title: Successful introduction of an underutilized elderly pneumococcal vaccine in a national immunization program by integrating the pre-existing public health infrastructure.
abstract: BACKGROUND
  Although pneumococcal vaccines had been recommended for the elderly population in South Korea for a considerable period of time, the coverage has been well below the optimal level. To increase the vaccination rate with integrating the pre-existing public health infrastructure and governmental funding, the Korean government introduced an elderly pneumococcal vaccination into the national immunization program with a 23-valent pneumococcal polysaccharide vaccine in May 2013.
  
  
  OBJECTIVE
  The aim of this study was to assess the performance of the program in increasing the vaccine coverage rate and maintaining stable vaccine supply and safe vaccination during the 20 months of the program.
  
  
  METHODS
  We qualitatively and quantitatively analyzed the process of introducing and the outcomes of the program in terms of the systematic organization, efficiency, and stability at the national level.
  
  
  RESULTS
  A staggered introduction during the first year utilizing the public sector, with a target coverage of 60%, was implemented based on the public demand for an elderly pneumococcal vaccination, vaccine supply capacity, vaccine delivery capacity, safety, and sustainability. During the 20-month program period, the pneumococcal vaccine coverage rate among the population aged ≥65 years increased from 5.0% to 57.3% without a noticeable vaccine shortage or safety issues. A web-based integrated immunization information system, which includes the immunization registry, vaccine supply chain management, and surveillance of adverse events following immunization, reduced programmatic errors and harmonized the overall performance of the program.
  
  
  CONCLUSIONS
  Introduction of an elderly pneumococcal vaccination in the national immunization program based on strong government commitment, meticulous preparation, financial support, and the pre-existing public health infrastructure resulted in an efficient, stable, and sustainable increase in vaccination coverage.
authors: Division of Vaccine-Preventable Diseases Control and National Immunization Program, Korea Centers for Disease Control and Prevention, Osong Health Technology Administration Complex, 187 Osongsaengmyeong 2-ro, Osong-eup, Heungduk-gu, Cheongju, Chungcheongbuk-do 363-951, South Korea. Electronic address: taeun.yang@gmail.com.
authors: Tae Un
authors: TU
authors: Yang
authors: Division of Vaccine-Preventable Diseases Control and National Immunization Program, Korea Centers for Disease Control and Prevention, Osong Health Technology Administration Complex, 187 Osongsaengmyeong 2-ro, Osong-eup, Heungduk-gu, Cheongju, Chungcheongbuk-do 363-951, South Korea. Electronic address: cairu@hanmail.net.
authors: Eunsung
authors: E
authors: Kim
authors: Division of Vaccine-Preventable Diseases Control and National Immunization Program, Korea Centers for Disease Control and Prevention, Osong Health Technology Administration Complex, 187 Osongsaengmyeong 2-ro, Osong-eup, Heungduk-gu, Cheongju, Chungcheongbuk-do 363-951, South Korea. Electronic address: pahmun@hanmail.net.
authors: Young-Joon
authors: YJ
authors: Park
authors: Division of Vaccine-Preventable Diseases Control and National Immunization Program, Korea Centers for Disease Control and Prevention, Osong Health Technology Administration Complex, 187 Osongsaengmyeong 2-ro, Osong-eup, Heungduk-gu, Cheongju, Chungcheongbuk-do 363-951, South Korea. Electronic address: dwkim0504@naver.com.
authors: Dongwook
authors: D
authors: Kim
authors: Division of Vaccine-Preventable Diseases Control and National Immunization Program, Korea Centers for Disease Control and Prevention, Osong Health Technology Administration Complex, 187 Osongsaengmyeong 2-ro, Osong-eup, Heungduk-gu, Cheongju, Chungcheongbuk-do 363-951, South Korea. Electronic address: yhhodori@gmail.com.
authors: Yoon Hyung
authors: YH
authors: Kwon
authors: Division of Vaccine-Preventable Diseases Control and National Immunization Program, Korea Centers for Disease Control and Prevention, Osong Health Technology Administration Complex, 187 Osongsaengmyeong 2-ro, Osong-eup, Heungduk-gu, Cheongju, Chungcheongbuk-do 363-951, South Korea. Electronic address: zora4@naver.com.
authors: Jae Kyong
authors: JK
authors: Shin
authors: Division of Vaccine-Preventable Diseases Control and National Immunization Program, Korea Centers for Disease Control and Prevention, Osong Health Technology Administration Complex, 187 Osongsaengmyeong 2-ro, Osong-eup, Heungduk-gu, Cheongju, Chungcheongbuk-do 363-951, South Korea. Electronic address: okpark8932@gmail.com.
authors: Ok
authors: O
authors: Park
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D017589:Immunization Programs / Q000458:organization & administration*; D008297:Male; D011008:Pneumococcal Infections / Q000517:prevention & control*; D022242:Pneumococcal Vaccines / Q000627:therapeutic use*; D015397:Program Evaluation; D011634:Public Health; D056910:Republic of Korea; D014611:Vaccination / Q000706:statistics & numerical data*
chemical_list: C414006:23-valent pneumococcal capsular polysaccharide vaccine; D022242:Pneumococcal Vaccines
keywords: Aged; National immunization program; Pneumococcal vaccines; Streptococcus pneumoniae; Vaccination; Vaccine coverage