Vaccine concerns versus vaccine hesitancy

The progress of vaccine rollout at the Philippine General Hospital is a topic of much interest, because as a COVID-19 center at the very forefront of the pandemic response, it should both be a priority and a template for coronavirus vaccination in the country. Obviously the path to vaccination has been a fraught one for such health workers, who have borne the brunt of the frontline response while dealing with understaffing, inadequate compensation, and lacking resources; who had to watch while the government prioritized vaccine procurement for administration and military forces; and who, for those who are willing or eligible to be inoculated, must now choose whether to be vaccinated with the Sinovac vaccine, or face the uncertain wait for rollout of the next brand. This is in light of confusing messaging, reflected by earlier recommendations of the Food and Drug Administration that CoronaVac is not recommended for health care workers exposed to COVID-19 patients, and hesitations about the vaccine’s performance versus its counterparts at specific end points. Various groups, including the Physician’s Association of the UP-PGH, have not dismissed the vaccine, but have called for appraisal of the said vaccine by the Health Technology Assessment Council prior to administering to health workers. Such concerns were also raised in a physical protest last week.

Protesting health care workers have subsequently been criticized for a multitude of reasons. Some say the qualms against the Sinovac jab are sheer racism, carelessly contributing to a nation already dealing with growing anti-Chinese tensions. Some have called protesters “choosy,” to borrow a classy description from presidential spokesperson Harry Roque, used last month to describe those with COVID-19 vaccine preferences as he all but flippantly told Filipinos to take the vaccine—or leave it. The most disturbing criticisms leveled at protesting health workers has been that mistrust of the Sinovac vaccine aggravates the already worrisome state of vaccine hesitancy in the Philippines.

This may be, to some extent, disappointingly true. Suffering as we are from an epidemic of health-related misinformation, compounded by problems in reading comprehension, false news, and poor access to health resources, any hesitation about the Sinovac vaccine may be easily manipulated or misunderstood as supporting the anti-vaccine sentiment that has overtaken the country since 2017’s Dengvaxia controversy. However, if there is any party who must shoulder the blame for the surge in vaccine hesitancy in the Philippines, it is not health workers, who have been vocal about supporting the country’s immunization programs particularly throughout recent re-emergence of polio and other preventable infections. For that, we have Persida Acosta — neither physician nor health care worker — and her Dengvaxia crusade to thank. What the Western “anti-vax” movement was unable to do here, Acosta and her ilk easily accomplished through intense media coverage and fearmongering, a spectacle woefully bereft of hard scientific fact. In contrast, the present demands by vulnerable health workers — for transparent, evidence-based procurement of safe, effective, appropriate vaccines — should not be demonized or equated to the damaging anti-vaccine sentiment that continues to hinder the country’s immunization programs.

The Unicef, in its guide to combating vaccine misinformation, cites the Philippines’ Dengvaxia controversy as an example of “how quickly anti-vaccine ideas can take hold, particularly in the absence of clear and consistent messaging from medical and political leaders.” It is March 2021, and we are still waiting for clear, unequivocal clarification from government and its agencies about the culpabilities and consequences of the dengue vaccine controversy. An effort must be made to dispel vaccine myths in a time when vaccine compliance is of utmost importance. That responsibility does not lie on the shoulders of vulnerable health care workers fighting for their rights for the best, safest, most effective vaccines that evidence-based medicine — and squandered government resources — should have been able to provide.

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