Rethink vaccination options & priorities

We are not yet a police state, although a few friends fear we’re heading that way, so it was indelicate of Malacañang to have told off the public to just accept, and not be choosy, whatever COVID-19 vaccine the government throws their way.

At a media briefing Monday, presidential spokesman Harry Roque said: “Totoo po, meron tayong lahat na karapatan para sa mabuting kalusugan pero hindi naman po pwede na pihikan dahil napakaraming Pilipino na dapat turukan (It is true that we all have the right to good health but we cannot afford to be picky because there are so many Filipinos who need to be injected).”

“Tama lang naman po yan, walang pilian kasi hindi naman natin makokontrol talaga kung ano ang darating at libre po ito (It’s only right because we really cannot choose which vaccine will arrive first, and this is free).”

Roque said the government had procured 25 million doses of China’s Sinovac vaccine, whose first shipment is expected to arrive in February.

He said those who do not want to be vaccinated with the Chinese serum will be made to sign a document waiving their priority. This point was reiterated the next day by Cabinet Secretary Karlo Nograles: “You may opt not to take it, but be prepared to be at the end of the line.”

A report yesterday out of São Paulo, meanwhile, said that a coronavirus vaccine developed by China’s Sinovac Biotech was just 50.4 percent effective at preventing symptomatic infections in a Brazilian trial, barely enough for regulatory approval. Details are on the news pages.

Malacañang should not be that imperious just because the vaccines it has procured will be given “free” to those on its priority lists. It is sad that during the bargaining and the long wait for delivery, at least 492,000 Filipinos have been infected and 9,555 have died.

Roque and the rest lie when they say that the vaccines are for “free,” like the occasional “ayuda” being doled out to the poor. Taxpayers are actually paying for that subsidy and the vaccines – as well as the pile of pandemic-related loans that we and our children and grandchildren will have to pay.

Being told to settle for the lone Chinese dish on the table, we wish people lining up for vaccination would have multiple choices, cafeteria-style, where those chosen for priority inoculation could select from several vaccines.

An example of a less limited menu is that one in Pasig City prepared by Mayor Vico Sotto who had ordered 400,000 doses of AstraZeneca vaccines worth P100 million to augment the Sinovac brand expected from the national government.

We could have had more choices had Malacañang moved earlier and faster instead of “dropping the ball” with other suppliers while giving preferential treatment to supposed friends who are actually using vaccines to advance their economic and geopolitical agenda.

There should be a deeper study of the apparent resistance to vaccination in about half of the population as brought out in surveys and social media discussions. Is the hesitation traceable to the hard sell of the Chinese vaccine? Or is it a fallout of mistrust of the system and the officials running it?

Based on an estimated cost of P1,200 per vaccinee, Finance Secretary Carlos Dominguez said the government must raise P73.2 billion for the mass vaccination of 70 percent of the 109 million population in two to five years. He said the government will borrow the bulk of that money.

Feeling the COVID-19 pressure magnified by its own sluggish reaction, the administration is telling local government units to share the burden. Some LGUs that can afford it are now shopping for vaccines for their constituents.

One odd detail here is that while LGUs will be using their own funds, the central authority is reportedly insisting that their purchases be coursed through the national government. Why is Malacañang seeming to corner the business?

Having acted rather late, the administration is constrained by the limited supply left after some 80 percent of the global production had been snapped up by the richer countries and those whose leaders were quicker to act.

With the low supply, we have to review the prioritizing by the task force led by vaccine czar Gen. Carlito Galvez Jr. He said that rollout priority would go to “high burden” areas and population groups that are “most at risk.” These are, in descending order:

1. Frontline health workers in public and private facilities, temporary treatment and monitoring units, regional health offices, field workers, contact tracers, barangay health stations and emergency response teams (they number 1.76 million or about 1.6 percent of the population).

2. Indigent senior citizens (3.78 million or 3.5 percent).

3. Remaining senior citizens (5.67 million or 5.3 percent).

4. Remaining indigent population (12.9 million or 12 percent).

5. Uniformed personnel (525,523 or .5 percent).

These five groups account for some 24.66 million Filipinos or 22.8 percent of the population.

Large numbers of undeserving recipients could still be weeded out in a review. The same lists of “ayuda” (cash aid) recipients should not be used in inoculating “indigent” vaccinees unless the rolls are purged first.

Also requiring review is the list of “uniformed personnel” which is presumably the full rosters of the armed forces and the national police combined – plus, on instructions of President Duterte, their family members.

The uniform should not be the qualifying factor for vaccinees. Priority should be limited to those who actually come in close and frequent contact with persons confirmed to be suffering from COVID-19. Extending the privilege to the family members of cops and soldiers may not sit well with other sectors hit severely by the pandemic.

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