[ANALYSIS] Vax on, vax off: Exploring vaccine hesitancy in the COVID-19 pandemic

As luck would have it, the Philippines now has vaccines, one of the most formidable weapons against COVID-19. Yet, oddly enough, some people refuse to be equipped with it, finding it more of a threat than the very virus itself.

The DOH defines vaccine hesitancy as “a delay in acceptance or refusal of vaccines despite availability of vaccination services.” In September 2020, a Social Weather Stations survey revealed that only two-thirds of Filipinos were willing to get the COVID-19 vaccine. In December 2020, the University of the Philippines recorded that 25% of people from Metro Manila stand in favor of the vaccine, 28% do not, and 47% were undecided. In March 2021, a Pulse Asia survey showed that a whopping 61% of Filipinos do not wish to be vaccinated.

With the idea of herd immunity anchored on a successful vaccination campaign, there lies a growing concern over vaccine hesitancy. At this instance, it is only timely to discuss its many dimensions and determine how it can be overcome in this country.

Vaccine hesitancy taking on various forms

Sometime in 2019, the DOH declared that vaccine hesitancy partly caused the measles outbreak in the Philippines. The WHO identified two reasons, namely “lack of time among households” and “fear due to Dengvaxia.”

To recall, the Dengvaxia controversy created a national health scare when Sanofi declared that its Dengvaxia vaccine posed risks to those not previously infected by the dengue virus. It prompted the halting of the country’s school-based vaccination program, including the vaccine’s sale and distribution in the market. The DOH, however, has confirmed that no deaths were directly attributable to Dengvaxia.

Public immunization schemes in the early 1990s have not had much success as well. Back then, several Catholic groups rallied against the government’s mass tetanus vaccination program, claiming that the toxoid in the vaccine caused “spontaneous abortion in pregnant women.” Accordingly, fear, distrust, and skepticism broke out where treatment was needed the most.

Verily, the fear of vaccines is not alien to many. In the US, parents have refused to inject their children with the MMR vaccine despite lack of proof that it causes autism. Other parents have failed to give their babies multiple vaccines out of fear that it might “overwhelm their immune systems.”

COVID-19 vaccine hiccups fueling vaccine hesitancy

Presently, vaccine hesitancy is being fueled by the vaccine’s reported side effects. Data shows that a very small fraction of AstraZeneca and Johnson & Johnson’s vaccine recipients have developed severe blood clots in Europe and the US, causing a major disruption in their vaccination campaigns as the number of new cases arises.

In Norway, records show that 29 elderly persons with “serious basic disorders” died after receiving the Pfizer and BioNTech SE vaccine. The Norwegian government cautioned its use after finding that the deaths were linked to the said inoculations.

Vaccine compulsion vs. the right to refuse

During the Philippine-American War, Filipinos had to be vaccinated by their “serological protectors” to contain the spread of smallpox. Some exercised restraint and were tracked down by American soldiers. One officer proudly remarked that there was “no small problem to sanitate eight [million] of semi-civilized and savage people, inhabiting scores of islands.”

Albeit the historical accuracy, this mode of compulsion has no place in a civilized society like the Philippines. With the advent of modernity, legal and political systems have been restructured to provide balance to rights, duties, and interests between individuals and States. To maintain this balance, the Philippine Constitution was then enacted.

Significantly, the 1987 Constitution affords protection to a person’s right to health. Article II, Section 15 provides that “the State shall protect and promote the right to health of the people and instill health consciousness among them.” Article XIII, Section 11 also mandates the State to “adopt integrated and comprehensive approach to health development which shall endeavor to make essential goods, health[,] and other social services available to all the people at affordable cost.”

That said, it appears that the Constitution does not authorize the conduct of a mandatory vaccination program to “protect and promote the right to health.” First, it does not qualify as an “integrated and comprehensive approach to health development.” Second, it infringes on other equally protected rights in the Constitution, like the rights to autonomy and privacy.

As aptly pointed out by Supreme Court Senior Associate Justice Estela Perlas-Bernabe, Filipinos have the constitutional right to refuse the vaccine, since “the right to health is a constitutional right and [that] employees should be given the right to refuse or not to refuse [the] vaccine.” Retired Supreme Court Justice Angelina Sandoval-Gutierrez expressed a similar sentiment, stating that “it will violate a person’s basic right to privacy” since the State “values the dignity of every human person” under the Constitution.

Ating Bayan to Heal as One

Ken Galbraith once said, “[a]ll of the great leaders have had one characteristic in common: it was the willingness to confront unequivocally the major anxiety of their people in their time. This, and not much else, is the essence of leadership.”

To restore vaccine trust, former US Presidents Barack Obama, George W. Bush, Bill Clinton, and Jimmy Carter, alongside their former First Ladies, urged the public to get vaccinated as they received their respective doses on national TV.

Meanwhile, in the Philippines, it was baffling to see our healthcare workers be inoculated with a low efficacy vaccine just to boost public confidence. Instead of exhibiting true and unparalleled leadership, our top officials have chosen to receive their shots in their own time and for personal reasons. Ironically, this holds true notwithstanding Republic Act No. 11525, also known as the COVID-19 Vaccination Program Act of 2021, taking effect to expedite the country’s vaccine procurement and administration.

In these most trying times, it is perhaps befitting to address the issue of vaccine hesitancy by reigniting the spirit of bayanihan, without wholly relying on the “role-modeling” aspect of the vaccination campaign. To achieve this, the medical sector would have to assume a pivotal role in providing transparent and reliable policy responses that dispel misinformation on vaccine credibility. More importantly, the private sector would have to encourage people to get vaccinated through a proactive civic engagement that measures not only the goal of the entire collective but also the needs and sentiments of every individual composing it. – Rappler.com

Niel Anthony Borja obtained his Juris Doctorate degree from the Ateneo School of Law and became a court attorney for Supreme Court Senior Associate Justice Estela Perlas-Bernabe. He was a part of the pioneer Winter Sessions batch of The Hague Academy for International Law.

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