PGH panel sees vaccine failure in 2 kids who died of dengue after vaccination

The Department of Health is looking at a possible vaccine failure in two of three children who died of dengue shock syndrome after receiving doses of the Dengvaxia vaccine.

A review conducted by experts from the Philippine General Hospital (PGH) revealed that of the 14 cases of children who died after receiving the vaccine, only three contracted the dengue virus.

“There is vaccine failure in two of the cases. But not for the 830,000 children who were given Dengvaxia. It’s a vaccine failure for these particular cases,” said health undersecretary Enrique Domingo.

He noted that a causal association was observed in these three cases, as the children died of dengue despite being vaccinated with Dengvaxia.

“These results strengthen our decision to suspend the dengue immunization program. Dengvaxia is not fit for a mass immunization program that does not screen for prior dengue infection and comorbidities of children before the administration of the vaccine,” Domingo added.

Not for sure

Dr. Juliet Sio-Aguilar, a pediatrician and head of the PGH expert panel, however, stressed that they cannot say for sure if Dengvaxia was indeed the culprit for the three deaths.

“We cannot say anything (to that effect), but we can say that they contracted dengue, the wild type. All of them succumbed to the dengue wild-type virus,” she said.

Aguilar added: “It takes a long process to understand what happened to a patient. Out of the 14, only three had dengue, one of them had antibodies and protection. We want to find out why it happened.”

She made the remarks in a press briefing on the initial results of the PGH expert panel’s clinical review of 14 cases of children who died after being inoculated with Dengvaxia.

Earlier, the DOH forwarded the clinical records of the 14 children to the PGH to find out if there was any correlation between the controversial vaccine and the deaths.

Aguilar explained that of the three cases, two children died after receiving three doses of the vaccine while one died days after being given the first dose.

The official cause of death for the three children was dengue shock syndrome.

The two children who completed the three doses fell ill a month or so after the third dose, and died five days or so after the onset of the illness.

Possible

Aguilar pointed out that one of the children fell ill only four days after the first dose, dying five days after the onset of the illness.

She noted that the course of the dengue infection was unusually acute or fast, and that it was possible that the child was already incubating a dengue infection when given the vaccine.

And despite being given Dengvaxia, two of the children did not develop any dengue antibodies while one developed dengue antibodies which were supposed to serve as protection against dengue.

All of them tested positive for the NS1 dengue antigen, or the presence of dengue.

“We really want to know what happened. The third case developed antibodies, protection against dengue, but the child still died,” Aguilar said.

Meanwhile, three of the 14 cases were found to be coincidental because there was inconsistent causal association to immunization, two cases were unclassifiable due to inadequate information, and six cases had other present illnesses.

The 10-man dengue investigative task force of the PGH reviewed each case three times before meeting together to discuss their findings.

Algorithm

The expert panel used the World Health Organization’s Algorithm for Causality Assessment of Adverse Events Following Immunization, a systematic, scientifically sound, and universally accepted proves of assessing causality of events following any vaccination.

Aguilar stressed that the three cases of children who died of dengue must still undergo tissue evaluation for polymerase chain reaction, and antibodies to yellow fever and dengue viruses.

They also recommended that four other cases be subjected to medical autopsy to determine any diseases and the cause of death.

The causes of death for the other four cases ranged from congenital heart disease, brain infection, pontine hemorrhage, and cardiac arrhythmia.

Domingo thanked the PGH expert panel for handling the investigation beyond their expectations.

“We appreciate the transparency and the tediousness as to how the 10 specialists from different fields conducted their study. We can only trust scientific evidence, and we were surprised at how scientific and thorough it was,” he said.