Ex-Health chief: Give Dengvaxia to those who got dengue

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Metro Manila (CNN Philippines, August 14) — A former Health Secretary campaigning for the return of Dengvaxia wants the dengue vaccine to be administered to the nearly 170,000 people who have been infected with dengue since January.

“These are precisely the people who should get the vaccine so that next time they don’t get dengue again,” former Health Secretary Esperanza Cabral told CNN Philippines’ The Source on Wednesday.

Cabral heads Doctors for Truth and Welfare, a group of medical professionals who want the controversial dengue vaccine back on Philippine shelves, after it was banned in February because its manufacturer, Sanofi-Pasteur, supposedly failed to comply with post-marketing authorization requirements.

This move came over a year after the Food and Drug Administration (FDA) suspended its certificate of product registration in December 2017, following Sanofi-Pasteur’s announcement that its dengue vaccine could cause severe dengue among those who have not had dengue when they contract the disease.

But Cabral said this “deprived” people who have received the initial doses of Dengvaxia of full immunity as they failed to complete all the three shots necessary for the vaccine to be effective.

She added it is also unfair to demand post-marketing surveillance from Sanofi-Pasteur, when they have not been allowed to sell Dengvaxia since December 2017.

“Post-marketing surveillance, ibig sabihin dapat nasa merkado ang gamot. Kung hindi, paano ka makakagawa ng surveillance? So unfair naman ata ‘yun na hihingan mo sila ng post-marketing surveillance report nang hindi mo man lang sila binigyan ng pagkakataon na i-market ‘yung produkto,” Cabral said.

[Translation: Post-marketing surveillance, so that means that the drug should be in the market. If not, how would you conduct post-marketing surveillance? So it’s quite unfair if you would ask a post-marketing surveillance report from them without even allowing them to market the product.]

The decision on whether Dengvaxia would return to the market rests on Health Secretary Francisco Duque III who can overturn or uphold the FDA’s revocation of its certificate of product registration.

But even in the event that Duque lets the dengue vaccine return, it may still take months before it is available to the public, as the FDA will have to approve its new label, which contains new information on who can receive the vaccine.

Talks of its return, however, fuels fears among anti-Dengvaxia advocates, like Dr. Anthony Leachon, that this may end up clearing government and pharmaceutical officials of charges over the allegedly anomalous purchase of the dengue vaccine.

“Perhaps somebody would like to impell estoppel. Meaning to say, they want it restored back in the market so that it will affect whatever political and legal issues that you have right now,” Leachon said.

Malacañang has assured that the cases will not be rendered moot if the government decides to bring back Dengvaxia to the market.

Leachon also said that even if the dengue vaccine returns, its effects on curbing a future dengue epidemic would be limited as it can only be administered to a certain group of people. Eradicating mosquitoes is key to reduce dengue cases, he added.

Cabral said that while it is important to target mosquitoes, the vectors or carriers of the dengue virus, it should be accompanied with the dengue vaccine.

“We should bring it as soon as we can so that the next dengue epidemic can be prevented,” she said.

She also advised families of children who died after getting vaccinated with Dengvaxia to listen to experts, stressing that the dengue vaccine is not to be blamed for their kids’ deaths.

The Health department itself has admitted that Dengvaxia can be useful in preventing future dengue epidemics.

The Philippine Pediatric Society and Pediatric Infectious Disease Society of the Philippines have said that Dengvaxia has been proven safe and effective to those who have had dengue previously.

The Philippines’ decision to pull out Dengvaxia runs counter to moves of other countries to allow the sale and use of the anti-dengue vaccine. The World Health Organization (WHO) said the vaccine is licensed in 20 countries.

The WHO also said that Dengvaxia has been shown to be 79.1 percent effective in the year following vaccination. It was more effective against dengue serotypes 3 and 4, at 71.6 percent and 76.9 percent, respectively, than serotypes 1 and 2, at 54.7 percent and 43.0 percent, respectively.

However, the WHO has also cautioned that countries who would want to include Dengvaxia in their dengue control program should conduct pre-screening of patients to ensure that only those who have been previously infected with dengue are vaccinated.