Prioritization of the introduction of new vaccines to the national immunization program in the Republic of Korea.

BACKGROUND: This study was performed to determine the priority of vaccine introduction for five vaccine-preventable diseases (VPDs) caused by Haemophilus influenzae type b (Hib), pneumococcus (Spn), hepatitis A virus (HepA), rotavirus (RV), and human papillomavirus (HPV) to the future Korean National Immunization Program (NIP) and to suggest framework programs to assist decision makers on implementation of the NIP. METHODS: Following analysis of the disease burden and economics of the five VPDs by the core team and Korean Advisory Committee on Immunization Practices sub-committee members, a Delphi survey was administered to 94 Korean experts using structured questionnaires that provided the reference data. The two evaluation frameworks for NIP prioritization were (1) a disease-related framework and (2) a vaccine-related framework. After analyzing the responses, a meeting of experts was held to build a consensus for determining how to prioritize NIP implementation. RESULTS: The average scores for relative importance were 63.29 for the disease-related framework and 36.71 for the vaccine-related framework. Within the disease-related framework, the mortality and case fatality rate was the highest scored factor (8.97), whereas within the vaccine-related framework, efficacy of the vaccine was considered the most important factor (9.56). On average, Spn, Hib, and HepA had the highest priority scores. CONCLUSION: The Korean experts suggested that the main factors influencing the decision to adopt new vaccines in the Korean NIP should be disease mortality, case fatality, and the efficacy and effectiveness of the vaccine. Among the five selected VPDs, Spn, Hib, and HepA were considered to be of higher priority than RV and HPV.

Active surveillance of adverse events following immunization against pandemic influenza A (H1N1) in Korea.

Surveillance of vaccine safety is one of the public health interventions used to investigate the causal relationship between vaccines and adverse events. Using active surveillance data, we aimed to compile a detailed summary describing the safety of the pandemic influenza A (H1N1) vaccine. Computer-assisted telephone interview was used to investigate adverse events for 9,000 subjects who had received non-adjuvanted vaccines between November 2009 and January 2010, and for 19,000 adults who received adjuvanted vaccines from January through March 2010. The participants were interviewed to obtain information about local and systemic adverse events. Among subjects who received the non-adjuvanted vaccine, 5.5% (n=492) reported adverse events after vaccination, while 6.7% of those who received the adjuvanted vaccine reported adverse events. In the group receiving the adjuvanted vaccine, the highest reported rate of adverse events was among persons aged 19-49 years (9.1%, 577/6,329), followed by persons aged 50-64 years (7.2%, 485/6,718), and elderly persons aged 65 years and over (3.4%, 204/5,953). The implementation of this active surveillance study demonstrated the safety of both the adjuvanted and non-adjuvanted H1N1 vaccines.