Garin-allied pathologist discredits PAO findings on Dengvaxia cases

MANILA, Philippines – Longtime pathologist Dr Raymundo Lo tagged as baseless and illogical the results of the autopsy done by the Public Attorney's Office (PAO) on children who died after receiving the Dengvaxia dengue vaccine.  

Lo, retired deputy director for professional services at the Philippine Children's Medical Center, was invited as resource person to the reopened probe into the Dengvaxia controversy by the House committee on health as well as committee on good government and public accountability on Wednesday, November 21.

"There are jumps to conclusion that are not logical and do not have basis," said Lo, who told lawmakers that he has 9 years of training in pathology.

"There are many gross findings that may have different causes and should not be assigned to one process, because these changes, like congestion, swelling, are non-specific and cannot be assigned to just one disease based on seeing them grossly," he added.

Ex-health chief Janette Garin – under whose term the now-suspended dengue vaccination program for students in 3 regions was implemented – had wanted to include Lo's testimony during the preliminary investigation of the Department of Justice (DOJ) into the deaths of 9 Dengvaxia recipients. But the DOJ rejected Garin’s plea.

PAO chief Persida Acosta filed complaints against Garin, ex-president Benigno Aquino III, and other officials over the controversy surrounding Sanofi Pasteur's vaccine. Acosta insists scores of children who received a Dengvaxia shot died because of the vaccine.  

PAO forensic consultant Dr Erwin Erfe said he has seen a "pattern" in his autopsies, with the children's organs enlarged and with internal bleeding or hemorrhage. He said the kids' symptoms also occurred within 6 months after getting a shot of Dengvaxia.

But on Wednesday, Lo said these findings do not necessarily indicate one disease. He said further tests, like microscopic examinations, should be done to corroborate results.

This was the same warning issued by a group of doctors from the University of the Philippines-Philippine General Hospital (UP-PGH) tasked by the Department of Health (DOH) to investigate the cases. (READ: DOH considers UP-PGH findings as primary 'evidence’ on Dengvaxia

"To submit such a false conclusion and dissemination to the general public as a valid medical finding is not only reckless but a blatant violation of our oath as medical practitioners to do no harm because we have now generated hysteria among the public that a lot of parents are now refusing to have their children vaccinated," said Lo.

PAO on the defense 

Acosta was defensive about Lo even before the latter was able to present his opinion before lawmakers. 

Lo began his presentation by saying that conducting proper autopsies requires years' worth of training. He then said that he interpreted PAO's findings "at face value, when valid" and "based on logical and practical aspects of the cases, correlating the clinical course of their autopsy findings."

Acosta immediately jumped in, questioning if Lo had any authority to interpret PAO's findings. She said the PAO results were validated by senior pathologists Dr Arnel Amata and Dr Jocelyn Cu from the University of the East Ramon Magsaysay Memorial Medical Center and the Ospital ng Maynila.

Antipolo City 2nd District Representative Romeo Acop then reminded Acosta that resource persons must ask permission from the presiding chairperson before speaking up. Otherwise, she would be cited in contempt. 

The House committees suspended the hearing for a minute, but later allowed Lo to finish his presentation. 

At the end of Lo's presentation, former health consultant-turned-Dengvaxia whistleblower Francis Cruz spoke up and said Lo should validate his claim that the Dengvaxia controversy is causing "hysteria" among the public. 

The DOH itself said the vaccination rate has gone down, as parents are now scared to immunize their children for other diseases following the Dengvaxia mess. 

Acop then called out Cruz. The congressman said that his wife and children are doctors, and they told him the claims of Cruz and PAO over the allegedly Dengvaxia-related deaths have led to a lesser number of parents getting their children vaccinated.

"For the information of Dr Cruz, my wife is a pediatrician, one of my daughters is a pediatrician, my son is a pediatrician," said Acop.

"Tinatanong ko po sila kapag kami'y kumakain. 'Yun pong sinasabi 'nyo, hindi po nila pinatototohanan. Ang pinatotohanan po, 'yung sinasabi po ni Dr Lo." (I ask them about this issue when we eat. They told me they do not believe what you are saying. They believe Dr Lo.)

The DOH's data as of September showed that 19 out of 154 children who died after receiving at least one dose of Dengvaxia, had dengue despite the vaccination.

Among these 154 deaths are "the first 62 deaths" examined by the UP-PGH team. Of the 62 deaths the task force investigated, one was "consistent with causal association to immunization," which means the patient's death occurred within 30 days and thus could be related to the Dengvaxia vaccine.

But Health Undersecretary Eric Domingo clarifed there is no solid evidence yet on whether or not Dengvaxia itself directly caused the deaths. – Rappler.com

Mara Cepeda

Mara Cepeda writes about politics and women’s rights for Rappler. She covers the House of Representatives and the Office of the Vice President. Got tips? Send her an email at mara.cepeda@rappler.com or shoot her a tweet @maracepeda.

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