Korean court rules for first time that Pfizer vaccine caused deaths

A Korean court has for the first time recognized a causal link between Pfizer’s Covid-19 vaccine and a death from thrombosis with thrombocytopenia (TTS) — a rare but serious blood clotting disorder — in a ruling that could open the door for others who have long sought compensation from the government.

The government had until now officially recognized TTS as causally linked only to adenovirus vector vaccines from the likes of AstraZeneca and Johnson & Johnson, not mRNA vaccines made by Pfizer and Moderna.

The court’s decision became final this month after the Korea Agency for Disease Control and Prevention (KDCA) declined to appeal. The victim, surnamed Hwang, was a physical education teacher at an elementary school in South Jeolla. He received his first dose of the Pfizer vaccine in July 2021 as a priority recipient under the government’s vaccination program. He soon developed indigestion, vomiting, and nausea, and a local hospital reported a suspected case of TTS. His condition worsened at a university hospital, where he developed slowed blood flow to his small intestine caused by a blood clot. Hwang later underwent surgery to remove part of his small intestine. He died in September 2021 at the age of 24.

His family applied for compensation from the state under the Infectious Disease Control and Prevention Act (KDCA), arguing that his death was linked to the vaccine. The KDCA rejected the claim, saying that Hwang’s pre-existing condition – Kimura’s disease, a rare chronic inflammatory disorder – had apparently caused the thrombosis, making it impossible to establish a causal link to the vaccine.

The family sued, and the Seoul Administrative Court ruled in their favor based on expert assessments from Seoul National University Hospital and Chungnam National University Sejong Hospital.

“A causal link between vaccination and disease does not need to be clearly proven through medical or scientific evidence,” the court said. “If causation can be inferred by considering circumstantial evidence and other circumstances, that is sufficient to establish the evidence.” The court found that timing alone was decisive.

“Hwang developed abnormal symptoms just nine days after receiving the vaccine and died while being treated for that thrombosis,” it said. “There is a clear temporal proximity between the vaccination and the death.”

The court also rejected the KDCA’s reliance on Kimura’s disease as an alternative explanation. “Kimura’s disease is not generally known to cause thrombocytopenia or extensive venous thrombosis,” it said, adding that it was “difficult to conclude that Kimura’s disease was the primary cause of the thrombosis that developed immediately after vaccination.”

Regarding mRNA vaccines specifically, the court acknowledged that TTS has been primarily associated with adenovirus vector vaccines, but said that recent research had also shown a potential link with mRNA vaccines. It added that “the fact that the research has not yet been sufficiently accumulated should not be treated as a categorically stronger argument than the other evidence pointing to a causal relationship.”

Park Cheol-hun, a former doctor and lawyer who represented the family, said that Hwang “was effectively forced to be vaccinated — as a school teacher, he could not perform his duties without being vaccinated, and he was designated as a priority recipient according to government policy.” He also criticized the KDCA’s reasoning, saying it was “inappropriate to directly link Kimura’s illness to thrombosis, as each illness has its own distinct mechanism.” “It took five years after my son’s death to win this case. Winning in court will not bring him back, but I hope it gives some hope to the vaccine victims who have been through the same painful time as us,” Hwang’s mother told the JoongAng Ilbo.

The government passed the special law on compensation for vaccination injuries resulting from Covid-19 last October, which relaxed the standards for recognizing a causal link between vaccination and illness or death. People who have previously applied for compensation but were unable to establish causation can also apply for a review. The KDCA also announced last month that it had expanded its compensation criteria under the law, reclassifying 13 conditions from “support” to “compensation” status.

But victims and their families say little has fundamentally changed.

“Vaccination policy was state-driven, but the burden of proof for adverse events was shifted to the public,” said Kim Doo-kyeong, chairman of the Covid-19 Vaccination Victims Council. “Even with the special law, this burden still lies with the public. We ask the government to use this ruling as an opportunity to ensure that vaccine injury victims no longer have to suffer.”