While the Philippines is expected to rollout coronavirus booster shots before the end of the year, medical experts stressed that reaching unvaccinated individuals should still be prioritized in the country’s vaccine drive until significant coverage is reached. 

“We won’t achieve herd immunity if one third of the population who have vaccines are given a booster while there is 65% who are unvaccinated. We really have to achieve first a very high vaccination coverage among people in the general population, especially among the unvaccinated,” Food and Drug Administration (FDA) Director General Eric Domingo said in a mix of English and Filipino a recent forum.

Domingo, who is tasked with approving amendments to existing emergency use authorizations (EUAs) for COVID-19 vaccines, was underscoring the position of health experts guiding government’s vaccine drive about the need and timing of offering booster shots in the Philippines. 

While the Health Technology Assessment Council cleared the rollout of boosters and third doses “in principle,” the group warned prematurely rolling out additional shots would further drive inequalities in the health system and during the pandemic. 

“The experts group of the DOH is reminding everybody that we have to recognize the equity concerns of COVID-19. There are still some 65% among us who are unvaccinated so it’s more important, more of a priority that the unvaccinated are vaccinated before we start giving an added doses to those who are vaccinated,” Domingo said in a mix of English and Filipino. 

So far, drug firms Pfizer, AstraZeneca, Sinovac, and Sputnik have all applied for changes in its EUAs to allow for an additional dose to be given to the public, Domingo said.

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Maximizing limited doses

The World Health Organization (WHO) had held the same position in its interim statement on COVID-19 boosters, saying that while there was still a shortage of vaccine supplies, it was “essential” to ensure equal access to doses among high risk populations in every country. 

“Improving coverage of the primary vaccination series should be prioritized over booster vaccination,” the WHO’s Strategic Advisory Group of Experts said. 

Scientists and medical experts have likewise underscored the need to stem infections, disease, and transmission on a wide scale to prevent the rise of a variant that could thwart immunity provided by the current crop of vaccines. In this case, primary doses which generate the body’s immune response would provide bigger benefit than additional booster shots. 

Epidemiologist Dr. Marie Carmela Lapitan of the University of the Philippines National Health Institutes, pointed to this, saying, “Given what we know and what we don’t know, the stand, particularly in a global context, of the WHO and I think this is also what the HTAC is recommending at the moment is to focus on vaccinating the unvaccinated.” 

Quoting the WHO, she added, “Each dose of a vaccine will save more lives if provided to the unvaccinated vs being used a booster in the general population.” 

Addressing this, the HTAC earlier advised health officials to first limit the rollout of booster shots to health workers and the elderly population – two groups that have the highest risk of COVID-19 and were among the first to receive vaccines in March and April 2021.

It added booster shots for other remaining priority groups – including persons with comorbidites (A3), economic frontliners (A4), and the indigent population (A5) – should be allowed only when at least 50% of each group has been fully vaccinated and at least 70% of the target population in “hotspot regions” are also covered with two doses. 

Since the Philippines started it vaccine drive in March 2021, at least 27% of the country’s total population has been fully vaccinated. 

The government is targeting to targeting to double this number in two month’s time to have 50% of the population fully vaccinated by December 2021. It later wants to see 70% vaccinated by the May 2022 polls, and 90% in early 2022. – Rappler.com