POSTSCRIPT / January 28, 2021 / Thursday


Philippine STAR Columnist

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Duterte’s butt shot: Unpresidential joke

AS FAR as presidential jokes go (from where we sit it looks like and sounds like a joke), that one saying that President Duterte wants his COVID-19 vaccine shot in the buttocks is not only unpresidential but also unprecedented.

In a Palace briefing Tuesday, presidential spokesman Harry Roque was asked if the President’s decision to be vaccinated in private was final. Reiterating an earlier announcement, he replied in all seriousness:

“I think so. He has said so. Sabi niya nga, sa puwet siya sa magpapasaksak, so hindi pwede na public. (He said he will get injected in the buttocks so it can’t be done in public.)”

Duterte announced in August last year he was willing to be the first to be injected with Russia’s Sputnik-V coronavirus vaccine to show his faith in its efficacy and safety. He apparently changed his mind after he sealed two months later a deal to get the vaccine of China’s Sinovac Biotech.

After confirming the order for Sinovac’s serum and approving the priority list of the mass inoculation led by public health frontliners followed by indigent seniors and others, he announced that he and other top officials would be last in line.

Suddenly President Duterte was no longer No.1 on the public vaccination list.

In one of his televised meetings with the COVID-19 vaccination task force in December, he was caught inquiring if he could take another shot, implying there had been a previous or first dose. If there was an answer from Health Secretary Francisco Duque, the audio failed to record it.

His taking back the promise to lead the public initial vaccinations departed from the usual scenario of government leaders taking the first shot to launch with (hopefully) contagious confidence the mass vaccination in their countries.

Examples of leaders publicly taking their inoculation are US President Joe Biden, Russian President Vladimir Putin and, closer to home, Singapore Prime Minister Lee Hsien Loong and Indonesian President Joko Widodo.

Pressed to explain Duterte’s withdrawing the idea of his taking the national first shot in public, Malacañang unreeled the line that he had decided to have his inoculation in private after everybody on the priority list has been vaccinated.

To address the followup question of why it should be in private, Malacañang came up with the story that he wanted to take the injection in his buttocks (and that, you know, can’t be in full public view).

We think that is already stretching it and we dismiss it as just another of those jokes that the Palace plays on the public now and then, sometimes as a distraction.

Has Duterte consulted a medical doctor about taking a butt jab? Secretary Duque, his top medical adviser, said he would try to convince him to change his mind as the President being vaccinated in public could encourage more Filipinos to be inoculated also.

Checking literature on vaccination, we have not found anything saying that an adult vaccinee must take it in the buttocks. On the contrary, we found warnings that targeting that area could irritate, compress, or inflame the major sciatic nerve passing the buttocks and down the thigh all the way to the heel and sole of the foot.

With Duterte already having a hard time walking, injury to his sciatic nerve by a misplaced jabbing in his buttocks may worsen his mobility issues. Sciatic nerve pain originates from spinal nerve roots in the lumbar (lower) and/or sacral spine.

The generally recommended site for vaccination of adults is the deltoid muscle forming the rounded contour of the shoulder where all leaders publicly vaccinated had taken it. A seldom-used alternative is the anterolateral thigh, but not the buttocks.

In the past, some vaccines had been administered in the buttocks or gluteal muscles but studies for some vaccines such as for Hepatitis B recommended that they be injected in the arms or deltoids, but not the rump.

The US Centers for Disease Control and Prevention has said that the buttocks should not be routinely used as a vaccination site and, to avoid injury to the sciatic nerves, they are generally not used, and that the central region of the buttocks should be avoided.

If the Palace sticks to its new line that the President no longer wants to be seen being vaccinated in public, what could be the real reason if they just made up his invoking the privacy of being injected in the buttocks?

There are several theories in social media, the most active sounding board for public opinion nowadays. One speculation is that the President already had his first dose and was not ready to risk a potentially problematic second first dose.

Another theory is that he has allergies or comorbidities that, at age of 75, argue against his taking new vaccines that could trigger adverse reactions. Note that his opting to take the jab in the buttocks was not announced by his doctors but by his spokesman.

If he has had a first injection, when was this? The speculation is already going too far, but one version is that he had it around the time his security men had their own secret injection with smuggled vaccines from China’s Sinopharm, a state-owned drug firm.

That is another big story that needs investigating. That event was patently illegal and could not have happened without at least the knowledge of the Commander-in-Chief.

Whatever it is, the matter is one that requires transparency. And accountability.

(First published in the Philippine STAR of January 28, 2021)

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