Causality Recognized for Severe Adverse Reactions After Vaccination, but Only '2 Cases'... "Measures Needed Such as Advance Medical Expense Payments"

Causality Clear to No Causality: 5-Stage Relative Evaluation

Intermediate Stages Do Not Confirm No Vaccine Effect
Task Force "Will Reassess When Evidence Accumulates"

Government Reluctant on Treatment Cost Compensation Demand
Experts "Need to Find Practical Support Measures"

On the 16th of last month, elderly individuals aged 75 and above who received the Pfizer vaccine at the vaccination center set up in Yongsan Art Hall, Yongsan-gu, Seoul, are waiting in the adverse reaction monitoring area. Photo by Mun Ho-nam munonam@

[Asia Economy Reporter Lee Chun-hee] Paralysis, acute disseminated encephalomyelitis, and cerebral hemorrhage are known severe side effects that have occurred after receiving the COVID-19 vaccine. Patients and their families are voicing demands for compensation due to the enormous burden of medical expenses, but the government and authorities are rejecting these claims, citing a lack of clear causality. Experts point out that because the nature of vaccination often makes it difficult to establish definite causality, measures such as advance payment of medical expenses should be implemented to prevent excessive social anxiety about vaccines.

According to the COVID-19 Vaccination Response Promotion Team on the 6th, among 67 death cases reviewed by the Vaccine Injury Investigation Committee, 65 cases were concluded to have little or no recognized causality with the vaccine. Two cases are pending judgment.

Among severe cases, there are instances where causality was recognized. The committee acknowledged causality in one case of cerebral venous sinus thrombosis and one case of hypotension caused by seizures following fever. However, out of a total of 57 cases, causality was not recognized in 53 cases, and two cases remain pending judgment.

This causality assessment is conducted as a form of ‘relative evaluation.’ Based on currently known data, evidence, and medical knowledge, the likelihood of the condition being induced by the vaccine is comparatively evaluated against the likelihood of it being caused by other factors. Using a method internationally accepted by organizations such as the World Health Organization (WHO), conclusions are drawn across five levels, ranging from ‘clear causality’ to ‘clearly no causality.’

The authorities explain that the middle levels 2 to 4, which are neither clear causality nor clearly no causality, do not imply that the vaccine’s influence is absent even if causality is not recognized. The Promotion Team plans to re-evaluate causality if further evidence accumulates regarding the relationship between the vaccine and the respective diseases.

Patients and families experiencing severe adverse reactions immediately after vaccination are complaining that the authorities’ stance is irresponsible. The husband of a female nursing assistant who was hospitalized with paralysis and acute disseminated encephalomyelitis after receiving the AstraZeneca (AZ) vaccine said, "Medical and caregiving expenses amount to 4 million won per week," adding, "This is an unaffordable level for ordinary people." President Moon Jae-in also directly ordered measures related to this issue.

However, the authorities express concerns that sudden expansion of compensation could spread distrust in vaccination. Son Young-rae, head of the Social Strategy Division at the Central Disaster and Safety Countermeasures Headquarters, explained, "If compensation is given simply because of a temporal sequence, it could undermine the credibility of vaccines and amplify anxiety."

Experts agree that the government must demonstrate ‘skillful management.’ Professor Jung Jae-hoon of the Department of Preventive Medicine at Gachon University College of Medicine said, "In cases of severe conditions with catastrophic medical expenses, rather than saying ‘we are following procedures,’ the government should find ways to provide practical assistance," adding, "For example, the state could advance medical expenses and handle the procedures later, which is probably the best way to reassure the public."

Professor Baek Soon-young, emeritus professor at the Catholic University College of Medicine, also stated, "As trust in vaccines is breaking down, people are refusing vaccination. Unless there is absolutely no causality, compensation should be provided," calling for the government’s prompt disclosure of information and response.