MANILA, Philippines (UPDATED) – Vaccination programs in the Philippines have come under the spotlight because of the Dengvaxia controversy and the measles outbreak which has caused at least 70 deaths.

The Department of Health declared measles outbreaks in Metro Manila, Calabarzon, Central Visayas, and Western Visayas. (READ: A year after Dengvaxia: Immunization drops, measles outbreaks soar)

Health Secretary Francisco Duque III appealed to the public to avail of free vaccination in public health centers. He noted that other vaccines were “long proven to be effective.”

Ensure access to vaccines

Established in 1976 through Presidential Decree 996, the Expanded Program on Immunization seeks to ensure that children, particularly infants, and their mothers have access to vaccines recommended for their age to prevent specific diseases. 

By providing them access to vaccines, the program aims to decrease the morbidity and mortality among children.  

When the program was first rolled out, the vaccine-preventable diseases include tuberculosis, diphtheria, tetanus, pertussis, poliomyelitis, measles and rubella.

In 2011, through Republic Act No. 10152, the mandatory basic immunization now covers: 

• Tuberculosis
• Diphtheria, tetanus and pertussis
• Poliomyelitis
• Measles
• Mumps
• Rubella or German measles
• Hepatitis-B
• H. Influenza type B (HIB) 

Because of the active campaign on vaccination, the number of cases of certain diseases have decrease in recent years. For example, the last case of wild poliovirus in the country was reported in 1993.

Reaching every barangay

Under the law, any “physicians, nurse, midwives, nursing aide, or skilled birth attendant” present during the delivery of a newborn are required to inform parents or legal guardians of the “availability, nature, and benefits” of immunizations against vaccine-preventable diseases at birth. 

The mandatory basic immunization is given free at any government hospital or health center for children up to 5 years old. 

Vaccine against Hepatitis-B, meanwhile, should be administered to an infant without 24 hours after birth. Subsequent doses shall be completed according to the recommended schedule as provided by the DOH.

In 2004, the DOH introduced the Reaching Every Barangay (REB) strategy which aimed to improve the access to routine immunization and reduce drop-outs in the program. 

All health centers are required to have at least one staff trained to follow through with this strategy which includes collating data on vaccinated children, strengthening links between the community and the health sector, and supportive supervision, among others.

The REB is just one of the strategies the health department deployed to ensure that each child in the Philippines is vaccinated. Another strategy is the Supplemental Immunization Activity (SIA) which targets children who did not develop sufficient immunity.

Under its 2018 budget of P107.3 billion, P7.43 billion of which will be used for public vaccination program that targets full immunization of 2.7 million infants while, 2.7 million pregnant women will receive tetanus vaccine.

Don’t be afraid

The Dengvaxia mess has led to more and more parents refusing to avail the government’s various vaccination program, according to DOH. 

Duque said that parents’ hesitation to have their children vaccinated is one of the reasons behind the measles outbreak.

In 2018, a total of 58 doctors and scientists, in a statement, expressed dismay that “unsubstantiated” claims over the Dengvaxia dengue vaccine is discouraging parents from availing of other government immunization programs for their children.  – Rappler.com