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COVID-19: Original Article
The bounds of meta-analytics and an alternative method
Ramalingam Shanmugam, Mohammad Tabatabai, Derek Wilus, Karan P. Singh
Epidemiol Health. 2024;46:e2024016.   Published online January 7, 2024
DOI: https://doi.org/10.4178/epih.e2024016
  • 2,224 View
  • 63 Download
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
Meta-analysis is a statistical appraisal of the data analytic implications of published articles (Y), estimating parameters including the odds ratio and relative risk. This information is helpful for evaluating the significance of the findings. The Higgins I2 index is often used to measure heterogeneity among studies. The objectives of this article are to amend the Higgins I2 index score in a novel and innovative way and to make it more useful in practice.
METHODS
Heterogeneity among study populations can be affected by many sources, including the sample size and study design. They influence the Cochran Q score and, thus, the Higgins I2 score. In this regard, the I2 score is not an absolute indicator of heterogeneity. Q changes by bound as Y increases unboundedly. An innovative methodology is devised to show the conditional and unconditional probability structures.
RESULTS
Various properties are derived, including showing that a zero correlation between Q and Y does not necessarily mean that they are independent. A new alternative statistic, S2, is derived and applied to mild cognitive impairment and coronavirus disease 2019 vaccination for meta-analysis.
CONCLUSIONS
A hidden shortcoming of the Higgins I2 index is overcome in this article by amending the Higgins I2 score. The usefulness of the proposed methodology is illustrated using 2 examples. The findings have potential health policy implications.
Summary
Key Message
An approach to overcome the hidden shortcomings of Higgens I2 in meta-analysis. The approach has potential health policy implications.
COVID-19: Original Article
Forecasting the effects of vaccination on the COVID-19 pandemic in Malaysia using SEIRV compartmental models
Mei Cheng Lim, Sarbhan Singh, Chee Herng Lai, Balvinder Singh Gill, Mohd Kamarulariffin Kamarudin, Ahmed Syahmi Syafiq Md Zamri, Cia Vei Tan, Asrul Anuar Zulkifli, Mohamad Nadzmi Md Nadzri, Nur'ain Mohd Ghazali, Sumarni Mohd Ghazali, Nuur Hafizah Md Iderus, Nur Ar Rabiah Binti Ahmad, Jeyanthi Suppiah, Kok Keng Tee, Tahir Aris, Lonny Chen Rong Qi Ahmad
Epidemiol Health. 2023;45:e2023093.   Published online October 17, 2023
DOI: https://doi.org/10.4178/epih.e2023093
  • 4,702 View
  • 97 Download
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
This study aimed to develop susceptible-exposed-infectious-recovered-vaccinated (SEIRV) models to examine the effects of vaccination on coronavirus disease 2019 (COVID-19) case trends in Malaysia during Phase 3 of the National COVID-19 Immunization Program amidst the Delta outbreak.
METHODS
SEIRV models were developed and validated using COVID-19 case and vaccination data from the Ministry of Health, Malaysia, from June 21, 2021 to July 21, 2021 to generate forecasts of COVID-19 cases from July 22, 2021 to December 31, 2021. Three scenarios were examined to measure the effects of vaccination on COVID-19 case trends. Scenarios 1 and 2 represented the trends taking into account the earliest and latest possible times of achieving full vaccination for 80% of the adult population by October 31, 2021 and December 31, 2021, respectively. Scenario 3 described a scenario without vaccination for comparison.
RESULTS
In scenario 1, forecasted cases peaked on August 28, 2021, which was close to the peak of observed cases on August 26, 2021. The observed peak was 20.27% higher than in scenario 1 and 10.37% lower than in scenario 2. The cumulative observed cases from July 22, 2021 to December 31, 2021 were 13.29% higher than in scenario 1 and 55.19% lower than in scenario 2. The daily COVID-19 case trends closely mirrored the forecast of COVID-19 cases in scenario 1 (best-case scenario).
CONCLUSIONS
Our study demonstrated that COVID-19 vaccination reduced COVID-19 case trends during the Delta outbreak. The compartmental models developed assisted in the management and control of the COVID-19 pandemic in Malaysia.
Summary
Key Message
The effectiveness of the Coronavirus disease 2019 (COVID-19) vaccination against the highly transmissible Delta variant remained uncertain during the initial phase of the Delta outbreak in Malaysia. The innovative use of compartmental models provided scientific evidence of the potential impact of COVID-19 vaccination in reducing COVID-19 case trends based on local epidemiological data and offered forecasts of COVID-19 case trends based on varying vaccination rates which assisted resource planning and enhanced healthcare system preparedness. This evidence played a crucial role in bolstering public confidence in vaccination efforts and assisted in the control and management of the pandemic.
Original Articles
Parental intention to vaccinate daughters with the human papillomavirus vaccine in Korea: a nationwide cross-sectional survey
Yejin Ha, Kyeongmin Lee, Bomi Park, Mina Suh, Jae Kwan Jun, Kui Son Choi
Epidemiol Health. 2023;45:e2023076.   Published online August 17, 2023
DOI: https://doi.org/10.4178/epih.e2023076
  • 3,212 View
  • 122 Download
AbstractAbstract AbstractSummary PDF
Abstract
OBJECTIVES
We aimed to identify and compare the characteristics and factors associated with parental intention to vaccinate daughters under 12 years old against human papillomavirus (HPV), examining data from 2016 and 2020.
METHODS
Data were obtained from the Korean National Cancer Screening Survey conducted in 2016 and 2020. The present study included 3,510 parents with daughters under 12 years old. Changes in parental intention-to-vaccinate rates were calculated. To identify factors associated with parental intention to vaccinate their daughters, the chi-square test and logistic regression analysis were used.
RESULTS
The percentage of respondents intending to vaccinate their daughters increased from 33.4% in 2016 to 58.9% in 2020, constituting a 25.5 percentage point (%p) increase. Since 2016, the proportion of men expressing positive intention towards HPV vaccination increased by 31.5%p, while that of women demonstrated a 20.9%p increase. Logistic regression analysis indicated that parents with a strong intention to vaccinate their daughters tended to be younger, more educated, and aware of the free vaccination program available, as well as to have a history of HPV vaccination and to have undergone cervical cancer screening within 2 years, compared to those who did not intend to vaccinate. Being a mother with a history of HPV vaccination was the strongest predictor of positive intention to vaccinate a daughter.
CONCLUSIONS
The intention among parents to vaccinate daughters remains relatively low, although it is rising. To increase the HPV vaccination rate, strong recommendations and education should be provided to parents and the younger generation.
Summary
Korean summary
한국정부는 2016년부터 HPV 백신을 국가예방접종사업으로 도입하여 만 12세 여아를 대상으로 무료접종을 실시하고 있다. 12세 여아가 접종대상인만큼 부모의 HPV 백신에 대한 인식과 태도가 실제 예방접종에 중요한 영향을 미친다. 이 연구를 통해 2016년과 2020년을 비교했을 때 딸의 백신접종에 대한 의향이 증가하였음을 알 수 있었고, 특히 HPV 백신접종 경험이 있는 경우 딸의 백신접종에 대한 의향이 유의하게 높음을 확인하였다.
Key Message
In Korea, HPV vaccination was included in the national immunization program in 2016 for 12-year-old girls. The decision to undergo the HPV vaccination is closely associated with their parents’ perceptions of and attitudes toward the HPV vaccine. This study identified that parental intention increased from 2016 to 2020, and maternal history of HPV vaccination was the strongest predictor of positive intention to vaccinate a daughter.
Viral shedding patterns of symptomatic SARS-CoV-2 infections by periods of variant predominance and vaccination status in Gyeonggi Province, Korea
Gawon Choi, Ah-Young Lim, Sojin Choi, Kunhee Park, Soon Young Lee, Jong-Hun Kim
Epidemiol Health. 2023;45:e2023008.   Published online December 21, 2022
DOI: https://doi.org/10.4178/epih.e2023008
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  • 1 Web of Science
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
We compared the viral cycle threshold (Ct) values of infected patients to better understand viral kinetics by vaccination status during different periods of variant predominance in Gyeonggi Province, Korea.
METHODS
We obtained case-specific data from the coronavirus disease 2019 (COVID-19) surveillance system, Gyeonggi in-depth epidemiological report system, and Health Insurance Review & Assessment Service from January 2020 to January 2022. We defined periods of variant predominance and explored Ct values by analyzing viral sequencing test results. Using a generalized additive model, we performed a nonlinear regression analysis to determine viral kinetics over time.
RESULTS
Cases in the Delta variant’s period of predominance had higher viral shedding patterns than cases in other periods. The temporal change of viral shedding did not vary by vaccination status in the Omicron-predominant period, but viral shedding decreased in patients who had completed their third vaccination in the Delta-predominant period. During the Delta-predominant and Omicron-predominant periods, the time from symptom onset to peak viral shedding based on the E gene was approximately 2.4 days (95% confidence interval [CI], 2.2 to 2.5) and 2.1 days (95% CI, 2.0 to 2.1), respectively.
CONCLUSIONS
In one-time tests conducted to diagnose COVID-19 in a large population, although no adjustment for individual characteristics was conducted, it was confirmed that viral shedding differed by the predominant strain and vaccination history. These results show the value of utilizing hundreds of thousands of test data produced at COVID-19 screening test centers.
Summary
Korean summary
코로나19 선별진료소에서는 확진 검사를 위해 수십만 건에서 수백만 건까지의 일회성 검사를 시행해왔다. 검사를 받은 개인의 특성과 관련된 데이터 제한으로 인해 분석 시 이를 보정할 수는 없지만, 대규모 인구집단에서 얻어진 검사 결과는 SARS-CoV-2 배출 특성을 평가하는 데 활용될 수 있다. 이번 연구에서는 바이러스 변이의 종류와 백신 접종 이력에 따라 증상 발생 후 시간 경과에 따라 바이러스 배출량이 달라지는 것을 확인하였다. 이러한 대규모 선별 검사자료는 향후에도 유용하게 활용 가능하다.
Key Message
The screening center for COVID-19 has conducted hundreds of thousands to millions of one-time confirmation tests for diagnosis. Although individual characteristics cannot be adjusted for due to data limitations, the test results from a large population can still be utilized to evaluate SARS-CoV-2 shedding. We confirmed that viral shedding varied over time after symptom onset, depending on the type of virus variant and vaccination history.
COVID-19: Brief Communication
Clinical severity according to the primary infection variant in patients with suspected SARS-CoV-2 reinfection in Korea
Myung-Jae Hwang, Insob Hwang, Chungmin Park, Hanul Park, Taejong Son, Jong-Hun Kim
Epidemiol Health. 2023;45:e2023007.   Published online December 21, 2022
DOI: https://doi.org/10.4178/epih.e2023007
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  • 3 Web of Science
  • 3 Crossref
AbstractAbstract AbstractSummary PDF
Abstract
OBJECTIVES
We aimed to evaluate the severity of suspected severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) reinfection according to variants of concern in Gyeongsangbuk-do and Daegu, Korea.
METHODS
The database of coronavirus disease 2019 (COVID-19) cases reported from epidemiological investigations through the integrated system operated by the Korea Disease Control and Prevention Agency, from January 20, 2020 to May 7, 2022 was combined with data from the Health Insurance Review and Assessment Service system. The severity odds ratio (SOR) in secondary infection episodes compared with primary infection was estimated using a generalized linear model with a binomial distribution.
RESULTS
In all patients, the SOR of SARS-CoV-2 reinfection was 0.89 (95% confidence interval [CI], 0.82 to 0.95), and the severity was lower than in the first infection. Patients who had been vaccinated within 91 days showed a more attenuated SOR (0.85; 95% CI, 0.74 to 0.98). However, despite vaccination, in patients with both primary and secondary infections caused by the Omicron variant, the severity was reduced to a lesser extent than in patients primarily infected with other variants.
CONCLUSIONS
We could make efforts to relieve the severity of COVID-19 in vulnerable populations, in which death is more likely, by recommending booster vaccinations in case of a resurgence.
Summary
Korean summary
국내 COVID-19 확진자들의 중증도 증가 위험은 재감염(2차감염) 시 감소하였지만, 1차감염과 재감염 모두 오미크론론 변이가 우세하였던 시기인 경우에는 오히려 증가하였다. 특히 마지막 예방접종일로부터 91일 이상인 확진자들과 60세이상 인구에서는 중증도 증가 위험이 더 높았다. 우리는 COVID-19가 장기화됨에 따라 취약인구집단에 대해 추가 예방접종을 권고함으로써 재감염시 중증도가 증가하는 것을 예방해야 할 필요가 있다.
Key Message
As COVID-19 prolongs, there is a need to recommend booster vaccinations for vulnerable populations to prevent the potential for increased severity in the event of reinfection.

Citations

Citations to this article as recorded by  
  • Changes in the intrinsic severity of severe acute respiratory syndrome coronavirus 2 according to the emerging variant: a nationwide study from February 2020 to June 2022, including comparison with vaccinated populations
    Boyeong Ryu, Eunjeong Shin, Dong Hwi Kim, HyunJu Lee, So Young Choi, Seong-Sun Kim, Il-Hwan Kim, Eun-Jin Kim, Sangwon Lee, Jaehyun Jeon, Donghyok Kwon, Sungil Cho
    BMC Infectious Diseases.2024;[Epub]     CrossRef
  • The effect of shortening the quarantine period and lifting the indoor mask mandate on the spread of COVID-19: a mathematical modeling approach
    Jung Eun Kim, Heejin Choi, Minji Lee, Chang Hyeong Lee
    Frontiers in Public Health.2023;[Epub]     CrossRef
  • Previous infection with seasonal coronaviruses does not protect male Syrian hamsters from challenge with SARS-CoV-2
    Magen E. Francis, Ethan B. Jansen, Anthony Yourkowski, Alaa Selim, Cynthia L. Swan, Brian K. MacPhee, Brittany Thivierge, Rachelle Buchanan, Kerry J. Lavender, Joseph Darbellay, Matthew B. Rogers, Jocelyne Lew, Volker Gerdts, Darryl Falzarano, Danuta M. S
    Nature Communications.2023;[Epub]     CrossRef
Review
Monkeypox: the resurgence of forgotten things
Sun Bean Kim, Jaehun Jung, Kyong Ran Peck
Epidemiol Health. 2022;44:e2022082.   Published online September 26, 2022
DOI: https://doi.org/10.4178/epih.e2022082
  • 4,660 View
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  • 3 Web of Science
  • 3 Crossref
AbstractAbstract AbstractSummary PDF
Abstract
Monkeypox, a rare zoonotic disease, is primarily prevalent in Central and Western Africa. However, monkeypox is emerging as a worldwide concern due to the 2022 monkeypox outbreak, which is the first instance of widespread community transmission outside Africa. Monkeypox is caused by the monkeypox virus, which belongs to the genus <i>Orthopoxvirus</i> and presents as a vesicular-pustular disease that may be preceded by fever, malaise, and other constitutional symptoms. If present, lymphadenopathy may distinguish it from chickenpox or smallpox. However, contrary to previous manifestations, most monkeypox patients presented with atypical features during the 2022 outbreak. Monkeypox is usually a self-limiting disease with symptoms lasting between 2 weeks and 4 weeks and is mainly transmitted when a person comes into contact with an infected animal, person, or fomites contaminated with the virus. Very few treatment options are available for this disease. Tecovirimat has been licensed in some countries for the treatment of smallpox and monkeypox infections. Two other medications, cidofovir and brincidofovir, have been found to be effective against poxviruses in in vitro and animal studies, but data on human cases of monkeypox are limited. Although Imvamune (JYNNEOS), a vaccine against monkeypox, is authorized in the United States, there are currently no established routine vaccination programs. Current preventive strategies focus on the detection of probable cases and containment of the outbreak through the implementation of selected ring vaccination programs. Fundamental principles to prevent the spread of monkeypox, including maintaining personal hygiene and avoiding close contact with symptomatic patients, are of paramount importance.
Summary
Korean summary
원숭이두창은 orthopoxvirus에 속하는 원숭이두창 바이러스에 의해 발생하며, 중앙아프리카와 서아프리카에서 주로 발견되는 희귀한 인수공통감염병이었으나 2022년에 집단 발병했던 원숭이두창 환자들은 이전부터 널리 알려진 증세와 달리 비전형적인 임상 특징을 보이고 있고, 전 세계적으로 아프리카와의 역학적 연관성없이 아프리카 이외의 여러 지역에서 원숭이두창이 집단 발병하면서 보건학적 화두로 대두되었다. 원숭이두창에 대한 치료는 증상 호전을 위한 대증 요법이 주가 되며, 매우 제한적인 항바이러스제가 치료 약제로 이용된다. 2019년 미국에서 Imvamune (Jynneos)가 성인을 대상으로 원숭이두창 백신으로 사용이 승인되었다. 하지만 예방 접종뿐만 아니라 손씻기 등의 개인위생 유지, 의심 혹은 확진 환자와의 긴밀한 접촉을 피하는 것 등이 원숭이두창 확산을 막기 위한 가장 중요한 기본 원칙이다.
Key Message
Monkeypox is caused by the monkeypox virus, which belongs to the genus Orthopoxvirus and presents as a vesicular-pustular disease that may be preceded by fever, malaise, and other constitutional symptoms. Contrary to previous manifestations, most monkeypox patients presented with atypical features during the 2022 outbreak. Very few treatment options are available for this disease and current preventive strategies focus on the detection of probable cases and containment of the outbreak through the implementation of selected ring vaccination programs. Fundamental principles to prevent the spread of monkeypox, including maintaining personal hygiene and avoiding close contact with symptomatic patients, are of paramount importance.

Citations

Citations to this article as recorded by  
  • Breaking Barriers: Current Advances and Future Directions in Mpox Therapy
    Bhumi M. Shah, Palmi Modi
    Current Drug Targets.2024; 25(1): 62.     CrossRef
  • How to cope with suspected mpox patients in the outpatient clinic
    Nam Joong Kim, Sun Huh
    Journal of the Korean Medical Association.2023; 66(5): 325.     CrossRef
  • An International Outburst of New Form of Monkeypox Virus
    Kiran Dobhal, Pallavi Ghildiyal, A.N.M. Ansori, Vikash Jakhmola
    Journal of Pure and Applied Microbiology.2022; 16(suppl 1): 3013.     CrossRef
COVID-19: Original Article
Maternal vaccine hesitancy towards COVID-19 immunisation of children in Qatar: a population-based cross-sectional study
Shuja Reagu, Suruchi Mohan, Johnny Awwad, Majid Alabdulla
Epidemiol Health. 2022;44:e2022056.   Published online July 6, 2022
DOI: https://doi.org/10.4178/epih.e2022056
  • 6,797 View
  • 197 Download
  • 1 Web of Science
  • 1 Crossref
AbstractAbstract PDF
Abstract
OBJECTIVES
This study was conducted in Qatar to explore beliefs and attitudes among mothers towards coronavirus disease 2019 (COVID-19) vaccination for their children and to understand major factors influencing vaccine hesitancy among these mothers.
METHODS
A population-based, online cross-sectional survey was conducted between 15 October and 15 November 2020. A composite questionnaire incorporating a validated vaccine hesitancy tool was developed and administered in both English and Arabic. Approval was obtained from the local ethics committee. Participation was voluntary and offered to all adult residents of Qatar through an online link available on social media platforms and local news portals. Only adult respondents who self-identified as mothers were included in the present study. No personal identifying data were collected.
RESULTS
Of the mothers surveyed, 29.4% exhibited COVID-19 vaccine hesitancy regarding their children. This exceeded these mothers’ rate of personal vaccine hesitancy (27.5%). Hesitancy rates varied significantly with ethnicity, with the highest among Qatari mothers (51.3%). Intention to vaccinate children did not differ significantly between mothers who accepted the vaccine for themselves and those who did not. Overall, the main reported concerns related to long-term vaccine safety. To a significant extent, mothers relied most on self-directed research on vaccine safety for decision-making.
CONCLUSIONS
The rate of maternal COVID-19 vaccine hesitancy exceeded both those mothers’ rate of personal vaccine hesitancy and the hesitancy rate in the general population. The intention to vaccinate children was independent of maternal vaccination history. Factors influencing maternal vaccine hesitancy differ from those influencing personal hesitancy and require an informed public health response.
Summary

Citations

Citations to this article as recorded by  
  • Key Lessons from COVID-19: A Narrative Review Describing Qatar’s Multifactorial Approach in Executing a Vaccination Campaign
    Soha Albayat, Muna Almaslamani, Hamad Alromaihi, Hayat Khogali, Jesha Mundodan, Jean Joury, Hammam Haridy
    Vaccines.2023; 11(5): 953.     CrossRef
COVID-19: Original Article
The vaccination coverage rate in under-5 children in Nasiriyah, Iraq before and during the COVID-19 pandemic
Ali Rifaat Alhaddad, Elham Ahmadnezhad, Akbar Fotouhi
Epidemiol Health. 2022;44:e2022035.   Published online March 14, 2022
DOI: https://doi.org/10.4178/epih.e2022035
  • 9,590 View
  • 321 Download
  • 2 Web of Science
  • 3 Crossref
AbstractAbstract AbstractSummary PDF
Abstract
providOBJECTIVES: This study compared the vaccination coverage rate (VCR) in children under 5 years old in Nasiriyah, Iraq before and during the coronavirus disease 2019 (COVID-19) pandemic.
METHODS
This cross-sectional study was conducted in the city of Nasiriyah in southeastern Iraq, with data collected from 79 primary healthcare facilities. This study evaluated the VCR in 3 periods (2018, 2019, and 2020) using multi-level random sampling. Pertinent data were extracted from the vaccination records of 598 children for Bacillus Calmette-Guérin (BCG); pentavalent 1, 2, and 3; measles; and activated oral poliovirus vaccine 1 and 2. Missing data were completed by telephone calls to participants’ parents. Logistic regression was applied to compare and estimate the odds ratios (ORs) with 95% confidence intervals (CIs) for the association between VCR and related factors.
RESULTS
The data showed the greatest decline in the studied vaccines in 2020. Among the vaccines studied, BCG had the highest rate in all 3 periods (100% VCR) and measles had the lowest rate (83.7%), reaching 63.6% in 2020 (p<0.001). The highest OR among all types of vaccine were found for the pentavalent-3 vaccine among city dwellers and those born in 2020 (OR, 2.67; 95% CI, 1.39 to 5.10 and OR, 2.34; 95% CI, 1.28 to 4.28, respectively).
CONCLUSIONS
The VCR for children decreased during the COVID-19 pandemic in Iraq, and new health policies are needed to increase the coverage rate. Improving the knowledge and attitudes of parents, as well as removing barriers or risk factors, can also be effective in improving the VCR.
Summary
Key Message
Vaccination is one of the most important essential health services. COVID-19 pandemic has reduced the coverage of vaccination among under five.

Citations

Citations to this article as recorded by  
  • COVID-19 infections among Iraqi school students: Severity, types, and symptoms
    Saad Hantoosh
    Journal of Medicine and Life.2023; 16(10): 1552.     CrossRef
  • Current Impact and Long-Term Influence of the COVID-19 Pandemic on Iraqi Healthcare Systems: A Case Study
    Taysir Al Janabi, Sunny Chung
    Epidemiologia.2022; 3(4): 412.     CrossRef
  • Dropout of Vaccination Among Iraqi Children
    Maha. A. Kadim, Anees Flayyih Abdulhasan, Zainab Abdulameer Abdulrasol, Ali Fadhil Obaid
    South Asian Journal of Social Sciences and Humanities.2022; 3(6): 163.     CrossRef
COVID-19: Perspective
Enhancing COVID-19 vaccination coverage using financial incentives: arguments to help health providers counterbalance erroneous claims
Jelena Dotlic, Vida Jeremic Stojkovic, Paul Cummins, Marija Milic, Tatjana Gazibara
Epidemiol Health. 2021;43:e2021081.   Published online October 6, 2021
DOI: https://doi.org/10.4178/epih.e2021081
  • 8,383 View
  • 132 Download
  • 5 Web of Science
  • 5 Crossref
AbstractAbstract AbstractSummary PDF
Abstract
Financial reimbursements after receiving the coronavirus disease 2019 (COVID-19) vaccine have been criticized in the literature. This strategy has been described as payment to receive the vaccines, undue inducement, and unethical. We are aware that healthcare workers who work in primary healthcare, prevention, and public health may encounter similar reasons from people who refuse vaccination against COVID-19. For this reason, we are compelled to clarify these claims and provide arguments for all healthcare workers who might be challenged by such reasoning. In this critical review, we discuss why the claims against financial incentives that have been presented in the literature are erroneous.
Summary
Key Message
When assessing the ethics of financial incentives to receive the COVID-19 vaccine, we must not confuse matters by invoking ethical concepts that are not relevant to this public health issue; calling a financial incentive an "undue inducement" is a mistake because it assumes that it would distort a potential recipient’s judgment to take on unacceptable risk, when these vaccines have already been tested and authorized by regulatory agencies, which suggests the risk is not substantial, but quite the opposite - they benefit the recipients.

Citations

Citations to this article as recorded by  
  • The effectiveness of financial incentives for COVID-19 vaccination: A systematic review
    Gabriela K. Khazanov, Rebecca Stewart, Matteo F. Pieri, Candice Huang, Christopher T. Robertson, K. Aleks Schaefer, Hansoo Ko, Jessica Fishman
    Preventive Medicine.2023; 172: 107538.     CrossRef
  • Mandatory and seasonal vaccination against COVID-19: Attitudes of the vaccinated people in Serbia
    Verica Jovanovic, Marija Milic, Jelena Dotlic, Smiljana Cvjetkovic, Vida Jeremic Stojkovic, Natasa Maksimovic, Maja Sekulic, Tatjana Gazibara
    Epidemiology and Infection.2023;[Epub]     CrossRef
  • Letter to the Editor: Financial incentives for COVID-19 vaccination
    Hyuncheol Bryant Kim
    Epidemiology and Health.2021; 43: e2021088.     CrossRef
  • Letter to the Editor: Enhancing COVID-19 vaccination coverage using financial incentives: arguments to help health providers counterbalance erroneous claims
    Yong-jun Choi
    Epidemiology and Health.2021; 43: e2021087.     CrossRef
  • Authors’ Reply: Vaccination, payment, and COVID-19
    Jelena Dotlic, Vida Jeremic Stojkovic, Paul Cummins, Marija Milic, Tatjana Gazibara
    Epidemiology and Health.2021; 43: e2021100.     CrossRef
COVID-19: Original Article
Risk of COVID-19 transmission in heterogeneous age groups and effective vaccination strategy in Korea: a mathematical modeling study
Youngsuk Ko, Jacob Lee, Yubin Seo, Eunok Jung
Epidemiol Health. 2021;43:e2021059.   Published online September 8, 2021
DOI: https://doi.org/10.4178/epih.e2021059
  • 9,081 View
  • 152 Download
  • 4 Web of Science
  • 7 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
This study aims to analyze the possibility and conditions of maintaining an effective reproductive number below 1 using a mathematical model.
METHODS
The total population was divided into five age groups (0-17, 18-29, 30-59, 60-74, and ≥75 years). Maximum likelihood estimation (MLE) was used to estimate the transmission rate of each age group. Mathematical model simulation was conducted until December 31, 2021, by establishing various strategies for vaccination and social distancing without considering variants.
RESULTS
MLE results revealed that the group aged 0-17 years had a lower risk of transmission than other age groups, and the older age group had relatively high risks of infection. If 70% of the population will be vaccinated by the end of 2021, then simulations showed that even if social distancing was eased, the effective reproductive number would remain below 1 near August if it was not at the level of the third re-spreading period. However, if social distancing was eased and it reached the level of the re-spreading period, the effective reproductive number could be below 1 at the end of 2021.
CONCLUSIONS
Considering both stable and worsened situations, simulation results emphasized that sufficient vaccine supply and control of the epidemic by maintaining social distancing to prevent an outbreak at the level of the re-spreading period are necessary to minimize mortality and maintain the effective reproductive number below 1.
Summary
Korean summary
본 연구에서는 질병관리청에서 제공하는 개별 확진자 데이터에 확률통계적 방법을 적용하여 연령군 간의 감염전파 행렬을 추정하였으며 연령군을 고려한 수리모델에 적용되었다. 본 연구에서 우리는 2020년 10월부터 2021년 5월까지 한국에서의 코로나19 유행상황을 정책 구간에 따라 분석하였으며 이를 토대로 거리두기 완화 수준에 따라 거리두기 완화 상태에서도 지속적으로 유효감염재생산지수가 1보다 작아지는 시점이 달라질 수 있음을 보인다.
Key Message
In this research, we estimated age-group-specified transmission rate matrix by applying maximum likelihood estimation into individual based data which was provided by Korea Disease Control and Prevention Agency. Our model simulation showed the moment, when the effective reproductive number is consistently below 1 even the distancing is eased, is ranged from August to the end of 2021 depending on the intensity of the social distancing during eased phase.

Citations

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Original Articles
Estimating the medical capacity required to administer mass prophylaxis: a hypothetical outbreak of smallpox virus infection in Korea
Sangwoo Tak, Soomin Lim, Heesu Kim
Epidemiol Health. 2019;41:e2019044.   Published online October 10, 2019
DOI: https://doi.org/10.4178/epih.e2019044
  • 9,564 View
  • 167 Download
AbstractAbstract AbstractSummary PDF
Abstract
OBJECTIVES
The aim of this study was to estimate the medical surge capacity required for mass prophylaxis based on a hypothetical outbreak of smallpox.
METHODS
We performed a simulation using the Bioterrorism and Epidemic Outbreak Response Model and varied some important parameters, such as the number of core medical personnel and the number of dispensing clinics.
RESULTS
Gaps were identified in the medical surge capacity of the Korean government, especially in the number of medical personnel who could respond to the need for mass prophylaxis against smallpox.
CONCLUSIONS
The Korean government will need to train 1,000 or more medical personnel for such an event, and will need to prepare many more dispensing centers than are currently available.
Summary
Korean summary
본 연구는 이미 박멸된 감염병인 두창이 발생됨을 가상하여 대규모 백신접종의 시나리오를 바탕으로 의료인력과 접종에 필요한 보건의료시설의 가용여부를 분석하였다. 두창 발생 1년 이내에 전국민의 70%를 대상으로 백신접종을 완료하기 위해서는 최소 1,000 명 이상의 훈련된 의료인력이 필요하며, 현재 병의원 시설을 포함하여 보건소 등을 백신 접종을 위한 시설로 활용하기 위해서 체계적인 대비노력이 필요한 것으로 판단된다. 한국정부의 대비역량에 대한 좀 더 면밀한 분석이 요구된다.
Why do some Korean parents hesitate to vaccinate their children?
Kyujin Chang, Soon Young Lee
Epidemiol Health. 2019;41:e2019031.   Published online July 9, 2019
DOI: https://doi.org/10.4178/epih.e2019031
  • 14,322 View
  • 296 Download
  • 17 Web of Science
  • 24 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
Vaccinations for infectious diseases are opposed despite their achievement, and this opposition has recently been revealed in Korea. However, research in Korea has not been vigorous. The authors studied why some Korean parents hesitate to vaccinate their children by applying the health belief model.
METHODS
Parents who hesitate to vaccinate and parents who do not were surveyed in alternative education preschools and elementary schools. They were classified into four types of hesitancy and statistically compared.
RESULTS
Among the 129 subjects, 43 vaccinated without hesitancy, 20 vaccinated on time with hesitancy, 32 vaccinated with a deliberate delay of one month or longer, and 34 did not vaccinate. Vaccination increased with an increase in the awareness that severe outcomes can occur when unvaccinated. Concerns about adverse reactions from vaccinations or direct/indirect experiences affected refusal. Furthermore, perceptions of the lack of meaningfulness of vaccinations, distrust of policy and safety management, influence of leaders or activists in joined organizations, and experts of Korean traditional or alternative medicine affected refusal. Explanations by doctors, text messages and mails from institutions, and concerns about disadvantages caused by not complying with government policies increased vaccination.
CONCLUSIONS
The reasons for vaccine hesitancy and acceptance were similar to the results of international research. Health authorities and professionals should communicate sufficiently and appropriately with hesitant parents and find ways to rationally resolve social conflicts. However, this sample was small and there is little Korean research, so more in-depth and diverse researchs are needed.
Summary
Korean summary
한국에도 있는 일부 소아 예방접종 망설임 부모들이 왜 그렇게 생각하고 결정하는지, 대안교육시설에서 129명을 대상으로 연구하였다. 예방접종 부작용 우려나 경험, 의미 격하, 정책 및 안전관리 불신, 관련 활동가, 한의학이나 대체의학 전문가가 미접종에 영향을 주었다. 보건관계자들은 망설임 부모들과 충분하고 적절한 의사소통을 하여, 사회적 갈등을 합리적으로 해소하는 방안을 찾아야 한다.

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The coverage rates for influenza vaccination and related factors in Korean adults aged 50 and older with chronic disease: based on 2016 Community Health Survey data
Kyeong Hyang Byeon, Jaiyong Kim, Boyoung Choi, Bo Youl Choi
Epidemiol Health. 2018;40:e2018034.   Published online July 24, 2018
DOI: https://doi.org/10.4178/epih.e2018034
  • 13,012 View
  • 219 Download
  • 11 Web of Science
  • 14 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
This study aims to identify the coverage rates for influenza vaccination and related factors depending on chronic disease in Korean adults aged 50 and older.
METHODS
The 2016 Korea Community Health Survey was used for analysis. Chi-square test was performed to investigate the coverage rates for influenza vaccination depending on chronic disease, and a multiple logistic regression analysis was used to identify the factors associated with influenza vaccination, by chronic disease.
RESULTS
In men with ≥1 chronic disease, 39.8% of 50-64 years of age, and 86.8% of elderly (over 65 years of age) received influenza vaccination. In women with ≥1 chronic disease, 58.7% of 50-64 years of age, and 89.9% of elderly (over 65 years of age) received influenza vaccination (p<0.001). The chronic diseases associated with influenza vaccination were hypertension (odds ratio [OR], 1.27; 95% confidence interval [CI], 1.19 to 1.37), diabetes (OR, 1.41; 95% CI, 1.28 to 1.55) in men aged 50-64, hypertension (OR, 1.34; 95% CI, 1.20 to 1.49), diabetes (OR, 1.17; 95% CI, 1.02 to 1.33), chronic cardiovascular disease (OR, 1.31; 95% CI, 1.07 to 1.60) in elderly (over 65 years of age). In women aged 50-64, hypertension (OR, 1.39; 95% CI, 1.30 to 1.49), diabetes (OR, 1.51; 95% CI, 1.35 to 1.68), chronic cardiovascular disease (OR, 1.31; 95% CI, 1.05 to 1.64), and hypertension (OR, 1.55; 95% CI, 1.40 to 1.71), diabetes (OR, 1.27; 95% CI, 1.12 to 1.43) in elderly (over 65 years of age).
CONCLUSIONS
Populations in aged 50-64 are recommendation subject for vaccination or classified as high-risk group in case with chronic disease. Though subject over 60 years old is age close to the elderly, the coverage rates for vaccination was low. It is necessary to devise strategies to raise the coverage rates for vaccination.
Summary
Korean summary
매년 인플루엔자 환자수는 증가하는 추세이며 인플루엔자로 인한 의료이용의 질병부담은 커질 것으로 생각된다. 국내에서는 우선접종 권장대상자들에게 예방접종을 받도록 권고하고 있으며, 예방접종은 인플루엔자를 예방할 수 있는 비용 효과적인 방법이다. 65세 이상 대상자는 국가 무료 예방접종 사업 대상으로 인해 예방접종률이 높은 것으로 확인되었다. 50-64세 인구는 예방접종 권고 대상자임에도 불구하고 낮은 것으로 나타났고, 50-64세 연령에서 만성질환을 동반할 경우 고위험군이지만 여전히 낮은 예방접종률을 보였다. 또한 50-64세 연령에서 1개 이상 만성질환을 동반할 경우 대도시, 중소도시에 거주하는 것보다 군지역에 거주할 경우 높은 예방접종률을 확인함으로써 대도시 및 중소도시에 거주하는 50-64세 연령에 대해 예방접종률을 올릴 수 있는 적극적인 예방접종 홍보가 필요할 것으로 생각한다.

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Epidemiologic Investigation
Vaccination history in elementary school children enrolled in the varicella epidemic investigations held in Jeju-si, Korea in the first half of 2017
Hyun-Suk Oh, Jong-Myon Bae
Epidemiol Health. 2017;39:e2017053.   Published online November 13, 2017
DOI: https://doi.org/10.4178/epih.e2017053
  • 12,289 View
  • 203 Download
  • 4 Web of Science
  • 4 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
The reported incidence rate of varicella infection in Jeju-do is higher compared with the national average. This study aimed to examine varicella vaccination history and evaluate clinical manifestation of varicella cases in Jeju-do.
METHODS
Based on the guideline suggested by the Korea Centers for Disease Control and Prevention (KCDC), two epidemic investigations for varicella infection were conducted in the first half of 2017. The history of varicella vaccination was confirmed using the Integrated Control System for Diseases and Health operated by the KCDC.
RESULTS
Out of a total of 60 elementary school children as the study subjects, all had been previously vaccinated against varicella. Twenty cases (33%) showed mild clinical manifestations and no complications.
CONCLUSIONS
As the government of Jeju-do has supplied a single-labeled vaccine since 2011, there is a need to evaluate the type of vaccination failure such as primary or secondary.
Summary
Korean summary
수두 발생 신고률에 있어 제주도는 전국에 비해 높은 수준을 보이고 있지만, 수둑접종률은 전국과 유사한 수준이다. 이에 2017년 상반기 수두 집단발생에 대응한 2건의 역학조사를 수행한 결과, 33%에서 돌발수두 임상 증상을 보였고 모두 백신 접종력이 있었다. 높은 발생 신고률은 지역사회 소아 개원의들의 높은 신고에 의한 것으로 유추할 수 있으며, 수두 백신 실패에 대한 추후 조사가 필요하다.

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Original Article
The exposure rate to hepatitis B and C viruses among medical waste handlers in three government hospitals, southern Ethiopia
Anteneh Amsalu, Mesfin Worku, Endale Tadesse, Techalew Shimelis
Epidemiol Health. 2016;38:e2016001.   Published online January 5, 2016
DOI: https://doi.org/10.4178/epih.e2016001
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  • 17 Web of Science
  • 19 Crossref
AbstractAbstract PDF
Abstract
OBJECTIVES
The aim of this study was to assess the rate of and risk factors for exposure to hepatitis B virus (HBV) and hepatitis C virus (HCV) among medical waste handlers.
METHODS
A cross-sectional study was conducted from December 2014 to January 2015. A total of 152 medical waste handlers (MWH) and 82 non-medical waste handlers (NMWH) were studied. Serum samples were collected from participants and screened for hepatitis B surface antigen (HBsAg), hepatitis B core antibody (anti-HBc) and anti-HCV using rapid immunochromatography assay. MWH were also screened for hepatitis B surface antibody (anti-HBs).
RESULTS
The respective prevalence of HBsAg, anti-HBc and anti-HCV was 1.3%, 39.4%, and 0.7% in MWH, compared to 2.4%, 17.1%, and 1.2%, respectively, in NMWH. Among MWH, 58.6% were susceptible to HBV infection. There was a significant difference in the rate of lifetime exposure to HBV in MWH compared with NMWH (odds ratio [OR], 3.17; 95% confidence interval [CI], 1.64 to 6.13). However, there was no significant difference between participant groups with respect to current HBV infection (OR, 0.53; 95%CI, 0.07 to 3.86) or anti-HCV (OR, 0.54; 95%CI, 0.03 to 8.69). Age older than 40 years and working in a hospital laundry were independent predictors of lifetime exposure to HBV infection. Eleven (7.2%) respondents were vaccinated against HBV.
CONCLUSIONS
Lifetime exposure to HBV infection was significantly higher in MWH than in NMWH. The majority of MWH was not vaccinated against HBV and thus remains susceptible to contracting the infection. Screening upon hire followed by vaccination of MWH is recommended to reduce the transmission of HBV.
Summary

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