Past dengue probe headed nowhere

Dengvaxia’s efficacy claim is so sly. About 830,000 nine-year-olds were injected with the dengue vaccine. If few of them thence get infected with the killer virus, then that’s supposedly how good the inoculant is. If  some still get sick, they’re the rare exceptions. But how good really is this product of Sanofi Pasteur and bought for P3.5 billion by health officials?

We’ll never know, won’t we?

Five children died of hemorrhagic fever shortly after Dengvaxia injection. But the fatalities never were properly autopsied. So is there a direct correlation between the deaths and the supposed side effects?

We’ll never know, won’t we?

Over a year ago, Nov. 18, 2016, five doctors and health activists asked the House of Reps committee on health to stop the vaccinations. Their reasons were clear in the position paper:

“Alarmed by a DOH program to vaccinate one million children against dengue virus, amidst questions about cost-effectiveness, safety and ethics, we the undersigned individuals hereby declare that:

“(1) There is lingering uncertainty about the long-term safety of this new vaccine against dengue fever. Evidence from the manufacturer’s trial shows that there may be a paradoxical increase in the incidence of severe dengue beginning a few years after children are vaccinated, and possibly continuing for the rest of their lives. This danger especially applies to children who have never had dengue fever before.

“The clinical trials on dengue vaccine were specifically designed to assess this danger. Sadly, this danger has been confirmed. In one study involving Asian children aged 2-14 years, vaccination increased the incidence of severe dengue by 400% on the 3rd year after vaccination. The authors concluded that the reasons for the rise in dengue need further investigation. We agree. Until these trials are completed, we recommend, as many other groups have, that children should be tested for past dengue infection before vaccination.

“(2) A cost-effectiveness study assessing potential use in the country was done but funded by the manufacturer rather than by an independent body. The study was biased in that there were clear measures to minimize expenses (it did not account for the potential cost of increased disease severity arising from the vaccine), and maximize savings (effectivity was assumed to last 10 years when it is clear that protection wanes by the 3rd year). These strategies make the vaccine seem highly cost-effective.

“(3) The current program is not a feasible strategy for easing the dengue burden in the country. The program cost the Philippine government P3.5 billion for just one million children in only three regions, representing a mere 1% of the population. Scale-up of this program, even for the lowest quintile of wealth, is simply not a viable option for the country.

“(4) There was inadequate community preparation for the implementation of the program. From the time the Formulary Executive Committee (FEC) issues guidance, it usually takes 12-18 months to prepare health workers and communities to introduce a new vaccine. Administrative orders and guidelines need to be issued to local government units. Field manuals need to be produced and translated into dialects. Health workers need to be trained to give the vaccine and answer questions from parents and children. Referral systems for adverse events need to be activated and tested, a research protocol for monitoring on adverse events should be in place. These could not have been done in 26 days. Many parents, teachers and healthcare workers claim they were never fully informed about the benefits and potential side effects of the vaccine.

“In view of all these problems, and in the interest of public safety, we strongly recommend that the DOH dengue vaccination program be suspended, pending completion of results of ongoing studies.

“Signed: Antonio L. Dans, MD, MSc, Academician, National Academy of Science and Technology;

“Leonila F. Dans, MD, MSc, Professor, University of the Philippines College of Medicine;

“Anthony Leachon, MD, Independent Director, Philhealth (Representative of the Monetary Board);

“Ana Maria R. Nemenzo, WomanHealth;

“Mercedes Fabros, Chairperson, Alternative Budget Initiative”

The five were special invitees to the committee hearing that day. On agenda was precisely their four objections to Dengvaxia. Yet they suddenly were disallowed from speaking. A last-minute guest, former health secretary Janette Garin who had purchased the vaccines, instead dominated the discussions. Why did that happen?
Well never know, won’t we?

Vital details came out of that hearing. Like, which prominent personalities of the past Aquino and present Duterte admins were promoting Dengvaxia. That some of them met with Sanofi Pasteur executives in Beijing and Paris. That the government’s entire budget for vaccinations against a dozen diseases (measles, mumps, small pox, polio, pneumonia, influenza, etc.) was only P3 billion – yet it spent P3.5 billion for dengue alone. That seven days after Dengvaxia was approved for sale in the Philippines on Dec. 22, 2015, the government released the stupendous amount to buy Dengvaxia. That Garin’s successor health secretary Paulyn Ubial already stopped the vaccine in July 2016, but was pressured by certain congressmen to resume it two months later. And more. These revelations could have lined up safety precautions against Dengvaxia, prevented thousands of sickness and deaths, and prosecuted corrupt and inept officials. Yet, why was there never a committee report?

We’ll never know, won’t we?

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