“The number of vaccinations should be reduced with the ‘6-valent combination vaccine’ for infants and young children.”

When receiving individual vaccinations, you may miss the ‘time lag’… Need to introduce national vaccination
The existing 5-valent DTaP is being replaced by 6-valent DTaP in Europe and the United States… 12 billion won economic effect
“Korea’s high rate of group childcare makes it vulnerable to infection… “The country needs to understand the vaccine status well.”

Although the combined vaccine, which combines several vaccines into one, has reduced the burden, it is still not easy to keep up with the vaccination schedule while raising a newborn. Recently, there are growing voices in the medical community calling for the use of a hexavalent combination vaccine for national vaccination instead of the previously mainly used pentavalent DTaP combination vaccine. This is because the greater the number of diseases that can be prevented with a single vaccine, the greater the advantages in many ways. We met with Choi Young-jun, a professor in the Department of Pediatrics and Adolescents at Korea University Anam Hospital, and an expert on pediatric and adolescent vaccination, to hear about everything from the issues surrounding the introduction of the hexavalent combination vaccine to the impact of childhood vaccination on public health.

– Many guardians feel burdened by the complex schedule of infant vaccinations. Please explain why vaccination is important.

“The domestic vaccination project has a long history, with the Korean Academy of Pediatrics producing a national vaccination schedule for children since the 1950s. In the past, it was relatively short and concise, but now it has become increasingly complex as new diseases are discovered and vaccines are developed and additional vaccinations are added. Among them, the most basic vaccine is the DTP (diphtheria, tetanus, pertussis) vaccine. These three infectious diseases have a very high fatality rate and a large disease burden when infected during childhood. “It has been about 50 years since individual vaccines were developed for each disease, and then the current combination vaccine was developed.”

-Currently in Korea, the pentavalent combination vaccine is being administered. Are there any advantages to combined vaccines?

“Polio vaccine, which prevents polio virus, was added to DTP, making it a quadrivalent DTaP combination vaccine, and Haemophilus influenzae type B vaccine, which prevents meningitis, was added to become a pentavalent DTaP combination vaccine. Here, a hexavalent combination vaccine was released, adding hepatitis B vaccine. The biggest meaning of the combined vaccine is the reduction in the number of vaccinations. Looking at the domestic childhood vaccination schedule, when the DTP vaccine was administered from immediately after birth to age 12, the number of doses exceeded 30. However, as it gradually changed to a combined vaccine, the total was reduced to five.”

– When the number of vaccinations was too high, there would have been many cases where the vaccination was not administered on time and the timing was missed.

“Another advantage of the combined vaccine is the improvement in the timely vaccination rate. There is a large number of vaccinations, so if you receive the vaccine a week later than you were able to administer in one day, there will be a lag and you may miss the vaccination. This period may become an incubation period and new cases of infection may occur. “For this reason, combination vaccines have public health advantages.”

– Currently, the representative combination vaccine mainly used in Korea is the pentavalent DTaP vaccine. Are there any other combination vaccines used in national vaccination?

“The MMR (measles, mumps, rubella) administered at the first birthday is also a combination vaccine. Although the combination vaccine, which combines several vaccines into one, has many advantages, some people are concerned that the effectiveness of multiple vaccines may be reduced. However, the effectiveness and safety of the vaccine are verified from the development and introduction process, and must also pass verification when reviewing approval after clinical trials, so there is no need to have great doubts about the combination vaccine.”

– Currently, the 5-valent DTaP combination vaccine is being used well, so is there a need to introduce the 6-valent DTaP combination vaccine into national vaccination?

“The reason we used the trivalent vaccine 15 years ago and now mainly use the pentavalent combination vaccine is because of the intention to reduce the number of vaccinations. This is a trend that will continue in the future. If there are no problems with the effectiveness or safety of the vaccine, it is natural that reducing the number of vaccinations through a combination vaccine will have a positive medical, public health, and socioeconomic impact. Children need fewer shots, and guardians can reduce the number of visits to hospitals and clinics. “I think it is a natural proposition that ‘it is better to reduce the number of vaccinations’ because there are many advantages.”

– Are there any studies that converted the benefits and effects of reducing the number of vaccinations into monetary amounts?

“According to the results of a study that estimated the socioeconomic costs incurred when inoculating the hexavalent DTaP combination vaccine, approximately 12 billion won can be saved in Korea. In particular, up to 6 months of age, the number of vaccinations is so large that it is not possible to administer all of them in one day, and sometimes the vaccinations are divided into several days. At this time, costs such as guardians taking leave from work or transportation costs for vaccination are estimated. In terms of medical practice, if 300,000 to 400,000 children are vaccinated 3 to 5 times a year, the number of medical treatments involved amounts to millions of times. Hexasym, a hexavalent DTaP combination vaccine used in Korea, is a formulation that contains everything in one syringe, so the vaccine can be used immediately without recombining, reducing the number of vaccinations and increasing convenience for medical staff.”

– I heard that the introduction of the hexavalent DTaP combination vaccine is a global trend.

“In the past 10 years, even in developed countries, the existing 4/5-valent DTaP combination vaccine has been largely replaced by the 6-valent combination vaccine. Considering that vaccines are mainly developed and produced in developed countries such as Europe and the United States, Korea may find it difficult to respond if the supply of the pentavalent vaccine currently being used becomes insufficient. Because vaccines have more complex composition and prescriptions than general medicines, if any part of the process goes wrong, a global supply shortage may occur. In fact, this issue of unstable supply and demand of vaccines occurs once every 2 to 3 years, and when children miss out on timely vaccinations during this period, statistics show that the number of infectious diseases and patients increases.”

– As an expert in pediatric and adolescent infectious diseases, is there anything else you would like to suggest besides vaccination?

“The domestic environment for infectious diseases in children has both disadvantages and advantages. The disadvantage is that the proportion of children in group childcare systems such as daycare centers and kindergartens, starting from day care centers as soon as they are born, is considerably higher than in other countries. Middle and high school students who spend a long time at school are also significantly exposed to the risk of infectious diseases. On the other hand, the advantage is that compared to other countries, access to hospitals and clinics is good and the vaccination infrastructure is quite good. Although not a large number of people in Korea, there are cases where people avoid using medical infrastructure or avoid getting vaccinated, which can put their children at risk. In addition, it would be good for the country to better understand current vaccination issues and study and discuss the global situation and vaccine development status, as well as domestic introduction methods.”