JYNNEOS vaccine safety monitoring in the Republic of Korea, 2022: a cross-sectional study.

BACKGROUND: With the recent global mpox outbreak, the JYNNEOS vaccine (Modified Vaccinia Ankara-Bavarian Nordic) was developed as a third-generation smallpox vaccine and initially favored for mpox immunization. Vaccine-associated side effects contribute to vaccine hesitancy. Consequently, tracking adverse events post-immunization is crucial for safety management. This study used data from the national active vaccine safety surveillance conducted in Korea from August 25 to November 24, 2022 to detect potential safety signals and adverse events. METHODS: Data on health conditions following vaccination were gathered from web-based surveys and reported via active surveillance through the Immunization Registry Information System. This follow-up system functioned via a text message link, surveying adverse events and health conditions beginning on the second day post-vaccination. Information about specific adverse events, including both local and systemic reactions, was collected. RESULTS: The study included 86 healthcare workers who had received at least 1 dose of the JYNNEOS vaccine. Among the respondents, 79.1% reported experiencing at least 1 adverse event, with the majority being local reactions at the injection site. The incidence of adverse events was higher following the first dose (67.9%) than after the second dose (34.4%). The most frequently reported adverse event for both doses was mild pain at the injection site. CONCLUSION: The study provides crucial information on the safety of the JYNNEOS vaccine, demonstrating that most adverse events were manageable and predominantly localized to the injection site. Nonetheless, additional research is needed on the safety of various vaccine administration techniques and the vaccine's effects on broader demographics.

Monkeypox Vaccination in the Republic of Korea: Identifying the High-Risk Target Group.

In June 2022, the first monkeypox case was reported as imported into Korea. The general public asked whether they should get vaccinated against monkeypox because of the recent COVID-19 vaccination experience. As of the current monkeypox outbreak situation, a ring vaccination strategy for the high-risk group is more appropriate than the mass population vaccination with smallpox vaccines. Therefore, identifying the proper target group by available vaccines based on the risk and benefit analysis is a key issue of the vaccination program. In addition, the target group should be reviewed by the epidemiological situation of the jurisdiction along with the updated evidence of the monkeypox virus on transmission dynamics, severity, and fatality.

Attitude and Acceptance of COVID-19 Vaccine in Parents and Adolescents: A Nationwide Survey.

PURPOSE: Coronavirus disease 2019 (COVID-19) vaccines are currently authorized for emergency use in adolescents aged 12-17 years; however, there is concern and uncertainty regarding the safety and necessity of COVID-19 vaccination. A survey was carried out to assess the attitudes and acceptance towards vaccination in adolescents. METHODS: A nationwide web-based survey was conducted among adolescents aged 12-17 years and their parents between June 29 and July 8, 2021 on a platform provided by the Ministry of Education. RESULTS: A total of 341,326 parents and 272,914 adolescents participated in this study. Intention for vaccination was 69.1% for adolescents, and 72.2% of parents reported they would recommend vaccination for their child. Among adolescents, perception of safety (odds ratio [OR] 4.09, 95% confidence interval [CI] 3.95-4.22), effectiveness (OR 2.24, 95% CI 2.17-2.32), and risk-benefit (OR 1.75, 95% CI 1.72-1.78) had the highest impact on intention for vaccination. Also, perceived risk (OR 1.14, 95% CI 1.12-1.17), severity (OR 1.12, 95% CI 1.10-1.13) for COVID-19 infection, self-health perception (OR 1.12, 95%, CI 1.10-1.14) and recent vaccination of childhood vaccines (OR 1.25, 95% CI 1.19-1.32) were related to intention for COVID-19 vaccination. On the other hand, self-perceived knowledge (OR 0.96, 95% 0.95-0.98) was related to vaccine hesitancy. Gender or school district did not influence intention for COVID-19 vaccination in adolescents. DISCUSSION: Decisions on COVID-19 vaccination for adolescents should be a shared process between adolescents, parents, and physicians based on updated information on safety and effectiveness.

Expert Consensus on COVID-19 Vaccination in Korean Adolescents: A Modified Delphi Survey.

The effectiveness of coronavirus disease 2019 (COVID-19) vaccines had been shown in many studies in adult population, however, the real-world evidence in the childhood population was scarce. We aimed to organize the collective expert's opinions on adolescent vaccination against COVID-19 in Korea, therefore to guide the vaccination policy in the setting of available evidence. The Delphi panels responded that adolescents were greatly impacted by the quarantine measures, and COVID-19 is an important health problem for adolescents. Panels responded that in general, the benefits of the COVID-19 vaccine overweigh the potential risks in Korean adolescents. Continuing monitoring of available data is needed to provide the best vaccination practices in adolescents guided by the updated evidence.

A cytokine study of pediatric Tourette's disorder without obsessive compulsive disorder.

It has been suggested that post-infectious inflammation in central nervous system is a cause of tic disorder including Tourette's disorder (TD). Since pro-inflammatory cytokines are important mediators inducing inflammation, the cytokine levels are regarded as one of the important indicators of inflammation. Several studies have investigated the relationship of autoimmunity and the pathogenesis of TD by measuring the inflammatory cytokine levels of blood. However, when using human samples, the experimental results can be affected by the factors like size of sample, comorbidity, medication that patients take and the severity of the diseases. Thus, it is important to exclude the possibility that comorbidity and medication affects the level of inflammatory cytokines in the serum of TD patients. In our experiment, we recruited 29 patients without obsessive compulsive disorder (OCD) comorbidity and the majority of these patients did not take medication. The six pro-inflammatory cytokine levels of blood between patient and healthy groups were compared, considering the factors above, to determine more accurate results. Of the cytokines we investigated, the interleukin 12 p70 (IL-12p70) and tumor necrosis factor α (TNFα) levels increased in patient group compared to healthy controls and the patient group which have anti-streptolysin O (ASO) score under the 200 or YTGSS score from 10 to 19 also showed higher IL-12p70 or TNFα levels. In addition, the patients who did not take medication showed higher TNFα levels compared to healthy controls. In conclusion, we suggest that inflammatory pathways that involve IL-12p70 or TNFα are important to the pathogenesis of TD.

Physicians' attitude toward the withdrawal of life-sustaining treatment: A comparison between Korea, Japan, and China.

End-of-life care decision making has become a matter of serious ethical and legal concern in the three Far East Asian Countries of China, Japan, and Korea. Researchers in the three countries collaboratively conducted a comparative descriptive study with respect to physicians' perspectives concerning end-of-life care decisions. In spite of cultural similarities, each country has its own unique set of social, cultural, and political circumstances. So the content and scope of policies and laws on end-of-life decision reflect the differing views of people based on their social status, moral values, religious beliefs, and economic status.

Physician liability for procedure related injury: Focused on central venous catheterization.

Central venous catheterization (CVC) is one of essential procedures in critical care medicine. CVC is relatively safe when performed by experienced physicians. Complications may occur due to various risk factors. Although the incidence of CVC-related complications is not high, a serious risk may ensue in cases of such complications. Procedure related complications could lead to civil and criminal lawsuits. This study reviewed the occurrence patterns and rulings of the courts related to CVC in South Korea and tried to find pitfalls that medical professionals should keep in mind before, during and after medical procedures. Various patterns of CVC-related lawsuits have been raised. During the procedure, physicians should perform their duty considering risk factors such as patients' underlying diseases and age. In addition, before the procedure, physicians must obtain written consent for CVC from patients or their legal guardians including explanation of rare complications that could be lethal. After the completion of CVC, surveillance of anticipated complications including chest radiographs should be conducted for the immediate management of any possible complications.

The ethical attitude of emergency physicians toward resuscitation in Korea.

This study was conducted to assess the various ethical attitudes of emergency specialists in Korea toward resuscitation. A questionnaire investigating the following key topics concerning the ethics of resuscitation was sent to emergency specialists in Korea: when not to attempt resuscitation, when to stop resuscitation, withdrawal of life-sustaining treatment, diagnosis of death by non-physicians, permission for family members to stay with the patient during resuscitation, and teaching with the body of the recently deceased patient. We found broad variation in medical practice at patient death and in the ethical considerations held and followed by emergency physicians (EPs) during resuscitation in Korea. Initiating and concluding resuscitation attempts were practiced according to ethical and cultural norms, as well as medical conditions. Guidelines for resuscitation ethics that are based on the Korean medico-legal background need to be developed. Education of EPs to solve the ethical dilemma in resuscitation is needed.

Legal aspects of the application of the lay rescuer automatic external defibrillator (AED) program in South Korea.

The American Heart Association has stated that the automatic external defibrillator (AED) is a promising method for achieving rapid defibrillation, and emphasized that AED training and use should be available in every community. The demonstrated safety and effectiveness of the AED make it ideally suited for the delivery of early defibrillation by trained laypersons, and the placement of AEDs in selected locations for immediate use by trained laypersons may enable critical intervention that can significantly increase survival from out-of-hospital cardiac arrest. The American Heart Association recommends the installation of AEDs in public locations such as airports, thus allowing laypersons to conduct defibrillation and cardiopulmonary resuscitation on the occasion of adverse cardiopulmonary events. In Korea, the Ministry of Health and Welfare officially prohibits the installation of AEDs in public locations on the grounds that cardiopulmonary resuscitation and defibrillation are understood as medical practices that can be conducted only by licensed medical practitioners. The purpose of this article is to discuss the necessity for AEDs and the appropriate process for their implementation in Korea, by examining the current pre-AED status of Korea and the relevant legal aspects.