17dec03 – Dengue vaccine failure: Who pays?

POSTSCRIPT / December 3, 2017 / Sunday

Dengue vaccine failure: Who pays?

By FEDERICO D. PASCUAL JR.

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SOMEBODY’S got to answer for having exposed thousands of innocent children to the ill effects of an anti-dengue vaccine that, according to the manufacturer itself, could pose health risks to those who got a shot although they never had the fever.

After more than 733,000 public school students had been vaccinated with the first of three doses of the Dengvaxia vaccine, the manufacturer Sanofi Pasteur says the immunization could cause “severe disease” in some cases.

Why is Sanofi telling us of possible negative effects only now, after innocent children had been vaccinated? Somebody has to pay for this, if it is shown that the officials acting as gatekeepers failed to do their due diligence.

The Department of Health, meanwhile, has suspended the P3.5-billion immunization campaign in highly endemic Metro Manila, Central Luzon and Calabarzon—while parents seek remedies and officials rush to review policies on drug procurement. Some P3 billion of the contracted amount reportedly has been paid.

The DoH reportedly still has 789,000 doses of the 300 million purchased. More than 500,000 stored at the Research Institute for Tropical Medicine and in regional centers would expire in August next year.

The dengue scare has revived questions over the use of poor and populous nations whose officials seem to be easily convinced to allow the field testing of new drugs in their area of responsibility.

Can government officials agree for the citizens to their being used for such testing, in effect waiving or usurping the individual’s personal right to agree or disagree?

While lauding the efficacy in many cases of its Dengvaxia vaccine, Sanofi warned on Wednesday – rather belatedly, we think – that severe negative side effects could manifest in recipients who have not had dengue fever before.

Sanofi said: “For those not previously infected by dengue virus, the analysis found that in the longer term, more cases of severe disease could occur following vaccination upon a subsequent dengue infection.”

• Duque allays fear, but reviews deal

HEALTH Secretary Francisco Duque III said the DOH would review its contract with Sanofi and the circumstances of the immunization program, and also determine if anyone should be held liable if anything was amiss.

The Food and Drug Administration, which had licensed the vaccine and approved its use, said that private physicians will decide for themselves whether or not to use the vaccine, but that its sale will be suspended until the product literature that goes with it is updated.

Duque allayed fears, saying that “the vaccine has a 30-month protection period against dengue, regardless if the child had prior infection or not.” He said he was awaiting clarification as to what Sanofi meant by “cases of severe disease,”

Julius Leccioness, chief of the Philippine Children’s Medical Center, said: “For those who were infected prior to receiving the vaccine, there is a 93-percent reduction in severity of the disease and 82-percent reduction in hospitalizations.”

He noted that Brazil, another country that used the same vaccine for mass immunization, has decided to continue with the program after seeing no severe cases attributable to Dengvaxia.

Duque said that the Strategic Advisory Group of Experts on Immunization of the World Health Organization will meet on Dec. 12 or 13 to discuss the matter.

The immunization program was launched in early 2016 under then Health Secretary Janette Garin despite opposition from medical experts who advised her to wait for the study to be completed.

Dengue fever and dengue hemorrhagic fever, transmitted by the Aedes aegypti mosquito, are acute viral infections affecting infants, young children and adults. About 200,000 dengue cases are reported yearly in the country.

• How did Duterte impress Trump?

WE STARTED to wonder what US President Ronald Trump thought of our President Rodrigo Duterte — loosened tie, crumpled barong, heavy accent and all — after we saw a video of the Donald mocking his hosts in his five-nation swing through Asia in November.

Speaking to a crowd Wednesday in St. Charles, Missouri, Trump diverted from his speech promoting Republican tax measures pending in the Congress and recalled advising Asian leaders he met in his trip about spending more for their defense.

As in a TV spoof, Trump imitated his Asian hosts, hunching his shoulders and looking around the room wide-eyed ― which media said mocked his Asian counterparts as not comprehending what he was telling them.

“When I was in Asia,” he said, “I spoke to a couple of the countries about it and they looked like this (he then parodied the supposedly clueless leaders whom he did not identify), you know what this is? Hmm, hmm. That means they know they’re getting away with murder and they got to start helping us out. OK?” The crowd laughed at his performance.

In the speech, Trump made a generalized claim that the US has been protecting rich (Asian) countries that do not properly manage their wealth. He said one country (which he did not identify) does not “know what to do with their money.”

He went on: “We’re going to work on trade, but we’re also going to work on military when we defend nations that are very wealthy… and we do it for almost nothing.”

In his 12-day Asian trip, he visited Japan, China, South Korea, Vietnam and the Philippines, his last stop.

Trump was dwelling on the same passing-the-bill theme he uses when he talked of NATO partners that, he said, virtually left it to the US to spend for and defend its North Atlantic allies.

He could not have been talking of Japan which spends to maintain US forces on its bases there – unlike the Philippines during the time of President Ferdinand Marcos who kept raising the rent of US military installations while cutting short the lease period.

 

(First published in The Philippine STAR of December 3, 2017)

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