EXPLAINER: Overworked, underpaid HCWs’ woes on Sinovac vaccine

MANILA, Philippines — It has been a year since the coronavirus disease 2019 (Covid-19) entered the country. With over 30,000 active cases and more than 12,000 deaths, hospitals and medical frontliners are still scrambling to manage the current health crisis as the nation waits for the arrival of the Covid-19 vaccines.

Although the healthcare workers have been included in the priority list for the government’s Covid-19 vaccination program, as they should be, the government’s anti-Covid-19 task force has decided to approve recommendations to inoculate frontliners with China’s Sinovac,  which has raised several questions due to its effectivity.

Aside from the possibility of receiving jabs of vaccines with questionable efficacy, the top brass are still dragging one of the foremost requests of  health professionals — a wage increase.

What happened?

Health Undersecretary Maria Rosario Vergeire on Friday announced in a press briefing that the Inter-Agency Task Force on Emerging Infectious Diseases (IATF) has approved the recommendation to use Sinovac’s Covid-19 vaccine for healthcare workers.

The recommendation was from the experts from the National Immunization Technical Advisory Group (NITAG) and Department of Health-Technical Advisory Group (TAG).

Here is a lookback on the previous statements regarding Sinovac’s vaccine:

• On February 22, the Food and Drugs Administration (FDA) has granted Sinovac’s Covid-19 vaccine an emergency use authorization (EUA). The China-based drugmaker applied for an EUA on January 14. The FDA said at least half a million doses of the said vaccines, which is a donation by the Chinese government, are expected to arrive in the country.

• FDA Director-General Eric Domingo detailed that Sinovac’s efficacy rate ranged from 65.3% to 91.2%. However, he emphasized that its efficacy rate only stood at 50.4% among healthcare workers, making it not the best vaccine for them. Sinovac’s efficacy rate varied from 50.4%, 65%, and 91.25% in trials in Brazil, Indonesia, and Turkey.

• In fact, the FDA earlier stated that it does not recommend administering Sinovac’s vaccine to healthcare workers and senior citizens, who are the top priority population for the government’s vaccination program.
• But on February 24, the FDA clarified that the vaccine can be used for those in the regular workforce, like construction workers and drivers. “Lalo na po yung 18 to 59 [years old] na mga workers sa community, for example, maganda po ang kanyang efficacy rate, 65 to 91 percent kaya talagang very good po siya,” FDA Director General Eric Domingo said in an interview over Teleradyo. (For example, for workers in the community who are 18 to 59 years old, it has a good efficacy rate of 65 to 91 percent, it’s very good.)

• On the other hand, Sinovac’s general manager Helen Yang defended the manufacturer’s vaccine and explained that it is recommend that its vaccine be administered on the elderly and health workers exposed to the disease. “I think generally, Sinovac would recommend, not only for the Philippines but also for other countries using our vaccines that the products should be used among the healthcare workers as well as the elderly,” said Yang in an interview over ABS-CBN News Channel.

Still, Vergeire said that the provision on the use of Sinovac vaccine for healthcare workers attending to Covid-19 patients included in the EUA granted for the vaccine “is not a contraindication nor a recommendation born of concern over the vaccine’s safety.”

“The DOH, the FDA, and our panel of experts concur that current available evidence is enough to establish that the vaccine is safe for use,” the health undersecretary clarified

“As the FDA has clarified, they included this specific provision not to question the vaccine’s safety but for the national government to consider that given the low reported efficacy in the specific recipient group, providing Sinovac vaccine to healthcare workers may not yield the most ideal results, hence may not be the most rational of this very limited resource given the context of limited vaccine supply,” she added.

The recommendation, which Vergeire said “will be beneficial for the healthcare workers,” still needs to be presented to President Rodrigo Duterte.

How about Pfizer-BioNTech’s vaccine?

In a separate online press briefing last February 15, the Department of Health (DOH) announced that personnel from 34 hospitals in the country will receive the initial batch of Covid-19 vaccines from US drugmaker Pfizer.

According to Vergeire, the hospitals will be composed of 32 facilities in Metro Manila, one in Cebu and one in Davao. https://newsinfo.inquirer.net/1395926/34-hospitals-to-get-initial-batch-of-pfizer-vaccine-doh

This assured several healthcare workers that they will get jabs of Pfizer-BioNtech’s vaccine, which showed a 95 percent efficacy rate during studies on the vaccine.

“Ang problema kasi natin, asang-asa tayo na darating na ‘yung [ibang brand] diba? To talk about PGH na lang for example because I’m also part of the community, there was a lot of anticipation na parating na ‘yung bakuna tapos syempre nasabi naman samin na mukhang Pfizer ‘yung darating,” said Dr. Anna Ong Lim, another member of TAG.

(Our problem is that we were already hoping that the other vaccine brands will finally arrive.

To talk about PGH for example since I’m also part of the community, there was a lot of anticipation that the vaccines will arrive and we were informed that those might be from Pfizer.)

“I have to say nabuhayan talaga ng loob ‘yung mga tao kasi finally andyan na ‘yung bakuna, alam naman natin na maganda ang data na nangyari sa trials, sa interim analysis ng data ng Pfizer,” she added.

(I have to say that the healthcare workers were really encouraged because the vaccines are finally arriving and we know that the interim analysis for Pfizer’s data showed good results.)

However, Lim explained that the NITAG and TAG recognized the uncertainty on when the Pfizer vaccines will be delivered and arrive in the country.

“Minabuti na ng grupo ng Tag at NITAG na bigyan ng pagkakataon ang mga tao na sila ang pumili,” she said, adding that the Sinovac doses will not be forcedly administered to healthcare workers.

(The TAG and NITAG thought that it would be good to give the people a chance to choose.)

“Hindi natin ito ipinipilit sa kanila. This is being given as an option kasi may mga tao na feeling nila bawat araw na pinapasok nila sa ospital, tinataya nila buhay nila eh tapos sasabihin natin ‘ito hindi ‘to puwede sa inyo’ when in fact may data naman na puwedeng magsabing puwedeng gamitin,” she added.

(We will not force it to them. This is being given as an option because there are some who feels like everytime they go on duty to their hospitals, they are risking their lives. Then we will tell them ‘this vaccine can’t be good for healthcare workers’ when in fact there is an available data which can tell that the [Sinovac] vaccine can still be administered to them.)

The doctor likewise clarified that healthcare workers can still avail of other vaccines against Covid-19 even if they have decided to decline the recommended Sinovac vaccine.

Sending a message?

Due to the safety and efficacy of Sinovac’s vaccine, many healthcare workers have expressed hesitations in receiving jabs of the donated vaccine doses.

Just after announcing the approval of IATF on the recommendation to use Sinovac, some healthcare workers from the Philippine General Hospital (PGH) staged a protest demanding free, safe, and effective Covid-19 vaccine doses.

But, according to  Dr. Nina Castillo-Carandang of NITAG, the healthcare workers’ disinclination towards the vaccine brand might “send a signal to the general public.”

“We always look up to our healthcare workers for good examples of how to take better care of ourselves. If health care workers are reluctant to accept vaccination, then that also sends a signal to the general public,” Castillo-Carandang said during the press briefing on Friday.

“We’d like to offer this opportunity for healthcare workers, if they’re willing to do so, to have themselves vaccinated with Sinovac,” she added.

In a recent survey done by OCTA Research, a group of top academicians studying the coronavirus pandemic, it showed that merely 19 percent of adult Filipinos are willing to get vaccinated against COVID-19 and 46 percent are unwilling even if a safe and effective vaccine is available.

The top reason for not getting the vaccine, given by 73 percent of respondents, was a concern for the safety of the vaccines, followed by doubt about their efficacy.

“If [the healthcare workers] don’t feel that this is the best vaccine for them, given with their risk-benefit analysis for themselves, then they can still wait for the other brands of the vaccines,” said Castillo-Carandang.

However, she emphasized that there is still limited information on the current status on the negotiation and procurement or delivery date of the Covid-19 vaccines from other manufacturers.

Still overworked and underpaid

The DOH reported on Friday that the country’s total Covid-19 caseload reached 571,327. Of the sum, 34,498 are active cases and 524,582 are the total recoveries.

Meanwhile, 12,247 individulas succumbed to the disease.

While healthcare workers have been seen and hailed as modern heroes for their efforts during the pandemic, they have been consistently calling for wage increase.

According to the Alliance of Health Workers (AHW), nothing has changed in the salaries of medical frontliners since the Covid-19 pandemic was declared early last year.

“Our salaries can no longer compensate to the everyday needs of our family. Especially now that there is pandemic, with the fare alone, our wages is not enough,” said Edwin Pacheco, president of the National Kidney and Transplant Institute Employees Association-Alliance of Health Workers (NKTIEA-AHW) in a statement on February 16.

“Last October 31, 2020, we no longer have free transportation provided by the hospital. So, I ride public transportation and since NCR are still in a General Community Quarantine (GCQ) not all PUV’s like jeepneys are allowed to travel yet, so from Antipolo I will be forced to take taxicab going to NKTI where I work,” he continued.

JPV