With the rise in the Covid-19 cases in the Philippines, vaccination against this virus has become more than ever a necessity as the government sees no better alternative to gain back the pre-pandemic status (health and economy-wise). The extensive damage this Covid-19 pandemic, especially to the economy, can only be addressed now through a general vaccination program. And as the government is preparing this solution as highly supported by most if not all medical health authorities, the expectation was for that program to get resounding public support. Interestingly, latest figures in a national survey showed 61% of the Filipinos “do not” want to get vaccinated. This is the purpose of the article, to try to shed comprehension on the situation of Covid-19 vaccine aversion tendencies found among the Filipinos despite their own recognition of the health risk and mortality associated with the present pandemic.
Keywords: Covid-19; Covid-19 vaccine; vaccine aversion; Philippines
Covid-19 cases came unrelenting as the tally of infected Filipinos came at a staggering rate in the last two weeks of March 2021 with about 9,500+ average cases per day. In the same official health report by Department of Health (2021), it has now reached to more than 110,000 in total afflicted individuals with total mortality of 13,159 souls. With the rise in figures and the arrival of available vaccines from foreign pharmaceutical suppliers, it could have been a greater force for the general public to clamor for vaccines and actively support any vaccination programs by the Philippine government. Practically, most if not all health authorities from different health groups both private and public had one voice declaring their support and ensued on the idea that the best vaccine is the one which is available.
Surprisingly, a conflicting behavior or attitude came as observed in the latest survey showing 61% of the general public or six in every ten Filipinos “do not” want to get vaccinated despite a 94% universal acceptance of the risk of contracting the Covid-19 virus disease from among the country’s adult population . Moreover, socio-economic class did not even become a factor as contracting the virus was so high a concern to all socio-demographic levels of the society. Admittedly, this condition seemed to defy logic and sound reasoning and therefore must be given attention not just as an epidemiological concern but also a public health issue that might affect health policy implementation. In a more detailed survey among adult Filipinos by a university-based organization done between January 26 to February 1, 2021, about 46% of them outright rejected to get vaccinated against Covid-19 virus . Among those who did not want to get vaccinated, a majority (73%) expressed being “not sure if it is safe”, and 29% were “not sure if vaccine is effective”. In that same survey result, concerns about the safety of presently available vaccines in the country seemed to be a real concern in all major areas: Mindanao-78%, Balance Luzon-76%, Metro Manila-69%, and the Visayas-64%. And about the concern on vaccine effectiveness, it was just about 21% to 46% among the participants from the same pool.
As a general concept, vaccine aversion (not just in the case of Covid-19 vaccines) is an old phenomenon with varied health and non-health related etiology considered as a serious threat to global health always resulting in infectious disease resurgences all over the world . Thanks to the advancement of science and technology through the help of modern and well-meaning advertisements, vaccine provision and inoculation are gaining more popularity and support among the general public. The present pandemic especially woke up the sense of urgency as all have been affected as economics and health conditions worsen every day. Internationally, Covid-19 vaccines acceptance were so high as seen in the following details: Ecuador (97.0%), Malaysia (94.3%), Indonesia (93.3%) and China (91.3%). However, the low COVID-19 vaccine acceptance rates were found also in countries like Kuwait (23.6%), Jordan (28.4%), Italy (53.7), Russia (54.9%), Poland (56.3%), US (56.9%), and France (58.9%). And now, Philippines came to become included in the list. Reasons for these behaviors of reluctance and seeming aversion were known to have been caused by vaccine-related issues like low efficacy and effectiveness, and duration of protection given [4-6]. According to a local author , there seemed to be a great concern on vaccines resulting to public trust issues especially on the manufacturer precisely to China’s Sinovac Biotech vaccine. Bloomberg article published as early as December 2020 featured how China has struggled on convincing the international community to trust its Beijing-financed vaccine to be accepted . On the local scene, there were reluctance even from health workers expressing their position to wait for different vaccines to become available pointing directly at the efficacy rate of 50.4% from the Phase 3 trials done among health frontliners in Brazil . In the country’s premier and lead health institution (PGH-Philippine General Hospital), the PGH Physician Association even urged officials to wait for the review of the country’s HTAC (Health Technology Assessment Council) before rolling out the said donated Sinovac vaccines that just arrived the country.
On another whole lot different factor, Philippine vaccine experience was also aggravated in the past by politics-related controversies. One most recent was the “Dengvaxia Controversy”. Dengvaxia controversy affected the trust locals have placed on vaccination program, a question of trust not mainly on any vaccine but on the government’s sincere intentions on programs related to this . Though this health scare happened in the immediate past administration, present policy implementation seemed to be haunted by it during the President Duterte’s Covid-19 vaccine roll out. Additionally, some observations were even evident that the present administration seemed to be repeating missteps that resulted to Dengvaxia Controversy contributing further to public doubt and vaccine hesitancy according to the same report. There was also this issue about the leadman of the country’s health agency, Sec. Francisco Duque of the Department of Health (DOH) . Though the said Department Secretary still enjoys the trust of the Executive Department, prominent politicians especially from the Philippine Senate begged the President to “fire and spare the country from more blunders in fighting the pandemic” . This kind of politics even showed the uncongenial rapport in the bureaucracy lessening more the eroded trust issues the general public has on health and other related programs or initiatives that supposedly could help alleviate the current pandemic situation in the country.
Public health and ending the Covid-19 Pandemic are the main focus in this article, and the hope of helping everyone to understand how to best proceed with everyday living without sacrificing lives of many because of misbeliefs and wrong impressions. Whether we all came out on the other side of the long dark tunnel in the “new normal” or the pre-Covid-19 pandemic normal, science and technology evidently has brought us the solution, e.g., Covid-19 Vaccine. Regardless of the manufacturers, trust in the different safeguards established by governments and their agencies as well as inoculation programs of safe and effective vaccines must be promoted to all. The ultimate goal is for everyone, regardless of country and color, to be given equal and universal access to life-saving health technologies like vaccines to finally stop this raging pandemic.
- Pulse Asia Survey (2021) Pulse Asia: 6 in 10 Filipinos don’t want to get vaccinated against Covid-19.
- Tomacruz S (2021) “46% of adult Filipinos still unwilling to get vaccinated vs Covid-19”.
- Wong LP, Wong PF, AbuBakar S (2020) Vaccine hesitancy and the resurgence of vaccine preventable diseases: The way forward for Malaysia, a Southeast Asian country. Hum Vaccines Immunother 16: 1511-1520.
- Sharma O, Sultan AA, Ding H, Triggle CR (2020) A Review of the Progress and Challenges of Developing a Vaccine for COVID-19. Front Immunol 11: 585354.
- Wang J, Peng Y, Xu H, Cui Z, Williams RO (2020) The COVID-19 Vaccine Race: Challenges and Opportunities in Vaccine. Formulation. AAPS Pharm Sci Tech 21: 225.
- Teerawattananon Y, Dabak SV (2020) COVID Vaccination Logistics: Five Steps to Take Now. Nature 587: 194-196.
- Capulong H (2021) Mindfulness as key in easing COVID-19 vaccine hesitancy. J Public Health (Oxf) 36: 92-103.
- Marlow I, Mangi F, Lindbert KS (2020) China is struggling to get the world to trust its vaccines.
- Tomacruz S (2021) “Philippines begins legally rolling out first Covid-19 vaccines”.
- Aljazeera (2021) Dengvaxia controversy haunts Duterte’s Covid Vaccine roll out.
- Department of Health (2021) DOH Covid-19 Case Bulletin #378.
- Lee-Brago P, Romero P (2020) “Duterte trusts Duque; Pacman urges DOH chief to quit.