Results from the School Entry Immunization Requirement Program for elementary and middle-school student, 2019

Kim Seon Ju; Park Jin Ju; Jeong Hang Jin; Yu Jeong-Hee; Cho En Hi

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Epidemiology and Surveillance

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Public Health Weekly Report 2020; 13(18): 1198-1206

Published online April 29, 2020

Results from the School Entry Immunization Requirement Program for elementary and middle-school student, 2019

Kim Seon Ju, Park Jin Ju, Jeong Hang Jin, Yu Jeong-Hee, Cho En Hi

Division of VPD Control & NIP, Center for Infectious Disease Control, KCDC

^*교신저자 : cho6404@korea.kr, 043-719-8350

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) which permits unrestricted distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

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Immunity to infectious diseases acquired from vaccinations received in childhood gradually decreases over time. The result is that students entering elementary and middle school are often vulnerable to infectious diseases. The most effective prevention method for infectious diseases targeted for vaccination is to maintain the vaccination rate above a certain level.
The main objective of this article was to study the school entry immunization requirement program which measures whether vaccinations are complete at the time of admission to elementary and middle schools. In 2019, 92.7% of elementary school students were certified for 4 types of vaccines (DTaP, IPV, MMR, JEV). In terms of middle school students, 89.6% were certified for the Tdap (or Td) vaccination, and 81.7% of the female middle school students were confirmed for the HPV vaccination. These findings mark an improvement of approximately 23.7 - 30.8% when compared to the results of December 31, 2018 and when compared with the results taken on June 30, 2019 after the implementation of the verification project.
This study concluded that the school entry immunization requirement program for elementary and middle school students was effective at maintaining a 95% vaccination rate. Furthermore, sending notices of the vaccination verification project to local government leaders and school principals, encouraging continuous inoculation, and preventing the loss of past immunization records at medical institutions contributed to increasing the immunization completion rate.
In addition, even though Korea maintains a high vaccination rate of over 95%, the vaccination rate for Japanese encephalitis is lower than that of other vaccines and in 2020 Japanese encephalitis was added to vaccinations subject to confirmation when entering middle school. The Korea Centers for Disease Control and Prevention (KCDC) will strengthen the vaccination rate by communicating its importance to municipal and provincial governments and with education ministries. Furthermore, the KCDC will continue to ask medical institutions to cooperate in the prevention of lost computer vaccination registrations. gistrations.

Key words Vaccination, Immunization, Vaccination Coverage, Immunization Requirement Program, Students

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Abstract
Reference

Table 1.

Elementary school student entry requirement program for immunization rate, 2019

Unit: n, %

Classification	No. of target students¹⁾	5^th DTaP		4^th IPV		2^th MMR		4^th IJE or 2^th LJE		Fully complete vaccination
Classification	No. of target students¹⁾	No. of cases	Coverage rate	No. of cases	Coverage rate	No. of cases	Coverage rate	No. of cases	Coverage rate	No. of cases	Coverage rate
Total	472,147	459,406	97.3	464,359	98.4	464,966	98.5	441,068	93.4	437,733	92.7
Seoul	71,905	70,240	97.7	70,919	98.6	70,995	98.7	67,701	94.2	67,280	93.6
Busan	27,395	26,826	97.9	27,035	98.7	27,075	98.8	25,838	94.3	25,700	93.8
Daegu	21,640	20,994	97.0	21,247	98.2	21,283	98.4	20,221	93.4	20,036	92.6
Incheon	27,277	26,594	97.5	26,891	98.6	26,941	98.8	25,662	94.1	25,472	93.4
Gwangju	15,207	14,619	96.1	14,847	97.6	14,872	97.8	13,943	91.7	13,790	90.7
Daejeon	13,918	13,540	97.3	13,703	98.5	13,728	98.6	13,116	94.2	13,037	93.7
Ulsan	12,055	11,786	97.8	11,931	99.0	11,917	98.9	11,495	95.4	11,440	94.9
Sejong	5,021	4,914	97.9	4,947	98.5	4,961	98.8	4,720	94.0	4,687	93.3
Gyeonggi	133,368	129,971	97.5	131,332	98.5	131,461	98.6	124,321	93.2	123,464	92.6
Gangwon	12,581	12,250	97.4	12,359	98.2	12,376	98.4	11,783	93.7	11,689	92.9
Chungbuk	14,745	14,338	97.2	14,468	98.1	14,502	98.4	13,863	94.0	13,746	93.2
Chungnam	21,031	20,485	97.4	20,666	98.3	20,645	98.2	19,531	92.9	19,375	92.1
Jeonbuk	16,236	15,768	97.1	15,937	98.2	15,997	98.5	15,048	92.7	14,933	92.0
Jeonnam	16,151	15,555	96.3	15,724	97.4	15,795	97.8	14,732	91.2	14,574	90.2
Gyeongbuk	22,999	22,300	97.0	22,550	98.0	22,584	98.2	21,344	92.8	21,166	92.0
Gyeongnam	33,458	32,327	96.6	32,833	98.1	32,841	98.2	31,208	93.3	30,874	92.3
Jeju	7,160	6,899	96.4	6,970	97.3	6,993	97.7	6,542	91.4	6,470	90.4

1) The number of elementary school entrants in 2019

Abbreviation: 5th DTaP, fifth dose of diphtheria and tetanus toxoids and acellular pertussis vaccine adsorbed; 4th IPV, fourth dose of inactivated poliovirus vaccine; 2nd MMR, second dose of measles, mumps, and rubella vaccine; 4th IJE fourth dose of inactivated Japanese encephalitis vaccine 2nd LJE, second dose of liveattenuated Japanese encephalitis vaccine

Table 2.

Elementary school student immunization rate by time, 2019

Unit: n, %

Classification	5^th DTaP		4^th IPV		2^th MMR		4^th IJE or 2^th LJE		Fully complete vaccination
Classification	No. of case	Coverage rate	No. of case	Coverage rate	No. of case	Coverage rate	No. of case	Coverage rate	No. of case	Coverage rate
Before school entry (12/31/2018)	421,921	89.4	421,025	89.2	417,540	88.4	307,886	65.2	292,336	61.9
On school entry (2/28/2019)	448,951	95.1	450,498	95.4	451,117	95.5	398,586	84.4	390,359	82.7
End of Program (6/30/2019)	459,406	97.3	464,359	98.4	464,966	98.5	441,068	93.4	437,733	92.7

Table 3.

2011, 2012 Elementary school student immunization rate by time

Unit: %

Division	Born in 2011					Born in 2012
Division	5^th DTaP	4^th IPV	2^th MMR	4^th IJE or 2^th LJE	Fully complete vaccination	5^th DTaP	4^th IPV	2^th MMR	4^th IJE or 2^th LJE	Fully complete vaccination
Before school entry	86.1	85.2	86.6	56.3	52.3 (12/31/17)	89.6	89.4	88.7	65.4	62.2 (12/31/18)
End of Program	96.6	98.1	98.3	90.4	89.5 (6/30/18)	97.5	98.5	98.6	93.6	93.0 (6/30/19)

Table 4.

Middle school student entry requirement program for immunization rate, 2019

Unit: n, %

Classification	No. of target students¹⁾			6^th Tdap (or Td)		1^th HPV (Girls)
Classification	Total	Boy	Girl	No. of case	Coverage rate	No. of case	Coverage rate
Total	433,823	224,367	209,456	388,609	89.6	171,032	81.7
Seoul	69,591	36,004	33,587	62,951	90.5	26,867	80.0
Busan	24,159	12,469	11,690	21,789	90.2	9,754	83.4
Daegu	20,376	10,627	9,749	17,930	88.0	7,531	77.2
Incheon	24,916	12,930	11,986	23,136	92.9	9,506	79.3
Gwangju	14,410	7,467	6,943	12,903	89.5	5,707	82.2
Daejeon	13,421	6,942	6,479	11,909	88.7	5,124	79.1
Ulsan	10,396	5,418	4,978	9,083	87.4	4,037	81.1
Sejong	4,062	2,073	1,989	3,694	90.9	1,607	80.8
Gyeonggi	120,047	61,612	58,435	109,492	91.2	47,975	82.1
Gangwon	12,224	6,370	5,854	10,636	87.0	5,021	85.8
Chungbuk	13,522	6,922	6,600	11,887	87.9	5,458	82.7
Chungnam	18,899	9,847	9,052	16,740	88.6	7,722	85.3
Jeonbuk	15,892	8,191	7,701	13,703	86.2	6,314	82.0
Jeonnam	15,220	7,812	7,408	12,867	84.5	6,042	81.6
Gyeongbuk	20,569	10,850	9,719	17,512	85.1	7,804	80.3
Gyeongnam	29,701	15,476	14,225	26,532	89.3	11,823	83.1
Jeju	6,418	3,357	3,061	5,845	91.1	2,740	89.5

1) The number of middle school entrants in 2019

Abbreviation: 6th Tdap (or Td), sixth dose of tetanus toxoid, reduced diphtheria toxoid and acellular pertussis vaccine, adsorbed or tetanus and diphtheria toxoids adsorbed; 1th HPV, human papillomavirus vaccine.

Table 5.

Middle school student immunization rate by time, 2019

Unit: n, %

Classification	6^th Tdap (or Td)		1^th HPV (Girls)
Classification	No. of case	Coverage rate	No. of case	Coverage rate
Before school entry (12/31/2018)	285,990	65.9	114,628	54.7
On school entry (2/28/2019)	340,928	78.6	141,964	67.8
End of Program (6/30/2019)	388,609	89.6	171,032	81.7

References

Sections

Abstract
Reference

질병관리본부. 취학시 제출된 홍역예방접종 증명자료 평가와 예방접종증명서 제출 확대사업을 위한 연구. 건국대학교 2005.
보건복지부. 2012 경제발전경험모듈화사업 : 어린이 예방접종사업 (2013).
질병관리본부. 2018년 전국예방접종률 현황 (2019).

Epidemiology and Surveillance

Public Health Weekly Report 2020; 13(18): 1198-1206

Published online April 29, 2020

Results from the School Entry Immunization Requirement Program for elementary and middle-school student, 2019

Kim Seon Ju, Park Jin Ju, Jeong Hang Jin, Yu Jeong-Hee, Cho En Hi

Division of VPD Control & NIP, Center for Infectious Disease Control, KCDC

Correspondence to:^*교신저자 : cho6404@korea.kr, 043-719-8350

Abstract

Keywords: Vaccination, Immunization, Vaccination Coverage, Immunization Requirement Program, Students

Body

Table 1 . Elementary school student entry requirement program for immunization rate, 2019.

Unit: n, %.

Classification	No. of target students¹⁾	5^th DTaP		4^th IPV		2^th MMR		4^th IJE or 2^th LJE		Fully complete vaccination
Classification	No. of target students¹⁾	No. of cases	Coverage rate	No. of cases	Coverage rate	No. of cases	Coverage rate	No. of cases	Coverage rate	No. of cases	Coverage rate
Total	472,147	459,406	97.3	464,359	98.4	464,966	98.5	441,068	93.4	437,733	92.7
Seoul	71,905	70,240	97.7	70,919	98.6	70,995	98.7	67,701	94.2	67,280	93.6
Busan	27,395	26,826	97.9	27,035	98.7	27,075	98.8	25,838	94.3	25,700	93.8
Daegu	21,640	20,994	97.0	21,247	98.2	21,283	98.4	20,221	93.4	20,036	92.6
Incheon	27,277	26,594	97.5	26,891	98.6	26,941	98.8	25,662	94.1	25,472	93.4
Gwangju	15,207	14,619	96.1	14,847	97.6	14,872	97.8	13,943	91.7	13,790	90.7
Daejeon	13,918	13,540	97.3	13,703	98.5	13,728	98.6	13,116	94.2	13,037	93.7
Ulsan	12,055	11,786	97.8	11,931	99.0	11,917	98.9	11,495	95.4	11,440	94.9
Sejong	5,021	4,914	97.9	4,947	98.5	4,961	98.8	4,720	94.0	4,687	93.3
Gyeonggi	133,368	129,971	97.5	131,332	98.5	131,461	98.6	124,321	93.2	123,464	92.6
Gangwon	12,581	12,250	97.4	12,359	98.2	12,376	98.4	11,783	93.7	11,689	92.9
Chungbuk	14,745	14,338	97.2	14,468	98.1	14,502	98.4	13,863	94.0	13,746	93.2
Chungnam	21,031	20,485	97.4	20,666	98.3	20,645	98.2	19,531	92.9	19,375	92.1
Jeonbuk	16,236	15,768	97.1	15,937	98.2	15,997	98.5	15,048	92.7	14,933	92.0
Jeonnam	16,151	15,555	96.3	15,724	97.4	15,795	97.8	14,732	91.2	14,574	90.2
Gyeongbuk	22,999	22,300	97.0	22,550	98.0	22,584	98.2	21,344	92.8	21,166	92.0
Gyeongnam	33,458	32,327	96.6	32,833	98.1	32,841	98.2	31,208	93.3	30,874	92.3
Jeju	7,160	6,899	96.4	6,970	97.3	6,993	97.7	6,542	91.4	6,470	90.4

1) The number of elementary school entrants in 2019.

Table 2 . Elementary school student immunization rate by time, 2019.

Unit: n, %.

Classification	5^th DTaP		4^th IPV		2^th MMR		4^th IJE or 2^th LJE		Fully complete vaccination
Classification	No. of case	Coverage rate	No. of case	Coverage rate	No. of case	Coverage rate	No. of case	Coverage rate	No. of case	Coverage rate
Before school entry (12/31/2018)	421,921	89.4	421,025	89.2	417,540	88.4	307,886	65.2	292,336	61.9
On school entry (2/28/2019)	448,951	95.1	450,498	95.4	451,117	95.5	398,586	84.4	390,359	82.7
End of Program (6/30/2019)	459,406	97.3	464,359	98.4	464,966	98.5	441,068	93.4	437,733	92.7

Table 3 . 2011, 2012 Elementary school student immunization rate by time.

Unit: %.

Division	Born in 2011					Born in 2012
Division	5^th DTaP	4^th IPV	2^th MMR	4^th IJE or 2^th LJE	Fully complete vaccination	5^th DTaP	4^th IPV	2^th MMR	4^th IJE or 2^th LJE	Fully complete vaccination
Before school entry	86.1	85.2	86.6	56.3	52.3 (12/31/17)	89.6	89.4	88.7	65.4	62.2 (12/31/18)
End of Program	96.6	98.1	98.3	90.4	89.5 (6/30/18)	97.5	98.5	98.6	93.6	93.0 (6/30/19)

Table 4 . Middle school student entry requirement program for immunization rate, 2019.

Unit: n, %.

Classification	No. of target students¹⁾			6^th Tdap (or Td)		1^th HPV (Girls)
Classification	Total	Boy	Girl	No. of case	Coverage rate	No. of case	Coverage rate
Total	433,823	224,367	209,456	388,609	89.6	171,032	81.7
Seoul	69,591	36,004	33,587	62,951	90.5	26,867	80.0
Busan	24,159	12,469	11,690	21,789	90.2	9,754	83.4
Daegu	20,376	10,627	9,749	17,930	88.0	7,531	77.2
Incheon	24,916	12,930	11,986	23,136	92.9	9,506	79.3
Gwangju	14,410	7,467	6,943	12,903	89.5	5,707	82.2
Daejeon	13,421	6,942	6,479	11,909	88.7	5,124	79.1
Ulsan	10,396	5,418	4,978	9,083	87.4	4,037	81.1
Sejong	4,062	2,073	1,989	3,694	90.9	1,607	80.8
Gyeonggi	120,047	61,612	58,435	109,492	91.2	47,975	82.1
Gangwon	12,224	6,370	5,854	10,636	87.0	5,021	85.8
Chungbuk	13,522	6,922	6,600	11,887	87.9	5,458	82.7
Chungnam	18,899	9,847	9,052	16,740	88.6	7,722	85.3
Jeonbuk	15,892	8,191	7,701	13,703	86.2	6,314	82.0
Jeonnam	15,220	7,812	7,408	12,867	84.5	6,042	81.6
Gyeongbuk	20,569	10,850	9,719	17,512	85.1	7,804	80.3
Gyeongnam	29,701	15,476	14,225	26,532	89.3	11,823	83.1
Jeju	6,418	3,357	3,061	5,845	91.1	2,740	89.5

1) The number of middle school entrants in 2019.

Table 5 . Middle school student immunization rate by time, 2019.

Unit: n, %.

Classification	6^th Tdap (or Td)		1^th HPV (Girls)
Classification	No. of case	Coverage rate	No. of case	Coverage rate
Before school entry (12/31/2018)	285,990	65.9	114,628	54.7
On school entry (2/28/2019)	340,928	78.6	141,964	67.8
End of Program (6/30/2019)	388,609	89.6	171,032	81.7

Abstract
Body

Table 1 . Elementary school student entry requirement program for immunization rate, 2019.

Unit: n, %.

Classification	No. of target students¹⁾	5^th DTaP		4^th IPV		2^th MMR		4^th IJE or 2^th LJE		Fully complete vaccination
Classification	No. of target students¹⁾	No. of cases	Coverage rate	No. of cases	Coverage rate	No. of cases	Coverage rate	No. of cases	Coverage rate	No. of cases	Coverage rate
Total	472,147	459,406	97.3	464,359	98.4	464,966	98.5	441,068	93.4	437,733	92.7
Seoul	71,905	70,240	97.7	70,919	98.6	70,995	98.7	67,701	94.2	67,280	93.6
Busan	27,395	26,826	97.9	27,035	98.7	27,075	98.8	25,838	94.3	25,700	93.8
Daegu	21,640	20,994	97.0	21,247	98.2	21,283	98.4	20,221	93.4	20,036	92.6
Incheon	27,277	26,594	97.5	26,891	98.6	26,941	98.8	25,662	94.1	25,472	93.4
Gwangju	15,207	14,619	96.1	14,847	97.6	14,872	97.8	13,943	91.7	13,790	90.7
Daejeon	13,918	13,540	97.3	13,703	98.5	13,728	98.6	13,116	94.2	13,037	93.7
Ulsan	12,055	11,786	97.8	11,931	99.0	11,917	98.9	11,495	95.4	11,440	94.9
Sejong	5,021	4,914	97.9	4,947	98.5	4,961	98.8	4,720	94.0	4,687	93.3
Gyeonggi	133,368	129,971	97.5	131,332	98.5	131,461	98.6	124,321	93.2	123,464	92.6
Gangwon	12,581	12,250	97.4	12,359	98.2	12,376	98.4	11,783	93.7	11,689	92.9
Chungbuk	14,745	14,338	97.2	14,468	98.1	14,502	98.4	13,863	94.0	13,746	93.2
Chungnam	21,031	20,485	97.4	20,666	98.3	20,645	98.2	19,531	92.9	19,375	92.1
Jeonbuk	16,236	15,768	97.1	15,937	98.2	15,997	98.5	15,048	92.7	14,933	92.0
Jeonnam	16,151	15,555	96.3	15,724	97.4	15,795	97.8	14,732	91.2	14,574	90.2
Gyeongbuk	22,999	22,300	97.0	22,550	98.0	22,584	98.2	21,344	92.8	21,166	92.0
Gyeongnam	33,458	32,327	96.6	32,833	98.1	32,841	98.2	31,208	93.3	30,874	92.3
Jeju	7,160	6,899	96.4	6,970	97.3	6,993	97.7	6,542	91.4	6,470	90.4

1) The number of elementary school entrants in 2019.

Table 2 . Elementary school student immunization rate by time, 2019.

Unit: n, %.

Classification	5^th DTaP		4^th IPV		2^th MMR		4^th IJE or 2^th LJE		Fully complete vaccination
Classification	No. of case	Coverage rate	No. of case	Coverage rate	No. of case	Coverage rate	No. of case	Coverage rate	No. of case	Coverage rate
Before school entry (12/31/2018)	421,921	89.4	421,025	89.2	417,540	88.4	307,886	65.2	292,336	61.9
On school entry (2/28/2019)	448,951	95.1	450,498	95.4	451,117	95.5	398,586	84.4	390,359	82.7
End of Program (6/30/2019)	459,406	97.3	464,359	98.4	464,966	98.5	441,068	93.4	437,733	92.7

Table 3 . 2011, 2012 Elementary school student immunization rate by time.

Unit: %.

Division	Born in 2011					Born in 2012
Division	5^th DTaP	4^th IPV	2^th MMR	4^th IJE or 2^th LJE	Fully complete vaccination	5^th DTaP	4^th IPV	2^th MMR	4^th IJE or 2^th LJE	Fully complete vaccination
Before school entry	86.1	85.2	86.6	56.3	52.3 (12/31/17)	89.6	89.4	88.7	65.4	62.2 (12/31/18)
End of Program	96.6	98.1	98.3	90.4	89.5 (6/30/18)	97.5	98.5	98.6	93.6	93.0 (6/30/19)

Table 4 . Middle school student entry requirement program for immunization rate, 2019.

Unit: n, %.

Classification	No. of target students¹⁾			6^th Tdap (or Td)		1^th HPV (Girls)
Classification	Total	Boy	Girl	No. of case	Coverage rate	No. of case	Coverage rate
Total	433,823	224,367	209,456	388,609	89.6	171,032	81.7
Seoul	69,591	36,004	33,587	62,951	90.5	26,867	80.0
Busan	24,159	12,469	11,690	21,789	90.2	9,754	83.4
Daegu	20,376	10,627	9,749	17,930	88.0	7,531	77.2
Incheon	24,916	12,930	11,986	23,136	92.9	9,506	79.3
Gwangju	14,410	7,467	6,943	12,903	89.5	5,707	82.2
Daejeon	13,421	6,942	6,479	11,909	88.7	5,124	79.1
Ulsan	10,396	5,418	4,978	9,083	87.4	4,037	81.1
Sejong	4,062	2,073	1,989	3,694	90.9	1,607	80.8
Gyeonggi	120,047	61,612	58,435	109,492	91.2	47,975	82.1
Gangwon	12,224	6,370	5,854	10,636	87.0	5,021	85.8
Chungbuk	13,522	6,922	6,600	11,887	87.9	5,458	82.7
Chungnam	18,899	9,847	9,052	16,740	88.6	7,722	85.3
Jeonbuk	15,892	8,191	7,701	13,703	86.2	6,314	82.0
Jeonnam	15,220	7,812	7,408	12,867	84.5	6,042	81.6
Gyeongbuk	20,569	10,850	9,719	17,512	85.1	7,804	80.3
Gyeongnam	29,701	15,476	14,225	26,532	89.3	11,823	83.1
Jeju	6,418	3,357	3,061	5,845	91.1	2,740	89.5

1) The number of middle school entrants in 2019.

Table 5 . Middle school student immunization rate by time, 2019.

Unit: n, %.

Classification	6^th Tdap (or Td)		1^th HPV (Girls)
Classification	No. of case	Coverage rate	No. of case	Coverage rate
Before school entry (12/31/2018)	285,990	65.9	114,628	54.7
On school entry (2/28/2019)	340,928	78.6	141,964	67.8
End of Program (6/30/2019)	388,609	89.6	171,032	81.7