The Transparency Dilemma in Public Health Crises

From the spring of 2020, the South Korean government implemented a comprehensive set of COVID-19 control measures and was praised internationally for its effective management of the pandemic, particularly in the absence of nationwide lockdowns. This outcome was attributable not only to the government’s use of advanced soft power and public healthcare infrastructure, but also to the willingness of many citizens to comply voluntarily with these measures, grounded in a relatively high level of trust in governmental authority and a pronounced sense of civic responsibility. This international recognition was, in turn, a source of national pride for many Koreans.[1]

In this context, large numbers of individuals willingly received vaccines to protect both themselves and others from the emerging infectious disease. Following the commencement of South Korea’s vaccination campaign on 26 February 2021, coverage expanded rapidly, with 86.0 per cent of the population receiving a first dose and 82.7 per cent, a second dose. The government emphasised that this swift uptake—facilitated by active public participation—contributed significantly to preventing infections and reducing severe illness and mortality.[2] High vaccination coverage was frequently cited as a key component of South Korea’s broader COVID-19 response. As the vaccines were newly and rapidly developed, however, concerns regarding their safety and potential side effects also emerged. The Korea Disease Control and Prevention Agency (KDCA) continued to emphasise their safety and efficacy in order to sustain public confidence and promote uptake.[3] Within a generally supportive public climate and amid sustained government promotion of vaccination, reports of adverse effects and deaths following immunisation received comparatively limited public attention during the vaccination campaign.

However, according to a report by the Board of Audit and Inspection, dated 23 February 2026, the KDCA received 1,285 warnings from medical institutions between March 2021 and October 2024 regarding “potentially hazardous foreign substances” detected in COVID-19 vaccines, including mould, hair, and silicon dioxide. Despite these reports, the KDCA did not notify the Ministry of Food and Drug Safety; instead, it informed only the manufacturer and permitted the company to conduct its own investigation. The agency also continued to administer vaccines from the same manufacturing lot without public disclosure, reportedly distributing approximately 14.2 million doses.[4]

The head of the KDCA during the pandemic, described as having “led the nation’s antiviral efforts to success through candid engagement with the public, grounded in principles of openness, transparency, and democracy”,[5] now serves as Minister of Health and Welfare. Although she has issued an official apology, it is unclear whether the government conducts any further investigation. The opposition party contends that the Democratic government misled citizens and compromised public health in order to secure domestic support. Public opinion appears to be divided largely along political lines. In an opinion poll released on 15 March, respondents were asked how the issue of defective COVID-19 vaccines containing foreign substances during the vaccination campaign should be addressed. The most common response (36.1%) was that a special prosecutor should be appointed to uncover the truth, followed by 26.6% who believed that an audit by the Board of Audit and Inspection would be sufficient, and 24.7% who supported a National Assembly hearing or parliamentary investigation. Preferences varied markedly by political affiliation. Among supporters of the Democratic Party, only 11.7% supported appointing a special prosecutor, while the largest proportion (43.3%) considered an audit to be sufficient. In contrast, among supporters of the conservative opposition party, a clear majority (65.2%) favoured appointing a special prosecutor, followed by 21.1% who supported a hearing or parliamentary investigation.[6]

As opinions on whether to initiate an investigation diverge along partisan lines, the issue has emerged as a central locus of political contestation. The opposition party has characterised the matter as involving “mould-contaminated vaccines” and has sought to align with groups such as the COVID-19 Vaccination Victims Council and the Association for the Investigation of the Truth of Vaccination Victims in order to pressure the government to undertake a formal inquiry. However, closer examination of the reports suggests that only one case involved mould and two involved hair. Approximately 65% of the reported foreign materials consisted of fragments generated when a syringe pierced the rubber stopper, while most of the remaining cases involved trace amounts of silicon dioxide, which are commonly detected even in standard injectable containers. The use of inflammatory rhetoric risks undermining the formation of a broad national consensus. In an increasingly polarised political climate, there is also a corresponding risk that the voices of those directly affected will remain marginalised. In particular, the deployment of sensationalised language may exacerbate hesitancy toward other essential vaccinations, including those for influenza, pneumococcal disease, and human papillomavirus (HPV).[7]

Ultimately, the core issue lies in the KDCA’s failure to disclose the presence of contaminated vaccines while continuing to administer doses from the same manufacturing lots. This conduct contrasts with assessments that Jeong Eun-kyeong, in her capacity as the head of the KCDC, responded to COVID-19 in a candid, transparent, and democratic manner. Moreover, the government has not formally announced any follow-up measures. This controversy extends beyond a reassessment of COVID-19 vaccines because it has the potential to erode public trust in the national immunisation system as a whole.[8]

This incident raises questions of value judgement, particularly regarding why the KDCA chose not to disclose the issue of vaccine contamination to the public. Leaving aside any political or reputational concerns, the agency may have determined that publicising such information could disrupt the smooth implementation of the vaccination campaign, particularly if the problem were amplified by hostile actors. However, failure to address and alleviate public distrust in health policy may hinder the government’s ability to secure public cooperation in future crises, including pandemics. It also, of course, carries the risk that individuals may be injured, perhaps gravely. Such dilemmas transcend this specific case and are intrinsic to public health interventions more generally, especially during health emergencies. In such cases, there is clearly a temptation to disregard, down-play or even conceal information that might damage an intervention which is otherwise considered vital for health and national security. How ought governments and health agencies deal with such problems? Please let us know your thoughts.

Acknowledgement

Blog by- Jeong-Ran Kim, Centre for History of Science, Medicine and Technology, The Faculty of History, University of Oxford.