By Joseph B.A. Marzan
The Department of Health-Western Visayas Center for Health Development (DOH-WVCHD) looks to move ahead with promoting the benefits of vaccination and further coordination on storage while awaiting instructions from its central office on the coronavirus disease 2019 (COVID-19) vaccination in the region.
The city and province of Iloilo both signed multilateral deals with British-Swedish pharmaceutical company AstraZeneca over the weekend for the AZD1222 vaccine, alongside the National Task Force to End COVID-19 (NTF) and the DOH.
Iloilo City will be procuring 600,000 doses of the vaccine worth US$3 million, while Iloilo province earmarked P95 million in its Annual Investment Plan for 2021 for 271,000 doses.
Various local government units (LGU) also signed multilateral deals with AstraZeneca, the NTF and the DOH.
This was apart from the “top 20” provinces in the country which will be supported by the national government for the free COVID-19 vaccination program.
The vaccine, however, has yet to secure Emergency Use Authorization from the Food and Drug Administration, which is needed before it is administered to the population.
Vaccine trials in the country must undergo three “approvals” – Single Joint Review Ethics Board, Vaccine Expert Panel, and FDA authorization.
The Single Joint Review Ethics Board determines whether the vaccination process is ethical, the Vaccine Expert Panel will provide the technical process of vaccination, and the FDA will give the final green light on the trials.
Despite the developments in procurement, confidence in the COVID-19 vaccines is low, with only nearly a third of Filipino adults willing to be vaccinated, according to a survey by Pulse Asia.
Iloilo City Mayor Jerry Treñas told Daily Guardian that the city government will conduct a survey through Barangay Health Workers this week to determine if residents want to be vaccinated.
Iloilo Governor Arthur Defensor Jr. said last week that the provincial government will also promote the vaccination process to encourage the public to participate.
Dr. Mary Jane Juanico, head of the Infectious Disease Cluster Unit of the DOH-WV CHD, told Aksyon Radyo Iloilo on Monday that vaccinations are voluntary, and that refusal to be vaccinated is well within an individual’s rights.
The regional health office is still awaiting guidelines from the national office on how they will be doing a public health campaign for the vaccine.
But Juanico said people’s understanding of the vaccine is crucial to its success.
“[A] very critical part of this COVID-19 vaccination deployment that those prioritized by the LGU understand the vaccine and what the effects are. That’s why the one target by the national government and of course the DOH is really to build the confidence of the people in our vaccination program, specifically for COVID-19,” Juanico said in a radio interview.
She clarified the role of the DOH regional offices in the COVID-19 vaccination “blitz” by the national government, which also includes monitoring for adverse effects.
The procurement of the vaccines, however, goes straight to the DOH Central Office, with Health Secretary Francisco Duque III being the signatory to the multilateral agreements with the LGUs’ preferred vaccine makers.
“Since these are task group processes, the vaccine roadmap, from evaluation to administration and monitoring and evaluation later on, different agencies are involved. But in almost all of the task groups, the DOH is there. The biggest role [of the DOH] is in the administration and evaluation later on in our post-vaccination deployment, especially in the monitoring of adverse events following immunization,” she said.
As to the storage of COVID-19 vaccines, the DOH has included in the multilateral agreements that the LGUs must first identify their storage areas before going ahead with procurement.
This aims to keep the vaccines safe and effective once these are delivered to the LGUs.
Both Treñas and Iloilo Governor Arthur Defensor Jr. said that they already have the refrigeration facilities ready for their vaccine orders and are open to request for additional funding should they need to buy more storage facilities.
The AZD1222 vaccine should be stored at a temperature of 2 to 8 degrees Celsius. Vaccines made by Pfizer and Moderna must be stored at temperatures below zero degrees Celsius.
Under its National Immunization Program, the DOH will also inspect the arrival of the vaccines, which are “almost always” transported through air travel, according to Juanico.
They conduct a “shake test” using samples from each box to identify whether the vaccines were stored in the ideal temperature.
If these vials have been considered either as deep freezing or are not compatible (visually) with the way it had been oriented with the receiving persons, these will be set aside.
Juanico said that while the DOH-WVCHD does have facilities under its regular program, they cannot handle the capacity of the COVID-19 vaccines ordered by the LGUs, which is why they advise to outsource storage facilities.
“For the storage, here in the regional office, with the local government—which is why it needs to be part of the agreements that [the DOH] needs to be aware of the LGUs who will proceed in procuring the vaccine – is that they need to have a nearest cold chain facility. Our DOH cannot handle all of the vaccines because even with our regular national immunization program, we also get a staggered supply from the national office. So that is one of the things we are coordinating with them, that they also need to have identified regular cold chain facilities, whichever would be necessary for the specific brand or company they have contracted with,” Juanico said.
The national government and LGUs have similar targets to put frontliners ahead of the pack in the vaccination process as they are in contact with COVID-positive patients.
Vaccine czar Carlito Galvez, the NTF’s signatory in the LGU vaccine agreements, said late last year that the national government expects 50-60 million people to be vaccinated by the end of this year.
Juanico also said that the DOH-WV CHD will start training on the COVID-19 vaccination process today, Jan 12.
