Need for immunization program to prevent future outbreaks cited

THE chairperson of the House committee on health on Wednesday reaffirmed her stand on mandatory immunization amid the COVID-19 pandemic as a way to prevent future outbreaks from happening.

During the very first online “Kapihan Sa Manila Bay” held Wednesday, Quezon Rep. Angelina Tan, the panel chairperson, cited the importance of pursuing the government’s immunization program even during the community quarantine as a way to ensure that children are protected from future pandemics.

“We have several initiatives in Congress in relation to the country’s immunization program,” Tan revealed. “We are pushing for the creation of the NITAG, a national immunization advisory board, and we are trying to adopt a school-based immunization program that will benefit our students,” Tan stressed.

Tan also reaffirmed her call for an open, competitive bidding process in vaccines. According to Tan, an important element in the immunization program is to ensure that the procurement of vaccines is done in such a way that no single manufacturer is favored. The specifications in bidding should not favor a single brand.

Late last year, the Department of Health (DOH) suspended a call for bidding for pneumococcal conjugate vaccines (PCVs) after medical experts noted that the bidding favored a single manufacturer.

Health Undersecretary Dr. Ma. Rosario Vergeire explained in the same forum that the DOH suspended the bidding for PCVs after new evidence that they need to look into more carefully was presented.

“Nung lumabas ang bagong ebidensiya na sinubmit sa atin, ang desisyon namin ay ipasok muna sa Health Technology Assessment Center (HTAC). HTAC is reviewing the procurement, which is really the right process. Ngayon po hindi pa lumalabas ang recommendation ng HTAC,” Vergeire revealed.

“Hindi natin tinigil ang programa, hinihintay lang namin ang recommendation ng HTAC at itutuloy natin ang programa,” she added.

The DOH previously requested the HTAC to review the National Immunization Program (NIP), particularly the Pneumococcal Vaccination Program for children, in light of new 2017 and 2019 evidence from the World Health Organization (WHO).

In February 2019, WHO reaffirmed this earlier position saying that the two available PCVs in the market--PCV10 and PCV13--are equally effective in preventing overall pneumococcal diseases in children. The position paper also states that there is at present insufficient evidence of a difference in the net impact of the two available PCVs on overall disease burden.

For her part, Dr. Lulu Bravo, an epidemiologist and professor of Pediatric Infectious and Tropical Diseases at the College of Medicine of UP Manila, stressed that the new evidence regarding PCVs that came out recently came from experts themselves. “According to the WHO, when it comes to pneumococcal vaccination for children, both PCV10 and PCV13 are just as good. The important thing is cost-effectiveness,” Bravo noted. “We should follow what the WHO says, being experts in their field. If you cannot believe WHO, who will you believe?” she added.

In the same Kapihan, epidemiologist Dr. Troy Gepte supported the DOH’s move to have the PCV procurement assessed, stressing that the HTAC review is indeed mandated by law. “It is something that we need to undergo so we can have a more objective way of determining both the effectiveness and cost-effectiveness of any medicine, vaccine, product or procedure that goes through our medical system,” Gepte noted.

When asked about the P4.9-billion budget for PCVs, Vergeire said, “Talagang mahal po yung bakuna. Matagal na naming pinag-aralan yan, late last year pa. Kaya nga po ay humingi na ng tulong sa HTAC. We wanted to know if we are being cost-effective. Lalo na meron na tayong pangangailangan sa mga ibang bakuna. Kailangan na talagang pag-aralan ang gastusin sa vaccine.”

Tan also stressed, “Both vaccines exist. If the health assessment proves that both PCV10 and PCV13 have the same effects, then we need to go through a procurement process that’s open and competitive so the government can save on costs.”

On a related note, Rep. Adriano A. Ebcas of the Ako Padayon Pilipino Partylist, revealed  that he and three other partylist representatives filed a resolution urging the DOH to ensure the continued safe implementation of the mandated National Immunization Program for children despite the challenges posed by the COVID-19 pandemic.

The House Resolution aims to encourage and support the DOH in its endeavor to contain the current outbreak and prevent future community outbreaks of vaccine-preventable diseases (VPDs) during the COVID-19 pandemic.

The resolution also aims to secure and ensure a stable supply of available vaccines through the continued conduct of open, fair, and competitive bidding, thereby preventing any “outbreak within an outbreak.”

In the resolution, the solons declared, “An open, fair, competitive public procurement of NIP vaccines provide the Filipino people the broadest possible options for affordable, quality, and registered vaccines, allowing for potential significant savings to the government while at the same promoting strong public governance.”