"Health care professionals are the real experts."
If fake news has had dire consequences on Philippine politics, its impact had been similarly disastrous, if not worse, on public health. The Department of Health (DOH), reputable health care groups and medical professional have discredited the controversial accusations that has reportedly caused increasing casualties because of the fear of vaccines created largely by the handiwork of the Public Attorney’s Office (PAO)—notably its chief Persida Acosta and forensics chief Erwin Erfe.
DOH Undersecretary Enrique Domingo said health experts from the World Health Organization (WHO) were at a loss trying to understand the public health disaster that had become of the Dengvaxia scare.
“Nobody understands why we’re reacting this way. The other countries do not understand why we’re acting this way. The WHO does not understand what happened. On a global level, it seems that only the Philippines is reacting this way,” he said.
True enough, DOH officials recently clarified that, despite the hubbub, there have been no deaths that had been conclusively linked to Dengvaxia, which had been approved in over 20 countries.
But the damage had been done. According to DOH figures, both reported dengue cases and deaths had increased year-on-year in 2018. Government hospital reported a total of 179,540 dengue cases until November 17 last year, of which 907 resulted in deaths, an increase of 44,374 cases and 197 more deaths, respectively.
Worse, the politics-tainted smear campaign has not only demonized the drug, it has also compromised the very process of vaccination and other public health programs as well. In the wake of the scandal, DOH noted that Filipino parents in particular are still scared of the free vaccines that the government administers.
DOH National Immunization Program Manager Maria Silva said most regions recorded “very low” coverage, resulting in outbreaks of otherwise preventable diseases, such as measles in early 2018. “[The Dengvaxia issue] resulted in a very low MCV1 and MCV2 (measles continuing vaccine) coverage, which is why we had outbreaks left and right,” she added.
Affected programs, other than its “Ligtas Tigdas” campaign, include its supplemental immunization activities and the school-based and community immunization programs. This alarmed the health agency because vaccines for diseases like measles, rubella, tetanus, diphtheria, and cervical cancer are coursed through the school-based immunization program.
At the height of the scare, for instance, DOH officials in Eastern Visayas had to work hard to convince worried and incredulous parents to let their 213,717 children to take part in the otherwise routine administration of deworming pills.
“Our vaccines in the regular immunization program have been proven … Imagine what would happen to our children three to five years from now if they’re not immunized,” Molon added.
Domingo said the effect had been unprecedented. “Talagang never nangyari ‘yan sa history ng healthcare delivery na biglang whatever was given is now under suspicion. Nobody was prepared for it. We assumed that we were all OK.”
Understandably, there had been a public outcry for accountability. Doctors for Truth and Welfare, a group of doctors led by former DOH secretary Esperanza Cabral, has called on PAO to stop spreading unproven claims about Dengvaxia, which had eroded the public’s trust on vaccination in general.
“We call for a halt to the continuous spread of unproven claims of deaths caused by the dengue vaccine by the same unqualified but noisy people who are largely responsible for the fall in vaccine confidence in the country,” the group said. DOH Secretary Reynaldo Duque had also urged the public, especially infants and children, to get vaccinated from vaccine-preventable diseases.
Vaccination is of course a fundamental aspect of public health. In the context of an immunization scare, DOH said there is a need to “convince our people anew on the safety and value of vaccines,” which protect the population, especially the most vulnerable, from endemic diseases.
WHO had also expressed concern over “vaccine hesitancy,” or how people display reluctance or even refusal to get vaccinated despite the availability of vaccines. “One of the most cost-effective ways of avoiding diseases, it currently prevents two to three million deaths a year, and a further million and a half could be avoided if global coverage of vaccinations improved,” it said.
Incidentally, last year marked the 100th anniversary of the disastrous 1918 influenza pandemic that infected some 500 million people across the globe, a third of the world’s population, of which at least 50 million died. A hundred years hence, WHO warned that the world could be in for another influenza pandemic, just ten years after the A (H1N1) virus, or the swine flu, caused some 17,000 deaths worldwide. Eight deaths were recorded in the Philippines.
“The only thing we don’t know is when it will hit and how severe it will be. Global defenses are only as effective as the weakest link in any country’s health emergency preparedness and response system,” WHO said.
The efforts of the DOH to reverse the negative impression on vaccines might be put to the test as it prepares to introduce a new vaccine for Japanese Encephalitis this year. The vaccine should have been introduced in late 2017 and is thus long overdue, said Silva. “We really cannot postpone giving the much-needed vaccine because a lot of children are suffering as we speak.”
The universal health care bill is also expected to be fully rolled out this year, another test for the department. Despite some encouraging signs—improving trust ratings, for instance—just how well it can implement what is perhaps the most comprehensive public health measure in Philippine history will require, first of all, recovering from the mass hysteria triggered by irresponsible misinformation.
Trust our health care professionals, they are the real experts. Protect the lives of your loved ones. Trust vaccines.