Earlier this week, we shared the story of dad Neil Licayan who lost his daughter, 15-year-old Jessica Denise, to a devastating illness -- Japanese Encephalitis (JE). “Wala siyang cure, pero may vaccine. Please get it for yourselves and your children!” he said. “Wish ko lang na wala na sanang magulang ang makakaranas ng pinagdaanan at pagdadaanan pa namin.” (Read the full story here.)
Soon after, the comments section of the article was filled with questions from concerned parents, particularly about the vaccine for JE and its availability. We asked pediatricians to shed light on your queries:
1. Para saan ang vaccine na ‘to? -- Melanie Gali Adlawan It protects humans from the severe symptoms of Japanese Encephalitis. Like dengue, JE (also known as Jap B) is a disease that is acquired from a mosquito bite. Symptoms include fever, headaches, abdominal pain, seizures, and brain swelling. “In worst cases, patients go into a coma,” said Dr. Sally Gatchalian, president of the Pediatric Infectious Disease Society of the Philippines (PIDSP) told SmartParenting.com.ph.
Severe JE is seen in 1 in every 250 cases, and 30 percent of the patients die from it, according to the World Health Organization (WHO). “There is no cure for Japanese Encephalitis, just supportive treatment,” said Dr. Ma. Eleanor Sevilla-Sia, a pediatrician and neonatologist at St. Luke’s Medical Center in Taguig and at the Asian Hospital and Medical Center in Muntinlupa.
“Encephalitis is a very serious disease. Of those who survive, some will continue to suffer from neurological problems such as motor defects (weakness) and recurrent convulsions (seizures). Some will also suffer cognitive language problems (the inability to speak),” added Dr. Gatchalian.
The carrier mosquitoes of JE are of the Culex tritaeniorhynchus species and are often found in rural areas. “Ang may greatest risk are those living around domestic animals (pigs), birds (like chickens and ducks), rice fields, and areas na may flooding,” said Dr. Gatchalian.
2. Ilang taon puwede ang Jap B vaccine? Yung mga anak ko are 8, 7 and 3 years old. --Bebe Castro Ilang months dapat kay baby? --Hazel Dimaculangan Yung vaccine ba ay available din sa adult? --Kath Falceso As per recommendations, “The vaccine is given at a minimum age of 9 months,” said Dr. Jamie Isip-Cumpas, a pediatrician from Parkview Children’s Clinic in Makati.
“Children 9 months to 17 years old should receive one primary dose. This is followed by a booster dose 12 to 24 months after. Those age 18 and above should receive a single dose only.”
3. [Does] anyone have an idea how much the vaccine costs? --Kimy Alix “There is only one licensed brand in the Philippines for the JE vaccine. That’s Imojev from Sanofi Pasteur,” said Dr. Gatchalian. We asked several doctors for its price at their clinic, and the vaccine typically costs around P3,000 per shot.
4. Wala ba sa health centers ang vaccine na 'to? --Tine Padohinog The Department of Health has been working to include the JE vaccine in the Expanded Immunization Program. By 2018, JE will be available in health centers, reported the Manila Standard. The immunization program already includes free vaccines for diseases such as hepatitis B, measles, mumps and rubella, rotavirus, and polio.
5. If mabakunahan ba nito ang toddler, what are the side effects? Is it the same with other vaccines? --Nelia Serbosquez Jumaday “Side effects are mild. As with any vaccine, they should expect some soreness on the injection site, fever among children, or headaches and muscle aches among adults. Severe allergic reaction is very rare, based on a big body of evidence from the Centers for Disease Control and Prevention,” said Dr. Faith Alcazaren, who practices general pediatrics at Perpetual Succor Hospital and Maternity in Marikina and at Marikina Doctors Hospital and Medical Center.
6. Meron ba nito sa lahat ng pedia? --Maria Teresita Suarez Pediatricians should be able to procure it for you. To make sure, inquire with your child’s doctor.
7. Ngayon ko lang nalaman [ito]. --Lauren Conel Estrella Is this the new vaccine I’ve been hearing about? --Cherry Aquino Chavez It was first assumed that Japanese Encephalitis was only isolated in specific areas in the country, said Dr. Gatchalian. However, a 2015 epidemiologic study conducted by Dr. Anna Lena Lopez and others from the National Institute of Health (NIH) found that it is endemic all over the Philippines. “So from north to south makikita natin ang JE,” she explained.
In 2016, the vaccine for JE was included in the recommended childhood immunization schedule provided by the Philippine Pediatric Society (PPS) and the Philippine Foundation for Vaccination. This year, dengue was added to the list.
“In the Philippines, JE is often underreported and unrecognized for various reasons such as lack of confirmatory lab facilities in many areas and lack of disease surveillance,” reported Business Mirror. According to the Philippine Council for Health Research and Development (PCHRD), there were 34 cases of JE in 2013, and 69 cases in 2014.
8. Do doctors recommend the vaccine? “Ako personally, I would recommend the vaccine. Majority of the cases are those less than age 15. Teens should get it as well,” said Dr. Gatchalian.
“Yes, I would recommend the JE vaccine. It’s also recommended by the PIDSP. As it is established to be endemic in our country, routine vaccination is needed especially since JE can cause substantial disability and death,” said Dr. Alcazaren. “It’s alarming to know that a simple mosquito bite can lead to such a fatal illness. The vaccine should be more available to everyone.”
“Yes, I would recommend the vaccine to children 9 months to 18 years old,” said Dr. Isip-Cumpas. “Adults in areas where there is active JE virus transmission will also benefit from immunization.”
“Yes, I recommend it. It’s already part of the immunization recommendation by the Philippine Pediatric Society,” said Dr. Sevilla-Sia.