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The Philippines has become the first country in the world to roll out a government-sponsored vaccination program against dengue. The country approved the use of the dengue vaccine back in December, and is the first to be licensed globally to combat the mosquito-borne disease for people aged between nine and 45.
The Department of Health (DOH) launched the program last April 4, beginning with 250 Grade 4 students of Parang Elementary school in Marikina City. The first recipients of the first ever vaccine against the mosquito-carrying disease will also include public school kids from the National Capital Region (NCR), Central Luzon, and Calabarzon, three areas where reported dengue cases have been high. The succeeding two shots will be given in September and in March of next year.
"We are the first country to introduce, adopt, and implement the first-ever dengue vaccine through the public health system and under public school settings," said DOH Secretary Janette Garin.
However, many health advocates are questioning the safety of the vaccine. Dengvaxia, made by French drug manufacturer Sanofi, took 20 years to develop and the immediate approval and dissemination of the vaccine is raising some eyebrows.
Dr. Antonio Dans, professor at the University of the Philippines College of Medicine, raised the issue on "antibody dependent enhancement (ADE)." While the vaccine could eliminate mild cases of dengue, ADE could pave the way for more severe cases of the disease. "The real dengue we are afraid of is severe dengue, not the mild ones. If a vaccine prevents mild disease but causes severe dengue, we shouldn’t be using it at all," Dr. Dans said in a news release.
The president of the Philippine College of Physicians Foundation, Dr. Anthony Leachon, also called into question the hasty implementation of the vaccine program. "Why rush this when even the World Health Organization’s (WHO) report from the Strategic Advisory Group of Experts (SAGE) on the vaccine is yet to be released?" he said. "As health advocates, we appeal to the DOH to wait until the study is completed and put in place safeguards to protect children from possible adverse effects on their health," Dr. Leachon added.
DOH representative Dr. Lyndon Suy, however, explained that it is not a prerequisite for a country to wait for the SAGE recommendation before using the vaccine. "The SAGE will not say, 'Yes you can use it' or 'No you cannot use the vaccine.' It will only provide recommendations on how you can best use the vaccine. It is the wisdom of the country whether to use the vaccine now or not," explained Dr. Suy.
Dr. Rosario Capeding, from the Research Institute for Tropical Medicine (RITM), also clarified the issue about ADE. She says the dengue vaccine reduces the severity of the disease by 93 percent. "Remember, 80.8 percent of the children who were included in the studies were not hospitalized,” Dr. Capeding said.
While WHO hasn’t issued its SAGE report on the recommended use of the vaccine (the health organization said it will “likely” publish its recommendation in May), WHO has expressed its support for the DOH's dengue vaccination program. In a press briefing, WHO country representative Dr. Gundo Weiler said that the organization is providing the DOH with technical advice on the implementation of the vaccination program, especially in monitoring and surveillance of the possible side effects, such as fever, headache, joint pain, and redness in the area of the injection.
In 2015, there were 200,415 dengue cases reported in the country. The DOH stressed that the Dengvaxia vaccine has undergone extensive clinical trials that tested, and proved its high effectivity rate. Other anti-dengue programs, which include elimination of the mosquito’s breeding grounds and use of anti-mosquito bite products, will be continuously implemented.