COVER STORY

COVID-19 vaccination: Sourcing the shots that save

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Metro Manila (CNN Philippines) — A significant portion of the country's population should be protected against COVID-19 through vaccination to stop the spread of SARS-COV2. However, four months into the government's vaccination program, only a measly 3% have been fully vaccinated.

Early this year, vaccine czar Carlito Galvez Jr. confidently declared the country can attain herd immunity by the end of 2021, with the government seeking to inoculate 50 to 70 million of the population by December.

Only about 3.5 million of 110 million Filipinos have been fully vaccinated as of July 12.

While daily vaccination numbers are steadily rising and have reached up to over 250,000 in July from a mere 32,000 when the national vaccination program started in March, this is still a far cry from the target of inoculating 500,000 people every day to attain herd immunity by year-end.

In May, health officials admitted that the country cannot reach herd immunity within a year, saying it remains as the government's long-term goal.

The government then shifted its sights on "population protection," a clear admission of the challenges presented by limited and erratic global vaccine supply. From the goal of vaccinating 70% of the population for herd immunity, the target was lowered to inoculate only 50% of the population, with a focus on Metro Manila and eight other target areas which were then logging high virus numbers.

“Ang iniiwasan natin ay ang maospital o ang mamatay... November 27 nga po iyong target natin for population protection sa Metro Manila,” Presidential Spokesperson Harry Roque said.

[Translation: We intend to prevent hospitalizations and deaths. November 27 is our target for population protection in Metro Manila,” presidential spokesperson Harry Roque said.]

In fact, United Kingdom-based think tank Pantheon Macroeconomics projected in June that the Philippines will be the last Southeast Asian country to achieve herd immunity due to the snail-paced vaccination. But the Palace was quick to dismiss this, saying the group based the report on the data when the country was still getting fewer vaccines.

Delays in vaccine procurement

With the tight supply, the government had to prioritize groups and regions that will receive more vaccines. But with the rise of new cases outside Metro Manila in June, several local officials aired their grievances over perceived inequitable, slow, and insufficient distribution of vaccines.

Philippine College of Physicians president Dr. Maricar Limpin said the Philippines could have had a head start in COVID-19 vaccination if the government negotiated for vaccine supplies earlier in the game.

“Umpisa pa lang stage ng development ng vaccine, we should have started the negotiation… Para by the time mag-release ng bakuna, isa na tayo sa unang nakakatanggap ng bakuna,” Dr. Limpin said.

[Translation: We should have started negotiating for the vaccines at the stage when these were still being developed so that by the time they released the vaccines, we would be among the first to receive it.]

Instead, the Philippines became the last country in the ASEAN region to roll out its vaccination program. In February, the Philippines remained as the only Southeast Asian country with no COVID vaccine. Health Secretary Francisco Duque III was fiercely criticized for "dropping the ball" on procuring millions of Pfizer vaccines, with the Philippines missing the opportunity to have received the shots as early as January.

Laos, Singapore, and Indonesia started administering shots back in December 2020, while the Philippines' vaccination drive only started four months later due to lack of supplies.

The country's first batch of vaccines — some 600,000 Sinovac doses donated by China — arrived on February 28. Inoculation started on March 1.

The rest of Sinovac and other vaccine brands such as AstraZeneca came in trickles in March and April either due to logistics problems or the lack of additional documentary requirements. During this time, daily inoculation ranged only between 22,932 to 47,545 shots

More of the donated and government and private sector-procured doses were shipped to the country on near the end of May and June.

Secretary Roque argued the government acted quickly to secure vaccines. However, he said the government faced challenges in settling advanced payments sought by vaccine manufacturers.

“We negotiated about the same time as everyone did, kaya lang money talks. ‘Yung mga nagbayad, nagbigay ng pera habang dinedevelop ang vaccine. Sila siyempre ang unang nakakuha ng vaccine. Alam mo problema talaga natin COA challenges. Advanced payment hindi talaga allowed, which we solved through the tripartite agreement,” Roque said.

[Translation: We negotiated about the same time as everyone did, but money talks. Those who were able to make payments even if the vaccines were still in the development stage, they were the ones that got first crack at the vaccines. There are challenges in our Commission on Audit because advanced payment is not allowed. This we solved through the tripartite agreement.]

Officials earlier claimed the government was already talking to vaccine developers in August 2020. President Rodrigo Duterte only allowed the advance payment for the vaccines in November---nine months into the pandemic.

Congress passed the Republic Act 11525 or the COVID-19 Vaccination Program Act to expedite vaccine procurement and administration in February this year.

Vaccine hesitancy

Supply limitations were not the only obstacles in the Philippines' mass COVID-19 vaccination program.

Despite the growing global demand for the precious doses, there are still Filipinos who do not want to receive the shots.

A Social Weather Station survey conducted in late April to May 2021 done on 1,200 adults showed that only a third of Filipinos are willing to be vaccinated. The rest expressed uncertainty, or simply refused to receive the vaccine citing fears of severe adverse effects.

Then, there is the issue of who will administer the doses if and when vaccine supply stabilizes. There are concerns on how the country could reach its goal to inoculate half a million individuals per day with the limited number of vaccinators in several areas.

There are also reported lapses in vaccination procedures. Cases of improper injections surfaced in June and July. This happened just when the government was gathering momentum in its inoculation. The health department attributes the lapses to human error. Alliance of Health Worker national president Robert Mendoza said health workers are tired and demoralized, with many volunteer nurses not receiving promised benefits.

Treatments and future plans

The country still lacks the capability to develop its own vaccines but is opening its doors to initiatives of local vaccine makers. The DOST has also launched trials on COVID-19 treatments.

To boost local vaccine development, the Duterte administration is creating the Virology Science and Technology Institute of the Philippines. This will serve as a research facility on viruses and viral diseases affecting humans, plants and animals.