate settings in Korea.

알코올리즘 선별검사 도구들의 진단 효율 비교

박병강,이동배,이태용,조영채,권윤형 충남대학교 의과대학 지역사회의학연구소 2000 충남의대잡지 Vol.27 No.1

To compare the clinical usefulness of four alcoholism-screening tests frequently used in Korea such as MAST, NAST, AUDIT, CAST, 96 drinking males were given diagnostic interview based on DSM-IV criteria and scores from four tests were obtained and analyzed. Of 96 subjects, 52.1% were normal without drinking problems, 38.5% with alcohol abuse and 9.4% with alcohol dependence. In terms of reliability of items in screening tests, four items in MAST were not found to have statistically significant item-total correlation. The appropriate cut-off value for screening tests to detect alcohol use disorders were above 15 points in AUDIT, above 5 points in MAST, above one item in NAST and above 2 items in CAGE. In terms of sensitivity for detection of alcohol use disorders, NAST was highest with 93.5%, and specificity, CAGE was highest with 90.0%. Considering the lowest sensitivity of 76.0% in CAGE and 76.J% of specificity in MAST, AUDIT and NAST were the most appropriate in screening alcohol abuse. The appropriate standard values for screening alcohol dependence were above 26 pants in AUDIT, above 13 points in MAST, above 5 items in NAST, and above 3 items in CAGE. In screening alcohol dependence AUDIT had the highest sensitivity of 100.0%, and both AUDIT and NAST had the highest specificity of 94.3%, respectively. The sensitivity of three screening tools except AUDIT were the same with the value of 88.9% and therefore AUDIT were the most appropriate in detecting alcohol dependence taking into consideration the relatively low specificity of 85.1% in CAGE.