Waning immunity

It is an officially confirmed fact that the “Delta” variant of the coronavirus disease 2019 (COVID-19) have caused the spike in cases of infections here and in other pandemic-hit countries, despite the ramping up of vaccinations all around the world. Thus, no less than the Inter-Agency Task Force for the Management of Emerging Infectious Diseases (IATF-MEID) recommended the administration of booster shots, at least for the thousands of our health care workers (HCWs), they being the frontliners in our campaign to control the spread of the COVID-19 pandemic.

But as soon as Presidential Spokesman Harry Roque, who is concurrently the IATF official spokesman, announced this last Monday, our own Department of Health (DOH) immediately clarified there is no final decision yet on the matter. The differing announcements from the IATF did not surprise anymore Senator Nancy Binay and Iloilo Rep. Janet Garin who were my guests in Kapihan sa Manila Bay Zoom Webinar last Wednesday.

What surprised both Sen. Binay and Rep. Garin was the stand taken by the World Health Organization (WHO) against the administration of anti-COVID booster shots in the Philippines when other countries, like the United States (US) and Israel, were already giving out third jabs for their own people.

A former DOH Secretary during the previous administration, Garin particularly questioned the government’s kowtowing to the WHO advisory against third dose at this time. As it is right now, Garin pointed out, the Philippines has been able to buy and procure its own anti-COVID vaccines and therefore should not be tied down by dictates of the WHO.

“We’re on survival mode and our responsibility is not to WHO but to the people… We don’t have to follow the WHO recommendations all the time because they have their own interest,” Garin argued. A senior deputy minority leader in the House of Representatives, Garin raised the “sense of urgency” for third jabs due to the rising number of the so-called “breakthrough infections” attributed to the “Delta” variant. Garin feared many of our HCWs getting more exposed to “Delta” and other foreign variants of COVID-19 already detected here got the Sinovac shots last March. By now, many of our HCWs have lower immunity.

Sen. Binay concurred with Garin as she scored the government’s anti-COVID-19 pandemic responders could not even get their acts together to make a definitive stand to administer booster shots. Binay, who chairs the Senate committee on science and technology, warned against a “collapse of our country’s health system” with hundreds of our HCWs already vaccinated but still getting COVID-19 infection.

The Geneva-based WHO has been appealing to wealthier countries for a moratorium on the use of a third dose while many people in poorer countries across the globe have yet to receive even a first dose. “It is more important to address the global inequity in access to vaccines,” WHO Representative to the Philippines Dr. Rabindra Abeyasinghe explained on Tuesday.

Garin countered that the Philippine government should not wait for the go-signal from the WHO. “The reason of WHO is equitable distribution of vaccine supply all over the world, especially in Africa. But we’re a small country to affect global supply. We should not make decisions based on WHO but rather on the situation of our country. It’s a bold step, but we have to do it for our people,” she urged.

“We really have to take that bold step because if we keep on delaying and delaying and delaying the decision, time will come that decision will not already be of use to our country,” a visibly exasperated Garin stressed during our weekly Kapihan sa Manila Bay virtual news forum.

But how come there is still dilly-dallying on the part of the DOH, our Food and Drug Administration (FDA) and the IATF.

“There is such a thing as ‘mature regulatory agencies’ with actual trials already for booster shots. If Pfizer already has full authorization from the US-FDA, this can be used as basis of the Philippine FDA to give access to the local government units, or LGUs, and also the private sector,” Garin pointed out.

Binay expressed the same sentiments on the government’s always being “a step behind” in anti-COVID responses. “We are always merely catching up. So for next year, let’s prioritize this and look at the best practices in other countries. Many countries are now administering booster shots and I think this is also where we should be heading,” she pointed out. Speaking for her fellow lawmakers, Binay vowed: “So the best is to provide the budget for it.”

During 2022 proposed budget briefing to the Senators, Binay learned in dismay that a P45-billion budget for booster shots was put under “un-programmed,” referring to appropriations that depend on the availability of funds.

The two lawmakers argued that the private sector and LGUs have funds and, in fact, have been trying to procure their own anti-COVID-19 vaccines. Binay and Garin pointed out that Republic Act (RA) 11525 or the Vaccination Act of 2021 had already authorized the private sector and the LGUs to purchase vaccines, including booster shots. But tripartite agreements for vaccine procurement remain pending at the desk of designated “vaccine czar” Secretary Carlito Galvez Jr.

If only to address the concern of Galvez against unscrupulous “consolidators” of vaccine procurement, Garin suggested, the DOH can be designated as the “consolidator” for the LGUs and the private sector.

Manufacturers of China’s Sinovac and US vaccine-maker Pfizer have respectively admitted that the protection given by their anti-COVID-19 immunity wanes over a stretch of time. So both vaccine-makers have recommended booster shots after about six to eight months from the second dose.

Garin, who has asthma comorbidity, is one of the confirmed “Delta” cases in Iloilo – now among the high-risk COVID-19 areas. Although she had two doses of vaccine, Garin disclosed in between coughs, she is still in recovery. With waning immunity of vaccines, our goal to reach safe population might be compromised without booster shots.