Where should blame fall?
The hottest controversy on the local health (and political) front these days involves the suspended dengue vaccination program. The program was suspended after Sanofi Pasteur, the drug manufacturer, released findings that Dengvaxia (the trade name of the vaccine) could worsen the effects of dengue among vaccinated individuals who had not yet had dengue.
The Department of Health revealed that more than 733,000 children age 9 and above had been vaccinated in public schools in Metro Manila, Central Luzon and Calabarzon, and in health centers in Cebu. The vaccine is supposed to be given in three doses, and there is no word yet on whether those who received one or two doses would complete the cycle, and what adverse effects, if any, the curtailed vaccination schedule would have on the children.
An investigation is ongoing on whether any shortcuts were resorted to in approving Dengvaxia for the immunization drive, along with suspicions of neglect and even possible corruption.
But it seems there were more than enough reasons to embark on a dengue vaccination program. As the World Health Organization website states, “the incidence of dengue has grown dramatically around the world in recent decades.”
One recent estimate is that 390 million dengue infections occur each year, with 3.9 billion people in 128 countries deemed “at risk of infection.”
In the Philippines, according to a report in the newspaper Sunstar, the DOH epidemiology bureau has reported 207 deaths due to dengue, with majority of the cases in Central Visayas. The number of dengue cases has grown to nearly 36,000 in the first five months of the year, but lower than the same period last year, but certainly a major public health concern.
A dismaying but expected development is the use of the dengue issue to demonize the Aquino administration under whose watch the program was approved. For guidance on this development, I turn to Dr. Junice L. Demetrio Melgar, executive director of Likhaan, an NGO on women and community health.
“When it was introduced,” writes Dr. Melgar, “the WHO Guidelines on the use of the vaccine was used, which actually flagged the likelihood of infection by another mosquito as triggering more severe reaction.” Melgar points out that, for health authorities, it was a matter of “balancing potential risk and benefit in populations where dengue is endemic.”
She adds, “I know that DOH and all the experts have been monitoring adverse effects since 2015. Can we be, for once, because of the Christmas season, be rational and judicious and let scientific studies qualify whether the use of the vaccines [was warranted]. Not before.”
And it’s not as if the Duterte administration’s health officials are themselves blameless when it comes to the dengue vaccine. My source for the following information is “Pinoy Ako Blog,” itself controversial after its writer was exposed, but which I have found to be generally reliable, no fake news in the site.
According to PAB, the Philippines was indeed the first country in the world in December 2015 to allow commercial distribution of Dengvaxia under the administration of then Health Secretary Janette Garin. (Eleven other countries have since joined us.) In July 2016, about eight months after the start of the immunization program, Duterte-era Health Secretary Paulyn Ubial suspended the program, citing safety concerns, but two months later, in September, Dr. Ubial exempted Dengvaxia from her order and the vaccination drive continued.
As a parent (and grandparent), I sympathize with the parents of the children who underwent vaccination and now have to wait for any adverse consequences. My two children have had dengue, with my now-adult son suffering a second round recently.
But also as a parent, I appreciate the efforts (and the funds) being expended to find a way to protect more children against this disease. There may indeed have been lapses in the testing and trials, but as long as those responsible own up to their failings, and prove there was no malice or underhanded motives in approving the vaccines, then we should all wait for justice to take its course.
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