(This is the first installment of a four-part special report by SunStar Philippines on efforts to defeat the Covid-19 pandemic through vaccination.)

“I’M PFEELING pfine, pfantastic with no pfever, thanks Pfizer,” Singapore-based Cebuano doctor Elisse Nicole Catalan wrote on Facebook a day after getting her first shot against coronavirus disease 2019 (Covid-19) on January 15, 2021.

She said she was just feeling “some fatigue” and the injection site was sore. But there were no other symptoms.

“Honestly, compared to the flu shot (northern hemisphere strain) I received late last year, where I got a stronger reaction post-vaccination, this Covid vax doesn't feel nearly as bad,” she added.

Another Cebuano, New York-based medical frontliner Mimi Beltran-Dispo, had her first dose of the Pfizer-BioNTech vaccine on December 24, 2020 and her second dose on January 16, 2021. Her husband Jojo, also a frontliner, is scheduled to get his second dose on February 6.

Beltran-Dispo said her husband did not experience any side effects. But she felt soreness in her arm immediately after the first inoculation. She suffered body aches after six to eight hours, although these were resolved with a dose of paracetamol.

After the second shot, she had left ear pain, headache, body aches and sore arm, but these were again resolved with paracetamol.

These symptoms are among the temporary side effects reported by Pfizer and other vaccine developers based on their phase 3 clinical trials. Other vaccinees may also experience chills, joint pain and fever.

Risks vs benefits

The protection promised by these candidate vaccines against severe Covid-19, which could be fatal, still beats the risk of allergic reactions to a vaccine, which could be treated, Beltran-Dispo said.

Studies on long-term side effects and long-term immunity are still ongoing, though.

For now, Beltran-Dispo said she and other medical frontliners in New York continue to don their personal protective equipment (PPE) as they care for their patients.

“Because I need to protect myself even if my immune system will start working to produce antibodies. Antibodies are evident two weeks after vaccination, some even later,” she added.

More importantly, she noted that worrisome variants of severe acute respiratory syndrome coronavirus 2 (Sars-CoV-2), the virus that causes Covid-19, have emerged.

The B.1.1.7 from the United Kingdom, B.1.351 from South Africa and P.1 from Brazil have been reported to be more transmissible and deadlier than the D614G, the dominant form of the virus that is circulating globally.

Variants are likely to emerge in areas where transmission is intense. Everytime a virus replicates, it has the opportunity to acquire mutations, American virologist Angela Rasmussen said in a webinar for journalists on January 29.

In the Philippines, the Department of Health has confirmed 17 cases of the B.1.1.7 variant from the UK.

These include a cluster of 12 patients in Bontoc, Mountain Province and a 23-year-old male from Calamba City in Laguna, who was swabbed four days before the UK announced the new variant on December 14, 2020.

Read: New virus variant appears in sample taken in early December

Previous pandemics

The emergence of these rapidly spreading variants have made the rapid and equitable rollout of vaccines all the more important, World Health Organization (WHO) director general Tedros Adhanom Ghebreyesus said at the opening of the 148th session of the Executive Board on January 18.

“We have an opportunity to beat history, to write a different story, to avoid the mistakes of the HIV and H1N1 pandemics,” he said.

The HIV (human immunodeficiency virus) epidemic was first reported in 1981. Ghebreyesus said more than a decade passed before the poor got access to life-saving medicines. More than 25 million died from acquired immune deficiency syndrome (Aids), the US Centers for Disease Control and Prevention (CDC) said.

In 2009, a novel influenza A (H1N1) virus emerged in the US and spread globally. Ghebreyesus said vaccines were developed, “but by the time the world’s poor got access, the pandemic was over.” CDC said 151,700 to 575,400 people died from H1N1.

To combat Covid-19, candidate vaccines were developed and approved in what Ghebreyesus described as a “stunning scientific achievement and a much-needed source of hope.”

“Vaccines are the shot in the arm we all need - literally and figuratively,” he said.

The challenge now is to equitably distribute these vaccines as quickly as possible.

The WHO hopes to achieve vaccine equity through Covax, an initiative that aims to accelerate the development and manufacturing of Covid-19 vaccines, and to guarantee fair and equitable access for every country. It is led by the WHO, Gavi Vaccine Alliance and Coalition for Epidemic Preparedness Innovations.

Vaccination drive

Mass vaccination campaigns, unprecedented in terms of speed and scale, began in the US and Canada on January 4, and in the European Union on January 9, 2021.

In the Philippines, mass vaccination is targeted to start in February 2021, a little more than a year after the DOH confirmed the first case of infection on January 30, 2020 and first death from Covid-19 on February 1, 2020.

Vaccine czar Carlito Galvez Jr. is eyeing to procure at least 140 million doses in 2021 to inoculate up to 70 million Filipinos, around 64 percent of the Philippine population. The Philippines has a population of 109.58 million based on the 2020 census.

Finance Secretary Carlos Dominguez III said the budget for vaccines this year is P82.5 billion, including P70 billion that will be sourced from multilateral and bilateral loans, as well as loans from the domestic market.

These loans will be used to procure the vaccines while the remaining P12.5 billion (P2.5 billion from the DOH budget and P10 billion from Bayanihan 2) will be used for logistics and supplies.

The P82.5 billion is on top of the funds allotted by local government units (LGUs) and the donations from the private sector.

Mass vaccination saves lives, reduces hospitalizations and eases pressure on public health systems, and is seen as key to recovery from the pandemic and its devastating economic fallout.

The Covid-19 pandemic, which began with reports of mysterious respiratory infections in Wuhan City in central China in December 2019, pushed economies around the world into deep recession as countries closed borders, major urban areas went into lockdown, and governments imposed stringent restrictions on people and services.

The Philippines dived into recession in the second quarter of 2020, with gross domestic product (GDP) growth sinking to its lowest level in decades to -16.9 percent.

Millions of jobs were lost, causing a spike in unemployment to 17.7 percent in April 2020, when most of the businesses in the entire Luzon and key cities nationwide were forced to temporarily cease operations.

The economy improved as government gradually eased restrictions beginning July 2020, but GDP still contracted by 9.5 percent at the end of the pandemic year. This was worse than the 7.3 percent negative growth in the 1984-1985 political crisis.

Acting Socioeconomic Planning Secretary Karl Kendrick Chua said the economy should recover when the government will have rolled out enough vaccines against Covid-19.

“The efficient and immediate rollout of the vaccine against Covid-19 will further help in safely opening the economy, as well as restore and create new jobs,” he said.

As of January 31, the Philippines has recorded 525,618 cases of coronavirus infection with 10,749 mortalities, the second highest in Southeast Asia, after Indonesia’s 1.078 million cases and 29,998 deaths.

WHO director of communications Gabriella Stern, during the January 29 webinar for journalists, said there can be no global economic recovery until all countries are protected through vaccination.

“Covid-19 can’t be beaten one country at a time. The epidemiology shows that no country will be safe from the fallout from the pandemic until all countries are protected,” she said.

Until then, she said, “we have to continue wearing masks, physical distancing, ventilating, avoiding crowds, washing hands and all the other measures that we know work.” (SunStar Philippines)

Next Part 2: A matter of choice

Part 3: Government prepares for vaccine rollout

Part 4: Building vaccine confidence