Sunday Essay: What ails us

Sunday Essay Cartoon by John Gilbert Manantan

IT IS tempting to place the blame for the measles outbreak on Persida Acosta, chief of the Public Attorney’s Office (PAO), who led the much-publicized investigation on the purchase of Dengvaxia by former President Benigno Aquino’s administration.

Last Friday, Sen. Risa Hontiveros called for Acosta’s resignation, saying that “her lies and hysterics contributed directly to the erosion of public trust in our vaccination programs.” Acosta and her defenders in Malacañang insist she was just doing her job and pursuing an “impassioned advocacy” in helping families who blamed their children’s deaths on the new vaccine. In an interview last week with ABS-CBN, the PAO chief also asked whether the Department of Health (DOH) had done as much to promote the measles vaccine, as it had Dengvaxia.

Unfortunately—not just for Acosta, but for all of us—there is evidence that fewer Filipinos trust vaccines now than they did before the Dengvaxia controversy erupted. And that will continue to have serious implications on public health, unless we support efforts to restore trust in vaccines.

In October 2018, a study by the London School of Hygiene and Tropical Medicine (LSHTM) found that the percentage of Filipino respondents who “strongly agreed” that vaccines were important dropped from 93 percent in 2015 to 32 percent in 2018. Out of 1,500 participants, those who believed vaccines were effective dropped from 82 percent in 2015 to only 22 percent last year. The Vaccine Confidence Project also found out that Filipinos who strongly agreed that vaccines were safe dropped from 82 percent in 2015 to only 21 percent in 2018.

How did so many slip back into ignorance so fast? In November 2017, Sanofi Pasteur said it would not recommend that Dengvaxia be given to those who had not previously fallen ill with dengue fever. That was 19 months after the Department of Health (DOH) had launched its dengue immunization program.

“While some countries proceeded with adjusting guidance accordingly, the Philippines reacted with outrage and political turmoil, with naming and shaming of government officials involved in purchasing the vaccine, as well as scientists involved in the vaccine trials and assessment,” the LSHTM research team led by Heide Larson wrote in their study’s abstract. “The result was broken public trust around the dengue vaccine as well as heightened anxiety around vaccines in general.”

Vaccine resistance is one reason measles is rising again in the Philippines, nearly six decades after an effective and safe vaccine for this viral disease was made available. The DOH has declared an outbreak in five regions, including Central Visayas, where the number of measles cases rose from only two in January last year to 71 as of Jan. 26 this year. Acosta has said in one interview that measles is rising worldwide, and she is right. The World Health Organization (WHO) reported last month that it had documented a 30 percent increase in measles cases globally.

It also said, though, that while not all of these cases can be traced to vaccine resistance or hesitancy, this refusal to vaccinate despite available supplies is one of the top 10 public health threats for 2019.

There’s been plenty of colorful language on social media thrown Acosta’s way, but it’s short-sighted to think she’s the only one responsible. So, too, were some politicians, journalists and social media propagandists who let her rail about Dengvaxia without challenging her claims or reminding their communities that vaccines, overall, remained safe and effective. Ignorance, in this context, isn’t bliss. We can only hope some form of herd immunity to it remains possible.


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