South Korea’s COVID-19 vaccination program has on critical occasions disregarded evidence-based approach and principles of safety first, a top infectious disease epidemiologist and vaccine expert said.

“In a race to vaccinate Koreans as quickly as possible, safety concerns went unaddressed, costing in the process what is most integral to any successful vaccination program -- public trust in the system,” Dr. Chun Byung-chul, a professor at Korea University’s preventive medicine department, said in an interview with The Korea Herald.

The government has made it a goal to accomplish herd immunity by November, if not sooner, but rushing “will do more harm than good,” he warned.

“In the early weeks of the program, the government told the hospital where I work to complete vaccinations of over 2,000 employees within five days,” he said. Other hospitals of similar sizes were instructed the same. As a result, some staffers had to go into surgery and other appointments on fever reducers without being able to take time off for the now well-known debilitating side effects, he said.

But a more hazardous oversight occurred in the country’s approach to vaccine side effects, according to Chun, as pace takes precedence.

Since the national campaign launched in end-February, Korea often stood alone in ignoring potential red flags and pushed ahead with vaccinations when other countries were exercising caution, he said.

“For instance, AstraZeneca’s vaccine was granted approval for anyone 18 years of age and over here on Feb. 10 when there was no data available yet to support its use in older adults, namely those 65 and up,” Chun said.

Soon after that, the authorities said they would leave it up to doctors to decide whether to give the AstraZeneca vaccine to people in the over-65 age group. “That did not bode well in terms of safety reassurance, for both those on the giving and receiving end of the vaccination,” he said.

When regulators in Europe said they were looking into an unusual type of blood clot that had occurred following AstraZeneca inoculations in March, several countries put the jabs on hold until the interim findings that were due shortly for announcement. Korea was not one of them.

“Such significant side effects must be approached with the utmost circumspection. But what Korea did instead was proceed without addressing the questions surrounding safety, as it waited for the results of a probe by an outside regulator,” he said.

Korea decided to stop AstraZeneca vaccinations in people younger than 30 eventually, only after the European Medicines Agency listed the specific blood clotting condition as a rare side effect of the vaccine. The condition was more frequently observed in young people, the European Union agency said.

But by that point at least two people in their 20s had already developed severe blood clots after AstraZeneca shots in Korea, just about a month into the vaccination campaign. One of them was diagnosed with blood clotting in the brain called the cerebral venous sinus thrombosis, and the other pulmonary embolism, or blockage in the lung arteries.

More reports of clotting have surfaced since, but so far Korea hasn’t recognized any of them as having a connection to the vaccine, which means that they won’t be compensated. Chun said spare compensations, too, “may further harm uptake.”

“People suffering from serious post-vaccination injuries should be compensated regardless of whether the vaccine was found to be the cause,” he said. “Proving a link can be extremely difficult for many of the cases, and I don’t think it’s fair to have people shoulder the burden of medical bills entirely.”

He added that since these vaccines were new, side effects unseen in clinical trials may well emerge as wider populations are covered. “No vaccine is without side effects. But like I’ve said before, we need to be humble before what we don’t know and take every red flag very seriously,” he said.

He also called for more transparency from authorities in vaccine communications.

He pointed to an incident in which potentially defective syringes were used in vaccinating hundreds of thousands was kept from public knowledge for nearly a month until there was a press leak. The government’s adverse event report data was woefully lacking in details as well. The official updates on the website only categorized the reports in terms of severity -- mild, severe and fatal -- without specifying what they are.

In spite of all, Chun said he is confident speeding up vaccinations won’t be a problem in the latter half of the year, when most of the country’s vaccine supplies are due. 

He said the main reason Korea has not been able to accelerate the pace of vaccinations so far is that there just aren’t enough vaccines to go around. First-dose appointments are currently being withheld for about a month until the last week of May amid a supply shortage.

“I don’t think the hesitancy we are seeing now is because Koreans don’t understand the perks or necessity of vaccination. Korea is an exceptionally well-vaccinated country,” he said.

The way authorities are maneuvering the vaccination efforts and the emerging side effects signals to the public that “safety is taking a back seat for the sake of other priorities, such as speed,” he said.

He said “there’s no denying” Korea’s early success with the pandemic was in large part owed to a society that was highly compliant with health orders.

“Here we didn’t hear about the kind of resistance against face masks or other safety practices that erupted elsewhere,” he said. “With the right approach, Korea could rally a public cooperation in the campaign like no other.”

He went on, “There is no doubt that vaccines are the most powerful weapons we have against the virus, and the only way out of the pandemic.”

“Public confidence in the program, aside from the threats of variants and the question of the longevity of vaccine-induced immunity, remains the biggest variable in our path to herd immunity.”

By Kim Arin (arin@heraldcorp.com)