국가표준 예방접종률 조사방법을 이용한 7세 아동의 예방접종률

Abstract

Objectives: Vaccinations are recommended throughout life to prevent vaccine-preventable diseases and their sequelae. The various efforts for effective vaccination came huge outcomes in short periods. These experience in health program is very rare. But the problems are many in front of vaccinations, for examples, development new vaccines or combo vaccine with high price, low coverage of booster vaccines, difference in vaccination rate between regions or population groups. So there are too many challenging problems to solve. To measure immunization rate is very important because we can know adequate vaccination status for reducing communicable disease occurrence. So lots of nations survey vaccination coverage with various measuring methods, and develop immunization policy and program following to these survey results. This study has two goals. the first goal is to develop standard Korean National Immunization Survey method among 7 year olds in national and metropolitan level, and the other goal is to measure real status. Methods: We carried out the formal process for confirm standard survey method as a national standard, and went through Korean national advisory committee for vaccination and then Statistics Korea. And we performed the computer aided telephone interview (CATI)). The source of information is household-retained vaccination cards. The survey population is 6,700 at 7 year olds (cohort born in 2004) who registered in national immunization registry information system. The unit of sampling is each metropolitan and provincial area using minimum sample size determination method (precision 5%p, confidence interval 95%, assumed coverage rate 50%). Results: The national vaccination coverage per dose was 1 dose BCG 99.6%, 1st dose Hepatitis B 99.4%, 2nd dose Hepatitis B 99.4%, 3rd dose Hepatitis B 98.8%, 1st DTaP 99.9%, 2nd dose DTaP 99.8%, 3rd dose DTaP 99.5%, 4th dose DTaP 98.2%, 5th dose DTaP 91.0%, 1st dose poliovirus 99.7%, 2nd dose poliovirus 99.5%, 3rd dose poliovirus 99.1%, 4th dose poliovirus 90.2%, 1st dose MMR 99.7%, 2nd dose MMR 97.3%, 1 dose varicella 96.5%, 1st dose Japanese encephalitis 99.3%,2nd dose Japanese encephalitis 98.1%, 3rd dose Japanese encephalitis 91.3%, 4th dose Japanese encephalitis 79.7%. In completeness for each vaccine, total 3 doses of Hepatitis B was estimated at 98.6%, 3 doses of DTaP 99.5%, 4 doses of DTaP 98.1%, 5 doses of DTaP 90.5%, 3 doses poliovirus of 98.9%, 4 doses poliovirus of 90.0%, 2 doses MMR of 97.2%. And series vaccination coverage was 97.4% at 3:3:3:1 (3DTaP, 3Polio, 3Hepatitis B, 1BCG=coverage at 1 year), 97.3% at 4:3:1 (4DTaP, 3Polio, 1MMR), 96.1% at 4:3:1:3:1 (4DTaP, 3Polio, 1MMR, 3Hepatitis B, 1BCG),93.0% at 4:3:1:3:1:1 (4DTaP, 3Polio, 1MMR, 3Hepatitis B, 1BCG, 1Varicella), 80.4% at 4:3:1:3:1:1:3 (4DTaP, 3Polio, 1MMR, 3Hepatitis B, 1BCG, 1Varicella, 3 (or2) JEV=coverage at 3 year),80.9% at 5:4:2:3:1:1 (5DTaP, 4Polio, 2MMR, 3Hepatitis B, 1BCG, 1Varicella), 60.0% at 5:4:2:3:1:1:4 (5DTaP, 4Polio, 2MMR, 3Hepatitis B, 1BCG, 1Varicella, 4 (or3) Japanese encephalitis=coverage at 6 year). Conclusions: The Korean vaccination coverage rates among 7 year olds revealed relatively high than we were expected in terms of the herd immunity except a some series vaccinations. To measure more accurate national vaccination coverage rate, our nation must have adequate national immunization registry system. So, we can obtain accurate and timely individual immunization history.