Domino Effect: Vaccine Hesitancy on the rise, a problem for the Philippines’ COVID-19 Response

Promised with dengue immunity, left with a dead son. That is the story of Jonathan de Guzman, father of then 12-year-old Elijah Rain de Guzman who is thought to have died after receiving the controversial Dengvaxia vaccine (Isoux, 2019). Left distraught, Jonathan became part of the Public Attorney’s Office (PAO) campaign against government officials and private sector leaders behind the Dengvaxia vaccination program (Araja, 2019). Along with other grieving parents, de Guzman rallied behind PAO. However, unbeknownst to him, PAO would weaponize their cries to create smears that would be felt in the country until today.

In the forefronts of the Dengvaxia fiasco, PAO, especially its head, Persida Acosta, and its forensic lab director, Erwin Erfe, riddled the news with gravely misinformed notions on the vaccine coupled with stories of the grieving parents (Punongbayan, 2019). Acosta and Erfe insisted that the vaccine caused the reported deaths, but the Department of Health (DOH) stood by their findings that Dengvaxia was not behind these deaths (Punongbayan, 2019). However, PAO’s antics resonated more with the public and now, many parents shy away from vaccines, and not just Dengvaxia.

Around the country, parents became less confident in the safety of using vaccines for their children and many opted out of the DOH’s vaccination program. Perceptions on vaccine safety dropped from 82% in 2015 to 32% in 2018, a trend seen also in actual vaccination participation which dipped to 60%, far from the DOH’s 85% target (Punongbayan, 2019).

These numbers are a problem as they do not ensure herd immunity within many communities across the country. Herd immunity is the state wherein vaccination rates in a community are high enough to render diseases defenseless. If vaccinations do not reach a certain threshold, herd immunity cannot be attained and the diseases that these vaccines are supposed to prevent could be transmitted within the community, placing unvaccinated individuals, whether by choice or by circumstance, at risk of contracting such diseases (Punongbayan, 2019).

Sure enough, preventable outbreaks followed this abysmal vaccination trend. In different regions in the Philippines, measles outbreaks were reported even though measles vaccinations are offered free of charge by the DOH (Punongbayan, 2019).

Today, hesitancy towards vaccines persists despite the clear display of its consequences. This threatens the success of the Philippines’ upcoming COVID-19 vaccination program.

Deadly Hesitations

COVID-19 cases in the country still rack up more than a thousand a day, even after months of lockdown. With multiple vaccines already approved for use around the world, hopes to end the crisis are high but a crucial problem may prove to be hope-crushing.

Vaccine hesitancy, three years after Dengvaxia, is still high. In a survey by a team from the University of Sto. Tomas, results show that 44.1% of Filipino respondents expressed hesitancy in taking any COVID-19 vaccine (Ilano, 2021). In the same way that high hesitancy rates corresponded to low vaccination rates last 2018, COVID-19 vaccinations might see low rates too, rates that are too low for herd immunity (World Health Organization, 2020).

Without herd immunity, the disease will persist. The battle then, today, is to increase vaccine confidence again before the vaccines are rolled out. One effective route to take is effective science communication.

A well-informed public can make well-informed decisions, and a community knowledgeable about vaccines will most likely be receptive of vaccines. Regaining vaccine confidence entails the effective communication of important information about vaccines including the mechanisms, risks, and effects of vaccines.

Nonetheless, this will be difficult in the Philippines, where science communication is marred with a lot of problems.

Deadly Decisions

The Philippines is a diverse country that is rich in culture and languages but is also rich with social inequalities reflected in many sectors of society, be it education, health, or information.

These characteristics form a problem for communication, making the status of science communication in the Philippines rather problematic (Navarro & McKinnon, 2020). Social inequalities lead to information accessibility challenges and unequal education access, which means a significant portion of the population may not be able to access nor understand vaccine information (Navarro & McKinnon, 2020). The presence of different languages also poses a challenge, as despite the country-wide Filipino language education, fluency is a problem for those that have had less education opportunities (Navarro & McKinnon, 2020).

Even with accurate information on-hand, it is useless to a lot of Filipinos, and to the goal of increasing vaccine confidence, if Filipinos cannot access nor understand this information. This is a problem that can be solved, or at least appeased, with well-supported information campaigns backed by well-supported science communication programs.

Unfortunately, science communication is badly-supported, under-funded, and underappreciated in the country (Navarro & McKinnon, 2020). Science communicators are poorly-paid, systemic problems make science generally inaccessible to many, and science is almost always communicated only to those that are interested in science (Navarro & McKinnon, 2020). These problems piled up shows the big picture: science communication is not yet for all.

The exclusivity of science communication and information means that problems like vaccine hesitancy will be difficult to solve, and, if nothing changes, the current COVID-19 crisis might remain in the country for a long time.

Deadly Priorities

Even with a pile of problems today that can be solved with science’s leadership, the focus now is still on different matters (Jalea, 2020). The Department of Science and Technology recently faced budget cuts that particularly hit their research programs and the DOH’s budget seems underwhelming for a nation in a pandemic (Albert, 2020). Instead, the military was given prime importance by the recent national budget.

Clearly, the focus is not science nor health. With blurred priorities, problems on vaccine hesitancy might be here to stay, science communication problems might remain unsolved, and COVID-19 might be far from its end.

COVID-19 kills, but it is not alone. Unsolved systemic problems are its accomplice.

The grievances of De Guzman and many other parents in the country are still heard today, but PAO’s exploitation painted their cries for a fraudulent story – a story that resonates to today’s public health problems. Dengvaxia and COVID-19 are two stories of exploitation, corruption, and systemic problems, while the Filipinos are the ones bearing the brunt of it all.