영•유아 백신 접종의 특성 및 의료 접근성이 접종률에 미치는 영향

Abstract

Immunization is one of the worlds most effective and cost-effective tools against the treat of emerging diseases. It is a fundamental strategy to achieve other health priorities and provide a platform for public health care improvement with powerful impact on social and economic development. To secure high level of vaccination rate is the key factor for evaluation of the success. The infant vaccination rate in Korea is recognized relatively high but still the gap between type of vaccines and regions. Thereby, continuous efforts with strategy of stakeholders are required also in Korea. The representative program of government is NIP(National Immunization Program) which was rolled out in 2009 supporting partial fee for infant vaccination. As of the year, vaccination rate showed increasing trend. Based on previous studies result, the change could be come from various factors influencing to vaccination simultaneously. And the study analyzing regional level of vaccination is not enough in Korea. So the objective of this study was to analyze which factors impact to the regional level of infant vaccination rate and the size of the impact and propose policies which be worth consideration in the future vaccination strategy. The data analyzed was National vaccination rate report sample survey conducted in 2012, 2013 as a project of Korea CDC. Independent variables were comprised of two categories Vaccination specific characteristics and Health care accessibility. The all independent variables of vaccination specific characteristics category showed impact to the vaccination rate with statistical significance. Amongst the variables from health care accessibility, only the variable, number of public healthcare center per infants, influenced to vaccination rate. The factors which showed impact to the first and the last vaccination was mandatory vaccine or not and fee for vaccination. The age and the number of simultaneous shots influenced to first vaccination statistically significant but not to last vaccination. In case of vaccination rate of mandatory & the other vaccines, the fee, age and the term affected both of the rates. Whereas, number of simultaneous shots showed impact only to the mandatory vaccination rate and the number of public healthcare center per infants influence only to the other vaccines vaccination rate. The result proved that some part of the factors reported in preceding researches in Korea and other countries also affect as influencing factors to regional infant vaccination rate in Korea. The study result showed that multiple factors are influencing to the each type of immunization rate with different impact power. Referring to the result of this analysis, some suggestions for vaccination program could be proposed. Because financial burden to the parents has high impact at the decision for vaccination, the government should consider sustainable support on fee for vaccination such as NIP and expansion of the coverage of the program. In parallel, to prevent the cases that the financial problem itself to be a decision barrier in starting vaccination especially for optional vaccination, the health care professionals (doctors and nurses) should take more efforts to explain the benefits of vaccination with sufficient information. And the sustainable political focus, support and communication from government side on this area including the market price of optional vaccines could be required as well. Considering the current vaccination behavior in Korea, the discussion reducing infants physical burden and parents psychological burden induced by lots of simultaneous vaccination shots also should be held by government continuously.