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JPMPH : Journal of Preventive Medicine and Public Health



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Women’s Empowerment Facilitates Complete Immunization in Indonesian Children: A Cross-sectional Study
Gede Benny Setia Wirawan, Ni Luh Zallila Gustina, Putu Harrista Indra Pramana, Made Yuliantari Dwi Astiti, Jovvita Jonathan, Fitriana Melinda, Teo Wijaya
J Prev Med Public Health. 2022;55(2):193-204.   Published online March 8, 2022
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  • 110 Download
  • 1 Web of Science
  • 2 Crossref
AbstractAbstract PDF
The primary objective of this study was to examine the effect of women’s empowerment on the immunization of Indonesian children. The secondary objective was to examine the effect of wealth as a factor modifying this association.
We utilized data from the 2017 Indonesian Demographic and Health Survey (IDHS). The subjects were married women with children aged 12-23 months (n=3532). Complete immunization was defined using the 2017 IDHS definition. Multiple components of women’s empowerment were measured: enabling resources, decision-making involvement, and attitude toward intimate partner violence. The primary analysis was conducted using binomial logistic regression. Model 1 represented only the indicators of women’s empowerment and model 2 controlled for socio-demographic variables. Subgroup analyses were conducted for each wealth group.
The primary analysis using model 1 identified several empowerment indicators that facilitated complete immunization. The analysis using model 2 found that maternal education and involvement in decision-making processes facilitated complete immunization in children. Subgroup analyses identified that wealth had a modifying effect. The indicators of women’s empowerment were strong determinants of complete immunization in lower wealth quintiles but insignificant in middle-income and higher-income quintiles.
To our knowledge, this study is the first to explore women’s empowerment as a determinant of child immunization in Indonesia. The results indicate that women’s empowerment must be considered in Indonesia’s child immunization program. Women’s empowerment was not found to be a determinant in higher wealth quintiles, which led us to rethink the conceptual framework of the effect of women’s empowerment on health outcomes.


Citations to this article as recorded by  
  • Of Money and Men: A Scoping Review to Map Gender Barriers to Immunization Coverage in Low- and Middle-Income Countries
    Anna Kalbarczyk, Natasha Brownlee, Elizabeth Katz
    Vaccines.2024; 12(6): 625.     CrossRef
  • Health Beliefs and Socioeconomic Determinants of COVID-19 Booster Vaccine Acceptance: An Indonesian Cross-Sectional Study
    Gede Benny Setia Wirawan, Ngakan Putu Anom Harjana, Nur Wulan Nugrahani, Pande Putu Januraga
    Vaccines.2022; 10(5): 724.     CrossRef
Hepatitis A Outbreak in a Facility for the Disabled, Gyeonggi Province, Korea: An Epidemiological Investigation
Yeonhwa Chang, Chanhee Kim, Nayoung Kim, Joon Jai Kim, Heeyoung Lee
J Prev Med Public Health. 2021;54(5):370-375.   Published online September 2, 2021
  • 3,085 View
  • 104 Download
  • 3 Crossref
AbstractAbstract AbstractSummary PDF
The number of cases of hepatitis A virus (HAV) infections has sharply increased in Korea, especially among young adults. In this study, an HAV outbreak in a facility for disabled people was investigated, and we found epidemiological differences both between 2 different generations and between generally abled and disabled groups.
We analyzed the incubation period and attack rate of an HAV outbreak and investigated the prevalence of HAV antibodies among the staff and residents of a facility for the disabled. We performed a retrospective cohort study during the HAV outbreak, which lasted from February 8 to 25, 2019, including examinations of HAV antibody tests and post-exposure HAV vaccination for the staff or residents of the facility.
There were 9 confirmed cases in 2 staff members and 7 residents. Among 53 people (30 staff and 23 residents), except for the 9 confirmed cases and 1 staff member with a known history of HAV infection, HAV seroprevalence was seen in 16.7% of the staff under 40 years of age and 95.2% of those over 40 years of age, while the corresponding rates in the residents were 0.0% and 58.8%, respectively.
This result implies that it is necessary to prioritize HAV vaccination for vulnerable groups and workers of residential care facilities.
Korean summary
본 연구는 장애인 거주시설에서 발생한 A형간염 유행 사례를 다루고 있다. 그 결과 거주시설 소속의 장애인들은 종사자들보다 높은 발병률(attack rate)을 나타냈을 뿐만 아니라, 비슷한 연령의 일반 인구집단보다 낮은 항체유병률을 나타내는 것으로 확인되었다. 거주시설 소속의 장애인들과 같이 취약한 인구집단은 예방접종 이력을 확인하기 어려울 뿐만 아니라 병원체에 자연스럽게 노출 기회가 적을 수밖에 없기 때문에, 예방접종 정책 수립 시 우선 접종의 대상으로 고려될 필요가 있다.


Citations to this article as recorded by  
  • The Shifting Epidemiology of Hepatitis A in the World Health Organization Western Pacific Region
    Nina G. Gloriani, Sheriah Laine M. de Paz-Silava, Robert D. Allison, Yoshihiro Takashima, Tigran Avagyan
    Vaccines.2024; 12(2): 204.     CrossRef
  • A Study on the Detection Rate of Hepatitis A from Gastroenteritis Patients and the Genotype Analysis of Hepatitis A Virus in Busan
    Sun Hee Park, Chanhee Kim, Summi Lee, Jihye Jeong, Junghye Choi, Seung Ju Lee
    Journal of Bacteriology and Virology.2023; 53(2): 74.     CrossRef
  • A Study on the Detection Rate of Hepatitis A from Gastroenteritis Patients and the Genotype Analysis of Hepatitis A Virus in Busan
    Sun Hee Park, Chanhee Kim, Summi Lee, Jihye Jeong, Junghye Choi, Seung Ju Lee
    Journal of Bacteriology and Virology.2023; 53(2): 74.     CrossRef
Factors Influencing Vaccination in Korea: Findings From Focus Group Interviews
Bomi Park, Eun Jeong Choi, Bohyun Park, Hyejin Han, Su Jin Cho, Hee Jung Choi, Seonhwa Lee, Hyesook Park
J Prev Med Public Health. 2018;51(4):173-180.   Published online May 25, 2018
  • 10,663 View
  • 257 Download
  • 15 Crossref
AbstractAbstract PDF
Immunization is considered one of the most successful and cost-effective public health interventions protecting communities from preventable infectious diseases. The Korean government set up a dedicated workforce for national immunization in 2003, and since then has made strides in improving vaccination coverage across the nation. However, some groups remain relatively vulnerable and require intervention, and it is necessary to address unmet needs to prevent outbreaks of communicable diseases. This study was conducted to characterize persistent challenges to vaccination.
The study adopted a qualitative method in accordance with the Consolidated Criteria for Reporting Qualitative Research checklist. Three focus group interviews were conducted with 15 professionals in charge of vaccination-related duties. The interviews were conducted according to a semi-structured guideline, and thematic analysis was carried out. Data saturation was confirmed when the researchers agreed that no more new codes could be found.
A total of 4 main topics and 11 subtopics were introduced regarding barriers to vaccination. The main topics were vaccine hesitancy, personal circumstances, lack of information, and misclassification. Among them, vaccine hesitancy was confirmed to be the most significant factor impeding vaccination. It was also found that the factors hindering vaccination had changed over time and disproportionately affected certain groups.
The study identified ongoing unmet needs and barriers to vaccination despite the accomplishments of the National Immunization Program. The results have implications for establishing tailored interventions that target context- and group-specific barriers to improve timely and complete vaccination coverage.


Citations to this article as recorded by  
  • Twenty Years of Progress and the Way Forward: Immunization Registry Information System in Korea
    Junghee Kim, Minju Song, Seohyeon Ahn, Seunghyun Lewis Kwon
    Journal of Korean Medical Science.2024;[Epub]     CrossRef
  • Parental intention to vaccinate daughters with the human papillomavirus vaccine in Korea: a nationwide cross-sectional survey
    Yejin Ha, Kyeongmin Lee, Bomi Park, Mina Suh, Jae Kwan Jun, Kui Son Choi
    Epidemiology and Health.2023; 45: e2023076.     CrossRef
  • Letter to the Editor: Effectiveness of the Varicella Vaccine Among Korean Children: Suggestions for Future Research
    BongKyoo Choi, Hyunjeong Cho, Younchul Shin, Eun-Kyoung Lee
    Journal of Korean Medical Science.2022;[Epub]     CrossRef
  • Vaccine hesitancy and emerging parental norms: A qualitative study in Taiwan
    Chen‐I Kuan
    Sociology of Health & Illness.2022; 44(3): 692.     CrossRef
  • Physical and mental health characteristics related to trust in and intention to receive COVID-19 vaccination: results from a Korean community-based longitudinal study
    Ye Jin Jeon, Youngrong Lee, Ji Su Yang, Young Su Park, Sun Jae Jung
    Epidemiology and Health.2022; 44: e2022064.     CrossRef
  • Vaccine Hesitancy and Concerns About Vaccine Safety and Effectiveness in Shanghai, China
    Abram L. Wagner, Zhuoying Huang, Jia Ren, Megan Laffoon, Mengdi Ji, Leah C. Pinckney, Xiaodong Sun, Lisa A. Prosser, Matthew L. Boulton, Brian J. Zikmund-Fisher
    American Journal of Preventive Medicine.2021; 60(1): S77.     CrossRef
  • Paradoxical health care utilization patterns among children in Korea who did not receive mandatory pneumococcal vaccination
    Sangho Sohn, Kwan Hong, Hari Hwang, Byung Chul Chun
    Vaccine.2021; 39(7): 1096.     CrossRef
  • Differential Demographic and Clinical Characteristics between MMR Vaccinated and Unvaccinated Children in South Korea: A Nationwide Study
    Dongwon Yoon, Juhwan Kim, Juyoung Shin
    Vaccines.2021; 9(6): 653.     CrossRef
  • Understanding parents’ views toward the newly enacted HPV vaccine school entry policy in Puerto Rico: a qualitative study
    Vivian Colón-López, Diana T. Medina-Laabes, Roxana Soto Abreu, Olga L. Díaz Miranda, Ana P. Ortiz, María E. Fernández, Pamela C. Hull
    BMC Public Health.2021;[Epub]     CrossRef
  • The need for pertussis vaccination among older adults and high-risk groups: a perspective from advanced economies of the Asia Pacific region
    Leong Hoe Nam, Cheng-Hsun Chiu, Jung Yeon Heo, Margaret Ip, Ki-Suck Jung, Robert Menzies, Rodney Pearce, Philippe Buchy, Jing Chen, Michael Nissen, Kyu-Bin Oh
    Expert Review of Vaccines.2021; 20(12): 1603.     CrossRef
  • Comparison of the Seroprevalence of Measles Antibodies among Healthcare Workers in Two Korean Hospitals in 2019
    Yee Gyung Kwak, Je Eun Song, Gang-Bok Oh, In Hye Jeong, Chong Rae Cho, Namhee Kim, Hyeon Mi Yoo, Gyeong Min Yoo, Myung Jin Lee, Baek-Nam Kim
    Infection & Chemotherapy.2020; 52(1): 93.     CrossRef
  • Unvaccinated children as community parasites in National Qualitative Study from Turkey
    Sıddıka Songül Yalçin, Ayça Gelgeç Bakacak, Osman Topaç
    BMC Public Health.2020;[Epub]     CrossRef
  • Mapping global trends in vaccine confidence and investigating barriers to vaccine uptake: a large-scale retrospective temporal modelling study
    Alexandre de Figueiredo, Clarissa Simas, Emilie Karafillakis, Pauline Paterson, Heidi J Larson
    The Lancet.2020; 396(10255): 898.     CrossRef
  • Sustained Vaccination Coverage during the Coronavirus Disease 2019 Epidemic in the Republic of Korea
    Jeong Hee Yu, Hang jin Jeong, Seon Ju Kim, Jae Young Lee, Young June Choe, Eun Hwa Choi, En Hi Cho
    Vaccines.2020; 9(1): 2.     CrossRef
  • Why do some Korean parents hesitate to vaccinate their children?
    Kyujin Chang, Soon Young Lee
    Epidemiology and Health.2019; 41: e2019031.     CrossRef
Health Impact Assessment of Free Immunization Program in Jinju City, Korea
Keon Yeop Kim, So Youn Jeon, Man Joong Jeon, Kwon Ho Lee, Sok Goo Lee, Dongjin Kim, Eunjeong Kang, Sang Geun Bae, Jinhee Kim
J Prev Med Public Health. 2012;45(4):267-275.   Published online July 31, 2012
  • 7,968 View
  • 57 Download
  • 3 Crossref
AbstractAbstract PDF

This study was conducted to assess the potential health impacts and improve the quality of the free immunization program in Jinju City by maximizing the predicted positive health gains and minimizing the negative health risks.


A steering committee was established in September 2010 to carry out the health impact assessment (HIA) and began the screening and scoping stages. In the appraisal stage, analysis of secondary data, a literature review, case studies, geographic information systems analysis, a questionnaire, and expert consultations were used. The results of the data collection and analyses were discussed during a workshop, after which recommendations were finalized in a written report.


Increased access to immunization, comprehensive services provided by physicians, the strengthened role of the public health center in increasing immunization rates and services, and the ripple effect to other neighboring communities were identified as potential positive impacts. On the other hand, the program might be inaccessible to rural regions with no private clinics where there are more at-risk children, vaccine management and quality control at the clinics may be poor, and vaccines may be misused. Recommendations to maximize health gains and minimize risks were separately developed for the public health center and private clinics.


The HIA provided an opportunity for stakeholders to comprehensively overview the potential positive and negative impacts of the program before it was implemented. An HIA is a powerful tool that should be used when developing and implementing diverse health-related policies and programs in the community.



Citations to this article as recorded by  
  • Cross-Sectional Study of Varicella Zoster Virus Immunity in Healthy Korean Children Assessed by Glycoprotein Enzyme-Linked Immunosorbent Assay and Fluorescent Antibody to Membrane Antigen Test
    Yunhwa Kim, Ji-Young Hwang, Kyung-Min Lee, Eunsil Lee, Hosun Park
    Vaccines.2021; 9(5): 492.     CrossRef
  • Health Impact Assessments of Health Sector Proposals: An Audit and Narrative Synthesis
    Nelius Wanjiku Wanjohi, Reema Harrison, Ben Harris-Roxas
    International Journal of Environmental Research and Public Health.2021; 18(21): 11466.     CrossRef
  • Epidemiological Impact of the Korean National Immunization Program on Varicella Incidence
    Jaehun Jung, Young-Jin Ko, Young-Eun Kim, Kyungmin Huh, Byung-Joo Park, Seok-Jun Yoon
    Journal of Korean Medical Science.2019;[Epub]     CrossRef

JPMPH : Journal of Preventive Medicine and Public Health