정보화파트업무계획 [GHSA] Immunization Towards the Achievement of GHSA 2024 s Overarching Targets 2016년추진업무및 2017년업무계획 ( 사업관리 ) 7 th November 2018 Korea Centers for Disease Control and Prevention
I. Overview Contents II. Efforts to increase vaccine coverage and safety Expanded NIP in accessibility and types of vaccine Governance & Financial Support Computerized Immunization Record Information System Vaccine Safety Management Education and Campaign III. International cooperation & contributions
Republic of Korea = South Korea 51 million population 9 provinces Average life expectancy : 82.16 year Total fertility rate : 1.24 children born per woman
History of immunization in the ROK
Expansion of vaccine types covered through NIP Year Until 2011 2012 2013 2014 2015 2016 Children BCG, HepB, DTaP, IPV, DTaP-IPV, Td, MMR, IJEV, VAR + Tdap + Hib + PCV, LJEV + HepA + HPV, IIV Elderly IIV(influenza) + PPSV High risk group No. of vaccine types ViCPS *, hemorrhagic fever 12 13 15 17 18 20 * Typhoid fever vaccine
Expanded NIP List of vaccines in Korea NIP (2018) BCG (intradermal) Hepatitis B Diphtheria/tetanus/pertussis (DTaP)* Poliomyelitis (inactivated; IPV)* Measles/mumps/rubella (MMR) Varicella Japanese Encephalitis (inactivated, live-attenuated) Tetanus/diphtheria/pertussis (Tdap, Td) Haemophilus influenzae type b(hib) Pneumococcal Vaccines (PCV, PPSV) Human papillomavirus (HPV) Influenza Typhoid fever (Vi polysaccharide)* Korean hemorrhagic fever* * DTaP-IPV, DTaP-IPV-Hib combination vaccine also available as NIP vaccine * Only for high-risk groups
National immunization coverage High National Coverage at the 3 Years Old Cohort Classifica -tion 2012 (sample survey) 2013 (sample survey) 2014 (sample survey) 2015 (total N. birth cohort) 2016 (total N. birth cohort) 2017 (total N. birth cohort) BCG 99.7 99.8 99.6 96.7 97.8 98.0 3 HepB 98.8 99.4 99.3 96.3 97.3 97.6 4 DTaP 93.9 96.8 96.5 95.6 96.2 96.6 3 IPV 98.8 99.4 99.4 97.4 97.6 97.7 MMR 99.4 99.6 99.6 97.7 97.8 97.7 Varicella 97.8 98.7 98.7 97.3 97.5 97.6 3(2)JE 86.8 88.9 91.9 92.5 92.7 92.9
Key milestones 1912 Cholera Smallpox 1948 BCG 1950 1955 DTP 1960 1965 Measles 1970 1954 EPI by Act 1980 MMR 1980 1990 1985 Polio eradication 1995 HepB 2000/2001 Measles Outbreak 2000 2006 Measles Elimination Declaration 2014 Measles Elimination Verification 2017 Rubella Elimination Verification 2004 Td 2005 Varicella 2001 MR catch-up 2005 OPV IPV 2002 Perinatal HepB Program 2016 2010 HPV 2014 PCV 2009 Expand subsidy for NIP vaccines 1997 Immunization standard guideline(including 2 nd 2008 Verification for HBV Control 2015 HepA 2017 2013 Hib PPSV(for Elderly) 2010 Pandemic Influenza Control
How Did We Succeed?
Expanded programme on immunization Universal Coverage and Improvement of Accessibility on Immunization Expanded financial support and engagement of private sector : Forward universal coverage and improvement of accessibility ~2008 Public health centers(phcs): NIP vaccine for free of charge Private clinics: NIP (payment for vaccine cost + administration fee) In 2009 Reimbursement for vaccine cost for private clinics In 2012 Reimbursement for vaccine cost and part of administration fee for private clinics In 2014 Full reimbursement for vaccine cost and administration fee for private clinics Free of charge for NIP in all public health center and private clinics
Expanded NIP Universal Coverage and Improvement of Accessibility on Immunization Increased Financial Support and Accessibility Private clinics Proportion of immunization between public vs. private sector Improved accessibility and convenience on NIP
Governance & financial support Korea ACIP & ACVIC Ministry of Health and Welfare with KCDC - Korea Advisory Committee on Immunization Practice (Korea ACIP) - Adivisory Committee on Vaccine Injury Compensation (ACVIC) : To support evidence based immunization policy e.g, schedule, new vaccine (introduction & evaluation), AEFI compensation Prioritization of introduction to EPI in 2009 : Policy research project - Pneumococcal disease/ Hib / Hepatitis A/HPV /.Rotavirus Funding sources : Health promotion fund subsidy program central (national) & local (province, city) governments (50:50)
Immunization Registry Information System Immunization Registry system linkage and service composition Immunization Registry System Service Flowchart Ministry of Government Administration and Home Affairs Ministry of Health and Welfare National Health Insurance Service Ministry of Education Ministry of National Defense Resident computerized information Minwon24 Local Finance Resident information (Qualified data available) Immunization Information Social Security Information Integrated Childcare Information Local Healthcare Information Immunization Information Infant health screening system Immunization Information Educational information system Student information Immunization Information Military forces medical command system Immunization Information SMS Immunization Information Medical Institutions Immunization IR Immunization Information Reimbursement of expenses Target person management IR Immunization Issues immunization certificates
Immunization Registry Information system Child Search Search Results Personal details Individual Vaccination data
Individualized immunization service Ways to provide individual immunization service Immunization Assistant IT service official web site and mobile application 1) Send text message for recall/reminders 2) Issue certificates of vaccination on official website Children under 12 years 3) Check vaccination history by Mobile App. 4) Check vaccination history on NIP website
Vaccine requirement for school entry ( ~ 2012) Subject: children attending elementary and middle school Elementary school 4 type vaccines required children aged 4~6 years ( DTaP 5 th, IPV 4 th, MMR 2 nd, JE(inactivated) 4 th or JE(live attenuated, 2 nd ) Middle school 2 type vaccines required children aged 12 years ( Tdap 6 th, HPV for girls) - Certification method of vaccination completion to confirm the vaccination record registered in the IR system to present the vaccination certification (in case the record have not been registered)
Vaccine safety management System for safe national immunization program Ensuring safe vaccine supply & administration KFDA-approved vaccine supply Regular education for healthcare personals KFDA & KCDC National vaccine injury compensation program Safe Immunization Surveillance of AEFI Rapid response & investigation KCDC
Vaccine safety management Four Components for Vaccine Safety Management Subjects: individuals who experience adverse events on National Immunization Program(NIP) vaccine Eligibility: subjects who paid over 270 USD (300,000 KRW) for personal medical cost (excludes health insurance-covered cost) Assessment of causality : Advisory Committee on Vaccine Injury Compensation Funding: National Budget (313,000 USD/year) * AEFI: adverse event following immunization The average number of reported cases of AEFI per year : 270 cases (2011-2015) Reported AEFI Cases / 100,000 population: 0.54
Education program Various learning program on vaccine and immunization For public health officials Offline learning courses : starter course, advanced course, electronic practice course, Influenza NIP course, safety management course etc. E-learning course: basic and advanced course For healthcare professionals in private clinics participating in NIP E-learning education course: basic and advanced course Completing basic course is required for physicians before participating in NIP; Advanced course is required for physicians to renew contracts for NIP in private clinics
Communication of public relations Immunization awareness campaigns & promotion Parents guidebook in different languages Immunization guideline book : Epidemiology and Prevention of VPDs Immunization week events (4th week, April)
Communication of public relations Immunization awareness campaigns & promotion Integrated communication program for NIP (Strategic promotions on immunization policy) Immunization App. promotion
International cooperation & contribution Visit for workshop from Vietnam (2017) Held workshop on EPI policy and IR system with Vietnam EPI team on 27 Feb, 2017 at KCDC Goals and contents Shared information on NIP in each country Showed Vietnam participants how to operate and input/output data in immunization registry system Proposed anticipated challenges in establishing IRS in Vietnam (e.g. personal data protection, data from private clinics, etc.) Workshop with Vietnam on EPI policy and IR system, 2017
Way forward International cooperation & contribution Strengthen international cooperation Development ODA program on EPI Inviting EPI managers from low or middle income countries (LMIC) To implement IR system To practice and train using IR system To benchmark EPI policy and management system in Korea
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