Background: Owing to limited experience with the new vaccine platforms, discussion of vaccine safety is inevitable. However, media coverage of adverse events of special interest could influence the vaccination rate; thus, evaluating the outcomes of adverse events of special interest influencing vaccine administration is crucial. Methods: We conducted regression discontinuity in time analysis to calculate the local average treatment effect (LATE) using datasets from Our World in Data and Johns Hopkins University Center for Systems Science and Engineering. For the United States, the United Kingdom, and Europe, the cutoff points were April 23rd and June 23rd, April 7th, and the 14th week of 2021, respectively. Results: The LATE of the Advisory Committee on Immunization Practices (ACIP) meeting held on April 23rd was −0.249 for all vaccines, −0.133 (−0.189 to −0.076) for Pfizer, −0.064 (−0.115 to −0.012) for Moderna, and −0.038 (−0.047 to −0.030) for Johnson & Johnson. Discontinuities were observed for all three types of vaccines in the United States. The June 23rd meeting of the ACIP (mRNA vaccines and myocarditis) did not convene any discontinuities. Furthermore, there was no significant drop in the weekly average vaccination rates in Europe following the European Medicines Agency (EMA) statement on April 7th. Conversely, there was a significant drop in the first-dose vaccination rates in the United Kingdom related to the EMA report. The first-dose vaccination rate for all vaccines changed by −0.104 (−0.176 to −0.032). Conclusion Although monitoring and reporting of adverse events of special interest are important, a careful approach towards public announcements is warranted.

BACKGROUND: An inactivated Hantaan virus vaccine (iHV) has been broadly used as a preventive strategy for hemorrhagic fever with renal syndrome (HFRS) by the South Korean Army. After the vaccination program was initiated, the overall incidence of HFRS cases was reduced in the military population. While there are about 400 HFRS cases annually, few studies have demonstrated the efficacy of the iHV in field settings. Therefore, this study aimed to evaluate the iHV efficacy on HFRS severity. METHODS: From 2009 to 2017, HFRS cases were collected in South Korean Army hospitals along with patients’ vaccination history. HFRS patients were classified retrospectively into two groups according to vaccination records: no history of iHV vaccination and valid vaccination. Vaccine efficacy on the severity of acute kidney injury (AKI) stage and dialysis events were investigated. RESULTS: The effects of the iHV on renal injury severity in between 18 valid vaccinated and 110 non-vaccinated patients were respectively evaluated. In the valid vaccination group, six of the 18 HFRS patients (33.3%) had stage 3 AKI, compared to 60 of the 110 (54.5%) patients in the non-vaccination group. The iHV efficacy against disease progression (VEp) was 58.1% (95% confidence interval, 31.3% to 88.0%). CONCLUSION: The iHV efficacy against the progression of HFRS failed to demonstrate statistically significant protection. However, different severity profiles were observed between the iHV and non-vaccination groups. Additional studies with larger populations are needed to demonstrate the effectiveness of the iHV in patients with HFRS.
Acute Kidney Injury ; Dialysis ; Disease Progression ; Hantaan virus ; Hantavirus* ; Hemorrhagic Fever with Renal Syndrome* ; Hospitals, Military ; Humans ; Incidence ; Military Personnel ; Preventive Medicine ; Retrospective Studies ; Vaccination

Background: Advances in medicine and changes in the medical environment can affect the diagnosis and treatment of diseases. The main purpose of the present study was to investigate whether the difference in accessibility to diagnosis and treatment facilities influenced the occurrence of appendectomy in Korea. Methods: We collected data on 183,531 appendectomy patients between 2003 and 2017 using the National Health Insurance Services claims. Retrospective analysis of relationship between the age-standardized rate (ASR) of appendectomy and clinical variables affecting medical accessibility was performed. Pearson’s correlation analyses were used. Results: The incidence of appendectomy decreased from 30,164 cases in 2003 to 7,355 cases in 2017. The rate of computerized tomography (CT) scans for diagnosis of appendicitis increased from 4.73% in 2003 to 86.96% in 2017. The ASR of appendectomy in uncomplicated and complicated appendicitis decreased from 48.71 in 2005 to 13.40 in 2010 and 8.37 in 2005 to 2.96 in 2009, respectively. The ASR of appendectomy was higher in the high-income group.The proportion and ASR of appendectomy in older age group increased steadily with years.The total admission days continued to decrease from 6.02 days in 2003 to 4.96 days in 2017. Conclusion The incidence of appendectomy was seemingly associated with the rate of CT scan. In particular, the incidence of appendectomy in uncomplicated appendicitis was markedly reduced. Through enhanced accessibility to CT scans, accurate diagnosis and treatment of appendicitis can be facilitated.

Background: Since March 2020, when coronavirus disease 2019 (COVID-19) was declared a pandemic, many countries have applied unprecedented restrictive measures to contain the spread of the virus. This study aimed to explore the optimal social distancing policy for COVID-19 control in South Korea to safely reopen the society. Methods: We developed an age-specific, deterministic compartment epidemic model to examine the COVID-19 control decision-making process, including the epidemiology of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) between 1 July 2021 and 30 December 2022.The model consists of the natural history of COVID-19, testing performance, vaccinations, and social distancing enforcement measures to detect and control SARS-CoV-2. We modelled potential intervention scenarios with three distinct components: 1) social distancing duration and level;2) testing intensity; and 3) vaccination uptake rate. The primary and secondary outcomes were COVID-19 incidence and prevalence of severe patients requiring intensive care unit (ICU) care. Results: Four (or more) months of social distancing (that can reduce 40–60% transmission) may mitigate epidemic resurgence and ICU demand in the future and keep the cases below the capacity limit if the testing intensity and vaccination rate remain constant or increase by 20% (with respect to the current level). In contrast, two months of strict social distancing enforcement may also successfully mitigate future epidemic surge and ICU demand as long as testing intensity and vaccination rates are increased by 20%. Conclusion In South Korea, given the relatively high vaccination coverage and low incidence, four or more months of social distancing enforcement can effectively mitigate epidemic resurgence after lifting the social distancing measures. In addition, increasing the testing intensity and vaccination rate may help reduce necessary social distancing levels and duration to prevent a future epidemic resurgence and mitigate social and economic damage.

The number of reported varicella cases is continuously increasing in Korea; however, associated medical utilization is declining. The ratio between varicella insurance claims and reports of passive infectious disease surveillance has gradually increased to > 80% since the second half of 2017. The recent increase in reported varicella cases is influenced by improved reporting. We calculated the varicella incidence and cumulative incidence in each birth cohort according to age. The cumulative incidence rate among children aged < 6 years in the birth cohort born after the National Immunization Program introduced the varicella vaccine was about 60% lower than among children born before
Chickenpox Vaccine ; Chickenpox ; Child ; Cohort Studies ; Communicable Diseases ; Humans ; Immunization Programs ; Immunization ; Incidence ; Insurance ; Korea ; Parturition

Purpose: This study aimed to investigate burnout and resilience among emergency physicians (EPs) at university teaching hospitals during the coronavirus disease (COVID-19) pandemic. Materials and Methods: In April to May 2021, a survey was administered to 331 and 309 emergency medicine specialists and residents, respectively, from 31 university teaching hospitals in Korea. Data on the respondents’ age, sex, designation, working area, experience with treating COVID-19 patients, and personal experience with COVID-19 were collected. Based on the participants’ characteristics, quality of life (compassion satisfaction, burnout, and secondary traumatic stress), resilience, emotional content, and self-image were analyzed. Results: A total of 247 responses were analyzed. Compared to specialists, compassion satisfaction and resilience in residents were not good, burnout was severe, and emotional content and self-image were less positive. Experiences with treating COVID-19 patients did not cause any difference in quality of life, resilience, emotional content, and self-image among participant subgroups. Personal COVID-19 experiences were associated with poor compassion satisfaction, resilience, less positive emotional content and self-image, and severe burnout. Compassion satisfaction, secondary traumatic stress, and resilience can definitively affect burnout. Conclusion The quality of life and resilience of EPs in university teaching hospitals in Korea during the COVID-19 pandemic have been low. Supportive measures to improve resilience can prevent burnout among emergency staff, particularly residents and EPs, with personal experiences related to COVID-19.

No abstract available.
Animals ; Mice* ; Skin*

Bacterial infection of the uterus in Hanwoo can kill embryos. Therefore, many antibiotics have been used to treat this infection in the uterus of repeat breeders. Incorrect use of antibiotics has led to resistance in bacteria. Natural compounds have used as substitutes for antibiotics because they are safe and have very mild side effects. This study was conducted to examine the antimicrobial effects of five extracts from medicinal plants including Humulus japonicas (Hj), Phelledendron amurense (Pa), Viola mandshurica (Vm), Carthamus tinctorius (Ct), and Chelidoni herba (Ch) on bacteria isolated from the uterus of Hanwoo using the paper disc diffusion method. Hj and Pa extracts had potent antimicrobial effects against Staphylococcus lentus, Streptococcus infantarius subsp. coli, and Bacillus pumilus. Pa had the greatest antimicrobial effect among the five medicinal plants and was effective against 19 types of bacteria from bovine uterus. Compared to Pa, Hj showed weaker antimicrobial effects on all the bacteria tested except Pseudomonas aeruginosa. Vm, Ct, and Ch also showed weak antimicrobial effects on the tested bacteria. The results obtained suggest that Hj and Pa are natural compounds suitable for treating bacterial infection in repeat breeders and improving conception rates of Hanwoo.
Anti-Bacterial Agents ; Bacillus ; Bacteria* ; Bacterial Infections ; Carthamus tinctorius ; Diffusion ; Embryonic Structures ; Fertilization ; Humulus ; Plants, Medicinal ; Pseudomonas aeruginosa ; Staphylococcus ; Streptococcus ; Uterus* ; Viola

Bacterial infection of the uterus in Hanwoo can kill embryos. Therefore, many antibiotics have been used to treat this infection in the uterus of repeat breeders. Incorrect use of antibiotics has led to resistance in bacteria. Natural compounds have used as substitutes for antibiotics because they are safe and have very mild side effects. This study was conducted to examine the antimicrobial effects of five extracts from medicinal plants including Humulus japonicas (Hj), Phelledendron amurense (Pa), Viola mandshurica (Vm), Carthamus tinctorius (Ct), and Chelidoni herba (Ch) on bacteria isolated from the uterus of Hanwoo using the paper disc diffusion method. Hj and Pa extracts had potent antimicrobial effects against Staphylococcus lentus, Streptococcus infantarius subsp. coli, and Bacillus pumilus. Pa had the greatest antimicrobial effect among the five medicinal plants and was effective against 19 types of bacteria from bovine uterus. Compared to Pa, Hj showed weaker antimicrobial effects on all the bacteria tested except Pseudomonas aeruginosa. Vm, Ct, and Ch also showed weak antimicrobial effects on the tested bacteria. The results obtained suggest that Hj and Pa are natural compounds suitable for treating bacterial infection in repeat breeders and improving conception rates of Hanwoo.
Anti-Bacterial Agents ; Bacillus ; Bacteria* ; Bacterial Infections ; Carthamus tinctorius ; Diffusion ; Embryonic Structures ; Fertilization ; Humulus ; Plants, Medicinal ; Pseudomonas aeruginosa ; Staphylococcus ; Streptococcus ; Uterus* ; Viola

Porcine epidemic diarrhea virus (PEDV), a porcine enteropathogenic coronavirus, causes lethal watery diarrhea in piglets, resulting in large economic losses because of high mortality. In November 2013, PEDV reemerged in Korea, and these outbreaks have since continuously occurred. In the present study, we determined the full-length nucleocapsid (N) gene sequences of three Korean PEDV field isolates collected in 2014-2015. Sequence and phylogenetic analysis of N genes revealed that recent prevalent Korean PEDV isolates were very closely related to the US PEDV isolates in 2013. Interestingly, the phylogenetic tree based on the nucleotide sequencing of the PEDV N gene was similar to the tree topology of the PEDV complete genomes. Therefore, our data provide a better understanding of the genetic diversity and contribute to the accurate diagnosis and development of vaccines against PEDV.
Coronavirus ; Diagnosis ; Diarrhea ; Disease Outbreaks ; Genetic Variation* ; Genome ; Korea* ; Mortality ; Nucleocapsid* ; Porcine epidemic diarrhea virus* ; Trees ; Vaccines