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Thursday, April 25, 2024

Boosting vaccine confidence

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"People are scared, confused, helpless, and frustrated."

 

A few years back, there was a big furor about Dengvaxia, the vaccine against killer disease dengue, that resulted in vaccine confidence to very significantly dive. The issue became so big that many Filipinos were outright scared to get inoculated against ANY disease. My own discussions with mothers in communities showed this. The issue, the fear then has not been properly addressed.

This has now been carried over to vaccines against the deadly COVID-19 that has already killed thousands of Filipinos and continues to ravage our lives, keeping us prisoners in our homes.

The results of the Pulse Asia survey conducted between November 23 and Dec. 2, 2020 bear this out. Nearly 50% of Filipinos were unwilling to get inoculated for COVID-19. Only 32% were willing to get the vaccine, and 21% were undecided. Among those who refused, 84% cited safety of the vaccine as their reason for refusal. The doubts on efficacy and fear of dangers that could be caused by the vaccine were the main reasons against Dengvaxia before.

In the Visayas, 55% were not willing to be vaccinated. In Mindanao it was 48%, 46% in Luzon excluding Metro Manila, and in Metro Manila it was 41%. In terms of economic classes, 56% among class E, 46% among class D, and 43% among classes ABC were not inclined to get vaccinated.

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Another survey by OCTA Research Tugon ng Masa conducted from December 9 to 13 in Metro Manila indicated that only 25% of Metro Manila residents aged 18 and up were willing to be vaccinated. They mostly belonged to the upper and middle income classes. 28% said they would not get the vaccine, and a whopping 47% were undecided.

The present controversy is not helped by the present administration’s lack of definitive national vaccination plan, the insistence on purchasing the China-manufactured vaccine Sinovac that reportedly only has around 50% efficacy rate, President Rodrigo Duterte’s difficult-to-understand pronouncements, and the Department of Health’s and the Inter-Agency Task Force’s (IATF) ever-changing guidelines and policies surrounding the pandemic.

People are scared, confused, helpless, and frustrated. And really, we have every reason to be.

Duterte pinned the nation’s hopes on the vaccines against COVID-19. He said many times before that we would already have some before the end of 2020. It turned out that indeed, there were some and those were used for the Presidential Security Group (PSG), some in his Cabinet, and from his initial statement, maybe also for himself even at a time when the Food and Drugs Authority (FDA) has not approved any vaccine yet for use in the country. We do not understand why until now, the national government has yet to finalize its vaccination plan when many countries around the world are already rolling out their own program.

While the national government is dilly-dallying, at least thirty nine (39) local government units (LGUs) have already allocated budgets for the procurement of, and finalized negotiations for anti-COVID-19 vaccines. Most of them chose the brand AstraZeneca. The LGUS include: Manila City that will also buy twelve refrigeration units and will also build a storage facility; Makati City; Valenzuela City; Caloocan City; Quezon City; Pasig City; Mandaluyong City; Muntinlupa City; San Juan City; Taguig City; Las Pinas City; Navotas City; Muntinlupa City; Paranaque City; Pulilan, Bulacan; Taal, Batangas; Baguio City; Albay; Legazpi City; Ilocos Norte; Vigan City; Oroquieta City; Iloilo City; Bacolod City; Cebu City; Davao City; Marawi City; Ormoc City; Tacurong City; Zamboanga City; and, Marawi City.

At first, LGUs plans to procure vaccines also met problems when the Health Department said that the LGUs would not be allowed to do this on their own and that such procurement should be done by the national government. The negotiations have since also involved the DOH.

The Department of Interior and Local Government (DILG) has recently said that it will soon release an advisory that will limit LGUs capacity to procure vaccines. Sec. Año said that LGUs may only procure up to 50 percent of vaccine requirements. This may again cause problems in the future because instead of being able to address the needs of their constituents fully assuming some local governments have the funds, they will again be dependent on DOH for what their constituents urgently need. And we know how slow and bureaucratic the DOH procurement processes are. It will be in the best interest of the people to allow LGUs to do what they can against the pandemic.

People are also up in arms with the national government’s insistence on using the Chinese vaccine Sinovac. It has the lowest efficacy rate, and the second most expensive of the known available vaccines. Choosing Sinovac over the cheaper and more effective ones does not make sense any which way we look at it.

In terms of efficacy, these are the available data: Pfizer-BioNTech—95%; Moderna —94%; Gamaleya—91.4%; AstraZeneca— 62% – 90%; and Sinovac—50% – 78%.

In terms of vaccine estimated costs, the following data for the required two doses (from cheapest to most expensive) were released by the office of Sen. Sonny Angara per DOH submission to the senate: Novavax – P366; Astrazeneca – P610; COVAX Facility – P854; Gamaleya – P1,220; Pfizer – P2,379; Sinovac – P3,629.50; and Moderna – P3,904 to PhP4,504.

These costs do not include other logistical requirements such as vaccinators estimated at P1,200 (1 per 350 people), needed PPEs and supplies (masks, face shields, alcohol, cotton balls) that will cost about P1,924 for two doses of vaccine, and storage requirements.

There is no question that Sinovac should be the last option if only cost and efficacy are the consideration. It is really hard to understand why government is insisting on this. What don’t the people know? Ordinary people are asking why on earth would they agree to be inoculated using the least effective and very costly vaccine?

One important thing that government can do to boost vaccine confidence is to tell the people that they are going to use the best and the safest anti-COVID-19 vaccine. And this is not Sinovac.

@bethangsioco on Twitter Elizabeth Angsioco on Facebook

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