Ensure urban-rural vax equity – WHO

When we needed an excuse for our slow vaccination rollout, we whined that the wealthy nations had been cornering the COVID-19 vaccine supply, depriving the less progressive countries, including the Philippines, of their equitable share of the serum.

Now the representative of the World Health Organization in the country, if we are reading him correctly, seems to say that we similarly had given less than equitable vaccine access to our rural population.

Dr. Rabindra Abeyasinghe of the WHO office in Manila was sharing his observation Monday of an “inequitable situation with regard to access to vaccines” in the provinces, that is, outside the National Capital Region and major cities.

“Several times, WHO has raised its concern that we do not see equity… especially for the most vulnerable, the A2 and A3 groups where coverage ranges from about 30 to 40 percent in many of the regions and provinces,” he said.

He was referring to senior citizens and those with comorbidities who have been given vaccination priority together with frontline health workers exposed to direct contamination in their workplaces.

Since some weeks ago, in a shifting of focus, the government paid more attention to urban areas, which are more densely populated, partly to arrest the surges in the crowded communities whose economies have suffered.

The focusing of intensified vaccination in urban centers appears to have paid off with the lowering of the daily number of infections to 4,393 the other day, compared to more than 26,238 on Sept. 12.

There has been also a reduction to 8.5 percent of the positivity rate or the number of positive results per 100 tests conducted, which hit 29 percent last month. A rate within the 3-5 percent range is said to be ideal.

The slowing down of the spread of the pandemic in densely populated areas has emboldened authorities to allow more movement of people in public places and the resumption of near-normal businesses.

With the arrival of more purchased and donated vaccines, the government has been able to fully inoculate 26 million Filipinos since the vaccination started in March. Some 30 million have received their first dose, according to government data.

Vaccine czar Carlito Galvez Jr. has grown optimistic enough to say that it is possible to fully vaccinate 50 percent of the population by yearend, with injections being ramped up by local governments to as many as 1.5 million jabs per day. The average inoculation has been 487,350 in the past seven days.

While 50 percent inoculation is still below the 70 percent promised to achieve herd immunity by December – through vaccination and the gaining of immunity by contracting and beating the disease – this could lead to the pushing back of the viral spread and the boosting of economic activity.

The political dividends of this positive development cannot be overemphasized as the nation moves forward to the May 2022 national elections.

Ready for a booster shot?

Filipinos, are you ready? Health Secretary Francisco Duque III has approved the recommendation of the Health Technology Assessment Council to administer a COVID-19 booster shot or an additional vaccine dose to those who need it.

The HTAC recommended booster shots to health care workers and seniors at least six months after they have completed the primary COVID-19 vaccine series.

Booster shots may also be given to eligible priority sectors including those from A3 (people with comorbidities), A4 (economic frontliners) and A5 (poor population) by 2022, if 50 percent of the population have completed the initial series.

The reason behind the 50-percent threshold requirement is similar to the equity mentioned by Abeyasinghe of the WHO intended to ensure that vaccines used as boosters will not take away doses needed by those still awaiting their first dose.

Under the guidelines, those who have been injected with AstraZeneca, CoronaVac (Sinovac) and Moderna vaccines were also advised to use Pfizer for their booster shots. AztraZeneca, on the other hand, can be used for those injected with CoronoVac (Sinovac).

Those who were injected with Pfizer and Janssen vaccines should receive the same brand for their booster.

Individuals who are immunocompromised are advised to get additional shots, or a third dose of the same brand, at least 28 days after the completion of their initial vaccination.

Immunocompromised persons include those receiving active cancer treatment for tumors or cancers of the blood, those receiving an organ transplant, those with advanced or untreated human immunodeficiency virus or HIV infection, those with rare diseases and dialysis patients.

A prominent example of a person who already had a two-vaccine series but died of COVID-19 while awaiting his booster shot was US State Secretary Colin Powell, who died at age 84 on Oct. 18. He was immunocompromised as he was receiving treatment for cancer of the blood.

President Biden had his picture published showing him taking his second Pfizer shot on Jan. 11 in Newark, Delaware, to assure the public of the safety of the vaccines.

In Manila, we are still waiting for President Duterte to take the third or booster shot for his Sinopharm series. No information has been released if he is immunocompromised or has any morbidity. As for the date of his reported second jab, it was reportedly in July.

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NB: All Postscripts are also archived at ManilaMail.com. Author is on Twitter as @FDPascual. Email: [email protected]