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North Korea Hints at Vaccine Campaign, But No One Knows the Details

seoul, south korea - North Korea has suggested it could soon begin COVID-19 vaccinations, but it remains unclear what vaccines it will use, where it will get them, or how many doses it will administer.

In a passing reference during a speech last week to the Supreme People's Assembly, the country's parliament, North Korean leader Kim Jong Un seemed to indicate a COVID-19 vaccination campaign would start in November.

"While administering vaccination in a responsible way, we should recommend that all residents wear masks for the protection of their own health from November," Kim said, warning of a possible resurgence of COVID-19 and influenza this winter.

Kim's warning came less than a month after he declared victory over the virus and relaxed some of North Korea's most stringent anti-epidemic measures.

North Korea has repeatedly ignored vaccine offers from COVAX, the United Nations-backed vaccine distribution effort. Even after Kim's latest comments, there is no evidence North Korea has made any vaccine requests from Gavi, the vaccine alliance that helps run COVAX.

"If DPRK requests our assistance for its COVID-19 vaccine introduction, we'll happily share vaccine doses with them, as we have done with 146 other countries - over 1.7 billion doses so far," a Gavi spokesperson told VOA, without specifying whether a request had been made. DPRK is the abbreviation for North Korea's official name, the Democratic People's Republic of Korea.

One of last to start vaccinations

North Korea and Eritrea are the only countries yet to begin mass COVID-19 vaccinations. Experts have long warned North Korea could be hit particularly hard by the coronavirus pandemic because of its lack of medical resources, especially in rural areas, where poverty is also more common.

So far, there is no evidence of mass COVID-related deaths in North Korea. That could be because North Korea acted quickly to close its borders after the coronavirus emerged in neighboring China in early 2020. North Korea's authoritarian government also has a much higher degree of social control than almost any other country.

But even if North Korea has experienced mass COVID-19 outbreaks, the world would not necessarily know. During the pandemic, North Korea's secretive government has cut off nearly every point of contact with the outside world. It also does not have adequate COVID-19 testing supplies, experts say.

For more than two years into the pandemic, North Korea denied experiencing any COVID-19 cases. The North finally acknowledged an outbreak in May, but in subsequent weeks reported a steady decline in cases. At the time, a World Health Organization official expressed skepticism about the North's claim the situation was improving.

If North Korea does begin a mass vaccination campaign, it would most likely use vaccines from China, according to many analysts.

In early June, Gavi said it "understands" North Korea accepted a vaccine offer from China and had started to administer doses. However, it did not provide any details.

Around that time, North Korea started small-scale vaccinations for targeted groups, according to several unconfirmed reports in Radio Free Asia, which relied on unnamed sources inside North Korea. There has been no evidence, however, of a widespread vaccination campaign.

Russia and China, North Korea's two closest international partners, are the most likely to provide North Korea mass quantities of vaccines, according to Nagi Shafik, a former WHO official who has worked in North Korea.

"But I think China in this context is more qualified because of the mass production they have, not only [of] the vaccines, but also [because] they can give support for the cold chain, as well," Shafik told VOA.

Refrigerated vaccines could be challenging

The most effective COVID-19 vaccines, which use advanced mRNA technology, require a network of ultra-cold refrigerators and specialized delivery trucks. That may be a challenge in many parts of North Korea, though Shafik has argued that North Korea's cold chain system is more advanced than commonly thought.

Even though China has not produced an mRNA vaccine, Beijing's potential offer may still be preferable to those of COVAX and others who are likely to require international observers to be present during the vaccine delivery and distribution.

"They don't want foreigners to come right now maybe, I'm not quite sure," said Shafik, stressing that Pyongyang may be open to Western vaccine offers at a later stage.