Trust: Key element in vaccination drive

The Senate public hearing into the government’s COVID-19 mass vaccination program needs concurrent research looking beyond the efficacy and prices of vaccines and digging into the underlying reasons why people may accept/reject inoculation.

The vaccination has not started but there is already palpable resistance, estimated by poll surveys at some 47 percent. That’s almost half of the adult population expressing reluctance to submit to vaccination.

Health Secretary Francisco Duque’s saying on Sunday that the government has secured 25 million doses of the COVID-19 vaccine of the Chinese firm Sinovac to be delivered starting February has raised a howl in social media, the main outlet of pent-up public opinion.

Objections welled even before the details could be explained, indicating that there is bias against the drug and/or its source (China). One recurring criticism is that Sinovac has a lower efficacy rating than other vaccines, yet is more expensive at P3,629.50 per two doses.

There is a danger that the Senate inquiry may start looking like a criminal investigation, what with insinuations of kickvacs (sic) and questions of whether the country is being sold piecemeal down the Yangtze River.

Senate President Tito Sotto said the hearing will touch on the vaccination roadmap, the drugs’ safety, efficacy, sensitivity, cost and supply chain requirements, access to clinical trials, local production and distribution.

Hovering over the entire operation is the key element of Trust. The rollout of the mass vaccination, however efficient, could be dragged down by lack of trust not only in the vaccines but also in the officials procuring and administering them.

“What’s so special about Sinovac?” Sen. Ping Lacson asked in a radio interview, voicing the question on many people’s minds, seeing the delay in the processing of other brands as if to enable the Chinese vaccines bogged in clinical trials to catch up.

Duque has been criticized for supposedly “dropping the ball” in the processing of purchase papers for Pfizer-BioNTech vaccines, resulting in the failure to nail down the drugs eyed for delivery this January.

The lack of trust is more than a hangover from the Dengvaxia scandal of 2016-2017 whose dust has not settled yet. The hesitation to accept COVID-19 vaccines looks like the fallout of a wider mistrust of government officials.

How come a purchase by private firms in November of an initial 2.6 million doses of AstraZeneca vaccines, to be followed by 20 million more, was not met with as sharp criticism? Half of the vaccines are to be given free to workers of the firms and the rest to the government.

The Sinovac vaccines announced by Duque and other serums from other sources are also to be given free to recipients on priority lists, so the cost to the vaccinees could not be the trigger to the apparent resistance.

Whatever be the individual and collective reasons for hesitation, aggravated by suspicion of monkey business in government, will have to be studied in depth for remedial measures.

Aside from asking random people in a survey, there could be in-depth discussions with representative recipients of the free vaccines that have been declared by scientists (not by generals and politicians) to be safe and effective.

A study by the Kaiser Family Foundation in the San Francisco Bay Area brought out in December these reasons why various focus-groups would hesitate to accept COVID-19 vaccines:

Possible side effects (59 percent cite this as a major reason), lack of trust in the government’s ensuring the vaccines’ safety and efficacy (55 percent), concerns that the vaccine is too new (53 percent) and worries over the role of politics in the development process (51 percent).

Filipinos being offered COVID-19 vaccines are not similarly situated as the KFF respondents, but the reasons gathered in the Kaiser study may give hints on how to approach the communication challenge.

The pandemic in the Philippines is more than a public health problem that has infected more than 487,700 Filipinos and killed 9,405 as of yesterday. It has wrought economic dislocation, rendered millions jobless and caused the padlocking of businesses of all sizes.

In addition, the quarantine restrictions, especially on the movements of persons and activities of groups, have impinged on civil liberties and made easier police violation of human rights.

These non-medical aspects of the scourge should also be looked into by the Senate if it wants to develop a wide-spectrum vaccine to treat the social ills brought by the coronavirus and the variants that came after it.

The Sinovac deal announced by Duque has earned him fresh brickbats and heckling that he held back other vaccine developers to give preferential treatment to the Chinese drug company. But we find it hard to imagine Duque making such a major decision on his own.

After an initial delivery of 50,000 doses in February, Duque said, the succeeding batches will follow – 950,000 by March and 2 to 3 million in succeeding months until December to complete the 25 million doses.

Vaccine czar Gen. Carlito Galvez Jr. has said that they plan to inoculate 50 to 70 million Filipinos (70 percent of the population) this year to achieve herd immunity.

He also announced his signing papers with the Serum Institute of India for the Philippines to buy 30 million doses of the vaccine developed by Novavax. What was signed, however, was merely a piece of paper containing the intended terms of the projected purchase.

For reference, here are prices for two doses per person gathered late last year by the office of Sen. Sonny Angara:

Novavax, P366 per 2 doses; AstraZeneca, P610; Covax facility, P854; Sputnik V, P1,220; Pfizer, P2,379; Moderna, P3,904-P4,504; SinoVac, P3,629.50. The prices include value-added tax and contingency for 10-percent “inflation,” which looks like a catch-all term for commissions or any rise in the quoted price.

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