Supplementary Infection & Chemotherapy 2014 년대한감염학회권장성인예방접종개정안 최원석 1, 최정현 2, 권기태 3, 서경 4, 김민아 4, 이상오 5, 홍영진 6, 이진수 7, 송준영 1, 방지환 8, 최희정 9, 최영화 10, 이동건 2, 정희진 1 ; 대한감염학회성인예방접종위원회 1 고려대학교의과대학내과학교실, 2 가톨릭대학교의과대학내과학교실, 3 대구파티마병원, 4 연세대학교의과대학산부인과학교실, 5 울산대학교의과대학내과학교실, 6 인하대학교의과대학소아과학교실, 7 내과학교실, 8 서울대학교의과대학내과학교실, 9 이화여자대학교의과대학내과학교실, 10 아주대학교의과대학내과학교실 2007 10 (, ) 5 2012 5 2 ( MIP, ). 2,, 2012 8., 2012 2., - -,,,,,,., - -,,,,,. 2. 폐렴사슬알균백신 < 폐렴사슬알균백신의권장대상과접종시기 >. 65 : 13 23.. 65 (,,,, ) 1) 65 : 13 6-12 23. 13 23 8. 2) 13 65 : 13 23 1. 3) 13 23 65-65 23 : 13 23 1. 23 1 23 Received:?, 2015 Corresponding Author : Hee Jin Cheong, MD, PhD, Division of Infectious Disease, Department of Internal Medicine, Korea University Guro Hospital, Korea University College of Medicine, 148 Gurodong-ro, Guro-gu, Seoul 152-703, Korea Tel: +82-2-2626-3050, Fax: +82-2-2626-1105, E-mail: heejinmd@korea.ac.kr
최원석외 2014 년대한감염학회권장성인예방접종개정안 5, 13 6-12 ( 8 ). - 65 23 : 23 1 13. 23.. 18-64 (,,,, ): 13, 13 23. 18 (, HIV,,,,,,, ),, 1) : 13, 8 23. 2) 23 1 : 23 1 13. 13 8 23 5 23. 3) 23 2 : 1 13 1. 1. 성인대상 13가단백결합폐렴사슬알균백신의허가 2013 10 13 (13-valent pneumococcal conjugate vaccine; PCV13) 18. 23 (23-valent pneumococcal polysaccharide vaccine; PPSV23), 23 [1, 2]. PPSV23. PPSV23 T- 5. PPSV23 PCV13 T-,, [1]. 90%, [1]. 85,000 65,, (community-acquired pneumonia trial in adults, CAPiTa) 46%, / 45%, 75% [3]. 18 PCV13 PPSV23, [4-6]. PCV13 PPSV23, [7, 8]., PCV13., PCV13, PCV13 65 PCV13 PPSV23.,,., 65 [9, 10]. 2. 폐렴사슬알균감염질환의발생양상과혈청형분포 5 50 U. 65 PCV13 1/3, PPSV23 PCV13 11 25% [11]. 19 PCV13 50%, PPSV23 PCV13 11 21% [12]., 18 1,000 0.36, 30% 64.9% [13]. PCV13 19, PCV7 39.8%, PCV13 67.3%, PPSV23 73.4% [14]. PCV13 PCV13 PPV23
2014 년대한감염학회권장성인예방접종개정안 최원석외 그림 1. 65 세이상만성질환자의폐렴사슬알균백신접종권고. PCV13, 13-valent pneumococcal conjugate vaccine; PPV23, 23-valent pneumococcal polysaccharide vaccine. 15-20% [2].. 3. 대한감염학회의폐렴사슬알균백신접종권고 (Advisory Committee on Immunization Practice; ACIP) 2014 65 PCV13 PPV23 [15]. 65, CAPiTA PCV13, -. PCV13. PCV13, PCV13 PPV23 PCV13 PPV23. 65 PCV13-65 PCV13 PPV23. PCV13 PPSV23. PCV13 PPSV23, PCV13 (booster effect), PPSV23 (hypo-responsiveness) PCV13 [16, 17]. 65 PCV13 PPV23. 65 PCV13 6-12 PPV23., PCV13 PPV23 8 ( 1).
최원석외 2014 년대한감염학회권장성인예방접종개정안 파상풍 - 디프테리아 - 백일해백신 < 임산부또는임신예정인여성에대한파상풍- 디프테리아-백일해백신접종권고 >. - - (Tdap), 1. 27-36. 1. 국외의임신부대상파상풍-디프테리아-백일해백신접종권고 2013 - - (Tetanus-diphtheria-acellular pertussis; Tdap) [18]. 2000 2006 Tdap. 'cocooning' - - (DTaP) 2. 2011 6 ACIP Tdap ( 20 ). 2.6%. 2012 48,277 2-3, Tdap,, Td/Tdap, 27-36 Tdap. 2. Tdap [19], Tdap [20], DTaP [21], [22].,. 2011 64 65 12 [23], 2013 [24], 2014 11 [25] cocooning. 2012 8,819 10 13. 2013 28-38 28-32 [26]. Tdap 1 [27]. 26.,, 3. Tdap 5 [28]. 2. 대한감염학회의임산부또는임신예정인여성에대한파상풍-디프테리아-백일해백신접종권고 2012 2 Tdap 1.. 1995 2008 11.4 2009 66, 2010 27, 2011 97 [29], 2012 230 [30]. 2013 45.. Tdap 1. 27~36. Tdap,,. 대상포진백신 < 대상포진백신의권장대상과접종시기 >. 60.. 50-59.
2014 년대한감염학회권장성인예방접종개정안 최원석외 2011 7 (ZOSTAVAX R ) 60 50. 2011 50-59. ZEST Study. 2012 ZEST Study. ZEST Study, 50-59 69.8% (95% CI, 54.1-80.6) [31]., 73%, 42%, Shingles Prevention Study. ZEST Study. 2013 8 20 ZEST study Shingles Prevention Study., ZEST study 50-59 -. ACIP 50-59,,, [32]. -,, -. 인유두종바이러스백신 < 남성에대한인유두종바이러스백신접종권고 >. 9-26, 4. 1. 남성의인유두종바이러스백신접종권고 4, (human herpesvirus; HPV) 16 18,,, HPV 6 11 9-15.. 4,000 16-26 3 4 HPV 6, 11, 16, 18, [33, 34]. 4 26. 9-26, 4. 11-12 13-21 22-26 [35]. HIV 26 4.. HIV. 2. 인유두종바이러스백신의안전성. (World Health Organization, WHO) 2013 7 2014 2, 2 (Global Advisory Committee on Vaccine Safety, GACVS), [36, 37]. 2014 3 [38].,, (DTP)., (Food and Drug Administration; FDA) [39], WHO [40].
최원석외 2014 년대한감염학회권장성인예방접종개정안 인플루엔자백신 1. 임신부우선접종순위. 1918 (influenza-like illness, ILI) 1,350, 43% (585 ) 52% (302 ) [41]. 27%, 3. 1957 20%, [42]. 2009,. 2009 4 [43], 20% [44]., [45]. 2012 WHO, [46].. 2009 ILI 8 19,727 A(H1N1)pdm09 150, [47]., 5 A(H1N1)pdm09 1 [48].,,..,, [49-52]., 6.. (10-12 )., 4-20.9% [53-55].,. 2. 4가인플루엔자백신 A/H3N2, A/H1N1, B 3., B B/Victoria B/Yamagata (lineage),. WHO, 10 B 50%, [56]. 2001-2011 10 5 B (mismatch), 46%. 2003-2011 8 4 B, 58% [56]. 2009 B [57-59]. B -, WHO 2013-2014 B 4 [60]. 4, 4 3, [61, 62]., 5,168 3-8 4 59.3%, (74.2%) [63]. 2012 4 [56]. (Fluarix R Quadrivalent, GlaxoSmithKline), (Fluzone R Quadrivalent, Sanofi Pasteur), (Flulaval R Quadrivalent, ID Biomedical Corporation/ GlaxoSmithKline) 3 (Flumist R Quadrivalent, MedImmune). 3-4 B B 4. 4. B 4. 수막알균백신 Men- ACWY-CRM (Menveo R ). Menveo R 4
2014 년대한감염학회권장성인예방접종개정안 최원석외 2012 5 11-55. 2012 11 Menveo R. 2013 3 2-11, 2014 5 2. 4 MenACWY-D (Menactra ). Menveo R., 2~6 3, 7 5. 5.,. 0-2, 10-16 [64, 65]., PCR, [66]. ACIP 16~21 4, 11~15 5 1. 16~18 5 21 [67]. 10-16,. 일본뇌염백신 12~23 1 12 2 [68]. 12~23 1 12 2, 6 3. 3,. 3 2 (8, 2 ). 5~7 3, 2, 6 2. (National Immunization Program, NIP) [69]. 1, WHO 2013, NIP. Vero cell Beijing-1 2013 2014. Vero cell YF17D YF17D prm E SA14-14-2 Chimeric (ChimeriVax-JE) 2013 2014. 황열백신 2013 5 WHO Strategic Advisory Group of Experts (SAGE), 10 [70].,. 10, 10. References 1. Vila-Corcoles A, Ochoa-Gondar O. Preventing pneumococcal disease in the elderly: recent advances in vaccines and implications for clinical practice. Drugs Aging 2013;30:263-76. 2. Moberley S, Holden J, Tatham DP, Andrews RM. Vaccines for preventing pneumococcal infection in adults. Cochrane Database Syst Rev 2013;1:CD000422. 3. Bonten M, Bolkenbaas M, Huijts S, Webber C, Gault S, Gruber W, Grobbee D. Community acquired pneumonia immunisation trial in adults (CAPITA). 9th International Symposium on Pneumococci and Pneumococcal Diseases; 2014 Mar 9-13; Hyderabad, India. ISPPD; 2014;3:95. 4. Jackson LA, Gurtman A, van Cleeff M, Jansen KU, Jayawardene D, Devlin C, Scott DA, Emini EA, Gruber WC, Schmoele-Thoma B. Immunogenicity and safety of a 13-valent pneumococcal conjugate vaccine compared to a 23-valent pneumococcal polysaccharide vaccine in pneumococcal vaccine-naive adults. Vaccine 2003;31:3577-84. 5. Jackson LA, Gurtman A, Rice K, Pauksens K, Greenberg RN, Jones TR, Scott DA, Emini EA, Gruber WC, Schmoele-Thoma B. Immunogenicity and safety of a 13-valent pneumococcal conjugate vaccine in adults 70 years of age and older previously vaccinated with 23-valent pneumococcal polysaccharide vaccine. Vaccine 2013;31:3585-93.
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