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An individual in Cheongju receives their fourth COVID-19 vaccine at a hospital on April 14, the day fourth-dose vaccinations were started for Koreans 60 and up. (Yonhap News)

Shin, a company employee in their 40s, was recently left wrestling with a dilemma when their 78-year-old mother visited a website to reserve her fourth dose of a COVID-19 vaccine.

The reason for their quandary was that the list of vaccines available included one produced by Novavax. Shin’s mother received the Pfizer vaccine for her first three doses, the last of them in November.

“My mother didn’t have any major side effects from the Pfizer vaccine, but I’d seen on the news that Novavax was more stable, so I wasn’t sure what to do,” Shin said.

“It looks as though she’s going to keep needing to get vaccinated repeatedly, and we still haven’t decided if she should continue getting the same vaccine or switch to Novavax, or when she should be getting it,” they added.

Administration of fourth vaccine doses began on April 14 for individuals aged 60 and over in South Korea, but many in this population are hesitant to get their shots, citing anxieties about vaccination and lack of information.

The government is recommending vaccination for older Koreans due to the dwindling effectiveness of the third dose in that population and the fact that around 90% of critical cases are occurring in the age group. But as of Thursday, the reservation rate for a fourth dose among South Koreans in their 60s and older was a low 13.8%.

For the fourth dose, disease control authorities are currently giving priority to mRNA vaccines such as those produced by Pfizer and Moderna, with Novavax as the next best option. Unlike the Pfizer or Moderna vaccines, the Novavax vaccine is produced with traditional genetic recombination methods.

“We’re recommending a fourth dose with an mRNA vaccine because it’s more effective,” said Kwon Geun-yong, director of the preventive vaccination management team at the Korea Disease Control and Prevention Agency.

“If people are hesitant about getting mRNA vaccines, it’s much better for them to get vaccinated than not, so they may also reserve a Novavax [dose],” he added.

Choi Won-suk, a professor of infectious disease at Korea University Ansan Hospital, said, “Clinical experience suggests that it is possible to mix vaccines, so Novavax is an option, but there’s no basis for recommending Novavax over mRNA vaccines.”

“The Novavax vaccine has the least amount of data available for it,” Choi added.

In contrast, Eom Joong-sik, a professor of infectious disease at Gachon University Gil Medical Center, said, “While there isn’t enough evidence yet, I’ve been recommending Novavax a lot for a fourth dose because few side effects have been reported.”

By Lim Jae-hee, staff reporter; Kwon Ji-dam, staff reporter; Jang Hyeon-eun, staff reporter

Please direct questions or comments to [english@hani.co.kr]