성인 예방접종의 일반적인 원칙과 최신 지견
General Recommendations and Recent Update in Adult Immunization
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연구배경: 예방접종은 백신으로 예방할 수 있는 질병 발생및 합병증을 예방하기 위한 1차 예방 전략이다. 국내에서 성인 예방접종은 주로 소아를 대상으로 시행되었지만 2000년대이후 백신으로 예방할 수 있는 질병이 유행하면서 성인예방접종의 중요성이 새롭게 부각되었다. 그러나 백신접종에 일반적으로 적용하는 최신 원칙에 대해서는 강조되지 않았다. 방법: 2011년 미국 예방접종자문위원회에서 발표한 예방접종에 대한 전반적인 권고안을 중심으로 성인 예방접종에서 적용할 수 있는 원칙을 기술하였다. 또 최근 국내에 도입되었거나 도입될 것으로 예상되는 백신에 대해 간단히 소개하였다. 결과: 2011년 미국 예방접종자문위원회에서 발표한 예방접종에 대한 전반적인 권고안에 따라 백신의 접종 간격,면역글로불린 및 수혈과 백신 접종, 면역력이 변화한 사람의 예방접종, 특별한 임상 상황에서의 예방접종, 예방접종금기사항과 주의해서 접종해야 하는 경우, 예방접종 후 이상반응에 대한 내용이 포함되었다. 그동안 사용되었던 인플루엔자 사백신 외에 다양한 인플루엔자 백신, 성인용 파상풍-백일해-디프테리아 백신, 수막알균 백신, 대상포진백신에 대한 정보를 소개하였다. 결론: 예방접종의 일반적인 원칙과 최근 도입된 다양한백신에 대한 정보를 숙지함으로써 의료인들이 최신 원칙에입각한 예방접종을 시행하는 데 도움이 될 것으로 기대한다.
Abstract
Backgrounds: Vaccination is the primary prevention strategy which aims to prevent various vaccine-preventable diseases and its complications. Although immunization practice had been centered on children in Korea,recent epidemic of several vaccine-preventable diseases such as hepatitis A and novel influenza H1N1 made people pay more attention on adult immunization since 2000. Methods: This article reviews the general recommendations of adult immunization based on the recent report from the US Advisory Committee on Immunization Practices in 2011. New vaccines which have been introduced or will be introduced are briefly reviewed. Results: Following topics are included: 1) principles for vaccine scheduling, 2) spacing of vaccines and antibody-containing products, 3) vaccination in altered immunocompetence, 4) vaccination in special situations, 5)contraindications and precautions, and 6) preventing and managing adverse reactions. Brief information on various influenza vaccines, adult pertussis vaccine, meningococcal vaccine, and zoster vaccine are reviewed and provided. Conclusions: Updated general recommendations and information on the new vaccines are intended for clinicians and other health-care providers who vaccinate patients.
참고문헌 (12)
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