5.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. 
		                        		
		                        		
		                        		
		                        	
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.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. 
		                        		
		                        		
		                        		
		                        	
10.Effectiveness of Two-dose Varicella Vaccination: Bayesian Network Meta-analysis
Kwan HONG ; Young June CHOE ; Young Hwa LEE ; Yoonsun YOON ; Yun-Kyung KIM
Pediatric Infection & Vaccine 2024;31(1):55-63
		                        		
		                        			 Purpose:
		                        			A 2-dose varicella vaccination strategy has been introduced in many countries worldwide, aiming to increase vaccine effectiveness (VE) against varicella infection. In this network meta-analysis, we aimed to provide a comprehensive evaluation and an overall estimated effect of varicella vaccination strategies, via a Bayesian model. 
		                        		
		                        			Methods:
		                        			For each eligible study, we collected trial characteristics, such as: 1-dose vs. 2-dose, demographic characteristics, and outcomes of interest. For studies involving different doses, we aggregated the data for the same number of doses delivered into one arm. The preventive effect of 1-dose vs. 2-dose of varicella vaccine were evaluated in terms of the odds ratio (OR) and corresponding equal-tailed 95% confidence interval (95% CI). 
		                        		
		                        			Results:
		                        			A total of 903 studies were retrieved during our literature search, and 25 interventional or observational studies were selected for the Bayesian network metaanalysis. A total of 49,265 observed individuals were included in this network meta-analysis.Compared to the 0-dose control group, the OR of all varicella infections were 0.087 (95% CI, 0.046–0.164) and 0.310 (95% CI, 0.198–0.484) for 2-doses and one-dose, respectively, which corresponded to VE of 69.0% (95% CI, 51.6–81.2) and VE of 91.3% (95% CI, 83.6–95.4) for 1- and 2-doses, respectively. 
		                        		
		                        			Conclusions
		                        			A 2-dose vaccine strategy was able to significantly reduce varicella burden.The effectiveness of 2-dose vaccination on reducing the risk of infection was demonstrated by sound statistical evidence, which highlights the public health need for a 2-dose vaccine recommendation. 
		                        		
		                        		
		                        		
		                        	
            
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