Making sense of the measles outbreak
KALIBO, Aklan — The rural health workers here in Panay Island are worried about the measles outbreak, and rightfully so. They have seen the news — over 90 deaths and counting; many of them have personal knowledge of children who were not vaccinated, and they are well aware of the potential consequences for their communities.
How do we make sense of the measles outbreak?
For many, it is directly linked to the Dengvaxia scandal, and thus the prime suspect is Persida Acosta. However, I think what’s happening is that the Public Attorney’s Office chief — quick to lay blame and even quicker to jump to conclusions — is getting a dose of her own medicine. While her damage to public health is undeniable, the fact that older children and even adults — people who should have been vaccinated when they were below 5 years of age — are getting measles means there’s more to the whole picture than Acosta’s fearmongering.
To begin with, we must also consider other people who participated in spreading panic: TV anchors, bloggers, politicians and, sadly, even some doctors. President Duterte has taken the welcome step of urging parents to vaccinate their children, but he should hold his subordinates to account for their theatrics and deceit.
Of course, we also have to look at the health department. While investigations should not devolve into witch hunts, they must nonetheless ascertain what truly happened in the dengue vaccine case — whether there were breaches of law and errors of judgment in implementing (and seemingly rushing) a massive, costly program.
Crucially, we have to look beyond the Dengvaxia scandal. Our country’s immunization rates have long fallen short of the hoped-for 95-percent coverage; there was, in fact, a major measles outbreak from 2013 to 2014, with over 20,000 confirmed cases and 110 confirmed deaths. While vaccine hesitancy has doubtless played a role, the shortcomings on the part of the Department of Health (DOH) and local government units — e.g., human resources, communications efforts — must be identified and acted upon.
Moving forward, one clear challenge is to stop the sources and amplifiers of misinformation. Lives are at stake in medical knowledge, which is why it cannot be politicized by government officials, sensationalized by media and “creatively interpreted” by the likes of Acosta.
Given, moreover, the longer troubled history of the government’s immunization and infectious disease programs, such programs need more support — and critical review. What are the weakest links in the health system? What are greatest barriers to immunization? We need to answer these questions if we are to address today’s outbreak and avert future ones.
Another task is to restore people’s trust in public health programs. Precisely because vaccines work, it’s important to be transparent about their development and procurement. Precisely because vaccines work, it’s important to be forthcoming about their risks. With teachers complaining that they are often made to do health-related programs without proper support or orientation, it’s high time for the DOH and the Department of Education to coordinate more on school-based health programs.
Finally, we need to step up communications and education efforts. The groundwork is crucial: In the wake of the Dengvaxia scandal, some proactive municipal health officers conducted barangay-to-barangay seminars, thus preempting the misinformation. But media (and social media) are also vital. If marketing experts can sell do-nothing politicians, surely they can sell life-saving programs like childhood immunization.
Ironically, the measles outbreak itself is raising awareness about vaccination. One of the midwives I met in Antique told me the story of a tearful mother who came to their clinic with her children, pleading for them to get vaccines. She had heard about the measles outbreak and was worried that her children might die. She had also heard about the Dengvaxia scare, which was why she didn’t have her children vaccinated earlier.
Many other parents, acting out of love for their children, are feeling the same way today. But we cannot allow unnecessary deaths to do the talking. If we are to convince parents to get their children vaccinated, we need to appeal to them not out of fear, but based on knowledge and trust.
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