근대 중국 우두지식의 보편화를 향한 노력: 민중 계몽에서 학생 교육까지

조정은 의료역사연구회 2022 의료사회사연구 Vol.9 No.1

This study aims to examine the process of spreading Chinese modern vaccination knowledge using vaccination-related articles in newspapers, magazines and textbooks. It analyzed civil recognition of vaccination and implications of vaccination knowledge education and propaganda by carefully looking all around from basic vaccination knowledge propaganda to student education. Being able to prevent smallpox more simply and safely than the traditional Chinese variolation, vaccination was highlighted early on. In the Republican period, the increase in news media and national intervention facilitated systematic and full-scale vaccination propaganda and education. First, the state put efforts into conveying accurate information of vaccination and stressed shortcomings of variolation and strengths of vaccination by comparing vaccination with variolation. It also endeavored to change the existing wrong notion by providing scientific information of vaccination time and re-vaccination. On the other hand, it explained the occurrence of smallpox and the concept of vaccination using traditional Taidu. When persuading people, it was more convenient to use conventional knowledge of Taidu than to introduce virus, which was then new knowledge. Meanwhile, vaccination-related articles often appeared in educational magazines, school magazines and even magazines for children. Magazines, textbooks and teaching aids for children cited poetry, songs and picture books at the level of children’s eyes to propagate vaccination. In particular, they displayed pictures of people suffering from smallpox and pictures of young children’s faces full of pockmarks to emphasize the fear of smallpox and the importance of vaccination. The articles argued that students should learn songs recommending vaccination and also teach vaccination to rural people; this proves not only were students subject to propaganda but also they had to play a role as an instrument of propaganda itself. Students propagated strengths of vaccination among people in country towns, who did not know properly about vaccination and still preferred to get variolated due to a lack of knowledge in hygiene. As explained above, vaccination of students could be an effective propaganda to their siblings and furthermore, to the whole society. Many schools ranging from small primary schools to universities compulsorily vaccinated students every spring or whenever smallpox spread. Moreover, in order to impart information of vaccination, many articles stressed that young children were willing to get vaccinated rather than being afraid of cowpox and highly praised female students for getting vaccinated with no fear, as a symbol of wise mother and good wife. In other words, vaccination propaganda and education for children and students and compulsory vaccination at school was a smart strategy to generalize vaccination knowledge and vaccination. 이 논문의 목적은 중국 근대 우두(牛痘) 지식의 확산과정을 신문잡지 및 교과서의 우두관련 기사를 이용하여 검토하는 것이다. 기본적인 우두 지식 선전부터 학생 대상의 교육까지 두루 살펴봄으로써 민간의 종두인식과 더불어 우두지식의 교육과 선전이 지닌 함의를 분석하였다. 우두는 기존의 인두법(人痘法)보다 간단하고 안전하게 두창 (痘瘡)을 예방할 수 있기 때문에 일찍부터 주목받았다. 민국시기에 들어서는 언론매체의 증가와 국가의 본격적인 개입 덕분에 체계적이고 본격적인 우두 선전과 교육을 할 수 있었다. 먼저 두창과 우두의 정확한 정보를 전달하고자 노력하였으며, 우두를 인두와 비교하며 인두의 단점을 부각하고 우두의 장점을 내세웠다. 우두의 접종 시기와 재접종에 대해서도 과학적인 정보를 제공하여 기존의 잘못된 관념을 바꾸고자 노력했다. 한편으로는 여전히 전통적인 태독설(胎毒說)을 이용해서 두창의 발병과 우두의 개념을 설명하기도 했다. 바이러스라는 새로운 지식을 알리기 위해 노력하는 것보다, 태독이라는 기존 지식을 이용하는 게 사람들을 설득하기 편했기 때문이다. 한편 어린아이 대상의 잡지와 교과서, 보조교재에서는 아 이들의 눈높이에 맞춰 시, 노래, 그림책 형식을 빌려 우두 접종을 선전했다. 두창의 무서움과 우두의 중요성을 각인시키기 위해 두창을 앓는 모습의 그림, 마맛자국이 가득한 어린아이의 얼굴 그림을 내세웠다. 마맛자국은 전통 시대와 달리 흉하고 추한 얼굴의 상징이자, 우두라는 과학을 모르는 무지함의 상징이 되었다. 어린 학생들이 우두를 두려워하지 않고 오히려 흔쾌히 접종받았음을 강조하고, 두려움 없이 우두를 접종받는 여학생을 현모양처의 표상으로 치켜세웠다. 우두를 권장하는 노래를 배워서 농촌 사람들에게 우두를 알려야 한다고 주장했다. 이러한 기사들은 학생이 선전의 대상일 뿐만 아니라 대중을 향한 선전용 도구 그 자체의 역할도 수행해야 했음을 보여준다. 학생들은 이러한 가르침을 마음에 새기고 향촌으로 직접 향했다. 위생 지식이 부족해 우두법을 잘 모르고 여전히 인두를 접종하는 사람들에게 우두의 장점을 선전하기 위해서였다. 이러한 선전과 교육은 학생들에게 우두에 대한 긍정적인 인식을 심어주어 의무접종을 무난히 시행할 수 있는 밑거름이 되었다. 소학교부터 대학교에 이르기까지 많은 학교에서 매년 봄이나 두창이 유행할 때 의무접종을 시행했다. 학생 대상의 종두 접종은 가깝게는 학생의 형제자매들에게, 멀게는 사회 전체에 유효한 선전이 될 수 있다. 즉 어린아이와 학생을 대상으로 한 우두 선전과 교육, 교내의 의무접종은 우두지식과 우두접종의 보편화를 위한 영리한 전략이었다.

치과위생사의 백신접종 인식과 COVID-19 노출경험에 따른 COVID-19 백신접종의 차이

최마이,박보영 한국보건복지학회 2022 보건과 복지 Vol.24 No.3

This study was conducted to invesigate the difference between dental hygienists' awareness of COVID-19 vaccination and whether or not they were vaccinated against COVID-19 according to their experiences of exposure to COVID-19. 106 dental hygienists were asked about their general characteristics, awareness of COVID-19 vaccination, their experiences of exposure to COVID-19, and whether they had been vaccinated against COVID-19. 81.1% of the study subjects had received at least one dose of COVID-19 vaccination, and the vaccination rate was higher among those in their 20s (93.3%) than those in their 30s (72.1%). As dental workers, the group who recognized the importance of COVID-19 vaccination, the group who trusted information on the COVID-19 vaccine, and the group who did not delay vaccination against infectious diseases showed a high rate of COVID-19 vaccination (p<.05). For a safe dental care environment from cross-infection, information and related education on COVID-19 vaccination should be provided to dental hygienists. In addition, dental medical institutions need to have a system to manage employees' vaccination information and to support inoculation leave for rest in order to encourage vaccination. 본 연구는 치과위생사의 COVID-19 백신접종 유무를 조사하고, 백신접종에 관한 인식과 COVID-19 노출 경험에 따른 COVID-19 백신접종 여부의 차이를 확인하고자 수행하였다. 2021년 8월부터 약 3개월간 치과위생사 106명을 대상으로 설문조사를 하였고, 일반적 특성, 백신접종 인식과 COVID-19 노출 경험, COVID-19 백신접종 유무를 조사하였다. 연구결과, 연구대상의 81.1%가 1회 이상 COVID-19 백신접종을 하였고, ‘나는 치과의료종사자로서 COVID-19 노출 가능성이 있다(100%)’와 ‘나는 COVID-19 백신에 대한 추가 정보가 필요하다(96.2%)’의 동의률이 높았다. COVID-19 백신접종이 중요하다고 인식하는 그룹, COVID-19 백신 정보를 신뢰하는 그룹, 감염병 예방 백신접종을 미루지 않는 그룹에서 COVID-19 백신접종률이 높게 조사되었다(p<.05). 교차감염으로부터 안전한 치과환경을 위하여 치과의료기관이나 관련 단체는 치과의료종사자에게 COVID-19 백신접종에 대한 정보와 관련 교육을 제공하고 직원의 백신접종 정보를 관리할 수 있는 시스템을 갖출 필요가 있다. 또한 직원의 보건복지를 고려하여 백신접종자에게 휴가를 지원하는 제도를 마련할 필요가 있다.

초등학생 딸을 둔 어머니의 HPV 예방접종 의도 영향요인

김선화,성미혜,김윤아,박혜진 한국여성건강간호학회 2019 여성건강간호학회지 Vol.25 No.3

Purpose: The purpose of this study was to identify the impacts of human papillomavirus (HPV) vaccination-related health belief, attitudes toward HPV vaccination, and subjective norms on HPV vaccination intent targeting mothers of elementary school daughters. Methods: The study use a correlative survey design. The subjects of the study were 121 mothers of elementary school daughters located in metropolitan city B. All subjects agreed to participate in the study. The data were collected from September 1 to October 18, 2018, and were analyzed using descriptive statistics, Independent t-test, ANOVA with a post hoc Scheffé test, Pearson's correlation coefficients, and stepwise multiple regression. Results: Attitude toward HPV vaccination, subjective norms, vaccination plans for their children, and mother's vaccination status were significant factors influencing HPV vaccination intention. These factors accounted for 72% of the HPV vaccination intention. Conclusions: This study showed that factors affecting the intention of mothers of elementary school daughters to vaccinate against HPV were HPV vaccination attitudes, subjective norms, vaccination plans for their children, and mother's vaccination status. The biggest influencing factor was HPV vaccination attitudes. Therefore, in order to encourage mothers of elementary school daughters to vaccinate against HPVs, national-level policies should be implemented to create a social atmosphere of positive attitudes toward HPV vaccinations that also emphasizes how easy it is to get vaccinated against HPV. Based on this, mothers of elementary school daughters should be encouraged to have them vaccinated against HPV, thus contributing to improving the HPV vaccination rates of elementary school girls.

Vaccination and Complementary and Alternative Medicine in Patients with Inflammatory Bowel Disease

( Sung Bae Kim ),( Soo Jung Park ),( Sook Hee Chung ),( Kyu Yeon Hahn ),( Do Chang Moon ),( Sung Pil Hong ),( Jae Hee Cheon ),( Tae Il Kim ),( Won Ho Kim ) 대한장연구학회 2014 Intestinal Research Vol.12 No.2

Background/Aims: Vaccinations in patients with inflammatory bowel disease (IBD) are recommended to prevent infectiousdiseases. However, there are few reports of vaccination in IBD patients in Korea. The frequency of complementary and alternativemedicine (CAM) use is high despite its uncertain effectiveness. This study aimed to identify the rates of vaccination anduse of CAM in patients with IBD. Methods: A total of 219 patients attended an education session for IBD patients held at SeveranceHospital on March 23, 2013. We conducted a survey on vaccination and CAM use in IBD patients; 120 patients completedthe questionnaire. Results: The influenza vaccination rate was 44.2% and pneumococcal vaccination rate was 4.2%. Thirtyone(66%) patients were aware of the importance of vaccination. The vaccination rate was higher in patients who were awareof the importance of vaccination compared with that in patients who were unaware of the importance of vaccination (70.1%vs. 41.7%, P =0.004). The rate of CAM use was 30.0%. The most commonly used CAMs were oral products: vitamins (33.3%),red ginseng (25.0%), and probiotics (19.4%). Conclusions: Awareness of the importance of vaccination and actual vaccinationrates were low in IBD patients. Despite insufficient evidence on the effectiveness of CAMs in IBD patients, many patients usedCAMs. We believe that repeated education and promotion of vaccination are important. Further large-scale studies to investigatethe efficacy and safety of CAMs are warranted in patients with IBD. (Intest Res 2014;12:124-130)

온라인 커뮤니티에 따른 영.유아 예방접종에 대한 정보습득 경로 및 지식수준 비교

최인영,정미은,최순,김석일,Choi, In-Young,Chung, Mi-Eun,Choy, Soon,Kim, Suk-Il 대한예방의학회 2007 예방의학회지 Vol.40 No.4

Objectives : To explore the information sources and knowledge on infant vaccinations of pro-vaccination community members and anti-vaccination community members on the internet. Methods : An online survey of 245 parents from three pro-vaccination communities and 92 parents from one anti-vaccination community was conducted from June 7 to June 23, 2006. Results : Parents from pro-vaccination communities usually gained the information regarding vaccination efficacy and risk mainly from healthcare providers (49.8%) and mass media (47.7%). Pro-vaccination community members considered healthcare providers as the most credible sources of information on vaccination, whereas the anti-vaccination community members usually gained their information regarding vaccine efficiency and risk from Internet child-care cafes and online vaccination communities. Parents of the anti-vaccination community considered the internet as the most credible information source (77.6% for efficacy, 94.8% for risk). In addition, the major reason why anti-vaccination community members didn't vaccinate and, will not vaccinate, was concern about possible side effects of the vaccine. The knowledge level on infant vaccination, education and economic status was higher in the anti-vaccination community. Conclusions : On-line communities concerned with vaccination are getting popular. The influence of anti-vaccination parents on the Internet is expected to be high. The government and healthcare providers need to increase their efforts to improve the credibility of information about vaccination. Our findings suggest that online communication regarding vaccinations needs to be considered as a means to increase vaccination rates.

예방접종과 관련된 소아 혈소판 감소 자반병의 임상적 특성

이완수,유승택,신새론,최두영 대한소아청소년과학회 2008 Clinical and Experimental Pediatrics (CEP) Vol.51 No.6

Purpose:Idiopathic thrombocytopenic purpura (ITP) is a relatively common hematological disease in children. It generally occurs after exposure to a common viral infection episode; however, it may occasionally follow immunization with measles, measles-mumps-rubella (MMR), hepatitis B (HBV), influenza, diphtheria–tetanus-pertussis (DTP), or chickenpox vaccines. In this study, the incidence, clinical characteristics, and treatment outcome of vaccination-associated ITP were investigated and compared with non-vaccination-associated ITP. Methods:The admission records of 105 pediatric ITP patients between 0-14 years of age admitted to Department of Pediatrics, Wonkwang University Hospital from January 1994 to July 2007 were retrospecitively reviewed. Patients were grouped into a vaccination-associated group and a non-vaccination-associated group according to vaccination history within the previous 1 month, and various clinical features between the two groups were statistically analyzed. Results:Thirteen patients (12%) had a preceding vaccination. Eight had received DTP vaccination, 2 had received hepatitis B, and 1 each had received influenza, MMR, and Japanese B encephalitis vaccination. However, none of the patients had a recurrent thrombocytopenia after subsequent vaccinations. In the vaccination-associated group, the age was significantly lower, anemia was more common, and the risk period with blood platelet count <20×109/L was significantly shorter than for the in non-vaccination-associated group. Also, wet purpura was less prominent and the remission within 1month was more frequently achieved in the vaccination-associated ITP group. Conclusion:Vaccination-associated ITP patients showed mild symptoms with a more benign and shorter lasting course than non-vaccination-associated ITP patients. Moreover, platelet count assessment at the time of the next immunization may not be necessary. (Korean J Pediatr 2008;51:610-615) Purpose:Idiopathic thrombocytopenic purpura (ITP) is a relatively common hematological disease in children. It generally occurs after exposure to a common viral infection episode; however, it may occasionally follow immunization with measles, measles-mumps-rubella (MMR), hepatitis B (HBV), influenza, diphtheria–tetanus-pertussis (DTP), or chickenpox vaccines. In this study, the incidence, clinical characteristics, and treatment outcome of vaccination-associated ITP were investigated and compared with non-vaccination-associated ITP. Methods:The admission records of 105 pediatric ITP patients between 0-14 years of age admitted to Department of Pediatrics, Wonkwang University Hospital from January 1994 to July 2007 were retrospecitively reviewed. Patients were grouped into a vaccination-associated group and a non-vaccination-associated group according to vaccination history within the previous 1 month, and various clinical features between the two groups were statistically analyzed. Results:Thirteen patients (12%) had a preceding vaccination. Eight had received DTP vaccination, 2 had received hepatitis B, and 1 each had received influenza, MMR, and Japanese B encephalitis vaccination. However, none of the patients had a recurrent thrombocytopenia after subsequent vaccinations. In the vaccination-associated group, the age was significantly lower, anemia was more common, and the risk period with blood platelet count <20×109/L was significantly shorter than for the in non-vaccination-associated group. Also, wet purpura was less prominent and the remission within 1month was more frequently achieved in the vaccination-associated ITP group. Conclusion:Vaccination-associated ITP patients showed mild symptoms with a more benign and shorter lasting course than non-vaccination-associated ITP patients. Moreover, platelet count assessment at the time of the next immunization may not be necessary. (Korean J Pediatr 2008;51:610-615)

2000년도 경남 서부 지역에 유행한 홍역의 임상양상

권병오,주혜영,김정희,유황재,김천수,Kwon, Byoung O,Ju, Hye Young,Kim, Jeong Hee,Yoo, Hwang Jae,Kim, Chun Soo 대한소아청소년과학회 2002 Clinical and Experimental Pediatrics (CEP) Vol.45 No.3

목 적 : 1965년 국내에 홍역 예방 접종이 도입된 후 1985년대부터 국가사업으로 무료예방 접종을 실시하면서 홍역 환아의 발생이 급격하게 줄었다. 1990년과 1994년의 전국적인 유행에 따라 예방 접종방법이 조금씩 바뀌었다. 이러한 노력에도 불구하고, 2000년도에는 사상 유래 없는 32,080명이라는 엄청난 환아가 전국적으로 발생하였다. 보건복지부에서 자체 역학조사가 있었지만, 학계에서는 이시기에 유행했던 홍역에 대한 임상연구 및 보고가 미비하여 저자들은 이시기에 경남 서부 지역에 유행한 홍역의 역학을 조사하여 2000년 홍역의 대유행의 역학적 특징을 분석하고, 예방 접종과의 관계를 분석하여 홍역근절이라는 예방 대책을 세우는데 도움이 되고자 본 연구를 시작하였다. 방 법: 2000년 1월부터 12월까지 마산삼성병원을 방문 또는 입원한 환아들 중에 경남 서부 지역에 거주하는 자로서 임상적으로 홍역이 의심되어 홍역 IgM 항체 검사를 실시한 15세 미만의 환아 489명 중에 홍역 IgM 항체가 양성반응으로 확인된 344명만을 대상으로 하여 발병연령 및 월별 발생, 임상증상 및 합병증, 예방 접종력과 홍역 IgG 항체에 대하여 조사하였다. 결 과 : 1) 발병연령 및 월별 발생현황 : 발병연령은 12개월 미만의 환아가 127명(36.9%)으로 가장 많은 빈도를 보였으며, 그 이후에는 11세에 정점을 보였다. 월별 발생현황은 5월에 첫 환아가 발생하여 10월부터 기하급수적인 증가를 보였다. 2) 임상증상 및 합병증 : 모든 환아에서 발열과 기침, 발진을 볼 수 있었으며, 결막염은 54.9%에서 발견되었으며, Koplik 반점은 23.8%에서 관찰되었다. 합병증을 보인 환아는 112명(32.6%)이었으며, 폐렴이 80명(71.4%)으로 가장 많았으며, 다음은 기관지염, 장염, 후두염, 중이염의 순서였다. 3) 예방 접종력 : 예방 접종력을 확인할 수 있었던 261명 중에 1차 예방 접종을 했던 환아는 109명(41.8%)이었고, 연령별 1차 예방 접종률과 환아 발생 수를 비교하였을 때 12개월 이하에서 1차 접종률이 가장 낮았으며, 가장 많은 환아가 발생하였다. 이후 접종률이 증가하면서 환아수가 감소하였다가 접종률이 떨어지는 10세 전후로 해서 환아 발생이 증가하는 양상을 보였다(P<0.01). 하지만, 2차 접종률과 비교하였을 때는 오히려 2차 접종률이 높은 연령에서 환아수가 증가하는 양상을 보였다. 4) 홍역 IgG 항체 : 홍역 IgM 항체와 IgG 항체를 동시에 검사한 환아는 152명이었으며, 이들 중에 1차 예방 접종을 받은 35명의 환아 중에 IgG 항체가 음성인 환아는 22명(62.9%)이었으며, 2차 예방 접종을 받은 6명중에는 3명(50%)이 IgG 항체가 음성이었다. 결 론: 2000년 홍역의 대유행은 전국적이었으며, 여전히 12개월 미만의 홍역 환아가 많은 비중을 차지하였다. 그러므로 현재 유행 시에만 실시하는 생후 6개월의 홍역 단독 예방 접종을 유행지역에서는 기본 접종에 준해서 시행할 수 있는 제도적 장치를 마련하거나 원천적으로 기본 예방 접종으로 전환이 고려되어야 할 것으로 사료된다. 그리고, 예방 접종 후에 홍역 IgG 항체 형성율이 낮은 것은 예방 접종의 방법보다는 백신자체의 문제나 백신의 운반이나 유통과정에 문제가 있을 것으로 사료되므로 객관적인 판단을 위해서는 보다 많은 증례를 대상으로 한 체계적인 조사가 필요하리라 생각된다. Purpose : To investigate the feature of the range of measles in 2000, we studied epidemics of the measles in western Kyungnam District. Methods : Among 489 patients under 15 years of age who visited or were admitted to in our hospital from January to December in 2000, we selected 344 patients whose measles IgM antibody was positive. We investigated age, monthly incidence, clinical features, vaccination history, and measles IgG antibody. Results : Patients under 12 months of age occupied the largest proportion(36.9%). Patients firstly occurred in May and geometrically increased from October. Fever, cough and rashes were observed in all patients but conjunctivitis in 54.9%, Koplik spot in 23.8%. The first vaccination ratio was 41.8%. Compared with the number of patients and the first vaccination ratio, the first vaccination ratio was the lowest under 12 months of age. After that age group, the number of patients was decreased as the first vaccination ratio was increased. Among 152 patients sampled for measles IgG antibody, 35 patients had received the first vaccination and 6 patients had received the second vaccination. Among 35 patients who received the first vaccination, 22(62.9%) patients were negative of measles IgG antibody. Among 6 patients who received the second vaccination, 3(50%) patients were negative. Conclusions : Measles patients under 12 months still dominated. Therefore, routine vaccination of single measles vaccine, is currently done at 6 month when measles are prevalent, should be considered. High first vaccination failure suggests problems of vaccines itself, transport and storage rather than vaccination methods. Therefore a thorough investigation should be made.

Cost-Effectiveness Analysis of HPV Vaccination: Comparing the General Population with Socially Vulnerable Individuals

Han, Kyu-Tae,Kim, Sun Jung,Lee, Seo Yoon,Park, Eun-Cheol Asian Pacific Journal of Cancer Prevention 2014 Asian Pacific journal of cancer prevention Vol.15 No.19

Background: After the WHO recommended HPV vaccination of the general population in 2009, government support of HPV vaccination programs was increased in many countries. However, this policy was not implemented in Korea due to perceived low cost-effectiveness. Thus, the aim of this study was to analyze the cost-utility of HPV vaccination programs targeted to high risk populations as compared to vaccination programs for the general population. Materials and Methods: Each study population was set to 100,000 people in a simulation study to determine the incremental cost-utility ratio (ICUR), then standard prevalence rates, cost, vaccination rates, vaccine efficacy, and the Quality-Adjusted Life-Years (QALYs) were applied to the analysis. In addition, sensitivity analysis was performed by assuming discounted vaccination cost. Results: In the socially vulnerable population, QALYs gained through HPV vaccination were higher than that of the general population (General population: 1,019, Socially vulnerable population: 5,582). The results of ICUR showed that the cost of HPV vaccination was higher for the general population than the socially vulnerable population. (General population: 52,279,255 KRW, Socially vulnerable population: 9,547,347 KRW). Compared with 24 million KRW/QALYs as the social threshold, vaccination of the general population was not cost-effective. In contrast, vaccination of the socially vulnerable population was strongly cost-effective. Conclusions: The results suggest the importance and necessity of government support of HPV vaccination programs targeted to socially vulnerable populations because a targeted approach is much more cost-effective. The implementation of government support for such vaccination programs is a critical strategy for decreasing the burden of HPV infection in Korea.

근대 일본의 종두: 제도 정비와 실제

김영수 의료역사연구회 2022 의료사회사연구 Vol.9 No.1

Studies on smallpox vaccination in nineteenth-century Japan have mainly focused on the importation of cowpox vaccine and the implementation of smallpox vaccination, emphasizing the medical achievements of doctors practicing Western medicine (蘭方醫) in the late Edo period. As a result, smallpox vaccination of the early Meiji period has not garnered much scholarly attention. In order to understand the characteristics of smallpox vaccination during the early Meiji period, this paper aims to examine the practice of “Jennerization,” which began at the end of the Edo period, and the process of institutionalizing smallpox vaccination in the early Meiji period. It analyzes regulations for a vaccinator (種痘醫), whose role in smallpox vaccination changed over time, and legal and institutional support for compulsory vaccination. In the process, smallpox vaccination came to be practiced no longer by a vaccinator but by a doctor with a license from the government, and as the vaccinator’s technique of “Jennerization” became standardized, smallpox vaccination transformed from a matter of individual competency to that of national/government competency. In addition, in order to institutionalize its implementation, the Meiji government introduced supplementary measures, such as laws and regulations that mandated those who got vaccinated to report their cases to the government, offered free vaccination for the poor, and required compulsory vaccination before entering elementary school. The various regulations for smallpox vaccination manifested both pre-modern and modern elements, which were characterized by the establishment of the vaccination institute (種痘館) and the modern medical approaches of its members. They suggest that there was continuity between pre-modern medicine (蘭方醫學) and the infectious disease control measures of the early Meiji period. At the same time, they offered a case study of the process by which the Meiji government modernized these regulations. 지금까지 19세기 일본의 종두에 관한 연구는 주로 에도 후기의 우두묘의 수입과 우두법의 실시에 주목하며, 난방의들의 의학적 성취에 초점을 맞춰왔다. 상대적으로 메이지기 이후에 진행된 종두사업에 관해서는 주목하지 않았다. 본 논문에서는 에도 말기부터 시작된 종두사업의 실제를 확인하고, 메이지 초기에 관련 법령이 정비되어 종두사업이 제도화되는 과정을 살펴보고자 한다. 이를 위해 종두사업을 시행하는 과정에서 중심적인 역할을 수 행한 종두의(種痘醫)의 규정과 역할 변화, 그리고 종두 의무화에 따른 제도적 지원이라는 측면에서 관련 규정을 분석하였다. 그 과정에서 종두사업의 주체인 종두의의 역할이 면허를 받은 의사의 역할로 변경되고, 그들이 가지고 있는 종두술이 표준화되어 가면서 종두사업은 개인의 역량에서 국가, 정부의 역량으로 변화해 간 모습을 확인할 수 있었다. 또한 종두시행을 제도화하기 위하여 접종자에게 보고의무 부여, 빈민을 위한 무료접종 실시, 소학교 입학 시에 의무접종 등의 제도적 장치를 마련하였다. 종두에 관한 규칙은 종두관(種痘館)의 설립과 구성원의 의학적 경향으로 인해 전근대와 근대적인 요소를 동시에 내포한다는 특징을 가지고 있다. 이는 메이지 초기 감염병 규칙이 갖는 전근대 의학과의 연속성을 보여줌과 동시에, 메이지 정부가 여기에 어떻게 근대적 특성을 부여해 나아가는지를 살펴볼 수 있는 사례연구라고 할 수 있다.

임산부를 대상으로 한 BCG접종법의 바른 인식과 선택 교육의 효과

이승희(Seung Hee Lee),전채민(Chae Min Chun),전진호(Jin Ho Chun) 한국역학회 2008 Epidemiology and Health Vol.30 No.2

Purpose: The most effective and basic Tb preventive measure is BCG vaccination. Even though the Intradermal vaccination method in BCG vaccination is known to be the most accurate method in preventing the advanced Tb, nowdays most of the Korean civilian hospitals utilize multipuncture BCG vaccination method ,which is quite contrary to the national standard intradermal vaccination method. Therefore I decided to inform and educate the pregnant women who would be in a position to choose the BCG vaccination method. This will help them understand the BCG vaccination methods properly. We should urge the intradermal method which is acknowledged as the national standard vaccination method. Methods: The questionnaire was mailed twice to 214 pregnant women requring the antenatal care who visited any of the 9 health centers in Busan from the period of Aug to Oct. 2007. The 1st questionnaire was done in 214 pregnant women prior to education concerning the BCG vaccination methods and Tb, and the 2nd questionnaire was done after education. Contents of the questionnaire were general knowledges for BCG vaccination method, intention of selection for BCG vaccination, knowledges for the adverse effect, etc. Data analysis was performed utilizing SPSS (ver12) and the pregnant women’s change in concept was comparatively analyzed with percentage, χ2 -test. Results: Considering the general characteristics of the pregnant women who participated in the study, the highest percentage was noticed in their 15-28 gestational weeks (60.8%), Age over 30 (70.1%), Education level-college graduate (76.6%). Recognition to the presence of two types BCG vaccination method was 27.6% before education and 95.3% after education which showed a marked improvement (p=0.0001). After education, 82.2% of pregnant women decided to choose intradermal BCG vaccination method at birth which was 23.4% before education (p=0.0003). Despite the fact that intradermal BCG method is the national standard vaccination method, some of them prefer multipuncture BCG vaccination method, because most of the scars (41.3%), the civilian hospitals do it (35.7%), because of the lack of the education and information from the health centers and public institutions (17.4%). The future selection of BCG vaccination methods as follows: before education, intradermal BCG vaccination 31.0%, multipuncture BCG vaccination 14.6%, uncertain 54.4%, and after education, intradermal BCG vaccination 72.4%, multipuncture BCG vaccination 2.8%, uncertain 24.8% (p<0.0001). Conclusions: The pregnant women were not fully aware of intradermal and multipuncture BCG vaccination methods. Through education and information, it was possible for them to thoroughly recognize the BCG vaccination methods. In order to urge the intradermal BCG vaccination method, the health centers and public institutions need to educate and inform the pregnant women regarding the intradermal BCG vaccination method which is the standard vaccination method in Korea.