J Korean Med Sci.
2025 Mar;40(10):e36. 10.3346/jkms.2025.40.e36.
The Vaccine Cold Chain in North Korea: Assessing the Capacity to Store Routine Vaccines and Potential to Support Pandemic Vaccination Activities
- Affiliations
-
- 1Program in Public Health, Korea University Graduate School, Seoul, Korea
- 2Department of Preventive Medicine, Korea University College of Medicine, Seoul, Korea
- 3Transdisciplinary Major in Learning Health Systems, Graduate School, Korea University, Seoul, Korea
- 4Institute for Future Public Health, Korea University, Seoul, Korea
- 5Program in Korean Unification Studies, Yonsei University, Seoul, Korea
- KMID: 2565806
- DOI: http://doi.org/10.3346/jkms.2025.40.e36
Abstract
- Background
The health system's capacity to store vaccines in North Korea has been less studied. In this study, we aimed to investigate if the current vaccine cold chain in North Korea can store routine vaccines and if it has the storage capacity to handle pandemic vaccination activities (PVAs) without interrupting the country’s successful routine immunization program.
Methods
We used tables extracted from an evaluation report of The Global Alliance for Vaccines and Immunization (GAVI)’ Health Systems Strengthening program in North Korea from 2007 to 2014. We then used the World Health Organization’s Immunization Supply Chain Sizing Tool to estimate gaps and the cost of scaling up cold chain storage.
Results
We found that the vaccine cold chain in North Korea has adequate storage capacity for routine vaccines. While we found a deficit of 7,172 L at the central medical warehouse (CMW) and 14,256 L at the provincial medical warehouses (PMWs), the storage at the county warehouses (CoMW) had a surplus. When assessed for PVA, we found an aggregated deficit of 115,574 L (CMW), 113,160 L (PMW), and 25,133 L (CoMW). To fill the gaps, investments of 229,917 USD, and 2,262,211 USD were estimated for routine and PVA vaccination programs, respectively.
Conclusion
As countries and the international community work to improve systems in preparation for future pandemics, there is a need to scale up the North Korean vaccine cold chain to a pandemic-ready state.
