Neglected issues related to the COVID-19 pandemic.

Abstract

Since June 1, our country has reduced the disaster alert level from “serious” to “caution,” after maintaining it for 3 years and 4 months. We have transitioned to a quarantine system that primarily relies on recommendations and voluntary compliance, except for the requirement to wear masks in medical institutions. The World Health Organization (WHO) declared the end of the Public Health Emergency International Concern (PHEIC) on May 5, prior to its 75th General Assembly. The United States also terminated its public Health Emergency declaration as of May 11. Japan has announced that it will manage the crisis level at the level of seasonal influenza. The easing of measures is attributed to the significant reduction in the fatality rate of coronavirus disease 2019 (COVID-19), which has reached an endemic level. The WHO's Strategic Advisory Group of Experts released a COVID-19 vaccination roadmap in March. Based on analyses of the effectiveness of vaccine administration, guidelines recommended prioritizing the elderly [1]. In accordance with this, recent discussions among Western Pacific countries took place in Manila, Philippines (June 19−23, 2023) to address their respective responses to these guideline changes and prepare alternatives for a potential resurgence in the coming autumn, along with the public health emergency caused by wild poliomyelitis virus and circulating vaccinederived poliovirus (cVDPV). However, we are overlooking the fact that the PHEIC caused by poliomyelitis remains unresolved. China, which shares borders with Afghanistan and Pakistan, has already experienced an imported polio outbreak. Although we have been preparing effective measures to deal with imported cases of polio, we need to doublecheck our efforts. Countries that have switched to injectable vaccines from oral vaccines, such as the United Kingdom, Canada, Israel, and United States, have reported positive environmental samples of cVDPV2 and acute flaccid paralysis patient sample in cVDPV3. Therefore, careful attention should be given to procedures such as rapid confirmation tests, the diagnosis of acute flaccid paralysis, and environmental surveillance. The discussion at hand primarily concerns the repercussions of vaccination and the compensation for vaccine-related injuries. The proposal for a special law in the National Assembly arises from the fact that the existing compensation program for vaccine injuries, which mainly focuses on children, differs in its logic and compensation approach when it comes to COVID-19, especially for adults. This issue relates to the government's responsibility for adverse events not present during the emergency use authorization, due to the indemnification granted to pharmaceutical companies for vaccine development in crisis management situations. The government actively promoted vaccination to achieve herd immunity. Booster doses were administered to prevent hospitalization, severe complications,