All vaccines work, whether bivalent or not, in preventing Covid-19 severe disease, death

VIRUSES are meant to mutate and thus, the general population and more importantly the health workers, need to be constantly protected from outbreaks through vaccination.

Aside from the basic wearing of face masks in enclosed areas, vaccination remains the primary protection from the spread of Covid-19, especially now that face-to-face classes have resumed, office workers have returned working at physical offices, and many people are now going back to pre-pandemic activities and behavior. These developments may still put people at risk and thus would need further protection from Covid-19’s deadly consequences.

To continually protect its citizens, the US Food and Drug Administration (FDA) authorized in October of last year the use in the US of two bivalent vaccines made by Moderna and Pfizer-biontech to provide that layer of protection.

What are bivalent Covid-19 vaccines?

BIVALENT Covid-19 vaccines, per definition, contain a component of the original virus strain and a component of the Omicron variant. It targets both the virus’s initial strain and the original Omicron variant. Some refer to bivalent Covid-19 vaccines as an updated version of the Covid-19 vaccine booster dose.

Dr. Razel Nikka Hao, MBA, MSC, the Director for Standards and Sectoral Strategy for the Disease Prevention and Control Bureau of the Department of Health (DOH) said during the Stop C.O.V.I.D Deaths webinar organized by the University of the Philippines, UP Manila NIH National Telehealth Center together with the UP-PGH, that through the years, there were less cases already, less critical admissions and hospitalization, which the country maintained even if it is slowly opening up the economy. “Many of these gains were possibly due to the protection provided by the country’s Covid-19 vaccination program where everyone was really involved, even in the promotion of things related to vaccination.”

She reported that today, the country has already administered over 166 million doses where the majority have already received their first two doses and more than a fourth of the population already received their booster dose.

With the full reopening of schools and of the economy, there should be additional layers of protection, and vaccines provide that additional protection to maintain a strong wall of immunity. The national government targets to achieve 90 percent coverage for the A1 or health-care workers and A2 or senior citizens for the primary series and 50 percent coverage for the first booster dose for the general population.

“We all know that vaccine efficacy wanes over time. It’s very clear that the primary series of the two doses is not enough. At least three is necessary that’s why globally and of course the DOH continues to promote and strongly push for this message.”

Will people take bivalent vaccines or not?

DR. Hao said that in a recent study they made, people will be interested to receive their booster if they get an additional vaccine such as the bivalent ones although a certain number still have doubts up to this time of the vaccination program. It was also shown that people think that there is an additional protection to be brought about by the bivalent vaccines as opposed to the other vaccines available now.

She noted that the global community has been moving towards bivalent vaccination especially when the US Centers for Disease Control and Prevention (CDC) and their Advisory Group changed their recommendation from the old vaccine to the bivalent vaccine which has the newer strain, and also when the European Medicines Agency (EMA) started authorizing the use of the bivalent vaccine.

However, she highlighted the strong position of the World Health Organization and also the DOH’S current assessment that original vaccines maintain a relatively high vaccine effectiveness. She said that even though these newly authorized vaccines can broaden and enhance the immune system, there is not much evidence at this point to support any preferential recommendation for the use of bivalent vaccines over the prior vaccines. “The message is very clear that everyone needs to be boosted and that any of the vaccines, whether the old monovalent ones or the new bivalent vaccines, will be able to provide protection against severe disease and death.”

Dr. Hao also assured that the DOH is always on the lookout for new developments, and is in fact tracking global developments. She said a lot of the old monovalent vaccines are already under standard authorization or regulatory approvals among FDAS of other countries, and even the Philippines’s own FDA is actively transitioning some of the old vaccines from an emergency authorization status to regular product authorization. “This means it can also now be available in private markets or retail establishments. That is already upcoming especially with a very clear directive from the Office of the President that we are now shifting towards the new normal or going back to the standard protocols of how things are being done.

Similarly, Dr. Hao noted that in a few countries like in the European Union, bivalent vaccines are now being granted full authorization but pointed out that what usually happens is if one country already allows it, some may already follow and suppliers now broaden the reach to the different regulatory agencies in other countries and in a matter of like a year or so it will also be available in other settings.

Will the country follow suit?

SHE revealed that in the coming weeks or months, the DOH will also start an initial rollout of bivalent vaccines coming from donations from the Covax Facility, which is a global risk-sharing mechanism for pooled procurement and equitable distribution of Covid-19 vaccines. The country is set to receive a few initial doses of bivalent vaccines and will again be distributed in a phased implementation where health-care workers and senior citizens will be prioritized before it is rolled out to other populations.

Dr. Hao also appealed to fellow health-care workers, particularly in the implementation of systems and structure-related changes to “maintain what have been protecting us, infection prevention and control measures, ventilation, sanitation.” There should be long-term plans to make sure that all of these are part of the development and investment planning. However, she emphasized the value of vaccination should be top-of-mind for everyone.

She also encouraged everyone to remain up-to-date with vaccination and sought support in the vaccine rollouts. “Both original and bivalent vaccines work especially against severe disease and death. We will be needing your support in all of these rollouts and if you want more information, the DOH is always willing to help out and explain.”