Focus on the kids
Questions continue to be asked about the dengue vaccine Dengvaxia and how it became part of the Department of Health’s vaccination program despite the red flags it raised among health experts.
The most asked question: How could then Health Secretary Janette Garin ignore a panel of experts who
argued that there weren’t enough clinical studies at the time to guarantee that Dengvaxia was effective against the dengue virus? At P1,000 per dose and three doses per child, the panel pointed out, the vaccine wasn’t even cost-effective for a government-funded health program.
With Sanofi Pasteur’s recent warning that new analysis of clinical data showed that its vaccine could lead to more severe cases of dengue among the vaccinated who contract it for the first time, current Health Secretary Francisco Duque said he would demand that Sanofi refund the P3.5 billion spent by the government on Dengvaxia and that the drug firm set up an indemnity fund to cover the hospitalization costs of vaccinated children who would fall ill.
But even as the Senate, politicians, anxious parents and health practitioners inquire into culpability on this issue and demand recompense, the government should posthaste see to the wellbeing of the more than 830,000 schoolchildren who received at least one dose of the vaccine. Are they being monitored? Has the DOH set up a long-term health surveillance program to identify those children needing medical assistance?
The Department of Education has announced a “strong monitoring and surveillance system.” Education Secretary Leonor Briones has required all schools in Metro Manila, Central Luzon, Calabarzon and Central Visayas to review the master list of vaccinated students and identify them for close monitoring, and has called on the community to report cases of high-grade fever and other symptoms of dengue.
Indeed, the government’s proactive stance is crucial at this point, lest it lose the trust of the public—especially mothers, the keepers of the family’s health. The rumor of a child dying after receiving three doses of the vaccine has led to fear and panic among parents, and could easily lead people to swear off vaccines and other medical interventions.
It is important that the government keep an active engagement with the community on health matters—through barangay town hall meetings, the 4Ps program, the mothercraft classes in daycare and maternal health centers, and even through public-service-oriented commercials and breaks in popular broadcast programs.
It will also be instructive for the government to study how other countries handled similar circumstances, notably Brazil, one of the 11 countries that first approved the sale and use of Dengvaxia. The other countries, aside from Brazil, are Mexico, Indonesia, El Salvador, Costa Rica, Paraguay, Guatemala, Peru, Thailand and Singapore.
Unlike the Philippines which has stopped the vaccination program, Brazil’s Parana state health secretary Michele Caputo Neto decided to continue implementing its vaccination program but restricting it to those who had previously been infected with the dengue virus—after carefully studying the implications of Sanofi’s damning report and after examining the profile of areas where the vaccine was needed most.
Neto has been quoted as saying that Sanofi’s new study showed “just a 0.5 percent higher risk for a vaccinated individual not previously exposed to the virus to develop dengue with alarm signals than an unvaccinated individual who has never been exposed.” Neto also pointed out that the vaccine was offered in only “30 municipalities that (registered) 82 percent of the [dengue] cases, 91 percent of severe cases and 87 percent of dengue deaths.” These are the cities that have faced consecutive epidemics, with high viral circulation and which recorded a large number of cases.
Such scientific minutiae are the stuff that medical experts and health professionals trade in, and one compelling reason they should be given stronger recommendatory power, perhaps even the power to veto plans or actions that concerns public health, which is certainly not an area that should be left to politicians. Because if anything, this crisis shows how health issues and politics can intersect, to disastrous results.
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