Not immune to questions
Exactly two weeks ago, the pharmaceutical company Sanofi Pasteur announced some findings that concerned its product Dengvaxia. The Philippine response has been swift and sharp.
The Department of Health (DOH) suspended its school-based dengue vaccination program, while its Food and Drugs Administration ordered Sanofi last week to pull the vaccine from the market. The Senate began an inquiry. And the secretary of health, Dr. Francisco Duque III, said that Government would demand from Sanofi a refund of the P3.5 billion paid for the vaccine.
Before we yield to any fears that the “anti-vaxxers” among us might encourage, let’s consider what Sanofi actually announced. “For individuals who have not been previously infected by dengue virus, vaccination should not be recommended,” it said last Nov. 29 on its website.
That caution is not new. As early as July 2016, the World Health Organization (WHO) pointed out that the dengue vaccine “may be ineffective or may theoretically even increase the future risk of hospitalized or severe dengue illness in those who are seronegative at the time of first vaccination, regardless of age.” In other words, persons who have not been bitten before by the mosquito that harbors the dengue virus do not need the dengue vaccine.
While the DOH is right to be cautious and to air its grievances about Dengvaxia, Secretary Duque is also right in saying that the dengue vaccination program will proceed, but with better safeguards. DOH can help allay parents’ fears by providing more facts. How many, of the 832,000 vaccinated since April 2016, have contracted severe dengue fever? What steps has DOH taken to ensure that WHO guidelines, especially on deciding which communities should receive the vaccine, were followed?
In its position paper on dengue vaccination, WHO recommended distributing the vaccine only in areas where at least 70 percent of the target age group already tested positive for dengue fever. It also recommended that children younger than nine years old be excluded from the vaccination program, after it studied the results of clinical trials in 10,275 persons, ages 2 to 14 years old, in 10 Asian and Latin American countries.
At no point did the WHO recommend axing the use of vaccines to prevent dengue fever, which has struck an estimated 50 million each year “in recent years, predominantly in Asia.” Narrowing the target groups for dengue vaccination is cautious and rightly so, but keeping the dengue vaccine away from the truly vulnerable communities’ reach would be reckless.