DOH’s lack of vaccine urgency

The problems that hobbled the government’s response to COVID-19 four years ago remain a factor in the worrying rise of vaccine-preventable diseases, particularly pertussis, which has killed 54 babies in the first three months of the year. The country still lacks storage facilities for vaccines and vaccine hesitancy remains prevalent, especially in the rural areas, which begs the question: has the Department of Health (DOH) learned anything from the coronavirus pandemic?

The DOH reported this week that cases of pertussis totaled 1,112 from Jan. 1 to March 30, or almost 34 times that of the same period last year; all the 54 deaths were children less than 5 years old. The increase in pertussis cases was observed in Eastern Visayas, Cagayan Valley, Caraga, Central Luzon, and Cordillera Autonomous Region.

Low stocks

What makes the situation more alarming is the government’s low stocks of pentavalent vaccine (a five-in-one combination vaccine that protects against diphtheria, tetanus, whooping cough, hepatitis B, and Haemophilus influenzae type B) with a shortage anticipated next month. Don’t worry, Health Secretary Teodoro Herbosa assured, the DOH has already ordered an additional three million pentavalent vaccines that will arrive in June, and they can still be bought from the private sector for those who can afford (price: P3,800). Those who can’t, meantime, can have DTP (diphtheria, tetanus, and pertussis) vaccines to fill the gap.

The United Nations Children’s Fund (Unicef), in 2022, revealed that the Philippines was among the top 5 contributors to the 18 million zero-dose children globally, with one million Filipino children who have not received a single dose of childhood vaccine making them susceptible to life-threatening diseases such as polio, measles, and tuberculosis. Aside from pertussis, the country has reported a rise in measles and rubella cases in the first quarter of this year.

Plugging vaccine gap

Unicef Philippines Representative Oyunsaikhan Dendevnorov previously said falling child immunization rates and the rise in vaccine-preventable diseases “must be treated as a public health emergency that needs urgent action. Lessons learned from COVID-19 highlight the need to strengthen primary health care through integrated health and nutrition services for a strong and resilient health system in the long term.”

Despite all these data and repeated warnings from health authorities, the Philippines has failed to plug the vaccine gap even after pandemic restrictions were lifted. Unicef noted that the Philippines has never met the ideal target of a 95 percent routine coverage rate for children since the 1990s. Last year, the DOH launched the “Chikiting Ligtas” immunization drive, aimed at increasing the uptake of routine vaccines among children aged 0-59 months old. But this week, it reported that only 72 percent of the two million children below 1 year old were fully immunized—way below the target of 95 percent to achieve herd immunity.

Cold storage systems

“It is shameful that we have many zero-dose children. Other countries are wary of us because we could be a source of an outbreak in other parts of the world,” Herbosa said. He appealed to parents to have their children vaccinated but news reports noted complaints that barangay health centers did not have pentavalent vaccines. Herbosa responded that while the DOH had an adequate supply, it was indeed having distribution issues and assured that they were working on the problem.

This “problem,” or the lack of storage facilities in the health centers, was already exposed as one of the weaknesses of the health sector during the COVID-19 pandemic. There was much talk then about pouring government resources into building cold storage systems. But apparently, this remains unaddressed until today even if the government had at least three years to find a way to establish an important, life-saving facility.

Reactive stance

The government’s reactive stance on almost every issue should never be normalized. The cold storage issue could have been addressed by now through efficient budget planning and coordination with local government units and the private sector. The vaccination gap could have been plugged if health officials reassessed the program and strengthened the campaign in areas where uptake was low. The vaccine shortage won’t even occur if inventory is methodical and well-organized; health officials are very much aware that these vaccines are only manufactured once the order has been placed so why was there no timely effort to avoid a shortage?

DOH’s lack of urgency in procuring and distributing vaccines is appalling considering the country’s experience during the COVID-19 pandemic. Secretary Herbosa, children are dying. Give the DOH a much-needed shot of urgency, efficiency, and genuine public service.