DOI QR코드

DOI QR Code

예방접종 동시접종에 대한 접종의사의 인식 조사

A Survey of Doctors' Awareness of Simultaneous Vaccination

  • 이호준 (대동병원 소아청소년과) ;
  • 서현석 (대동병원 소아청소년과) ;
  • 최석원 (대동병원 소아청소년과) ;
  • 김지성 (대동병원 소아청소년과) ;
  • 김은의 (대동병원 소아청소년과) ;
  • 김철암 (대동병원 소아청소년과) ;
  • 손병희 (대동병원 소아청소년과) ;
  • 이균우 (대동병원 소아청소년과)
  • 투고 : 2014.11.11
  • 심사 : 2015.03.06
  • 발행 : 2015.08.25

초록

목적: 예방접종을 시행하는 의사들에게 설문지를 이용해 동시접종 시행 여부와 안전에 대한 염려가 없는가를 조사하여, 동시접종 시행 시 문제점을 파악하고자 하였다. 방법: 조사자가 부산 6개 행정구 내에 있는 국가필수예방접종 사업 등록기관을 방문하여 의사들에게 설문을 실시하였다. 결과: 응답자 155명 중 144명(93%)이 동시접종을 시행하고 있었으며, 141명(91%)이 동시접종에 긍정적인 반응을 보였다. 동시접종을 시행하고 있는 144명 중 67명(47%)은 동시접종의 안전성에 대해서 확신을 가지지 못한 채 접종을 시행 중이었으며, 동시접종 시행 중 부작용을 경험한 86명 중 35명(41%)은 동시접종이 단독접종보다 부작용 빈도가 높을 수 있다고 생각하는 것으로 나타났다. 결론: 동시접종은 높은 비율로 시행 중인 것으로 나타났지만, 동시접종을 시행하는 의사들 중 안전성에 대해 확신을 가지지 못하는 비율이 높게 나타났다. 원활한 접종 시행을 위해 이런 의문을 해소할 수 있는 근거를 제시할 필요가 있다.

Purpose: In this study, doctors were surveyed with a questionnaire to determine whether they performed simultaneous vaccination and whether there were any concerns about safety or anxiety. The purpose of this study was to determine any problems associated with doctors readily performing simultaneous vaccination. Methods: A trained surveyor visited 241 doctors from every institution registered with the National Immunization Program (NIP) located within six districts (gu) in the City of Busan (Dongnae-gu, Geumjeong-gu, Yeonje-gu, Suyeong-gu, Busanjin-gu, Haeundae-gu); a total of 155 (64%) valid responses were obtained. Results: Of the 155 respondents, 144 (93%) were already performing simultaneous immunizations and 141 (91%) had a positive view of the practice. However, among the 144 doctors performing simultaneous immunizations, 67 (47%) were not confident about its safety; side effects were seen after simultaneous immunization by 86 doctors, 35 (41%) of whom believed that the frequency or possibility of side effects in simultaneous immunizations was higher than that in sequential immunizations. Conclusions: The use of simultaneous immunization is expanding quickly. However, among the doctors performing simultaneous immunizations, a high percentage had concerns over its unproven safety and potential side effects, indicating the need for academic societies or government institutions to present evidence to address such concerns.

키워드

참고문헌

  1. Jong KL, Choi WS. Immunization policy in Korea. Infect Chemother. 2008;40:14-23. https://doi.org/10.3947/ic.2008.40.1.14
  2. Advisory Committee on Immunization Practices (ACIP). General recommendations on immunization. Recommendations and Reports 2011;60:1-64.
  3. Dubai health authority. Immunization guidelines. Dubai: Department of Public Health & Safety Policy & Strategy Sector 2012;1-79.
  4. Public Health Agency of Canada. Canadian immunization guide. Canadian Immunization Guide part 1 2014;1-131.
  5. The Korean Pediatric Society. Immunization guideline. Immunization guideline 7th edition 2012:1-309.
  6. Hanna JN, Bullen RC, Andrews DE. The acceptance of three simultaneous vaccine injections recommended at 12 months of age. Commun Dis Intell Q Rep 2004;493-6.
  7. Katsuta T, Miyazi Y, Nakamura Y, Tsuruoka Z, Tateyama S, Tokutake T, et al. A survey of doctors' awareness of simultaneous vaccination in Japan. Japan J Pediatr 2013;117:1645-51.
  8. Rhim JW, Kim CH, Lee WB, Kang JH. A survey of parental knowledge of vaccination. Korean J Pediatr 2006;49:251-7. https://doi.org/10.3345/kjp.2006.49.3.251
  9. Paik SH, Chung EH, Uhm MR, Shin SM, Lee WG, Lee MN, et al. A questionnaire on using informed consents of parents or guardians in vaccination of children. Korean J Pediatr 2003;46:647-54.
  10. Hong YJ. Combination vaccines. Korean J Pediatr 2003;46:213-6.
  11. Offit PA, Quarles J, Gerber MA, Hackett CJ, Marcuse EK, Kollman TR, et al. Addressing parents' concerns: do multiple vaccines overwhelm or weaken the infant's immune system? Pediatrics 2002;109-24.
  12. Meyerhoff AS, Weniger MG, Jacobs RJ. Economic value to parents of reducing the pain and emotional distress of childhood vaccine injections. Pediatr Infect Dis J 2001;20:57-62. https://doi.org/10.1097/00006454-200111001-00009
  13. Oh SH. Active immunization. Hanyang Medical Reviews 2008;28:4-15.
  14. Ju HG, Choi YY, Ma JS, Hwang TJ. Effect of simultaneous administration of hepatitis B vaccine with DPT and oral polio vaccine. Korean J Pediatr 1998;41:451-5.
  15. Melman ST, Nguyen TT, Ehrlich E, Schorr M, Anbar RD. Parental compliance with multiple immunization injections. Arch Pediatr Adolesc Med 1999;153:1289-91. https://doi.org/10.1001/archpedi.153.12.1289
  16. Kim CH. Combination vaccines. Korean J Pediatr 2000;43:322-5.
  17. McGowan A, Cottrell S, Roberts R, Lankshear A. Minimising pain response during routine infant imminisation. Community Pract 2013;86:24-8.
  18. Olin P, Rasmussen F, Gottfarb P. Schedules and protection, simultaneous vaccination and safety : Experiences from recent controlled trials. Int J Infect Dis 1997;1:143-7. https://doi.org/10.1016/S1201-9712(97)90077-1
  19. Shneyer E, Strulov A, Rosenfeld Y. Reduced rate of side effects associated with separate administration on MMR and DTaPHib-IPV vaccinations. Isr Med Assoc J 2009;11:735-8.
  20. Jo DS, Choi EH. General recommendations for immunization practices in children and adolescents. J Korean Med Assoc 2009;52:225-32. https://doi.org/10.5124/jkma.2009.52.3.225
  21. Engineer FG, Keskinocak P, Pickering LK. Catch-up scheduling for childhood vaccination. Operations Research 2009;57:1307-19. https://doi.org/10.1287/opre.1090.0756
  22. Anderson RS, Healey ML. Immunization rates in children receiving Diphtheria-Tetanus-Pertussis and Measles-Mumps-Rubella vaccines simultaneously. J Child Fam Nurs 2000;7:27-38.
  23. Advisory Committee on Immunization Practices (ACIP). Adolescent immunizations: A position paper of the society for adolescent medicine. J Adolesc Health 2006;321-7.