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Welfare, Health & Security News

  • [Damage Compensation] Medical Assistance for Severe Patients

  • Welfare, Health & Security News SMG 466

    Overview

    • Prioritized medical assistance for treatment in case of a severe adverse drug reaction (ADR) after COVID-19 vaccination, but compensation is not available due to insufficient evidence → Reduction of financial burden for patients with severe ADR and strengthening of national responsibility for adverse reactions

    Plan

    • (Target) Those who were hospitalized in the intensive care unit (ICU) or experienced an equivalent disease after COVID-19 vaccination, but were found to lack causal evidence (deliberation criteria ④-1) as a result of assessment by the Vaccination Damage Investigation Team or the Damage Compensation Committee, and therefore excluded from eligibility for damage compensation.
      • * ① Definite; ② Probable/likely; ③ Possible; ④ Unlikely (④-1 Conditional, ④-2 Unclassifiable); ⑤ Unrelated (Damage compensation is paid for deliberation criteria ①, ② and ③)
      • * Medical assistance can be provided in case of death after treatment due to a serious ADR.
    • (Scope) Treatment expenses for disease(s) incurred after COVID-19 vaccination
      • * Non-benefit examination fees and treatment expenses that are not related to ADR or conducted concerning underlying diseases are excluded from the target of support. Non-benefit treatments related to treating ADR are supported.
    • (Process)
      Process
      ① Report of ADR or application for damage compensation ② Basic investigation by local government ③ Review and selection of targets of support ④ Medical assistance
      Report: Doctor
      Application: Self/guardian
      Person or team in charge (city/district) Vaccination Damage Investigation Team or Damage Compensation Committee Korea Disease Control and Prevention Agency
    • (Scale) Up to KRW 10 million per person
    • (Follow-up management) When causality is confirmed from evidence → Compensation with excluded pre-supported medical expenses
      • * However, it will be refunded if the patient received duplicate benefits from other businesses, such as emergency welfare, with the same medical details.

    Vaccination Damage Compensation Deliberation Criteria

    Vaccination Damage Compensation Deliberation Criteria
    Category Deliberation Criteria (Plan)
    ① Definite (definitely related) When there is clear evidence that the patient had been inoculated, there is a temporal probability of the occurrence of an ADR after vaccination more than any other reason, and the symptoms are well-known ADR to the vaccine.
    ② Probable/likely (probably related) When there is clear evidence that the patient had been inoculated, and there is a temporal probability of the occurrence of an ADR after vaccination over than any other reason.
    ③ Possible (possibly related) When there is clear evidence that the patient had been inoculated, there is a temporal probability of the occurrence of an ADR after vaccination, and it is more possible that the ADR occurred due to the vaccination rather than any other reason.
    ④ Unlikely (probably not related) When there is a temporal probability of the occurrence of an ADR after vaccination, but there are insufficient supporting data on the vaccine and the ADR (④-1), or a clear different cause to be different causes than vaccine (④-2).
    ⑤ Unrelated (definitely not related) When there is no clear evidence that the patient had been inoculated (⑤-1), there is no temporal probability of the occurrence of an adverse reaction after vaccination (⑤-2), or there is a clearly different cause of the symptoms (⑤-3).

    ※ Compensation paid for ①, ② and ③

    Category

    Deliberation Criteria (Plan)

    ① Definite (definitely related)
    When there is clear evidence that the patient had been inoculated, there is a temporal probability of the occurrence of an ADR after vaccination more than any other reason, and the symptoms are well-known ADR to the vaccine.

    ② Probable/likely (probably related)
    When there is clear evidence that the patient had been inoculated, and there is a temporal probability of the occurrence of an ADR after vaccination over than any other reason.

    ③ Possible (possibly related)
    When there is clear evidence that the patient had been inoculated, there is a temporal probability of the occurrence of an ADR after vaccination, and it is more possible that the ADR occurred due to the vaccination rather than any other reason.

    ④ Unlikely (probably not related)
    When there is a temporal probability of the occurrence of an ADR after vaccination, but there are insufficient supporting data on the vaccine and the ADR (④-1), or a clear different cause to be different causes than vaccine (④-2).

    ⑤ Unrelated (definitely not related)
    When there is no clear evidence that the patient had been inoculated (⑤-1), there is no temporal probability of the occurrence of an ADR after vaccination (⑤-2), or there is a clearly different cause of the symptoms (⑤-3).

    ※ Compensation paid for ①, ② and ③