2nd booster shot: Continuing the fight against COVID-19 in PH

A Marikina resident takes a selfie while getting a booster shot. NIÑO JESUS ORBETA/FILE PHOTO

MANILA, Philippines—The country began its first day of administering the second booster shot against COVID on Monday (April 25), marking a continuing fight to defeat the still incurable disease.

Last April 13, the Department of Health announced that the country’s Food and Drug Administration (FDA) has granted emergency use authorization (EUA) for second booster shots against COVID.

The first day of the rollout was initially expected last April 20 but was moved to April 25.

READ: Second COVID-19 booster shot rollout underway

According to data from the National COVID-19 Vaccination Dashboard, 66,990,999 Filipinos were already fully vaccinated—or have received two doses of vaccine—against COVID as of April 18.

At least 12,970,445 Filipinos had received their booster dose.

The DOH previously said over 46.8 million individuals are qualified for a booster shot, which provides an additional layer of protection as vaccine efficacy wanes over time.

In this article, INQUIRER.net will provide more detail on the second booster shot as well as fears about a resurgence of COVID cases.

What we know so far

According to the DOH, for now, only immunocompromised individuals aged 18 years old and up can receive their fourth dose—or second booster shot.

GRAPHIC: Ed Lustan

Health Secretary Francisco Duque III said among those who are eligible to receive the second booster were:

• Patients who underwent organ transplants
• Patients taking medicines for immunosuppressives
• Cancer patients
• HIV/AIDS patients
• Patients with primary immunodeficiencies

The country’s FDA granted an EUA for the administration of an additional vaccine booster to senior citizens 60 years old and above, the immunocompromised and front line health care workers—the three priority groups in the government’s vaccination program

READ: EUA OK’d for second booster for seniors, immunocompromised, health workers

However, Duque announced that health workers and seniors would not yet be part of the rollout.

GRAPHIC: Ed Lustan

“For now, what I have approved based on the recommendation of the Health Technology Assessment Council (HTAC) is the second booster dose only for immunocompromised patients,” he said, referring to the advisory body of the DOH.

The health secretary said experts will soon study data on the second booster shot for health care workers and senior citizens.

The DOH said the second booster dose should be given four months after the first booster shot.

“For moderately and severely immunocompromised patients, the second booster could be given earlier subject to the attending physician’s assessment,” the DOH said in a statement.

Health Undersecretary Maria Rosario Vergeire said last week that “immunocompromised individuals can receive their fourth dose as early as three months after their [first COVID-19 booster dose].”

GRAPHIC: Ed Lustan

According to the DOH and the National Vaccination Operations Center (NVOC), among the six vaccine brands that have been approved for the administration of the second booster shot were:

• Pfizer-BioNTech
• Moderna
• Sinovac
• AstraZeneca
• Sputnik Light
• Janssen

In an interview with ANC last April 22, Health Undersecretary Myrna Cabotaje, who is also NVOC head, echoed the recommendation of the government’s Vaccine Expert Panel (VEP) and said that using a different vaccine brand as a second booster shot will be “more effective” in fighting COVID-19.

“A different brand will be more effective because it tries to give additional protection outside of the regular or the homologous primary booster,” Cabotaje said.

“They are thinking that it will have a better effect, it’s a complementary effect to the original vaccine doses that have been given,” she added.

GRAPHIC: Ed Lustan

However, she clarified that the use of a different vaccine brand as a second booster shot remains only a recommendation for now.

“There are preferences and based on studies, the recent clinical trials are showing that there may be more advantages. However, these are recommendations,” Cabotaje said.

READ: DOH: Different vaccine brand as 2nd COVID-19 booster shot ‘more effective’

According to Cabotaje, at least 7,000 to 13,000 immunocompromised individuals were expected to have their second booster shot on the first day of rollout on April 25.

She said the country has about 690,000 immunocompromised individuals who had already received their first booster shot.

GRAPHIC: Ed Lustan

Data from the National COVID-19 Vaccination Dashboard showed that 2,324,169 individuals—or persons with comorbidities under the A3 priority group—had already received their first booster shots.

In a radio interview last April 23, Cabotaje said the country’s supply of vaccines is enough for the rollout of the second booster shots.

“We have enough vaccines for primary doses, first and second booster shots,” she said.

Another surge?

Last week, Malacañang clarified that the administration of the second booster shot for persons with comorbidity “has nothing to do” with fears of a possible surge of new COVDI-19 cases next month.

Communications Secretary Martin Andanar, presidential spokesperson, said that the additional booster dose is the government’s “scientific response to waning immunity” and not to an anticipated spike in new cases by May.

“Our goal is to reinforce the shield that will protect us from any variants already here and that might come in later on,” Andanar said.

READ: Palace: 2nd booster shot meant for waning immunity, not surge

Earlier this month, Dr. Rontgene Solante, chief of the Adult Infectious Diseases and Tropical Medicine Unit at the government-run San Lazaro Hospital in Manila, said the country might face an uptick in new COVID-19 cases after the May 9 elections.

GRAPHIC: Ed Lustan

Aside from superspreader events, like the national elections on May 9 and the observation of Holy Week and Ramadan this April, “waning immunity” among people who have yet to get booster shots might lead to a surge in new cases.

“We may see a surge of cases, especially after the elections,” Solante said.

“They may infect one another, those who have been vaccinated but have yet to get their booster, there could be reinfection,” he added.

According to the DOH, over 33 million eligible individuals have yet to get their booster shots.

Solante also pointed out that some people begin to drop the use of face masks amid the eased restriction on movement.

“Some people don’t even wear a face mask. So this is multifactorial, the possible rise in cases after the election or during the next two to three months,” he said.

READ: Health expert warns of COVID-19 ‘surge’ after May 9 polls

On April 6, World Health Organization (WHO) released a statement warning about the possible surge in COVID-19 cases as “unsafe gatherings and social mixing” continue.

Dr Rajendra Yadav, acting WHO representative to the Philippines, said everyone should at least wear a mask and get booster shot to prepare for and possibly avoid a potential surge in the coming months.

READ: WHO warns of new COVID surge in 2 months, urges PH to prepare

Yadav said at a Laging Handa briefing last April 18 that the country may have as many as 300,000 active COVID-19 cases by mid-May if the public failed to comply with minimum health standards.

“I have seen those numbers, we have to prove those numbers wrong. That’s the challenge we face. If we relax our guard, if we relax our defenses, yes it’s possible to get to those numbers,” said Yadav.

“Whether the numbers will increase or not, only time will tell. We should not focus too much on the number of cases, rather on the number of people who are vaccinated. That’s more important,” he said.

READ: WHO: 300K active COVID-19 cases in PH by May possible if health standards neglected

Last week, however, the DOH said recent warnings on the possible uptick in COVID-19 cases by May is only a projection.

“I just want to remind everyone that this is just a projection,” said Vergere at a press briefing.

“Meaning this may or may not happen. It is being used as guide so we can plan, prepare and inform our countrymen,” she added.

READ: DOH says COVID surge by May if protocols aren’t met is just a projection

The health undersecretary clarified that projections are based on the risk factors present—including crowding and mass gatherings in events like campaign rallies ahead of the May 9 elections.

Lower public compliance with minimum health standards, such as social distancing and wearing of masks, is also considered a factor for the possible surge.

“These kinds of risk factors can contribute to the increase in cases. The projections include the assumption that if individuals, or the community or the population will have reduced compliance to minimum public health standards by about 30 to 50 percent, this kind of increase in cases will happen,” Vergeire said.

READ: DOH warns of possible COVID-19 surge by May due to neglected health standards

The DOH on Sunday recorded 205 new cases of COVID-19, bringing the total number of confirmed infections to 3,684,500 nationwide. This includes 3,610,658 recoveries and 60,182 deaths.

READ: PH logs 205 new COVID-19 cases – DOH

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