Girding up for the long COVID battle

Fifty million.

That’s the number of COVID-19 vaccines that the Philippines is about to waste, with 6.74 million doses set to expire by end of March on top of the 44 million doses worth P22 billion that expired last year. Assuming that each coronavirus jab costs P500, that’s some P25 billion wasted in vaccines that could have protected more Filipinos from a virus that has so far killed over 66,000 in the country, or could have been spent on other essential services.

Three years into the COVID-19 health crisis and the Philippine government’s response remains appalling.

“We are doing all things possible now so that we can intervene and be able to again ramp up the vaccination,” Department of Health (DOH) Officer in Charge Maria Rosario Vergeire told a Senate hearing earlier this month. Latest government data show that 73.8 million individuals or 94.62 percent of the qualified population have been fully vaccinated against the virus, with the DOH saying that it has integrated COVID-19 vaccination into its regular community programs. But despite the agency’s assurance that vaccines have been made more accessible to the public “anytime and anywhere,” only 27.65 percent, or 21.5 million individuals, have received their booster shot.

Poor supply chain management and vaccine hesitancy are the top factors cited for the wastage. The Dengvaxia controversy that intensified in 2017 has led to the perception that vaccines are unsafe and can cause deaths, resulting in the uptick of vaccine-preventable diseases, especially among children. The public has also been complacent, with COVID-19 vaccine uptake waning since the first quarter of 2022, according to the DOH. With less demand than expected and with the vaccines’ short shelf life, millions of doses were wasted.

Still, the government has had enough time to address these issues over the last three years and there’s no acceptable excuse for these wasted resources that the Philippines could barely afford in the first place. The country has borrowed at least $5.6 billion (about P280 billion) for its COVID-19 response, debt that economists said will take two generations to pay off.

It is now time for the government to assess its COVID-19 vaccine policy moving forward.

First, it needs to minimize vaccine wastage, or stop it altogether. Distributing the vaccines to local governments and making them available in health centers nationwide are a good start. At the same time, it must conduct an inventory of remaining stocks to ensure that they don’t run out when needed, since the private sector has stopped its planned purchase of bivalent vaccines to avoid further wastage. Instead, the private sector has urged pharmaceutical companies to apply for a certificate of product registration (CPR) to make vaccines commercially available. And while the public may believe that the country has already achieved natural immunity, the government cannot abandon its duty to protect public health, and must hasten the approval and evaluation of COVID-19 drugs so they can be issued a CPR. At the same time, it must set aside funds to keep an inventory of vaccines for those who cannot afford them.

Looking ahead, the government can take its cue from other countries. The United States, for example, will end its federal COVID-19 vaccination in May, but jabs will remain free for children whose families can’t afford them and for those covered by health insurance. Denmark, one of the first countries to suspend its COVID-19 vaccination program in April 2022, still rolled out its seasonal influenza vaccine program—including for the coronavirus—in October of the same year.

COVID-19 remains a threat and studies pointing to the disease’s long-term effects — what scientists call “long COVID” — only heighten the urgency to get protected from it. At least 65 million individuals globally are suffering from long COVID and cases are increasing daily.

This calls for the government to include COVID-19 prevention as part of its long-term public health policy. But its role should not be limited to the procurement of vaccines or making these commercially available: It must undertake a more aggressive public communications campaign on the risks and outcomes of long COVID, which impacts multiple organ systems and can cause lifelong disabilities. Long COVID affects people’s quality of life and productivity which, in turn, can impact public health systems and the economy. The government needs to make people understand, in very visual terms if necessary, why they need to get inoculated and what could happen to them if they don’t. Prevention, as always, is better than cure.

As an article published in Nature in December last year stated, the pandemic is far from over and there is no room for complacency. As COVID-19 has shown the world, strong healthcare systems made all the difference and will continue to do so in future health threats.