Vaccine expert pushes shorter wait before COVID-19 survivors can get inoculated
MANILA, Philippines — As the government ramps up its COVID-19 vaccination campaign to reach as many people as possible amid a surge in cases, experts have recommended changes in the inoculation guidelines, including giving jabs to patients two weeks after their recovery from the respiratory disease.
In a Department of Health (DOH) press briefing on Tuesday, Vaccine Expert Panel (VEP) member Dr. Gene Solante said they would write health officials about changing the guidelines on when a COVID-19 survivor could get vaccinated.
The panel recommends that those who have recovered be allowed to get a COVID-19 shot after 14 days, said Solante, who also heads the adult infectious diseases and tropical medicine department of San Lazaro Hospital.
Under the previous guideline, a recovered patient could be inoculated only after 90 days, a gap that Solante considered to be “too long.”
He also cited the amended rules for those who get infected with the coronavirus after receiving only one dose of the COVID-19 vaccine.
Previously, those who fall under this category would be required to wait for three months before they could get inoculated again, with what would be considered their first dose.
Interval
But under a March 30 memo from the DOH, all vaccine recipients who contracted COVID-19 after the first dose “may be given the second dose provided a recommended interval of 14 days from recovery or completion of treatment are met, without restarting the vaccine dose schedule.”
In the same briefing, Solante also said that the VEP had submitted its recommendation to the Food and Drug Administration (FDA) on whether to allow Chinese manufacturer Sinovac Biotech’s COVID-19 vaccine to be given to seniors or those 60 years old and above.
“We just finished the recommendation. We have forwarded it to the DOH,” he said. Declining to provide details, he asked the public to just wait for the DOH evaluation.
The FDA has allowed AstraZeneca vaccines to be given to the elderly while limiting Sinovac’s CoronaVac to those between 18 and 59 years old due to the lack of clinical data trial.
Solante said the panel thought it prudent to again examine the data submitted by Sinovac since the government was running out of AstraZeneca vaccines donated to the country through COVAX.
No to indiscriminate testing
Meanwhile, a group of medical doctors said the government must avoid indiscriminate testing or screening an entire population for the coronavirus.
“In a country like the Philippines [which is] already having difficulties in testing, tracing, and treatment…, indiscriminate mass testing of asymptomatic individuals using tests with suboptimal sensitivity is neither feasible nor practical,” the Healthcare Professionals Alliance Against COVID-19 (HPAAC) said on Tuesday.
The group said it does not recommend testing individuals who are asymptomatic and have no history of close contact with a positive case.
“Indiscriminate testing without proper counseling on the implications of the results can lead to complacency and [a] false sense of security if test results are negative. On the other hand, false positive results can lead to undue panic, stigma and unnecessary isolation,” it added.Risk-based, targeted
National Task Force Against COVID-19 deputy chief implementer Vince Dizon also cited HPAAC’s recommendation when he stressed that testing must be “risk-based and very targeted,” amid mounting calls for the government to conduct mass testing.
Dizon pointed out that experts worldwide had been unanimous in saying that mass testing was not advisable.
For him, those who undergo testing must fall under a set of guidelines or be supported by a doctor’s recommendation.
“There must be guidelines or somebody making an assessment when a person should undergo testing. The person himself should not be the one to determine when he would take the test. This must be either recommended by a doctor or because you have symptoms or fall under the guidelines set by experts,” Dizon said.
Under the guidelines, those who come into close contact with COVID-19 patients or are symptomatic or come from areas with a high incidence of the respiratory disease should be tested. The costs would be shouldered by the government, he added.
Timing also a factor
Infectious disease expert Dr. Edsel Salvana also said that targeted testing was important because the timing would affect the accuracy of the results.
It would take about three days after an infection for a person to test positive in an RT-PCR test, and even then, there would just be a 33 percent possibility that the person would have a positive result, he explained.
If a person already has symptoms, the accuracy of the test is about 62 percent, Salvana said, adding that this goes up to 80 percent on the third day after the appearance of the symptoms.
“If we test a person without considering the timing of infection and they don’t have symptoms, you are in danger of clearing someone—two out of three times—who has COVID-19 but is negative in the RT-PCR [test],” he said.
The government now conducts an average of 52,000 tests a day but seeks to increase this by another 30,000 with the use of antigen test kits.
However, the Office of the Civil Defense, which is in charge of buying 500,000 additional kits, has yet to finish assessing bids from manufacturers.
Civil Defense chief and Undersecretary Ricardo Jalad confirmed this in a text message but did not say exactly what was delaying the procurement.
