To accelerate vaccination drive, strengthen adolescent immunization
The Philippines remains at risk for vaccine-preventable diseases, underscoring the need to increase vaccination coverage in the new normal.
Based on joint monitoring by the World Health Organization (WHO) and the United Nations Children’s Fund (UNICEF), the Philippines follows the global trend of reporting lower immunization coverage throughout the pandemic.
Diminished coverage has resulted in measles outbreaks, with the Department of Health (DOH) currently ramping up vaccination efforts to forestall another potential outbreak.
Vaccine hesitancy, fueled by misinformation, remains a concern. Defined as a refusal to accept immunization services despite their availability, vaccine hesitancy was pinpointed by the DOH as a factor in the measles surge and the reemergence of polio in 2019, sparking an intensified immunization campaign to recover lost ground. Hence, healthcare personnel must continue to correct misconceptions about vaccines in general.
During the 23rd Philippine National Immunization Congress (PNIC), Dr. Anelyn Logrono-Reyes, who served as the conference’s overall chair, remarked on how vaccination could have prevented these outbreaks.
“The Philippines has a very low vaccination rate [so] sadly, we had a lot of outbreaks of vaccine-preventable diseases,” Dr. Reyes said, as she also confirmed that local studies have shown how vaccine hesitancy is partly caused by “the decrease in confidence in the vaccine itself.”
Mindful of these challenges, this year’s PNIC pushed for routine immunization to improve coverage. It also provided participants with learning opportunities through an updated vaccinology course.
With the theme, “Leaving the Pandemic: Accelerating the Vaccine initiative, Vaccination Practices in the New Normal,” the virtual conference was spearheaded by the Philippine Foundation for Vaccination, Inc. (PFV), together with the Philippine Pediatric Society – Southern Tagalog Chapter (PPS-STC), and their partners.
Healthcare professionals from both public and private sectors, patient groups, policymakers, corporate allies, and other vaccine advocates gathered to discuss the vaccination status of the country, disseminate best practices to increase immunization coverage, and explore strategies, and action plans to combat misinformation and strengthen confidence in vaccines, ultimately improving vaccine uptake.
“Normalizing” vaccination: a life-course approach
MSD in the Philippines, a staunch supporter of the annual PNIC, has long advocated for vaccines as a vital aspect of healthcare.
MSD has continuously developed innovative vaccines for over a century to help save lives and build vaccine-resilient communities. To that end, the company has worked closely with partner organizations and government institutions to inform the public of immunization’s benefits.
As part of its advocacy, MSD shares in the conference’s goal to disseminate updated information on vaccines and vaccination best practices, thus enhancing the public’s awareness of the importance of a life-course approach to vaccination for Filipinos to be protected at all stages of life.
Taking a life-course approach means that immunization schedules and access to vaccination must be responsive to an individual’s age, lifestyle, and specific vulnerabilities or risks to infectious diseases.
Dr. Arthur Dessi E. Roman, Medical Specialist III at the DOH-Research Institute for Tropical Medicine (DOH-RITM) and Vice-Chair of the Infectious Diseases Section at the Manila Doctors Hospital advised that immunization encompass pregnant mothers, newborns, infants, older children, adolescents, adults, and elderly. “There should be a change in the mindset on vaccination…vaccines are not just for kids, they are for life,” Dr. Roman asserted during his talk, “Updates on Adult Vaccination and Catch-Up.”
Protecting adolescents vs. HPV
“Today, vaccines are available to help protect against at least 20 vaccine-preventable diseases. Together, these vaccines may help save the lives of up to 3 million people [globally] every year,” noted Dr. Ma. Emma Alesna-Llanto, a clinical associate professor at the University of the Philippines College of Medicine, in the symposium entitled “Teen Vaccines: Harnessing the Power to Protect.”
Human Papillomavirus (HPV) is so common that nearly all women and men will get infected at some point in their lives, said Dr. Llanto. She explained that the HPV family of viruses numbers more than 100 types, with different levels of risk. Low-risk types of HPV cause genital warts, while high-risk types of HPV can cause cervical cancer, the second most common type among women in the Philippines. Other high-risk types of HPV may cause anal cancer, vaginal cancer, vulvar cancer, or oropharyngeal cancer (cancers of the mouth and throat).
However, Dr. Llanto said there is a tool for prevention in the HPV vaccine, which is used in over 100 countries and has been available in the Philippines since 2006. She emphasized that the HPV vaccine may help reduce cervical cancer to around 90%. She pointed out that this vaccine is recommended by the WHO and local medical societies like the Philippine Pediatric Society, the Pediatric Infectious Disease Society of the Philippines, and the Philippine Obstetrical and Gynecological Society. As for availability, she also noted that HPV is part of the DOH’s National Immunization Program, with the expanded Adolescent Immunization Program implemented in coordination with the Department of Education and the Department of the Interior and Local Government.
Dr. Llanto and Dr. Roman emphasized that adolescence is an ideal time to receive the HPV vaccine before the individual becomes sexually active. Dr. Llanto explained that HPV is spread through intimate skin-to-skin contact or by having vaginal, anal, or oral sex with someone infected with the virus. Two doses provided at age 9-14 years offer better immunogenicity (or a stronger response against HPV infections) than three doses given to young adults aged 15-26 years, said Dr. Llanto. “For HPV, giving [the vaccine] at an earlier age is the better option,” she added.
Unlocking herd immunity: we’re all in this together
Vaccines may help reduce the incidence of vaccine-preventable diseases in the community—even the immunocompromised, or those with an impaired or weakened immune system, said Dr. Elizabeth E. Gallardo, Chair of the Department of Pediatrics at Saint Louis University in Baguio City. “Immunocompromised persons are more susceptible to vaccine-preventable diseases and are at increased risk of severe illness. Therefore, vaccine providers should work together with specialists to improve vaccine coverage rates in this vulnerable population,” she urged.
Immunized individuals may help protect those who are vulnerable through population or herd immunity, said Dr. Llanto. “Herd immunity is especially important in highly contagious diseases such as measles, which requires 95% of a population to be immunized. When immunization rates drop, we can have outbreaks, which we experienced in 2019, with tragic results,” she said.