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Kim S, Choi JK, Suh J, Park SH, Lee J. The epidemiologic and economic impact of varicella and herpes zoster vaccination in South Korea: A mathematical modelling study. Vaccine 2024; 42:4046-4055. [PMID: 38762358 DOI: 10.1016/j.vaccine.2024.05.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2024] [Revised: 05/07/2024] [Accepted: 05/10/2024] [Indexed: 05/20/2024]
Abstract
BACKGROUND In South Korea, the National Immunization Program has included one-dose varicella vaccination for 1-year-olds since 2005. This study examines the potential impact of introducing a two-dose varicella vaccination for children, along with zoster vaccination for adults, using either the zoster vaccine live (ZVL) or recombinant zoster vaccine (RZV). METHODS The investigation considered four strategies in a base case scenario. The first involved introducing zoster vaccination for 60-year-olds, with a 60 % coverage. The second strategy combined zoster vaccination with a second-dose varicella vaccination for 4-year-olds, with a 90 % coverage. An age-structured model spanning 50 years was employed, assuming a zoster vaccine catch-up campaign over the initial 5 years. Cost-effectiveness analyses were conducted, assessing incremental cost-effectiveness ratios (ICERs), incremental net monetary benefits (INMBs), and net loss under different ages at zoster vaccination (50, 60, 65, and 70 years) and varying willingness-to-pay (WTP) levels from ₩40 million ($34,998) to ₩84 million ($74,000). RESULTS All strategies were cost-effective and significantly reduced herpes zoster (HZ) incidence, preventing approximately 3,077,000 to 7,609,000 cases, depending on the chosen strategy. The combined strategy prevented around 4,950,000 varicella and 653,000 HZ cases additionally. RZV outperformed ZVL by preventing twice as many HZ cases and offering greater QALY gains. However, ZVL was more cost-effective due to its lower cost. Probabilistic sensitivity analyses revealed that RZV became more cost-effective at higher WTP thresholds, exceeding ₩60.9 million ($53,193) in terms of ICER and ₩62.5 million ($54,591) for INMBs and net loss. The optimal age for zoster vaccination was 60 years concerning ICER but 50 years regarding INMB. CONCLUSIONS Combining RZV with a two-dose varicella vaccination strategy reduced the disease burden and improved QALY more effectively, though ZVL remained more cost-effective at lower WTP levels. Decisions regarding vaccination policies should be balanced between the public health needs and WTP levels.
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Affiliation(s)
- Sol Kim
- School of Mathematics and Computing (Mathematics), Yonsei University, Seoul, Republic of Korea
| | - Jae-Ki Choi
- Division of Infectious Diseases, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea; Vaccine Bio Research Institute, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Jiyeon Suh
- School of Mathematics and Computing (Computational Science and Engineering), Yonsei University, Seoul, Republic of Korea
| | - Sun Hee Park
- Division of Infectious Diseases, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea; Vaccine Bio Research Institute, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
| | - Jeehyun Lee
- School of Mathematics and Computing (Mathematics), Yonsei University, Seoul, Republic of Korea.
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Huang L, Chen Z, Song Y, Tan J, Jia N, You W, Yuan H, Feng G, Li C, Luan C, Quan Y, Wang Y. Immunogenicity and safety of a live-attenuated varicella vaccine in a healthy population aged 13 years and older: A randomized, double-blind, controlled study. Vaccine 2024; 42:396-401. [PMID: 38057208 DOI: 10.1016/j.vaccine.2023.10.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 09/27/2023] [Accepted: 10/13/2023] [Indexed: 12/08/2023]
Abstract
OBJECTIVES Vaccines for prevention against varicella are important for adolescents and adults, who have an increased risk of severe varicella. This study aimed to evaluate the immunogenicity and safety of a two-dose immunization schedule of a live-attenuated varicella vaccine (VarV) manufactured by Sinovac (Dalian) in healthy adolescents and adults. METHODS A randomized, double-blind, controlled clinical trial was conducted in healthy population aged ≥ 13 years old in China. Participants in block 1 were randomly assigned (1:1) to receive two doses of either the test vaccine or an active control vaccine, administered 4, 6 or 8 weeks apart. Participants in block 2 were randomly assigned (2:1) to receive two doses of test vaccine or placebo, administered 10 weeks apart. The primary immunogenicity endpoint was the seroconversion rates and GMTs of varicella zoster virus (VZV) antibodies measured by fluorescent-antibody-to-membrane-antigen (FAMA) 4 weeks post-immunization. The primary safety endpoint was the incidence of adverse reactions within 4 weeks after each dose. RESULTS A total of 2398 participants were enrolled. The seroconversion rates of VZV antibodies were 79.55 % in the test group and 76.41 % in the active control group respectively 4 weeks after two doses of pooled schedule, with the difference of 3.14 % (95 %CI: -0.69 %, 6.97 %). The GMTs were 1:162.07 and 1:160.04 respectively, with the ratio of 1.013 (95 %CI: 0.910, 1.127). Both the seroconversion rates and GMTs reached the prespecified non-inferiority criteria. Two-dose schedule with an interval of 10 weeks could also induce high immune responses, with a seroconversion rate of 83.22 % and a GMT of 1:160.38 in the test group. Safety profiles were similar among the test group, active control group and placebo group. CONCLUSION VarV, manufactured by Sinovac (Dalian), demonstrated higher immune response and better flexibility in the immunization schedule among heathy population aged 13 years and older, without increased safety risk.
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Affiliation(s)
- Lili Huang
- Henan Provincial Center for Disease Control and Prevention, Zhengzhou, Henan, China
| | - Zhen Chen
- National Institutes for Food and Drug Control, Beijing, China
| | - Yufei Song
- Sinovac Biotech Co., Ltd., Beijing, China
| | - Jiebing Tan
- Henan Provincial Center for Disease Control and Prevention, Zhengzhou, Henan, China
| | | | - Wangyang You
- Henan Provincial Center for Disease Control and Prevention, Zhengzhou, Henan, China
| | - Hongxue Yuan
- Sinovac (Dalian) Vaccine Technology Co., Ltd., Dalian, China
| | - Guangwei Feng
- Henan Provincial Center for Disease Control and Prevention, Zhengzhou, Henan, China
| | - Changgui Li
- National Institutes for Food and Drug Control, Beijing, China
| | - Chunfang Luan
- Sinovac (Dalian) Vaccine Technology Co., Ltd., Dalian, China.
| | - Yaru Quan
- National Institutes for Food and Drug Control, Beijing, China.
| | - Yanxia Wang
- Henan Provincial Center for Disease Control and Prevention, Zhengzhou, Henan, China.
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Zhang W, He Z, Li P, Zeng W, Feng J, Dong X, Lu H. The necessity for popularizing varicella-zoster virus vaccine programs worldwide: An age-period-cohort analysis for the Global Burden of Disease study 2019. J Infect Public Health 2023; 16:1093-1101. [PMID: 37224620 DOI: 10.1016/j.jiph.2023.05.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 03/26/2023] [Accepted: 05/11/2023] [Indexed: 05/26/2023] Open
Abstract
BACKGROUND Varicella-zoster virus (VZV) causes varicella and herpes zoster (VHZ), which is endemic worldwide. Although infection with VZV represents a considerable health threat, the global, regional and national burden of VZV infection, especially the probable relationship between VZV vaccines and the epidemiology of VZV infection, is poorly known. We sought to estimate the global spatial patterns and temporal trends of VHZ burden in 204 countries and territories from 1990 to 2019. METHODS Numbers and age-standardized rates (ASR) of VHZ incidence, and disability-adjusted life years (DALYs) were estimated using data from the Global Burden of Diseases Study (GBD) 2019. Spatiotemporal trends in ASR were evaluated by estimated annual percentage change (EAPC). RESULTS Worldwide, in 2019, there were approximately 84.0 million incidence and 0.9 million DALYs due to VHZ. The corresponding ASIR (age-standardized incidence rate) and ASDR (age-standardized DALY rate) drastically decreased in children (aged <20 years old), while the ASIR and ASDR of VHZ significantly increased in middle- and old-aged adults (aged >50 years old), with highest ASIR and ASDR in the High-income Asia Pacific and Western Sub-Saharan Africa, respectively. From 1990-2019, the corresponding EAPC in ASIR were 0.03 (95% uncertainty interval [UI]: 0.02-0.04). Whereas the global EAPC in ASDR decreased in all regions (-1.59, 95% UI: -1.64 to -1.55), expect for Australasia (0.46, [0.05, 0.88]). Notably, in 2019, age-specific rates of VHZ DALYs presented a rapid growth trend after 70 years old. CONCLUSION The spatiotemporal trends of VHZ were heterogeneous across countries from 1990 to 2019. The spatiotemporal trend in ASIR is highest in the High sociodemographic index (SDI) region, however the EAPC in ASDR is lowest, in part probably due to VHZ vaccination. Therefore, reducing morbidity and burden strategies such as vaccines programs for the prevention of VHZ should be promoted in those regions with high growth incidence and/or burden, especially for the population after 70 years old.
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Affiliation(s)
- Wei Zhang
- Department of Dermatology, Affiliated Hospital of Guizhou Medical University, Guiyang, Guizhou, China
| | - Zhi He
- Department of Dermatology, Affiliated Hospital of Guizhou Medical University, Guiyang, Guizhou, China
| | - Pinhao Li
- Department of Pathology, Affiliated Hospital of Guizhou Medical University, Guiyang, Guizhou, China
| | - Wen Zeng
- Department of Dermatology, Affiliated Hospital of Guizhou Medical University, Guiyang, Guizhou, China
| | - Jianglong Feng
- Department of Pathology, Affiliated Hospital of Guizhou Medical University, Guiyang, Guizhou, China
| | - Xian Dong
- Department of Dermatology, Affiliated Hospital of Guizhou Medical University, Guiyang, Guizhou, China
| | - Hongguang Lu
- Department of Dermatology, Affiliated Hospital of Guizhou Medical University, Guiyang, Guizhou, China.
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Wang L, Yang X, Wang X, Shi P, Zhang X. Assessing vaccine effectiveness for varicella in Wuxi, China: a time-series analysis. Ann Med 2023; 55:2246369. [PMID: 37585612 PMCID: PMC10434998 DOI: 10.1080/07853890.2023.2246369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 06/11/2023] [Accepted: 08/06/2023] [Indexed: 08/18/2023] Open
Abstract
OBJECTIVE The varicella vaccine is not included in the national childhood immunization schedules in China. Varicella epidemics and outbreaks are frequently reported, and the evidence for the effectiveness of the varicella vaccine remains unclear. The aim of this study was to investigate varicella vaccine effectiveness in Wuxi, China. METHODS Varicella surveillance data were extracted from the China Information System for Disease Control and Prevention, and vaccination data were obtained from the Vaccination Integrated Service Management Information System of Jiangsu Province, China. Time-series analysis approaches were used to estimate varicella vaccine effectiveness. RESULTS A total of 16,093 varicella cases among children aged 1-6 years between January 2016 and December 2020 were analysed. A total of 217,297 children completed a two-dose varicella vaccination series. Compared with districts with lower vaccination rates, districts in Wuxi with higher varicella vaccination rates had a lower proportion of cases (p < 0.001). In the time-series approach, 0.8% fewer varicella cases were associated with a 1% increase in the two-dose varicella vaccination rate (p < 0.001), and similar effects were found in both the male and female populations. CONCLUSIONS Two-dose varicella vaccination was recommended as an effective health intervention to prevent varicella in Wuxi, China. Varicella vaccination is urgently needed in routine childhood immunisation programs.
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Affiliation(s)
- Lingling Wang
- Wuxi Center for Disease Control and Prevention, Wuxi, Jiangsu Province, China
| | - Xu Yang
- Wuxi Center for Disease Control and Prevention, Wuxi, Jiangsu Province, China
| | - Xuwen Wang
- Wuxi Center for Disease Control and Prevention, Wuxi, Jiangsu Province, China
| | - Ping Shi
- Wuxi Center for Disease Control and Prevention, Wuxi, Jiangsu Province, China
| | - Xuhui Zhang
- Wuxi Center for Disease Control and Prevention, Wuxi, Jiangsu Province, China
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Shu M, Zhang D, Ma R, Yang T, Pan X. Long-term vaccine efficacy of a 2-dose varicella vaccine in China from 2011 to 2021: A retrospective observational study. Front Public Health 2022; 10:1039537. [PMID: 36424959 PMCID: PMC9679788 DOI: 10.3389/fpubh.2022.1039537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Accepted: 10/24/2022] [Indexed: 11/10/2022] Open
Abstract
Objective A 2-dose varicella vaccine immunization strategy has been implemented in many cities in China, but there is few evidence on a long-term evaluation of the efficacy of the 2-dose varicella vaccine from China. This study aims to assess the long-term vaccine efficacy of the two doses varicella vaccine and analysis of its influencing factors. Methods A retrospective study was carried out in 837,144 children born between 2011 and 2017 in Ningbo, Easten China. The logistic regression was performed to estimate varicella vaccine effectiveness (VE). Results The overall VE of 2 doses of varicella vaccine compared without the vaccine was 90.31% (89.24-91.26%), and the overall incremental VE of 2 doses of varicella vaccine compared to the 1-dose was 64.71% (59.92-68.93%). Moreover, the varicella vaccination age of the second dose and the interval between 2 doses were both associated with VE. The VE compared to that without the vaccine in children vaccinated at <4 years old was 91.22% (95%CI: 90.16-92.17%) which was higher than in children vaccinated at ≥4 years old (VE: 86.79%; 95%CI: 84.52-88.73). And the effectiveness of the vaccine was 93.60% (95%CI: 92.19-94.75%) in children with the interval of the 2 doses ≤ 24 months significantly higher than in children with the interval of ≥36 months (VE: 85.62%, 95%CI: 82.89-87.91%). Conclusions This study provides evidence for long-term VE of the 2-dose varicella vaccine and the better age for 2-dose vaccination and the interval between 2 doses of the vaccine in China.
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Affiliation(s)
- Mingming Shu
- Ningbo Women and Children's Hospital, Ningbo, China
| | - Dandan Zhang
- Ningbo Municipal Center for Disease Control and Prevention, Ningbo, China
| | - Rui Ma
- Ningbo Municipal Center for Disease Control and Prevention, Ningbo, China
| | - Tianchi Yang
- Ningbo Municipal Center for Disease Control and Prevention, Ningbo, China
| | - Xingqiang Pan
- Ningbo Municipal Center for Disease Control and Prevention, Ningbo, China,*Correspondence: Xingqiang Pan
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Suh J, Choi JK, Lee J, Park SH. Estimation of single-dose varicella vaccine effectiveness in South Korea using mathematical modeling. Hum Vaccin Immunother 2022; 18:2085468. [PMID: 35704399 PMCID: PMC9621034 DOI: 10.1080/21645515.2022.2085468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
In South Korea, despite the implementation of a universal single-dose vaccination program for children aged 12–15 months in 2005, the varicella incidence rate remains significant. Prior case-control studies have reported that currently used varicella vaccines are extremely inefficacious. We estimated vaccine effectiveness (VE) by fitting a dynamic transmission model to age-specific varicella incidence data from 2007 to 2015 and available vaccine coverage data. The initial vaccine efficacy and primary failure rates were estimated to be 61.1% and 38.9%, respectively. The average duration of protection was 21.4 years. The mean VE [(1-relative risk) %] for the simulated data of 2004–2014 birth cohorts decreased from 59.8% to 50.7% over 9 years. This mathematical modeling study demonstrated that the single-dose vaccine exhibits moderate effectiveness, and a high proportion of primary failure could be a main cause of breakthrough infections. Therefore, a two-dose vaccination strategy should be considered.
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Affiliation(s)
- Jiyeon Suh
- School of Mathematics and Computing (Computational Science and Engineering), Yonsei University, Seoul, Republic of Korea
| | - Jae-Ki Choi
- Division of Infectious Diseases, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.,Vaccine Bio Research Institute, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Jeehyun Lee
- School of Mathematics and Computing, Yonsei University, Seoul, Republic of Korea
| | - Sun Hee Park
- Division of Infectious Diseases, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.,Vaccine Bio Research Institute, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
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Suzuki A, Nishiura H. Transmission dynamics of varicella before, during and after the COVID-19 pandemic in Japan: a modelling study. MATHEMATICAL BIOSCIENCES AND ENGINEERING : MBE 2022; 19:5998-6012. [PMID: 35603388 DOI: 10.3934/mbe.2022280] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Public health and social measures (PHSMs) targeting the coronavirus disease 2019 (COVID-19) pandemic have potentially affected the epidemiological dynamics of endemic infectious diseases. In this study, we investigated the impact of PHSMs for COVID-19, with a particular focus on varicella dynamics in Japan. We adopted the susceptible-infectious-recovered type of mathematical model to reconstruct the epidemiological dynamics of varicella from Jan. 2010 to Sep. 2021. We analyzed epidemiological and demographic data and estimated the within-year and multi-year component of the force of infection and the biases associated with reporting and ascertainment in three periods: pre-vaccination (Jan. 2010-Dec. 2014), pre-pandemic vaccination (Jan. 2015-Mar. 2020) and during the COVID-19 pandemic (Apr. 2020-Sep. 2021). By using the estimated parameter values, we reconstructed and predicted the varicella dynamics from 2010 to 2027. Although the varicella incidence dropped drastically during the COVID-19 pandemic, the change in susceptible dynamics was minimal; the number of susceptible individuals was almost stable. Our prediction showed that the risk of a major outbreak in the post-pandemic era may be relatively small. However, uncertainties, including age-related susceptibility and travel-related cases, exist and careful monitoring would be required to prepare for future varicella outbreaks.
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Affiliation(s)
- Ayako Suzuki
- School of Public Health, Kyoto University, Kyoto, Japan
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Suzuki A, Nishiura H. Reconstructing the transmission dynamics of varicella in Japan: an elevation of age at infection. PeerJ 2022; 10:e12767. [PMID: 35111401 PMCID: PMC8783564 DOI: 10.7717/peerj.12767] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Accepted: 12/17/2021] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND In Japan, routine two-dose immunization against varicella has been conducted among children at ages of 12 and 36 months since 2014, and the vaccination coverage has reached around 90%. To understand the impact of routine varicella vaccination, we reconstructed the epidemiological dynamics of varicella in Japan. METHODS Epidemiological and demographic datasets over the past three decades were analyzed to reconstruct the number of susceptible individuals by age and year. To estimate the annual risk of varicella infection, we fitted a balance equation model to the annual number of cases from 1990 to 2019. Using parameter estimates, we reconstructed varicella dynamics starting from 1990 and modeled future dynamics until 2033. RESULTS Overall varicella incidence declined over time and the annual risk of infection among children younger than 10 years old decreased monotonically starting in 2014. Conversely, varicella incidence among teenagers (age 10 to 14 years) has increased each year since 2014. A substantial number of unvaccinated individuals born before the routine immunization era remained susceptible and aged without contracting varicella, while the annual risk of infection among teenagers aged 10 to 14 years increased starting in 2011 despite gradual expansion of varicella vaccine coverage. The number of susceptible individuals decreased over time in all age groups. Modeling indicated that susceptibility rates among pre-school children aged 1 to 4 years will remain low. CONCLUSION Routine varicella vaccination has successfully reduced infections in pre-school and early primary school age children, but has also resulted in increased infection rates among adolescents. This temporary increase was caused both by the increased age of susceptible individuals and increased transmission risk among adolescents resulting from the dynamic nature of varicella transmission. Monitoring susceptibility among adolescents will be important to prevent outbreaks over the next decade.
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Kang DH, Kwak BO, Park AY, Kim HW. Clinical Manifestations of Herpes Zoster Associated with Complications in Children. CHILDREN-BASEL 2021; 8:children8100845. [PMID: 34682110 PMCID: PMC8534401 DOI: 10.3390/children8100845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Revised: 09/13/2021] [Accepted: 09/19/2021] [Indexed: 11/16/2022]
Abstract
Herpes zoster (HZ) is caused by latent varicella-zoster virus (VZV) reactivation when VZV-specific cell-mediated immunity declines. Information on HZ in children is limited. Therefore, we retrospectively investigated HZ's clinical course and complications in children. We extracted the outpatient and hospitalization medical records of pediatric patients (<19 years) primarily diagnosed with HZ (ICD-10 B02 code) between January 2010 and November 2020. HZ was defined as a typical unilateral dermatomal vesicular rash where HZ was the treating physician's primary diagnosis. Recognized HZ complications included combined bacterial skin infection, ophthalmic zoster, zoster oticus without facial paralysis, meningitis, and PHN. We identified 602 HZ cases, among which 54 developed HZ complications and were included in our analysis. The median age was 14.7 years, most patients were aged ≥13 years (42, 79%), and none were aged <4 years. Fifty-three were immunocompetent, and only one had systemic lupus erythematosus. The most frequent complication was zoster ophthalmicus (n = 26, 48%). HZ complications were also observed in immunocompetent or vaccinated children exhibiting a head or neck rash before and after VZV immunization. Current VZV vaccination programs may be insufficient in preventing HZ complications. Therefore, close varicella and HZ burden monitoring and the establishment of effective VZV vaccination programs are imperative.
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Affiliation(s)
- Dong Ha Kang
- Department of Pediatrics, Hallym University Sacred Heart Hospital, Anyang 14068, Korea
| | - Byung Ok Kwak
- Department of Pediatrics, Hallym University Kangnam Sacred Heart Hospital, Seoul 07441, Korea
| | - A Young Park
- Department of Pediatrics, Hallym University Sacred Heart Hospital, Anyang 14068, Korea
| | - Han Wool Kim
- Department of Pediatrics, Hallym University Sacred Heart Hospital, Anyang 14068, Korea
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Choi B, Shin JH, Lee JE, Koh SB. Letter to the Editor: Effectiveness of the Varicella Vaccine in Korea: Unresolved Issues. J Korean Med Sci 2021; 36:e200. [PMID: 34254478 PMCID: PMC8275458 DOI: 10.3346/jkms.2021.36.e200] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2021] [Accepted: 07/01/2021] [Indexed: 11/20/2022] Open
Affiliation(s)
- BongKyoo Choi
- Department of Research and Development, GC Pharma, Yongin, Korea
- Department of Medicine, University of California, Irvine, CA, USA.
| | - Ji Hyeun Shin
- Department of Pharmacovigilance, LSK Global PS, Seoul, Korea
| | - Jee Eun Lee
- Department of Clinical and Regulatory Affairs, LG Chem Ltd, Seoul, Korea
| | - Sang Baek Koh
- Department of Preventive Medicine, Wonju College of Medicine, Yonsei University, Wonju, Korea
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