Waiting in line

A retiree in Manila received calls last Wednesday from two of his three children, both of them in the UK. The daughter is a nurse; the son is a seaman in a British firm. Both called to inform him that they had just received the Pfizer / BioNTech vaccine, and they were feeling fine.

The seaman said he and 14 other Filipinos on their ship received the jabs. All of them were doing fine, he said.

I didn’t know seamen were in the priority list of vaccine recipients, but maybe the company is eager to fully restore operations and has procured its own vaccines.

The retiree’s third child, an accountant in Manila, will have to wait for probably mid-2021 for his jab. As I have written, however, the silver lining in being far down the line is that they can see any adverse side effects of the different vaccine brands.

As for myself, so much for my excitement over the Pfizer vaccine… people with severe allergic reactions have been warned against taking the jab.

The vaccine uses the groundbreaking messenger RNA technology – also used by both US biotech firm Moderna and UK pharma AstraZeneca in their versions.

The allergy warning dampened excitement over the rollout of the world’s first vaccine that health experts say is backed by solid science. But health experts also quickly urged people to look at the bigger picture. Also, America’s top infectious disease expert, the much trusted Anthony Fauci, said he was still ready to get the vaccine and would recommend it to his family members.

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All drugs carry certain risks. Pregnant and lactating women are barred from taking a long list of medicines. Various illnesses and medications don’t react well with certain drugs. Pharmaceutical companies are required to specify contraindications and warnings in product packaging.

As far as I know, allergic reactions to medication are quite common. Two persons in Britain reportedly had allergic or anaphylactic reactions to the Pfizer vaccine, out of the tens of thousands of initial recipients. No one mentioned anaphylactic shock so I guess these were relatively mild reactions. That’s a pretty low percentage so it still looks like a safe product. But the vaccine will now have to carry a contraindication for those like me with a history of severe allergic reactions.

Maybe because of my maternal genetic roots, the Chinese vaccines will work on me, without the risk of going into anaphylactic shock, which I nearly suffered some years ago in Manhattan after eating giant clams, or Stevens-Johnson Syndrome, which I got from sulfanilamide and which nearly killed me when I was a toddler. I get skin allergies even from certain types of plastic used in apparel.

I got the polio vaccine in grade school, however, with zero adverse reactions. For people with severe allergies like me, perhaps the vaccine makers can provide testers. We put a tiny drop of food or medicine on the tip of our tongue without swallowing, and then wait for a minute for any adverse reactions. If there is, for example, a temperature rise or reddening of the cheeks or hands, sneezing or itching of the throat, we spit out the substance.

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Maybe the vaccines from AstraZeneca, Moderna and US multinational Johnson & Johnson will have no such side effects on allergy-prone people.

Health experts have hailed the arrival of COVID vaccines from reputable, long-established pharmaceutical and research firms. But they have also warned that coronaviruses, like the flu virus, can mutate, requiring new vaccines.

There is also the problem of haste in rolling out a COVID vaccine to end this pandemic. In the case of the world’s first vaccine against dengue, French pharmaceutical firm Sanofi Pasteur learned of the risk of adverse side effects for seronegative individuals – those with no history of dengue – only months after Dengvaxia had already been rolled out in the Philippines.

Emergency use authorization in the UK has allowed the administration of the Pfizer vaccine even before completion of the fourth and final phase of clinical trials. The mass rollout will effectively constitute the most extensive clinical trial.

Two other countries, Bahrain and Israel, now also have the Pfizer vaccine, with Israeli Prime Minister Benjamin Netanyahu volunteering to be the first recipient in his country, to promote vaccine confidence.

Canada also has advance-purchase deals for 20 million doses each from Pfizer and Moderna, with options for over 50 million more. The US is expected to begin vaccinations with the Pfizer jabs next week.

These countries are among the wealthiest. The vaccine rollouts are highlighting the yawning gaps between rich and poor in this world.

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In the past months, as companies and governments raced to produce vaccines, there have been many calls for equitable access to the jabs. It didn’t stop wealthy governments from making massive advance orders and cornering the products of the top vaccine makers.

China, projecting soft power, has stepped up and offered its vaccines for free to some of the poorest countries.

Beijing has been criticized for opaqueness in its pharmaceutical development. But there have been numerous reports of millions of Chinese already receiving their shots. Wuhan, the city where the coronavirus was first reported late last year, has reopened for business. Shanghai could afford to push through with the International Marathon last November, although with only a third of the usual number of participants, and with rigorous COVID testing for those in attendance.

In our case, we’ve been told that P72.5 billion has been set aside in the 2021 national budget for vaccine procurement.

Even if we have the money, supply and production capacities of the top pharmaceutical companies are limited, and we must wait a bit far down the line to actually get our hands on the vaccines. This means our economic recovery will also be delayed.

Several multilateral organizations and investment houses are already projecting a deeper and longer economic contraction for the Philippines, and slower recovery than its neighbors.

At least the wait, apart from allowing us to see more side effects of the different vaccine brands, should give everyone time to prepare for the efficient rollout of whatever vaccine we can get our hands on.

Seeing how other countries are implementing their vaccination, there is no excuse for us to be unprepared.