Journal of Preventive Medicine and Public Health

Original Articles

Non-vaccination Against COVID-19 Among Venezuelan Refugees and Migrants Adults in Peru: A Cross-sectional Study, 2022: Akram Hernández-Vásquez, Rodrigo Vargas-Fernández; J Prev Med Public Health. 2023;56(5):397-406. Published online August 17, 2023; DOI: https://doi.org/10.3961/jpmph.23.078

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Abstract Summary PDF: Objectives
The purpose of this study was to determine factors associated with non-vaccination against coronavirus disease 2019 (COVID-19) among the Venezuelan immigrant population residing in Peru.
Methods
A cross-sectional study was conducted using data obtained from the Second Survey of the Venezuelan Population Residing in Peru in 2022. The dependent variable was vaccination status against COVID-19. The independent variables included socio-demographic, economic, and migratory characteristics of the included population. Crude and adjusted generalized linear Poisson-family models were used to calculate prevalence ratios with 95% confidence intervals (CIs).
Results
A total of 7739 Venezuelan migrants aged 18 years or older were included. The proportion of non-vaccination against COVID-19 was 5.7%. Regarding associated factors, unemployment (adjusted prevalence ratio [aPR], 1.31; 95% CI, 1.04 to 1.65) was linked to an increased likelihood of not being vaccinated against COVID-19. In contrast, women (aPR, 0.76; 95% CI, 0.61 to 0.95), possessing a migration permit (aPR, 0.41; 95% CI, 0.31 to 0.54), and having health insurance (aPR, 0.47; 95% CI, 0.27 to 0.81) were associated with a decreased likelihood of being unvaccinated.
Conclusions
The primary governmental and non-governmental institutions responsible for supporting and protecting the Venezuelan migrant and refugee population should improve vaccination access by issuing migration permits and providing health insurance.; Summary

Key Message
• Vaccination against COVID-19 is a strategy that should be provided equitably to the entire population. However, there are vulnerable groups such as Venezuelan migrants who have structural, cultural and socioeconomic barriers that limit access to this prevention system. • In Peru, about 6% of Venezuelan migrants have not received the complete vaccination schedule against COVID-19 due to the lack of employment in this population. In fact, the majority (61.9%) of Venezuelan migrants have only received two doses of the COVID-19 vaccine by February 2022.

COVID-19 Vaccination and Clinical Outcomes at a Secondary Referral Hospital During the Delta Variant-dominant Period in West Sumatra, Indonesia: Didan Ariadapa Rahadi, Elfira Yusri, Syandrez Prima Putra, Rima Semiarty, Dian Pertiwi, Cimi Ilmiawati; J Prev Med Public Health. 2023;56(3):221-230. Published online May 31, 2023; DOI: https://doi.org/10.3961/jpmph.23.077

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Objectives
The second wave of coronavirus disease 2019 (COVID-19) cases in Indonesia, during which the Delta variant predominated, took place after a vaccination program had been initiated in the country. This study was conducted to assess the impact of COVID-19 vaccination on unfavorable clinical outcomes including hospitalization, severe COVID-19, intensive care unit (ICU) admission, and death using a real-world model.
Methods
This single-center retrospective cohort study involved patients with COVID-19 aged ≥18 years who presented to the COVID-19 emergency room at a secondary referral teaching hospital between June 1, 2021 and August 31, 2021. We used a binary logistic regression model to assess the effect of COVID-19 vaccination on unfavorable clinical outcomes, with age, sex, and comorbidities as confounding variables.
Results
A total of 716 patients were included, 32.1% of whom were vaccinated. The elderly participants (≥65 years) had the lowest vaccine coverage among age groups. Vaccination had an effectiveness of 50% (95% confidence interval [CI], 25 to 66) for preventing hospitalization, 97% (95% CI, 77 to 99) for preventing severe COVID-19, 95% (95% CI, 56 to 99) for preventing ICU admission, and 90% (95% CI, 22 to 99) for preventing death. Interestingly, patients with type 2 diabetes had a 2-fold to 4-fold elevated risk of unfavorable outcomes.
Conclusions
Among adults, COVID-19 vaccination has a moderate preventive impact on hospitalization but a high preventive impact on severe COVID-19, ICU admission, and death. The authors suggest that relevant parties increase COVID-19 vaccination coverage, especially in the elderly population.

Summary

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Changes in the intrinsic severity of severe acute respiratory syndrome coronavirus 2 according to the emerging variant: a nationwide study from February 2020 to June 2022, including comparison with vaccinated populations
Boyeong Ryu, Eunjeong Shin, Dong Hwi Kim, HyunJu Lee, So Young Choi, Seong-Sun Kim, Il-Hwan Kim, Eun-Jin Kim, Sangwon Lee, Jaehyun Jeon, Donghyok Kwon, Sungil Cho
BMC Infectious Diseases.2024;[Epub] CrossRef

Special Article

Introduction of Vaccinomics to Develop Personalized Vaccines in Light of Changes in the Usage of Hantaan Virus Vaccine (Hantavax^®) in Korea: Jong-Myon Bae; J Prev Med Public Health. 2019;52(5):277-280. Published online August 7, 2019; DOI: https://doi.org/10.3961/jpmph.19.018

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Abstract Summary PDF Supplementary Material

The Ministry of Food and Drug Safety of Korea made an official announcement in March 2018 that the total number of inoculations of Hantaan virus vaccine (Hantavax^®) would change from 3 to 4. Some aspects of this decision remain controversial. Based on the characteristics of Hantaan virus (HTNV) and its role in the pathogenesis of hemorrhagic fever with renal syndrome, it might be difficult to develop an effective and safe HTNV vaccine through the isolate-inactivate-inject paradigm. With the development of high-throughput ‘omics’ technologies in the 21st century, vaccinomics has been introduced. While the goal of vaccinomics is to develop equations to describe and predict the immune response, it could also serve as a tool for developing new vaccine candidates and individualized approaches to vaccinology. Thus, the possibility of applying the innovative field of vaccinomics to develop a more effective and safer HTNV vaccine should be considered.

Summary

Korean summary
신증후출혈열 (Hemorrhagic fever with renal syndrome, HFRS)를 예방하기 위한 백신들이 여러 가지로 개발 중에 있지만, 한탄 바이러스 (Hantaan virus) 의 병원체 특성과 HFRS의 임상적 특성으로 효과적이고 안전한 백신 개발을 어렵게 하고 있다. 투여할 백신에 대한 ‘면역과정을 이해하고 백신효능을 예측하여’ 백신개발에 활용하는 백신체학의 적용을 적극 강구할 필요가 있다.

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Grant C Paulsen, Robert Frenck, Kay M Tomashek, Rodolfo M Alarcon, Elizabeth Hensel, Ashley Lowe, Rebecca L Brocato, Steve A Kwilas, Matthew D Josleyn, Jay W Hooper
The Journal of Infectious Diseases.2024; 229(1): 30. CrossRef
Zoonotic Hantaviridae with Global Public Health Significance
Rui-Xu Chen, Huan-Yu Gong, Xiu Wang, Ming-Hui Sun, Yu-Fei Ji, Su-Mei Tan, Ji-Ming Chen, Jian-Wei Shao, Ming Liao
Viruses.2023; 15(8): 1705. CrossRef
Current Challenges in Vaccinology
Richard B. Kennedy, Inna G. Ovsyannikova, Peter Palese, Gregory A. Poland
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Original Article

Vaccine Storage Practices and the Effects of Education in Some Private Medical Institutions: Saerom Lee, Hyun-Sul Lim, Ohyon Kim, Jeonggyeong Nam, Yeongsun Kim, Hyungrae Woo, Woojin Noh, Kyenam Kim; J Prev Med Public Health. 2012;45(2):78-89. Published online March 31, 2012; DOI: https://doi.org/10.3961/jpmph.2012.45.2.78

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Abstract PDF

Objectives

Although vaccination rates have increased, problems still remain in the storage and handling of vaccines. This study focused on inspecting actual vaccine storage status and awareness, and comparing them before and after education was provided.

Methods

In the primary inspection, a status survey checklist was completed by visual inspection. A questionnaire on the awareness of proper vaccine storage and handling was also administered to vaccine administrators in private medical institutions in 4 regions in Gyeongsangbuk-province. One-on-one education was then carried out, and our self-produced manual on safe vaccine storage and management methods was provided. In the secondary inspection, the investigators visited the same medical institutions and used the same questionnaire and checklist used during the primary inspection. The results before and after education were compared, by treating each appropriate answer as 1 point.

Results

The average checklists score was 9.74 (out of 15 points), which increased significantly after education was provided (by 0.84, p<0.001). The participants demonstrated improved practices in recording storage temperatures (p=0.016), storing vaccines in the center of the refrigerator (p=0.004), storing vaccines with other medication and non-medical items (p=0.031) after education. The average score calculated from the questionnaires was 10.48 (out of 14 points), which increased after education (by 1.03, p<0.001).

Conclusions

This study suggests that vaccine storage practices and awareness are inadequate, but can be partially improved by providing relevant education. Repetitive education and policy-making are required to store vaccines safely because one-off education and unenforced guidelines offer limited efficacy.

Summary

Citations

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Improving knowledge on vaccine storage management in general practices: Learning effectiveness of an online-based program
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Anika Thielmann, Marie-Therese Puth, Christine Kersting, Johannes Porz, Birgitta Weltermann, Sanjai Kumar
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Visual inspection of vaccine storage conditions in general practices: A study of 75 vaccine refrigerators
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Special Article

How to Improve Influenza Vaccination Rates in the U.S.: Byung-Kwang Yoo; J Prev Med Public Health. 2011;44(4):141-148. Published online July 29, 2010; DOI: https://doi.org/10.3961/jpmph.2011.44.4.141

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Abstract PDF

Annual epidemics of seasonal influenza occur during autumn and winter in temperate regions and have imposed substantial public health and economic burdens. At the global level, these epidemics cause about 3-5 million severe cases of illness and about 0.25-0.5 million deaths each year. Although annual vaccination is the most effective way to prevent the disease and its severe outcomes, influenza vaccination coverage rates have been at suboptimal levels in many countries. For instance, the coverage rates among the elderly in 20 developed nations in 2008 ranged from 21% to 78% (median 65%). In the U.S., influenza vaccination levels among elderly population appeared to reach a "plateau" of about 70% after the late 1990s, and levels among child populations have remained at less than 50%. In addition, disparities in the coverage rates across subpopulations within a country present another important public health issue. New approaches are needed for countries striving both to improve their overall coverage rates and to eliminate disparities.

This review article aims to describe a broad conceptual framework of vaccination, and to illustrate four potential determinants of influenza vaccination based on empirical analyses of U.S. nationally representative populations. These determinants include the ongoing influenza epidemic level, mass media reporting on influenza-related topics, reimbursement rate for providers to administer influenza vaccination, and vaccine supply. It additionally proposes specific policy implications, derived from these empirical analyses, to improve the influenza vaccination coverage rate and associated disparities in the U.S., which could be generalizable to other countries.

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Original Article

Mathematical Modeling of the Novel Influenza A (H1N1) Virus and Evaluation of the Epidemic Response Strategies in the Republic of Korea.: Mina Suh, Jeehyun Lee, Hye Jin Chi, Young Keun Kim, Dae Yong Kang, Nam Wook Hur, Kyung Hwa Ha, Dong Han Lee, Chang Soo Kim; J Prev Med Public Health. 2010;43(2):109-116.; DOI: https://doi.org/10.3961/jpmph.2010.43.2.109

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Abstract PDF

OBJECTIVES
The pandemic of novel influenza A (H1N1) virus has required decision-makers to act in the face of the substantial uncertainties. In this study, we evaluated the potential impact of the pandemic response strategies in the Republic of Korea using a mathematical model. METHODS: We developed a deterministic model of a pandemic (H1N1) 2009 in a structured population using the demographic data from the Korean population and the epidemiological feature of the pandemic (H1N1) 2009. To estimate the parameter values for the deterministic model, we used the available data from the previous studies on pandemic influenza. The pandemic response strategies of the Republic of Korea for novel influenza A (H1N1) virus such as school closure, mass vaccination (70% of population in 30 days), and a policy for anti-viral drug (treatment or prophylaxis) were applied to the deterministic model. RESULTS: The effect of two-week school closure on the attack rate was low regardless of the timing of the intervention. The earlier vaccination showed the effect of greater delays in reaching the peak of outbreaks. When it was no vaccination, vaccination at initiation of outbreak, vaccination 90 days after the initiation of outbreak and vaccination at the epidemic peak point, the total number of clinical cases for 400 days were 20.8 million, 4.4 million, 4.7 million and 12.6 million, respectively. The pandemic response strategies of the Republic of Korea delayed the peak of outbreaks (about 40 days) and decreased the number of cumulative clinical cases (8 million). CONCLUSIONS: Rapid vaccination was the most important factor to control the spread of pandemic influenza, and the response strategies of the Republic of Korea were shown to delay the spread of pandemic influenza in this deterministic model.

Summary

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English Abstract

The Current Trend of Avian Influenza Viruses in Bioinformatics Research.: Insung Ahn, Hyeon S Son; J Prev Med Public Health. 2007;40(2):185-190.; DOI: https://doi.org/10.3961/jpmph.2007.40.2.185

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Abstract PDF

OBJECTIVES
Since the first human infection from avian influenza was reported in Hong Kong in 1997, many Asian countries have confirmed outbreaks of highly pathogenic H5N1 avian influenza viruses. In addition to Asian countries, the EU authorities also held an urgent meeting in February 2006 at which it was agreed that Europe could also become the next target for H5N1 avian influenza in the near future. In this paper, we provide the general and applicable information on the avian influenza in the bioinformatics field to assist future studies in preventive medicine. METHODS: We introduced some up-to-date analytical tools in bioinformatics research, and discussed the current trends of avian influenza outbreaks. Among the bioinformatics methods, we focused our interests on two topics: attern analysis using the secondary database of avian influenza, and structural analysis using the molecular dynamics simulations in vaccine design. RESULTS: Use of the public genome databases available in the bioinformatics field enabled intensive analysis of the genetic patterns. Moreover, molecular dynamic simulations have also undergone remarkable development on the basis of the high performance supercomputing infrastructure these days. CONCLUSIONS: The bioinformatics techniques we introduced in this study may be useful in preventive medicine, especially in vaccine and drug discovery.

Summary

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Identification of novel conserved functional motifs across most Influenza A viral strains
Mahmoud ElHefnawi, Osama AlAidi, Nafisa Mohamed, Mona Kamar, Iman El-Azab, Suher Zada, Rania Siam
Virology Journal.2011;[Epub] CrossRef

Original Articles

Comparative Epidemiologic Survey of Measles in Two Primary Schools.: Sue Kyung Park, Jee Hee Kim, Joo Yeon Lee, Byoung Kuk Na, Woo Joo Kim, Hae Kwan Cheong; Korean J Prev Med. 2001;34(2):131-140.

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Abstract PDF: OBJECTIVES
During March-May, 2000, a measles outbreak occurred at Youngduk, Korea. This county is divided into two areas with different historical and socioeconomic background. The outbreak occurred in one of these areas. We conducted a comparative epidemiologic study on the two areas in order to evaluate the factors related to the epidemic. MATERIALS AND METHODS: We selected two groups, grades 3 and 5 in a primary schools in each area. We investigated outbreak-related factors using parent-questionnaires, the vaccination history from the students health record and the records concerning the recent measles-outbreak from the local health center. Serologic test on measles-IgG and -IgM antibody was done. RESULTS: The infection rate was 31.6% for the epidemic area and 3.7% for non-the epidemic area according to clinical or serological criteria (p<0.001). No difference was seen in the measles vaccination rate, residence at the time of vaccination or past measles infection history between the two areas. In the epidemic area, the attack rate for the 4-6 year-old MMR booster group(20.5%) was higher than the non-booster group(32.4%), but was not found significantly. Vaccine efficacy was 29.6% in the epidemic area and 87.0% in the non-epidemic area (p<0.001). The IgG level and positive rate were significantly different between the two areas (median 10727 IU/ml, 98.9% in epidemic area; median 346 IU/ml, 85.9% in the non-epidemic area, p<0.001). However, the IgG level and positive rate between the measles-cases and non-cases were not significantly different. CONCLUSIONS: This outbreak took place in mostly vaccinated children. These results suggest that a reduction of herd immunity for immunity failure after vaccination may be one of the feasible factors related to the outbreak pattern in the two areas. The results of the IgG level and positive rate suggest that re-establishment of a normal value for IgG level and of a qualitative method for IgG are needed.; Summary

An Epidemiologic Investigation on Mumps Outbreak in Cheju-do, 1998.: Myounghee Kim, Moran Ki, Youngjoo Hur, Boyoul Choi; Korean J Prev Med. 2001;34(1):89-99.

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Abstract PDF: OBJECTIVES
To describe the characteristics of a mumps epidemic in Cheju-do, 1998 and to identify the risk factors associated with mumps infection. METHODS: To estimate attack rate, previously collected data from the Nationally Notifiable Communicable Disease Reporting System and School Health Reporting System, temporarily administered by Division of Education, as well as additional surveillance data were used. In order to identify the clinical characteristics and risk factors associated with mumps, we conducted a questionnaire survey in 17 schools (9 elementary, 4 middle, and 4 high schools) among a population that included healthy students. RESULTS: From March 3 to August 31, 2,195 cases of mumps were identified, and patients under 20 years of age accounted for 2,162 cases (attack rate 13.2, 95% CI 12.6-13.7/1,000). The attack rate for the population under 20 years of age was the highest in Nam county (44.7/1,000), and in the 7-12 years old sub-group(>20.0/1,000). There was no sexual difference. 80.9% and 59.7% of patients presented periauricular and submandibular swelling respectively. Aseptic meningitis was a complication in 2.9% of cases, orchitis in 1.3%, epididymitis in 0.9% and oophoritis in 0.6% respectively. The overall MMR vaccination rate was 59.1% and it decreased in accordance with increasing age. In students aged 10 years old or below, household contact and MMR vaccination status was significantly associated with infection, and only among students with household contact, the risk of one dose MMR(OR=10.22, 95% CI 2.92-35.78) and non-vaccination (OR=11.62, 95% CI 1.96-68.96) was significantly greater when compared with that of two dose vaccination. Among students aged 11 years old or above, household contact history was significantly associated and MMR vaccination status was not associated. CONCLUSIONS: Low vaccination rate and vaccine failure were thought to predispose the population for this large outbreak. To prevent sustained mumps outbreaks, a second MMR vaccination should be encouraged and catch up vaccinations should be given to elderly children who remain susceptible.; Summary

Clinical trial of leptospires vaccine on its immunogenicity and safety.: Hyeong Ryeol Yoon, Jeong Soon Kim, Yong Heo; Korean J Prev Med. 1990;23(1):57-64.

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Abstract PDF: Since the reservior of leptospires organism is consisted of a broad spectrum of animals, the best method of prevention is vaccination. The clinical trial of leptospires vaccine conducted on human volunteer for its immunogenicity and safety. Summarized results are as follows: 1. The Oral temperature among vaccinated group ranged from 36.7 +/- 0.34 degrees C, while in placebo injected group it ranged from 36.4 +/- 0.46 degrees C to 36.7 +/- 0.53 degrees C. There wan no association between vaccination and fever (p<0.05). 2. Mild local reactions revealed in vacciness were swelling (50-75%), Redness(75-90%), and induration(25-40%). Placebo injected group revealed only redness in 12.5% in the 1st injection and 37.5% in the second injection. The duration local reactions on injection site for both vaccinees and placebo groups disappeared within 48 hours. 3. Generalized Symptoms complained by the vaccinees were myalgia (25%), back pain(15%), headache(15%), pruritus(15%), and abdominal pain(10%), whereas placebo group complained of headache(25%), myalgia(12.5%), back pain(12.5%), pain in eyes(12.5%), abdominal pain(12.5%) prutitus(12.5%) and nausea(12.5%). 4. The serological test(MAT) of vaccinees showed geometric mean antibody titer as follows: a. L. icterohemorrhagiae lai, 1 week after 1st vaccination: 22.45, 1 week after 2nd vaccination: 111.23, 3 week after 2nd vaccination: 266.64, b. L. canicola canicola, 1 week after 1st vaccination: 24.62, 1 week after 2nd vaccination: 123.92, 3 week after 2nd vaccination: 276.55, c. L. icterohemorrhagiae copenhageni, 1 week after 1st vaccination: 28.28, 1 week after 2nd vaccination: 128.55, 3 week after 2nd vaccinaton: 247.88, Whereas all of the placebo injected group, showed below 1 : 20 titers. The sero-conversion rate of vaccinees were 100 percent.; Summary

English Abstract

Seroprevalence of Measles Antibody and its Attributable Factors in Elementary Students of Routine 2-dose Schedule Era with Vaccination Record.: Geun Ryang Bae, Hyun Sul Lim, Un Yeong Goh, Byung Guk Yang, Young Taek Kim, Jong Koo Lee; J Prev Med Public Health. 2005;38(4):431-436.

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Abstract PDF: OBJECTIVES
We investigated the seroprevalence of the measles antibody and its attributable factors for the students who underwent routine 2-dose Schedule Era. METHODS: The subjects were 996 students of the national measles seroepidemiologic study in December 2000 who had vaccination records. We conducted a questionnaire survey and we performed serologic testing for the measles specific IgG by using an enzyme linked immunosorbent assay. RESULTS: The coverage for the first dose of the MMR vaccination at 12-15 months of age was 95.1% and the coverage for the second dose of MMR at 4-6 years of age was 35.0%. The proportion of subjects undergoing 2- doses of MMR decreased as the age of the subjects increased. The seropositive rate of the measles antibody was significantly high in the second dose vaccinees (93.5% in the second dose group, 84.7% in the non-second dose group, p< 0.001) and it was 72.0% in the 0-dose group, 85.4% in the 1-dose group and 93.7% in the 2-dose group (p< 0.001). Two point eight percent of the subjects had a past history of measles infection. On the multiple logistic regression analysis, the first and second dose (odds ratio, 8.54; 95% CI.=3.05-23.91), the first dose (odds ratio, 3.06; 95% CI.=1.20-7.81) and the outbreak in the year 2000 (odds ratio, 1.89; 95% CI.=1.24-2.88) were the significant factors for the eropositivity. CONCLUSIONS: Maintaining high coverage with a 2-dose vaccination program would be the decisive factor to prevent an outbreak of measles and to eliminate measles in Korea.; Summary

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