Securing vaccine equity
Nobody is left behind. This is equity in plain terms. Upholding the principle of equity is a challenge for society, more so equity in immunization, particularly to inoculate people against infection of the Sars-CoV-2 virus that causes coronavirus disease 2019 (Covid-19).
Yet, vaccine equity should remain a priority for governments, particularly the Philippines where deep social disparities create in the population large swathes of vulnerable citizens.
Reducing the vaccine inequity begins by identifying and addressing its root causes, advocates the World Health Organization.
Equity should be prioritized along with efficiency in the rollout of the Covid-19 vaccines in the country.
The Philippines has a total population of approximately 108 million, 70 million of whom are targeted for vaccination by the government.
This is according to Department of Health (DOH) 7 Director Jaime Bernadas, as reported on Jan. 20, 2021 by Wenilyn B. Sabalo and Philip A. Cerojano in “SunStar Cebu.”
Bernadas said the government aims to vaccinate 35.1 million Filipinos in 2021. The prioritized include “senior citizens, indigents, frontliners, and government employees.”
The rest of the 70 million will be vaccinated by the government in 2022. By 2023, all Filipinos should be inoculated, said Bernadas.
To prepare for the rollout, the DOH 7 began briefing its personnel and employees of local government units (LGUs), with the LGUs expected to “cascade” the information to the communities.
Bernadas said the DOH has scheduled briefings with private medical practitioners next week. This leveling-off of information about the vaccines among the stakeholders is expected to avoid spreading contradicting, conflicting information, he said.
The DOH’s preference for a “trickle-down” program of information, education and communication (IEC) is centralized, time-consuming and not guaranteed against misinformation and misperception, particularly in untangling the deep-set biases of many Filipinos against free government vaccines, following the Dengvaxia controversy in November 2017.
Fears and suspicions stirred up by conflicting health claims in media lingered and turned many parents against the government’s immunization campaigns even a year later, with only about 50 to 60 percent of Filipino children covered in vaccination programs compared to pre-Dengvaxia coverage of 90 percent, said DOH Undersecretary Enrique Domingo in September 2018, according to a Rappler report on Sept. 27, 2018.
Getting the trust back of the people in a vaccine, primarily its safety and efficacy, is crucial for vaccination to take place.
Regaining public trust will hardly result from a centralized IEC strategy, as gauged from low immunization rates following the 2018 DOH “Ligtas Tigdas” supplemental immunization activities and the school- and community-based immunization programs following the Dengvaxia scare.
Parents refused to give their consent for their children to participate in school immunizations. When health workers went house-to-house for vaccination, mothers hid their children. In Metro Manila, health workers spent as long as 30 minutes to try to convince parents to let their children be vaccinated, said DOH National Immunization Program Manager Maria Silva to Rappler in 2018.
The DOH, LGUs, and other public and private stakeholders should refocus their IEC campaigns on the Covid-19 vaccines in the communities, tapping influencers and the trimedia and social media, if applicable.
Citizens have questions about the safety and the efficacy of the vaccines, given the varying manufacturers and storage requirements.
For raising public confidence in the Covid-19 vaccines, particularly against the new strains, the public participation of key public figures, such as President Rodrigo Duterte, may counter citizens’ anxieties and contribute to achieving the vaccine equity that will be the key out of this pandemic.