Can the 4th Dose Overcome Vaccine Distrust and Fatigue? Experts Say "High-Risk Groups Must Get Vaccinated"

Vaccination Rate for 60+ Stays in 30% Range
Severe Prevention Effect 50% Higher Than 3rd Dose
Medical Association Includes 4th Dose in Public Recommendation for Re-epidemic Preparedness

On the 13th, a fourth vaccine dose is being administered at a health center of a public health center in Seoul.
[Image source=Yonhap News]

[Asia Economy Reporter Lee Gwan-ju] As the government unveils the '4th dose' card as a countermeasure against the resurgence of COVID-19, the key issue has emerged as how much the vaccination rate can be raised. Amid persistent distrust and fatigue toward vaccines, it is emphasized that additional vaccinations for high-risk groups are necessary to reduce severe cases and fatality rates.

According to the quarantine authorities on the 14th, as of the 11th, the 4th dose vaccination rate for those aged 60 and over stands at 31.8% of the population. When looking only at those in their 60s, the rate is even lower, at 21.1%. The prolonged COVID-19 pandemic, distrust of vaccines, and fatigue are analyzed as complex factors contributing to the low vaccination rate. During the 5th major wave caused by the Omicron variant, many cases were infected after completing the 3rd dose, which is expected to further reduce the incentive for the 4th dose in such cases.

Meanwhile, the government has decided to expand the 4th dose vaccination target, which was previously for those aged 60 and over, residents of infection-vulnerable facilities (nursing hospitals, facilities, mental health promotion facilities), and immunocompromised individuals, to include those aged 50 and over and individuals aged 18 and over with underlying conditions. This is due to the clear effect of the 4th dose in preventing severe illness. An analysis of the 4th dose effectiveness in Korea showed that compared to the 3rd dose group, the 4th dose group had a 50.6% prevention effect against severe cases and a 53.3% prevention effect against death.

To fully realize the effect of the 4th dose, the vaccination rate must be increased, but it is difficult to guarantee this at present. First, there is the challenge of alleviating concerns about side effects. The quarantine authorities' decision to expand compensation and support for adverse reactions after vaccination reflects their careful consideration. A dedicated organization, the 'COVID-19 Vaccination Injury Compensation Support Center,' is being operated for the prompt processing of compensation claims. Medical expenses for suspected related diseases will be increased from a maximum of 30 million KRW to 50 million KRW, and death consolation money will be raised from 50 million KRW to 100 million KRW. Additionally, a new 10 million KRW consolation payment for cases of undetermined cause of death after autopsy is being introduced. Measures to facilitate vaccination, such as reservation support for the elderly, have also been prepared.

Experts emphasize that lowering severe cases and fatality rates is the core of the 4th dose and recommend additional vaccinations for high-risk groups. The Korean Medical Association's COVID-19 Countermeasures Committee issued a public recommendation urging the 4th vaccine dose. They also advised that if there were side effects from previous vaccinations, individuals should consult medical staff and receive vaccines with relatively fewer side effects. The committee stated, "Considering various domestic situations such as fatigue from prolonged social distancing, reduced infection prevention effect of vaccines, and antibody decline over time after the Omicron wave, the possibility of COVID-19 resurgence approaching us more rapidly is high," and emphasized, "It is necessary to minimize the possibility of resurgence and prepare for COVID-19 at a level that Korea's medical infrastructure can handle." Professor Jeong Jae-hoon of the Department of Preventive Medicine at Gachon University College of Medicine also said, "High-risk groups who are elderly or have underlying conditions such as diabetes and have not yet been infected clearly benefit from the 4th dose," and "Even those high-risk groups who have already been infected are recommended to have at least two doses (basic vaccination)."

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