코로나19 백신 접종으로 인한 이상반응과 피해보상에 있어서의 인과관계

Abstract

In the Republic of Korea, a uniform standard is presently employed for assessing causation in adverse reactions and compensation for damages arising from preventive vaccinations, encompassing instances related to COVID-19. Nonetheless, these parallel procedural mechanisms, while sharing some conceptual foundation, serve divergent objectives, necessitating a nuanced differentiation in the evaluation of causation. The attribution of causality to adverse reactions should rely on the scientific and epidemiological underpinnings, while the assessment of causation in the context of compensation for vaccine-induced damages should be both grounded in scientific and epidemiological causation and attuned to legal and normative causal considerations. Consequently, the extant convergence in approach is deemed jurisprudentially incongruent. Moreover, in that the current standards allow the causality of adverse reactions and the causation of compensation for damages to be negated uniformly where data is insufficient, they are invalid in themselves. The conflation of causality criteria between adverse reactions and compensation for damages arising from preventive vaccinations, coupled with the composition of the Specialized Vaccine Compensation Committee, predominantly comprising epidemiological and medical professionals, results in a discernible constriction in the scope of acknowledged causation for vaccine-induced damages. Furthermore, the proclivity toward an epidemiological causation paradigm, in lieu of a balanced legal and normative causation nexus, engenders an oversight of the nuanced attributes inherent in individual cases. This proclivity assumes heightened significance, notably in the case of COVID-19 vaccines, where an elevated risk profile for adverse reactions prevails in comparison to other vaccine modalities, potentially resulting in an undue circumscription of the causal link between vaccination and resultant damages. This operational schema, by exacerbating the complexities surrounding the rectification of harm emanating from side effects, engenders a climate of skepticism toward preventive vaccinations, with attendant implications for the sustained acceptance thereof. Preventive vaccinations, beyond individual health imperatives, extend to a societal ambit wherein the mitigation of infectious disease dissemination within susceptible demographic cohorts and the fortification of national healthcare infrastructures are underscored. In the context of COVID-19 vaccines, characterized by governmental advocacy through policy measures such as vaccination passports, a recalibration of the causality criteria in the realm of compensation for damages is imperative. Such recalibration demands a bifurcation in criteria and adjudicative bodies, envisaging a simplified tripartite classification for adverse reactions - “consistent with,” “indeterminate,” and “inconsistent with.” Conversely, the criteria governing compensation for damages necessitate a more flexible rubric, affording latitude for the contemplation of case-specific nuances. Additionally, explicit recognition of causation should be afforded in instances where the exacerbation or expedited manifestation of a pre-existing condition is attributable to vaccination, thereby imparting a regulatory framework attuned to the intricate dynamics inherent in the system.