“Politics doesn’t interest you because you have no interest in
changing a world that suits you so well.”

– Enola Holmes

When a senior doctor at the hospital I serve enthusiastically encourages me and other junior doctors to choose, like him, to be vaccinated with Sinovac’s COVID-19 vaccine – after a preamble emphasizing his choice as the result of personal discernment – it is all too familiar, this betrayal by yet another doctor in a position of power.

Hazard pay promised to frontliners for their sacrifice, only to be withheld from them over and over. Medical experts dissembling the truth in order to defend this regime’s inutile pandemic response. Hospital directors embracing a vaccine overwhelmingly rejected by his institution’s staff.

What jolts me is the parade of pictures on social media, health workers from different public hospitals posing for the Department of Health’s vaccination campaign after receiving their first doses of Sinovac. Then, the disgust as another physician I know articulates everything I find objectionable about this particular vaccine drive — let us not be choosy; the best vaccine is the one in your arm; no politics, just science. Choose Sinovac.

It was naive of me, yes, but at some point, I actually thought that healthcare workers would be able to generate the critical mass necessary to reject the government’s imposition of Sinovac on frontliners. To demand for both respect and proper protection from the pandemic. The sudden change in discourse was quite unnerving. After months of reticence, physicians of various institutional affiliations have suddenly and very publicly changed their tune on Sinovac over the past week.

Again and again, the assertion that to be vaccinated is a duty, that the vaccine (Sinovac) is safe, and that some protection is better than no protection at all, so stop asking questions and get your shot today. However, when their very public endorsement of the vaccine is challenged with respect to evidence and actual, appraisable data, most would suddenly cite three apparently unassailable things in their defense: (1) Trust me, I’m a doctor; (2) Expert S got vaccinated with it, so why shouldn’t we; (3) It’s my personal choice, pakialam mo ba?

This has always been the trap: to frame the COVID-19 vaccination drive as purely a matter of personal choice. It is not. The mass distribution of a substance of unknown efficacy and safety is not just a matter of personal choice; it is a matter of public health. To endorse it with the weight of an MD is to prescribe it. No hiding behind the rhetoric of patient autonomy here. 

Let me make a few things clear. First of all, yes, to be inoculated with the proper vaccine is imperative as responsible citizens of our benighted country. We all deserve adequate protection from this interminable pandemic, and the sooner more people are vaccinated with vaccines that have been well-demonstrated to be effective and safe, the sooner it will end.

Second, there is nothing wrong with the concept of patient autonomy: choosing an unpopular treatment option is well within anyone’s rights. What is objectionable, however, is the blatant endorsement by numerous physicians of Sinovac as an acceptable vaccine for frontline health workers.

Here’s the deal: unlike the vaccines by Pfizer, Moderna, and AstraZeneca, there are as of yet no published and peer-reviewed Phase III clinical trial results for Sinovac. The US CDC defines Phase III clinical trials as the stage in the vaccine development process wherein the efficacy and safety of a vaccine is evaluated in its target population; as such, we have no idea if Sinovac will even be effective as a vaccine because we have no reliable information on its efficacy and safety profile. Data provided by the company that manufactured the vaccine should not count. However, even assuming that the data Sinovac provided the government (under a non-disclosure agreement) is to be trusted, two regulatory bodies, the FDA and the HTAC, have already asserted that Sinovac should not be used as a vaccine for individuals who have high exposure to COVID-19 cases. Read: frontline healthcare workers.

It is therefore irresponsible of doctors to endorse Sinovac to their fellow healthcare workers. By blatantly promoting this specific vaccine, these physicians are essentially telling all the health workers in this country to shut up, stop asking questions, and just be thankful for whatever scraps the government sees fit to throw our way. Never mind the appropriateness of the drug. Expendable bodies have no right to complain.

As I watched Dr. Gerardo Legaspi, the Philippines’ first legal COVID vaccinee and director of PGH, speak to the media through his teeth that there was no politics involved in his choice of Sinovac as vaccine, only science, and as I heard more doctors echo his misleading statement, I think about how we have to identify Dr. Legaspi as the first legal vaccinee, because certain groups close to the president have already been vaccinated against the law months before, in subversion of the vaccination priority lists.

I think about how Afghanistan, wracked by civil war, began their vaccination drive weeks before ours with the cooperation of the Taliban. I think about how the government has allegedly allocated millions of pesos for vaccines, yet we are still limited in our choices of vaccines. I think of all the hospital workers pressured by physicians in positions of power to accept a vaccine they would rather not be injected with. How quarantine protocols are being loosened further and further as COVID cases soar. How hospitals are still teetering from the pandemic, how poor patients still suffer the cramped conditions of public wards and ERs. I think of all the dead, their lungs transmuted into lakes of contagion, and how the presidential spokesperson has the gall to frame the government response to COVID-19 as excellent. How the first thing I learned in UP Manila is that there is no such thing as Medicine and Health beyond the pale of politics.

Ask enough questions and you begin to see that truly, everything is connected. This is not radical thought; even the World Health Organization recognizes the importance of the Social Determinants of Health. And ultimately, I think about how all these doctors, all too eager to bend over backwards, fearful, perhaps, but all grateful for scraps, are become instruments of oppression, legitimizing the way this regime has betrayed and continues to betray the Filipino people and the health workers that serve them.

The tragedy of the Filipino physician is that they are impotent political actors. As a class, doctors often portray themselves as apolitical, even during this season of madness when silence is complicity.

Less than a week after Sinovac was rolled out for use among health workers, doses of AstraZeneca, a vaccine that has published and peer-reviewed Phase III clinical trial data, arrived in the country. This is vindication for all the health workers, such as those in Palawan, who stood their ground, rejected Sinovac, and asserted their preference and worth, and the primacy of science and evidence.

We accept the vaccine we think we deserve. It’s been a year since the country was first placed under community quarantine and the COVID pandemic continues to rage among us. With no end to COVID in sight, it is imperative that health workers and the general populace be vaccinated with the appropriate vaccines as soon as possible.

But more than that, we cannot wait silently for the scraps the president and his minions would deign throw our way. We must clamor for our safety and our lives, for adequate protection for the sake of our bodies, our families, and our fellow Filipinos. We must demand what we are owed. We must shout. For the appropriate vaccines. For our hazard pay. For adequate public health measures. 

Anything less is to embrace our doom. – Rappler.com

Ralph Fonte is a writer and frontline physician.