1.Cohort profile: Korean Varicella Immunization Monitoring (K-VIM) Scheme: a national cohort of children born 2011–2022
Young Kyu SHIM ; Young Hwa LEE ; Young June CHOE ; Yoonsun YOON ; Yun-Kyung KIM
Epidemiology and Health 2026;48(1):e2026005-
Varicella, caused by the varicella-zoster virus, was once nearly universal in childhood before the advent of vaccination and may lead to severe complications and even fatalities. Monitoring varicella vaccine effectiveness is crucial yet often overlooked in settings with limited surveillance infrastructure. The Korean Varicella Immunization Monitoring (K-VIM) Scheme was established to address this gap by assembling a national, insurance-based birth cohort of children born between 2011 and 2022 (n=4,505,165). This cohort leverages comprehensive healthcare databases in Korea to capture vaccination records, medical visits, and varicella infection outcomes for virtually all children within the target birth years. We describe the enrollment and key characteristics of the K-VIM cohort, including vaccination coverage, demographic features, and varicella incidence to date. The structure and completeness of Korea’s national health insurance and immunization registries enable robust longitudinal tracking of varicella infections among vaccinated versus unvaccinated children. Early findings demonstrate distinct patterns in infection rates and disease severity according to vaccination status. The K-VIM Scheme provides a foundation for ongoing epidemiological studies of varicella vaccine effectiveness and public health impact in Korea. Future plans include evaluating the long-term effects of varicella vaccination, including potential impacts on herpes zoster incidence, using diverse study designs to strengthen causal inference and inform immunization policy.
6.Epidemiological Characteristics and Outcome of Myocarditis and Pericarditis Temporally Associated With BNT162b2 COVID-19 Vaccine in Adolescents: Korean National Surveillance
Bin AHN ; Seung Hwan SHIN ; Myung-Jae HWANG ; HyoSug CHOI ; Sara NA ; Sangshin PARK ; Jue Seong LEE ; Young June CHOE ; Yoonsun YOON ; Kyoungsan SEO ; Jong Hee KIM ; Hyun Mi KANG
Journal of Korean Medical Science 2024;39(49):e317-
Background:
This study aimed to investigate the epidemiological characteristics and outcomes of myocarditis/pericarditis after BNT162b2 vaccination in Korean adolescents.
Methods:
This was a retrospective cohort analysis of adolescents aged 12–19 years old diagnosed with myocarditis/pericarditis within 42 days of BNT162b2 mRNA vaccination. All reported cases were investigated by city or government epidemiologists and the diagnostic certainty and causality was determined by the Korea Disease Control and Prevention Agency’s Adverse Event Following Immunization Expert Advisory Committee according to the modified version of Brighton Collaboration Myocarditis/Pericarditis Working group’s case definitions.
Results:
A total 3,709,063 adolescents aged 12–19 received 8,135,240 doses of the BNT162b2 vaccine in South Korea, and 184 cases met the Brighton criteria for the case definition of myocarditis and pericarditis with diagnostic certainty of possible and above. The median age was 17 years old (interquartile range [IQR], 15–18) and boys accounted for 81.5% (n = 150/184) of the cases. The overall incidence was 2.25 (95% confidence interval [CI], 1.94–2.60) cases per 100,000 doses and severe cases was 0.25 (95% CI, 0.15–3.80) cases per 100,000 doses.The highest incidence rate was observed in boys after the second dose, with 5.01 (95% CI, 4.12–6.17) cases per 100,000 doses. A total 89.1% (164/184) were classified as mild, and no deaths were reported.
Conclusion
The highest incidence of myocarditis/pericarditis after BNT162b2 immunization was observed in male adolescents after the second dose, with majority of the cases presenting with a mild clinical course and favorable outcome.
7.Epidemiological Characteristics and Outcome of Myocarditis and Pericarditis Temporally Associated With BNT162b2 COVID-19 Vaccine in Adolescents: Korean National Surveillance
Bin AHN ; Seung Hwan SHIN ; Myung-Jae HWANG ; HyoSug CHOI ; Sara NA ; Sangshin PARK ; Jue Seong LEE ; Young June CHOE ; Yoonsun YOON ; Kyoungsan SEO ; Jong Hee KIM ; Hyun Mi KANG
Journal of Korean Medical Science 2024;39(49):e317-
Background:
This study aimed to investigate the epidemiological characteristics and outcomes of myocarditis/pericarditis after BNT162b2 vaccination in Korean adolescents.
Methods:
This was a retrospective cohort analysis of adolescents aged 12–19 years old diagnosed with myocarditis/pericarditis within 42 days of BNT162b2 mRNA vaccination. All reported cases were investigated by city or government epidemiologists and the diagnostic certainty and causality was determined by the Korea Disease Control and Prevention Agency’s Adverse Event Following Immunization Expert Advisory Committee according to the modified version of Brighton Collaboration Myocarditis/Pericarditis Working group’s case definitions.
Results:
A total 3,709,063 adolescents aged 12–19 received 8,135,240 doses of the BNT162b2 vaccine in South Korea, and 184 cases met the Brighton criteria for the case definition of myocarditis and pericarditis with diagnostic certainty of possible and above. The median age was 17 years old (interquartile range [IQR], 15–18) and boys accounted for 81.5% (n = 150/184) of the cases. The overall incidence was 2.25 (95% confidence interval [CI], 1.94–2.60) cases per 100,000 doses and severe cases was 0.25 (95% CI, 0.15–3.80) cases per 100,000 doses.The highest incidence rate was observed in boys after the second dose, with 5.01 (95% CI, 4.12–6.17) cases per 100,000 doses. A total 89.1% (164/184) were classified as mild, and no deaths were reported.
Conclusion
The highest incidence of myocarditis/pericarditis after BNT162b2 immunization was observed in male adolescents after the second dose, with majority of the cases presenting with a mild clinical course and favorable outcome.
8.Epidemiological Characteristics and Outcome of Myocarditis and Pericarditis Temporally Associated With BNT162b2 COVID-19 Vaccine in Adolescents: Korean National Surveillance
Bin AHN ; Seung Hwan SHIN ; Myung-Jae HWANG ; HyoSug CHOI ; Sara NA ; Sangshin PARK ; Jue Seong LEE ; Young June CHOE ; Yoonsun YOON ; Kyoungsan SEO ; Jong Hee KIM ; Hyun Mi KANG
Journal of Korean Medical Science 2024;39(49):e317-
Background:
This study aimed to investigate the epidemiological characteristics and outcomes of myocarditis/pericarditis after BNT162b2 vaccination in Korean adolescents.
Methods:
This was a retrospective cohort analysis of adolescents aged 12–19 years old diagnosed with myocarditis/pericarditis within 42 days of BNT162b2 mRNA vaccination. All reported cases were investigated by city or government epidemiologists and the diagnostic certainty and causality was determined by the Korea Disease Control and Prevention Agency’s Adverse Event Following Immunization Expert Advisory Committee according to the modified version of Brighton Collaboration Myocarditis/Pericarditis Working group’s case definitions.
Results:
A total 3,709,063 adolescents aged 12–19 received 8,135,240 doses of the BNT162b2 vaccine in South Korea, and 184 cases met the Brighton criteria for the case definition of myocarditis and pericarditis with diagnostic certainty of possible and above. The median age was 17 years old (interquartile range [IQR], 15–18) and boys accounted for 81.5% (n = 150/184) of the cases. The overall incidence was 2.25 (95% confidence interval [CI], 1.94–2.60) cases per 100,000 doses and severe cases was 0.25 (95% CI, 0.15–3.80) cases per 100,000 doses.The highest incidence rate was observed in boys after the second dose, with 5.01 (95% CI, 4.12–6.17) cases per 100,000 doses. A total 89.1% (164/184) were classified as mild, and no deaths were reported.
Conclusion
The highest incidence of myocarditis/pericarditis after BNT162b2 immunization was observed in male adolescents after the second dose, with majority of the cases presenting with a mild clinical course and favorable outcome.
9.Epidemiological Characteristics and Outcome of Myocarditis and Pericarditis Temporally Associated With BNT162b2 COVID-19 Vaccine in Adolescents: Korean National Surveillance
Bin AHN ; Seung Hwan SHIN ; Myung-Jae HWANG ; HyoSug CHOI ; Sara NA ; Sangshin PARK ; Jue Seong LEE ; Young June CHOE ; Yoonsun YOON ; Kyoungsan SEO ; Jong Hee KIM ; Hyun Mi KANG
Journal of Korean Medical Science 2024;39(49):e317-
Background:
This study aimed to investigate the epidemiological characteristics and outcomes of myocarditis/pericarditis after BNT162b2 vaccination in Korean adolescents.
Methods:
This was a retrospective cohort analysis of adolescents aged 12–19 years old diagnosed with myocarditis/pericarditis within 42 days of BNT162b2 mRNA vaccination. All reported cases were investigated by city or government epidemiologists and the diagnostic certainty and causality was determined by the Korea Disease Control and Prevention Agency’s Adverse Event Following Immunization Expert Advisory Committee according to the modified version of Brighton Collaboration Myocarditis/Pericarditis Working group’s case definitions.
Results:
A total 3,709,063 adolescents aged 12–19 received 8,135,240 doses of the BNT162b2 vaccine in South Korea, and 184 cases met the Brighton criteria for the case definition of myocarditis and pericarditis with diagnostic certainty of possible and above. The median age was 17 years old (interquartile range [IQR], 15–18) and boys accounted for 81.5% (n = 150/184) of the cases. The overall incidence was 2.25 (95% confidence interval [CI], 1.94–2.60) cases per 100,000 doses and severe cases was 0.25 (95% CI, 0.15–3.80) cases per 100,000 doses.The highest incidence rate was observed in boys after the second dose, with 5.01 (95% CI, 4.12–6.17) cases per 100,000 doses. A total 89.1% (164/184) were classified as mild, and no deaths were reported.
Conclusion
The highest incidence of myocarditis/pericarditis after BNT162b2 immunization was observed in male adolescents after the second dose, with majority of the cases presenting with a mild clinical course and favorable outcome.
10.The Impact of an Antimicrobial Stewardship Program on Days of Therapy in the Pediatric Center:An Interrupted Time-Series Analysis of a 19-Year Study
Kyung-Ran KIM ; Hyo Jung PARK ; Sun-Young BAEK ; Soo-Han CHOI ; Byung-Kee LEE ; SooJin KIM ; Jong Min KIM ; Ji-Man KANG ; Sun-Ja KIM ; Sae Rom CHOI ; Dongsub KIM ; Joon-sik CHOI ; Yoonsun YOON ; Hwanhee PARK ; Doo Ri KIM ; Areum SHIN ; Seonwoo KIM ; Yae-Jean KIM
Journal of Korean Medical Science 2024;39(21):e172-
Background:
We aimed to analyze the effects of an antimicrobial stewardship program (ASP) on the proportion of antimicrobial-resistant pathogens in bacteremia, antimicrobial use, and mortality in pediatric patients.
Methods:
A retrospective single-center study was performed on pediatric inpatients under 19 years old who received systemic antimicrobial treatment from 2001 to 2019. A pediatric infectious disease attending physician started ASP in January 2008. The study period was divided into the pre-intervention (2001–2008) and the post-intervention (2009–2019) periods. The amount of antimicrobial use was defined as days of therapy per 1,000 patientdays, and the differences were compared using delta slope (= changes in slopes) between the two study periods by an interrupted time-series analysis. The proportion of resistant pathogens and the 30-day overall mortality rate were analyzed by the χ2 .
Results:
The proportion of extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli and Klebsiella pneumoniae bacteremia increased from 17% (39 of 235) in the pre-intervention period to 35% (189 of 533) in the post-intervention period (P < 0.001). The total amount of antimicrobial use significantly decreased after the introduction of ASP (delta slope value = −16.5; 95% confidence interval [CI], −30.6 to −2.3; P = 0.049). The 30-day overall mortality rate in patients with bacteremia did not increase, being 10% (55 of 564) in the pre-intervention and 10% (94 of 941) in the post-intervention period (P = 0.881).
Conclusion
The introduction of ASP for pediatric patients reduced the delta slope of the total antimicrobial use without increasing the mortality rate despite an increased incidence of ESBL-producing gram-negative bacteremia.

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