韩国的流感疫苗恐慌为世界提供了哪些经验
How South Korea’s Flu Vaccine Scare Offers Lessons for Other Nations
CHOE SANG-HUN, DENISE GRADY
2020年11月25日
SEOUL, South Korea — The deaths were mounting, and so were the public’s fears.
韩国首尔——死亡人数不断上升，公众的恐惧也与日俱增。
South Korea had vastly expanded its flu vaccine program to cover millions more people, to prevent a one-two punch to its health system as the coronavirus spread globally. But as the injections got underway, reports of deaths started popping up.
为了防止新冠病毒全球传播对卫生系统造成双重打击，韩国将流感疫苗接种计划的覆盖面扩大到数以百万计的人。但随着注射进行，开始出现死亡报告。
South Korean scientists quickly determined that the deaths were unrelated to the flu shots. But they worried that if they didn’t stop the panic, the public might shun the vaccines altogether.
韩国科学家很快确定，死亡与流感疫苗无关。但他们担心，如果不停止恐慌，公众可能会彻底拒绝疫苗。
So health officials doubled down — and, in the process, gave the world a game plan for when coronavirus vaccines become widely available.
因此，卫生官员加倍努力，并在此过程中，给世界提供了一个战略计划，到新冠病毒疫苗广泛普及时就可以用上。
They ramped up efforts to communicate with the public. They disclosed data on what was found. And they quickly got the vaccination campaign back on track, at a time when scientists dealing with Covid-19 are increasingly worried about the rise of the anti-vaccine movement.
他们加大了与公众沟通的力度，披露有关发现的数据，从而迅速让疫苗接种运动回到正轨，与此同时，与新冠病毒作战的科学家们正越来越担心反疫苗运动的兴起。
“South Korea is doing everything right,” said Dr. Noel T. Brewer, a professor in the health behavior department at the Gillings School of Global Public Health at the University of North Carolina. “The government is gathering data, giving information to the public quickly and standing up for their vaccination program. That will ensure public trust, and help the program.”
“韩国把每一件事都做对了，”北卡罗来纳大学(University of North Carolina)吉林斯大学全球公共卫生学院(Gillings School of Global Public Health)健康行为系教授诺尔·T·布鲁尔(Noel T. Brewer)博士说。“政府收集数据，迅速向公众提供信息，支持他们的疫苗接种计划。这能确保公众的信任，并且有助于这个项目。”
As pharmaceutical makers rush to get a coronavirus vaccine approved, countries around the world are grappling with how to safely and quickly distribute hundreds of millions of doses. Already, the pandemic has created confusion and distrust in an era when misinformation can spread rapidly — all of which could complicate the global effort toward immunity.
在制药商争相让新冠病毒疫苗获得批准之际，世界各国都在努力解决如何安全、快速地分发数亿剂疫苗的问题。在这个错误信息可以迅速传播的时代，大流行已造成了混乱和不信任——所有这一切都可能增加全球免疫工作的困难。
If a long-proven, extensively tested flu shot can spark uncertainty and concern, it could portend challenges for mass inoculations of a brand-new coronavirus vaccine. The potential pitfalls played out on a small scale in South Korea.
如果一种经过长期验证和广泛测试的流感疫苗也可能引发不确定性和担忧，这可能预示着大规模接种一种全新的冠状病毒疫苗会面临挑战。这样的潜在隐患在韩国小规模上演。
The country’s ambitious flu vaccine campaign began on Sept. 8, a month earlier than usual. Health officials announced plans to inoculate 30 million people, 10 million more than last year. But in their haste, problems arose.
韩国雄心勃勃的流感疫苗接种活动于9月8日开始，比往常提前了一个月。卫生官员宣布计划为3000万人接种疫苗，比去年多出1000万人。但在匆忙之中，问题出现了。
A company hired to transport millions of doses of the vaccine had never carried such large quantities of cargo before. The flu vaccines need to stay refrigerated, at between 2 and 8 degrees Celsius. On Sept. 21, photos began circulating online showing boxes of vaccines stacked outdoors, in a parking lot.
一家被雇来运输数百万剂疫苗的公司以前从未运送过这样的大宗货物。流感疫苗需要冷藏，温度在二到八摄氏度之间。9月21日，网上流传的照片显示，成箱的疫苗被堆放在一个户外停车场。
Out of an abundance of caution, the government temporarily suspended the program to investigate. On Oct. 6, it concluded that the vaccines were still safe, but nevertheless recalled the 480,000 doses that had been left outside long enough to potentially become ineffective.
出于谨慎起见，政府暂时中止了该项目，并对其进行调查。10月6日，政府得出结论，这些疫苗仍然是安全的，但仍召回了48万剂疫苗，它们被长期放置在室外，可能会失效。
Three days later, 615,000 doses of a vaccine shipped by another company were also recalled, after white particles were found inside. The government concluded they were harmless protein particles.
三天后，另一家公司运送的61.5万剂疫苗也被召回，因为在疫苗中发现了白色颗粒。政府后来得出结论，它们是无害的蛋白质颗粒。
South Korea’s flu vaccine campaign was up and running again on Oct. 13. But the public was still wary.
韩国的流感疫苗接种活动于10月13日再次启动。但是公众仍然持谨慎态度。
The following week, a family reported that a 17-year-old high school student had died after receiving a flu vaccine. More reports of deaths came rushing in, most involving patients in their 70s and older. By Oct. 22, the reported death count had reached 28 and it was rising by the day. Singapore briefly suspended the use of a South Korean vaccine after the deaths were reported.
接下来的一周，一个家庭报告说，一名17岁的高中生在接种流感疫苗后死亡。越来越多的死亡报告纷至沓来，多数涉及70岁以上的病人。截至10月22日，录得死亡人数已达28人，而且还在不断上升。死亡事件发生后，新加坡暂停使用韩国疫苗。
As Dr. Jung Jae-hun, a professor of preventive medicine at Gachon University near Seoul, read the news, he felt an urgent need to push back.
位于首尔附近的嘉泉大学(Gachon University)预防医学教授郑在勋（Jung Jae-hun，音）看到这一消息时，感到有必要进行反击。
Flu vaccines had been tested and safely used for decades in South Korea. If the credibility of the program could be so easily undermined by unsubstantiated claims, he wondered what would happen once millions of people started taking coronavirus vaccines.
在韩国，流感疫苗已经经过测试，并安全使用了几十年。他想知道，如果这项计划的可信度能够如此轻易地被未经证实的说法所破坏，那么一旦数以百万计的人开始接种新冠病毒疫苗，将会发生什么情况。
“I think this extreme situation was created because we are living through this unusual time of Covid-19 and people are overly sensitive about vaccines,” Dr. Jung wrote on Oct. 22, in the first of a series of Facebook posts criticizing the news reports.
“我认为，之所以会出现这种极端情况，是因为我们正在经历新冠病毒这个不寻常的时期，人们对疫苗过于敏感，”郑在勋在10月22日写道，这是他在Facebook上发表的一系列批评新闻报道的帖子的第一篇。
He warned that reporting on “post-vaccination deaths” when there was no scientific evidence establishing a connection was like counting how many people had died after eating breakfast.
他警告说，在没有科学证据证明二者之间存在联系的情况下，报道“接种疫苗后死亡”，就像计算有多少人在吃早餐后死亡一样。
“If people don’t understand this, it could lead to the proliferation of anti-vaxxers here, like the ones in the West,” he said.
“如果人们不理解这一点，就可能导致这里反疫苗者的激增，就像西方国家一样，”他说。
While the government stood by the safety of the vaccines, it also launched an investigation into the deaths, hoping to use science to counter misinformation. If, for instance, all the cases were linked to a particular vaccine or clinic, or if all the deaths were similar, it would raise red flags. Multiple deaths from anaphylaxis, a severe allergic reaction, would also implicate the vaccine.
虽然政府坚持疫苗的安全性，但也对死亡事件展开了调查，希望利用科学来对抗错误信息。例如，如果所有的病例都与特定的疫苗或诊所有关，或者如果所有的死亡病例都相似，它就会发出警告。如果多起死亡由过敏性休克（一种严重的过敏反应）导致，也可能与疫苗有关。
But the government’s forensic investigations, which would eventually rule out such connections, didn’t move as quickly as the panic spread.
政府的法医调查最终排除了这类联系，但调查进行的速度比不上恐慌的蔓延。
“Elderly people die every day, of a stroke, of heart attack, but the media reported these deaths as if none of them died on a normal day,” said Dr. Ki Mo-ran, an epidemiologist at the National Cancer Center who sat on the government’s vaccination supervisory group. “As the people waited for the results, anxiety grew, trust fell and the vaccination program suffered.”
“每天都有老年人死于中风或心脏病，但媒体报道这些死亡事件时，就好像他们都不是在正常情况下死亡的，”国家癌症中心(National Cancer Center)的流行病学家奇牡丹（Ki Mo-ran，音）说，她是政府疫苗接种监督小组成员。“当人们等待结果时，焦虑加剧，信任下降，疫苗接种计划也受到影响。”
To help quell some of the public’s concerns, Dr. Jung published an opinion piece in the Journal of Korean Medical Science pointing out that it’s not unusual for some people to die coincidentally from unrelated causes, after receiving a vaccine. He cited a study published in 2013 that showed 23 out of every 100,000 Americans aged between 75 and 84 had died from a variety of causes within a week of taking their vaccines.
为了帮助平息公众的一些担忧，郑在勋在《韩国医学科学杂志》(Journal of Korean Medical Science)上发表了一篇评论文章，指出一些人在接种疫苗后，恰好因不相关的原因死亡的情况并不少见。他引用了2013年发表的一项研究，该研究显示，年龄在75岁至84岁之间的美国人中，每10万人中有23人在接种疫苗一周内死于各种原因。
Days after Dr. Jung’s essay was published, the South Korean government released corresponding national figures. Last year, it said, 1,500 South Koreans 65 or older had died within a week of taking a flu vaccine. None of the deaths were linked to the vaccines. As influenza usually kills 3,000 people each year in South Korea, health officials insisted that the benefits of vaccination far outweighed any risks.
郑在勋的文章发表几天后，韩国政府公布了相应的全国数据。政府称，去年有1500名65岁及以上的韩国人在接种流感疫苗一周内死亡。没有一例与疫苗有关。在韩国，流感通常每年导致3000人死亡，因此卫生官员坚称，接种疫苗的好处远远大于任何风险。
To Dr. Kim Woo-joo, a professor of medicine at Korea University, the government’s initial response could have been faster and more aggressive. “It was a failure in risk communication,” he said. “What was needed was fast, transparent and science-based communication to dispel misinformation and conspiracy theories and to show that these deaths were likely just coincidences.”
在高丽大学(Korea University)医学教授金宇柱（Kim Woo-joo，音）看来，政府最初的反应应该更快、更积极。“这是风险沟通的失败，”他说。“我们需要的是快速、透明和基于科学的沟通，以消除错误信息和阴谋论，并表明这些死亡很可能只是巧合。”
But Dr. Brewer, the professor at the University of North Carolina, held up South Korea as an example of how to respond to vaccine scares in the future. He noted that the main threat to vaccination programs around the world is misinformation, often related to an unproven safety scare.
但北卡罗来纳大学教授布鲁尔拿韩国作为例子，说明今后应如何应对疫苗恐慌。他指出，全球疫苗接种项目面临的主要威胁是错误信息，通常与未经证实的安全恐慌有关。
He pointed to Japan and Denmark, where misinformation spread about vaccines against the human papillomavirus, or HPV. The vaccines help prevent cervical cancer in women, among other diseases.
他以日本和丹麦为例，在这两个国家，有关人乳头瘤病毒(HPV)疫苗的错误信息不断传播。这些疫苗有助于女性预防宫颈癌和其他疾病。
Both countries failed to address inaccurate reports about the safety of the vaccines. As a consequence, Dr. Brewer said, the vaccination rate for HPV in Denmark dropped by 50 percent over several years, although it recovered after the government worked to counter the false reports. In Japan, it fell from 70 percent to 7 percent in just one year.
两国均未能有效化解关于疫苗安全性的不准确报道。布鲁尔说，结果丹麦的HPV疫苗接种率在过去几年里下降了50%，尽管在政府努力制止虚假报道之后有所恢复。在日本，这个数字在短短一年的时间里就从70%下降到7%。
In the weeks since South Korea’s vaccination campaign started, the government has received more than 100 reports of people dying after receiving a flu vaccine. Officials have promptly disclosed the causes, which were unrelated to the inoculations.
自从韩国开展疫苗接种行动后的数周时间里，政府接到了100多例接种流感疫苗后死亡的报告。官方立即对死因进行了披露，它们都跟疫苗接种无关。
Autopsies concluded that the patients often suffered cardiovascular and other diseases, and that all of them died of causes unrelated to vaccines, such as aortic dissection, acute myocardial infarction and cerebral hemorrhage. A medical examiner found poison in the body of the 17-year-old, and the police suspected suicide, although his family insists that he had no reason to kill himself.
尸检得出的结论是，这些人往往患有心血管疾病和其他一些病，而且都死于跟疫苗无关的原因，比如主动脉夹层、急性心肌梗死和脑溢血。一名法医在一名17岁死者的体内发现了毒药，警方怀疑系自杀，尽管他的家人坚称他没有理由这么做。
“If you just blindly say, ‘oh no, these are not related,’ you’ll build a lot of distrust,” said Dr. Vanessa Raabe, an expert on vaccines and infectious diseases at N.Y.U. Langone Health who praised South Korea’s response. “You need to do the science before you say they are not related.”
“如果你只是张嘴就来‘哦，不是啦，跟疫苗无关’，就会造成很大的不信任，”纽约大学兰贡医疗中心(N.Y.U. Langone Health)的疫苗和传染病专家凡妮莎·拉布(Vanessa Raabe)在称赞韩国的应对时说道。“你得先做科学研究，然后才能再说它们跟疫苗没关系。”
The flu panic has subsided in South Korea, but only 19 million people have so far received their shots, far short of the government’s target of 30 million. Dr. Jung said that, as in the United States, political polarization in South Korea had likely contributed to some of the confusion over the safety of flu vaccines.
韩国的流感恐慌已经消退，但到目前为止，仅1900万人接种了疫苗，比政府设定的3000万人目标差了一大截。郑在勋说，跟美国一样，韩国的政治两极分化可能导致了对流感疫苗的安全性存在误解。
“Rather than being divided, we must learn to fight together against the common enemy,” he said. “If we want to reclaim our pre-Covid-19 life, going out to eat and drink and traveling abroad, vaccines are our best chance.”
“我们必须学会团结起来，对抗共同的敌人，”他说。“如果大家想恢复到疫情之前的生活，出去吃喝玩乐，到国外去旅行，疫苗就是我们的最好机会。”
