Monday, June 25, 2018
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Panic over Dengvaxia hurting other immunization, health programs

The Department of Health (DOH) has expressed alarm that its public health and immunization programs were suffering due to the fallout from the botched dengue immunization program.

Health Undersecretary Rolando Enrique Domingo on Friday said many parents, fearing for the safety of their children, have kept them away from important vaccines after the DOH stopped the massive immunization program last November that inoculated 830,000 children.

The P3.5-billion school-based program that used the Dengvaxia vaccine was halted after its manufacturer, French pharmaceutical giant Sanofi Pasteur, said a study showed that it may increase the risk of severe dengue in patients who had no previous exposure to the mosquito-borne disease.

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“Our problem right now is that our health programs are suffering,” Domingo said. “Even vaccination rates are suffering.”

He cited the health department’s deworming program, usually held every January and July.

First deworming

He said the first deworming this year had a “very low” turnout and that even vaccination programs for preventable illnesses like polio, measles, tetanus and diphtheria were suffering.

“We recently had a measles outbreak in Davao. We’re trying to make up for it but the vaccination rate is very low. Our vaccine programs shouldn’t have to suffer,” Domingo said.

The ideal 85 to 90 percent vaccination coverage for Filipino children had gone down to 60 percent, the DOH said.

Domingo attributed the drop to the panic over Dengvaxia, especially after the reported deaths of more than a dozen children who were given the vaccine.

“It’s really hard for them. The parents are really afraid, but this doesn’t mean that we should be paralyzed with fear,” Domingo said.

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The Philippine General Hospital (PGH) on Friday disclosed results of a two-week clinical study of the medical records of 14 children who had received Dengvaxia shots and later died.

The study by a 10-member expert panel showed that only three of the 14 died due to dengue shock syndrome and two of them possibly from vaccine failure. The others died from other illnesses unrelated to dengue.

The panel also recommended further studies, especially a thorough evaluation of tissues from the three children who died of dengue, a tedious process that involves the examination of microscopic specimen.

Senate hearings, investigations by the Public Attorney’s Office (PAO) and allegations of corruption in the procurement of the vaccine have not calmed anxious parents and children despite public service announcements by the DOH regarding dengue.

In an effort to help ease fears about the vaccine and establish a scientific and medical basis for any relationship between the deaths and Dengvaxia, the PGH pathology department has volunteered to help perform autopsies on children suspected to have died because of the vaccine.

“The PGH is offering you the expertise of its staff for free for Dengvaxia cases. Only forensic pathologists know how to do medical autopsies,” said Dr. Maria Cecilia Lim, a forensic pathologist who was part of the PGH panel.

“If you feel that you don’t want the services of the PGH, the PSP (Philippine Society of Pathologists, or PSP) is also willing to help the public with these investigations and medical autopsies,” she added.

Dr. Sylvia Claudio, a medical doctor and dean of the College of Social Work and Community Development of the University of the Philippines, said the public needed to be reassured to stop the panic.

“People are turning away from much needed health services that will protect all of us. Time to counteract the ethically dubious acts of certain people,” she said on Facebook where she posted a statement by Doctors for Public Welfare led by former Health Secretary Esperanza Cabral.

Leave task to experts

The statement urged the Department of Justice to stop PAO from performing autopsies and leave that task to competent experts.

“In light of these findings by the pathologists of the Philippine General Hospital, it makes no sense for any more families to be subjected to the torture of having a loved one exhumed and cut up only to find out that no useful information was derived from the cruel act,” it said.

Lim said PAO had not shared its autopsy findings with them.

Lim said the PGH panel recommended that future medical autopsies of children given Dengvaxia be done with a representative from the PGH or the PSP.

She said medical autopsies, done on patients who died of nontraumautic causes, must be conducted by pathologists and not by general practitioners.

“A medical autopsy is 10 times more difficult than a forensic autopsy because you need to look at all clinical data, and you have to explain. You have to know what illnesses are present,” Lim said.

PAO chief Persida Rueda-Acosta said it was the parents of the children who requested the services of her office’s forensic doctors.

‘Matter of trust, confidence’

“It is a matter of trust and confidence,” she said, adding that PAO also tapped “external nonconflicted pathologists.”

“If the parents have trust on the (PGH doctors), they may do the examination. The doctors do not own the bodies of the dead but their immediate relatives. So the relatives are the proper parties who have the choice as to who will conduct the forensic exam,” Acosta said.

“The PAO forensic team will continue to follow the orders of proper authorities and not those of a private association of doctors,” she said.

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TAGS: Dengue Vaccine, Dengvaxia, DoH, immunization programs, Rolando Enrique Domingo, Sanofi Pasteur
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