Half of vaccinees miss 2nd dose, epidemiologist says

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(UPDATED) Over a million individuals who have received their first dose of a vaccine against coronavirus disease 2019 (Covid-19) have missed their second dose, according to an epidemiologist of the Inter-Agency Task Force (IATF) for the Management of Emerging Infectious Diseases.

In his presentation during a town hall on Wednesday, June 2, 2021, Dr. John Wong said this can be ascribed not only to vaccine hesitancy but also lack of access to the vaccines.

“We know that some of these people want the vaccine but they can’t access it...From vaccine hesitancy issue, we also have to address access issues,” he said.

As of May 29, or 12.7 weeks after the vaccinations started on March 1, Wong said a total of 3,101,559 people from Priority Groups A1 (health workers), A2 (senior citizens) and A3 (persons with comorbidities) have received their first dose.

After 8.7 weeks, 2,125,788 should have received their first dose. As of May 29, however, only 1,078,902 have been fully vaccinated.

All vaccines available in the Philippines require a two-dose regimen.

The Sinovac vaccine, which comprises around 66 percent of total doses delivered so far, is given 28 days apart while the AstraZeneca vaccine is given 12 weeks apart. The second dose for Sputnik V is given 21 days after the first while that of Pfizer is given 21 to 28 days after the first dose.

Deferment

In a statement on Thursday, June 3, the Department of Health (DOH) said the actual number of missed second doses on the ground may differ from Wong's data.

DOH data showed that only 9.0 percent, or 113,000 individuals, have deferred their second dose. The most common reasons for the deferment are: vaccinee gets sick, vaccinee is exposed to an infectious case, and vaccinee is undergoing quarantine, DOH Undersecretary Maria Rosario Vergeire said.

Eventually, however, Vergeire said these vaccinees end up getting their second dose as local government units (LGUs) reach out to them.

"What was presented (by Wong) was part of an independent assessment of the vaccine prioritization of the national Covid-19 vaccination program. It validated our prioritization criteria and showed that prioritizing the healthcare workers, senior citizens and persons with comorbidities will save lives as they are the most at risk for hospitalization and death caused by Covid-19," Vergeire said.

DOH Secretary Franciso Duque III said those who missed their second dose can still get inoculated.

"We urge you to coordinate with your LGUs to reschedule your vaccination. Makukuha lang natin ang proteksyon ng mga bakuna laban sa Covid-18 sa kumpletong doses," he said.

During the town hall on Wednesday, Wong also reported that vaccination targets for the A2 and A3 groups were missed. While 90 percent of the health workers have been vaccinated once, only 14 percent of the senior citizens and 8.0 percent of the persons with comorbidities have received one dose.

The senior citizens and persons with comorbidities are at highest risk of death from Covid-19.

Wong presented data that shows 81 percent of Covid-19 deaths came from these two groups. The mortality rate for senior citizens is highest at 80 out of 100,000. For non-elderly with comorbidities, the mortality rate is 15 out of 100,000.

Vaccinating these two groups, A2 and A3, would prevent at least 80 percent of deaths, Wong said.

Recommendation

He recommended that instead of verifying comorbidities or employment in determining vaccine eligibility, the government should instead use age which is easier to verify that either comorbidity or employment.

By using age as qualifying factor, Wong said the government would be able to vaccinate all of A2, up to 60 percent of A3 and 15 percent of A4.

Wong also noted in his presentation that not all NCR Plus 8 areas as vaccinating rapidly enough. He did not specify which areas have been underperforming despite having been prioritized in vaccine supply.

The NCR Plus 8, which was identified as priority for vaccine deployment because of a high number of Covid-19 deaths, consists of the National Capital Region (NCR), Metro Cebu, Metro Davao, Batangas, Bulacan, Cavite, Laguna, Pampanga and Rizal.

Dr. Anna Ong-Lim of the DOH Technical Advisory Group, for her part, also pointed to lack of access as a reason for the low vaccination rate.

She said LGUs must determine whether a low vaccination rate is due to hesitancy or lack of access.

“Knowing this will be crucial in helping our smaller LGUs with less capacity to implement an efficient vaccination program,” she said.

As of May 30, the Philippines has received 8.329 million doses of vaccines, consisting of 5.5 million doses of Sinovac, 2.556 million doses of AstraZeneca, 193,050 doses of Pfizer and 80,000 doses of Sputnik V. The AstraZeneca and Pfizer vaccines were donated through Covax while one million doses of Sinovac were donated by China. The rest were procured by the government.

The target is to vaccinate the vulnerable population especially in the NCR Plus 8, although President Rodrigo Duterte on Monday, May 31, directed vaccine czar Carlito Galvez Jr. to equally distribute the vaccines to all regions.

Government is targeting to vaccinate at least 58.8 million and up to 70 million this year. To achieve herd immunity, however, more than 75 million out of the Philippine population of 108 million should be inoculated. (Marites Villamor-Ilano / SunStar Philippines)

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