Some important questions answered on vaccines and boosters

Thankfully, I am experiencing very mild symptoms: a runny nose with no cough, no fever, no sore throat, and no loss of the senses of smell and taste. Choosing to look at the bright side, I am glad I caught the mild strain, perhaps Omicron. I am also thankful that I recently received my booster shot, because I don’t want to even think about how much worse my symptoms would be if I wasn’t vaccinated.

I know of so many families whose members are COVID-positive and are practicing home care since the cases are mild.

With more time on my hands because I’m working from home, I decided to ask Dr. Rommel Lobo — vice-chair of the Department of Health’s National Adverse Effect Following Immunization Committee (NAEFIC), current president of the Philippine Society of Allergy, Asthma and Immunology (PSAAI), and pediatrician in several Metro Manila hospitals — to answer a few questions about vaccines. I hope our Q&A will be  useful to you:

With daily cases rising exponentially, health experts are saying that getting vaccinated and practicing basic health protocols are our best defenses against COVID-19. But with so many vaccines in the market, can you share what you think is the best one if we had a choice?

“All vaccines available in the Philippines are working well against COVID-19 since all can prevent severe COVID-19 or death, which is the most important goal of prevention through vaccination. Based on the DOH table on vaccine efficacy, all have met the WHO standards of 50-percent vaccine efficacy against symptomatic infection. For me, all vaccines can save lives so I hope that Filipinos will not have brand preference when they go to the vaccination sites. Take what is available because all vaccines can save lives.”

Health experts are encouraging everyone to get a booster shot. Is it safe to mix and match the vaccines? If so, what cocktail do you recommend?

“Based on the DOH recommendations on boosters, you can mix and match your third dose or booster dose since several studies showed that mix-and-match can produce neutralizing antibodies and doesn’t result in serious adverse events. Several studies in Thailand showed that you can use viral vector like AstraZeneca and mRNA like Pfizer as third dose to Sinovac. We all know that most of the Filipinos have been given Sinovac.

“But some studies also revealed that a mix-and-match vaccine schedule can be reactogenic and can result to more adverse reactions such as fever and localized pain in the injection site.”

AstraZeneca has the longest waiting time between the first dose and second dose. Why is this so even when the booster shot was shortened from six months to three months for all vaccines? Is this really safe?

“The AstraZeneca vaccine can be given from four to 12 weeks because there is a clinical study conducted by the company that a longer interval between first and second dose will have a higher antibody titer level as compared to shorter interval. Whether it’s a shorter or longer interval, the vaccines produce antibodies and T-cells that can confer protection against severe disease and death.

“Regarding shortening the booster interval from six months to three months, safety is not an issue here but the threat of the new variants like the Omicron. The shortening of the booster interval is partly brought about by the Omicron wherein studies have shown that two doses of available vaccines will not be enough to prevent symptomatic infection against this virus. So a third dose is really recommended against this variant.”

Do you think getting inoculated against COVID-19 will be an annual or semi-annual thing we will have to do for the rest of our lives? Or will the virus eventually die a natural death?

“There are two things that can happen. One is the virus will mutate to a weaker strain and eventually disappear like the Spanish flu. However, some scientists predict that the virus will be like the Influenza that it can mutate to different strains and therefore we need to be protected against this new variant every year by getting vaccinated. Well, everybody hopes that the scenario will happen wherein the virus will die a natural death and we will be able to go back to our normal lives again.”

There is still some vaccine hesitancy in the country. Can you allay the fears of these people that a vaccine is still better than no jab at all?

“As you can read in the newspapers, they say that the Omicron is highly contagious but it seems to produce milder symptoms that people do home quarantine instead of being hospitalized. My take here is that the Omicron might not be a weaker variant but because of vaccination, people do not develop severe infection and they are spared from severe disease and even death. Most patients in the ICU are those that have not been vaccinated. So if you would like to save yourself from severe COVID, then have yourself vaccinated. You also save a lot of money from hospitalization.”

Do you think the Philippines is capable of manufacturing its own vaccine against COVID-19?

“When the pandemic was starting, I know that the Philippine government tried to explore the possibility of manufacturing its own vaccine through public-private partnership. This was initiated by the Department of Science and Technology (DOST). I think this did not push through because of lack of manufacturing capability such as infrastructure by local and multinational pharmaceutical companies here in the Philippines. The infrastructure will cost a lot of money to establish. However, it will be good for our country to produce our own vaccines. I hope that it will come true someday, especially if the virus will be here to stay.”

Do you think 2022 will be the end of the pandemic and that we can slowly transition to an endemic?

“It is my hope to end this pandemic in 2022 but anything goes with COVID-19. In December 2021, the cases reached to less than 1K but in January it went up to 20K plus. So it is really hard to predict what will happen in our country as well as in the rest of the world with COVID-19. But every ‘Juan’ dreams of ending this pandemic and going back to our normal lives.”