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A necessary reset of Dengvaxia issue

/ 05:34 AM June 22, 2018

The publication last week in the prestigious New England Journal of Medicine of a major study on the effects of the Dengvaxia vaccine on children who have not yet been infected by the dengue virus is significant—as much for its conclusions as for its timing. Health Secretary Francisco Duque III said the research conducted into the controversial Sanofi Pasteur vaccine did not really produce anything new.

“[W]ala naman kasing bago dyan sa sinasabi nila eh, ’yan din naman ’yong dati pang sinasabi, inulit-ulit lang nila (There’s really nothing new in what they’re saying, that’s what has already been said, they are just repeating it),” Duque told Radyo Inquirer.

In fact, the new study confirms what a belated advisory from Sanofi itself last November and a recommendation from the World Health Organization last April concluded about the possible impact of the vaccine on so-called seronegative recipients—children who have not yet been infected with the mosquito-borne virus endemic to countries like the Philippines. As in any scientific enterprise, confirmation is big news.

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To be sure, as in the development of any vaccine, the study reached a much more nuanced conclusion. To quote the Reuters report: “The study authors calculated that if Dengvaxia were given to 1 million children over age 9, it could prevent some 11,000 hospitalizations and 2,500 cases of severe dengue.” That’s the good news. The bad news: “But it could also lead to 1,000 hospitalizations and 500 severe cases of dengue in children who have not been previously infected.”

In sum, the researchers say: “Our findings support the hypothesis that in the absence of previous dengue exposure, the vaccine partially mimics primary infection and increases the risk of severe dengue.”

Duque’s understated response to the publication of the study should not lead to a missed opportunity. The Duterte administration’s initial response to the Dengvaxia controversy had been so alarmist, and transparently political, that it stoked fearful speculation and even panic in the general population. One terrible, and entirely predictable, consequence was a kind of collateral damage; all other vaccines, even the uncontroversial ones, suffered some guilt by association. Many parents and guardians decided to forgo other vaccinations for their children and wards.

Aside from the significance of confirmation, the study also presents the administration with an opportunity to reset the official response to the Dengvaxia controversy. Away from the politically motivated grandstanding of Sen. Richard Gordon and then Justice Secretary Vitaliano Aguirre II, and the histrionic performance of public-attorney-turned-instant-medical-expert Persida Acosta, the administration can follow the lead of the more sober-minded, like Duque, and heed the warnings of the medical community.

Last January, two former health secretaries (trusted members of then President Gloria Arroyo’s inner circle, like Duque) joined 56 other doctors in issuing a statement that expressed serious dismay over the handling of the Dengvaxia issue. “The unnecessary fear and panic, largely brought about by the imprudent language and unsubstantiated accusations by persons whose qualifications to render any expert opinion on the matter are questionable, at best, have caused many parents to resist having their children avail of life-saving vaccines that our government gives.”

The doctors also said: “Available documentary evidence that might have been offered to prove the innocence of some of the accused has not been made public for reasons that we can only speculate on. The public hearings have become avenues for ‘expert bashing’ rather than a genuine search for truth.”

Now, with the undisputed prestige of the New England Journal of Medicine supporting the cautionary approach to Dengvaxia vaccination, the administration has the opportunity to reset its response. If the evidence is on its side, it should not waste man-hours or airtime on imprudent language, expert bashing or unsubstantiated accusations. Follow the (real) experts’ lead.

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TAGS: Dengvaxia, Health Secretary Francisco Duque III
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