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Laguna measles crisis: Deaths mount as vaccine phobia spreads

Officials say fear caused by Dengvaxia, misinformation, and lack of health literacy among Lagunenses are driving the dismal immunization coverage in many parts of the province.

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By LEOBEL COLONA, MARI SANTILLES and NEAL ANDREI LALUSIN

SANTA ROSA CITY — The measles outbreak in Laguna province was a tragedy waiting to happen as parents failed to immunize their children because of the hysteria surrounding the Dengvaxia fiasco. Health workers tried desperately to assuage this fear, with limited success.

As a result, the crisis has eclipsed last year’s number of casualties. As of February 10, Laguna had 167 cases of measles. At least five have died three from Biñan, one from San Pedro, and another from Santa Rosa. Only 10 cases were recorded in the province last year, with zero death.

A child gets a vaccine shot at the health center of Barangay Don Jose, Santa Rosa City. (Photo by Dek Fernandez)

Laguna health officials, however, insist that the province is still in what they call a “safe zone,” the cases and deaths notwithstanding. “Measles is always around. There is no reason to fear it. The only logical thing to do is to get vaccinated,” said Dr. Rene P. Bagamasbad, chief of the Provincial Health Office (PHO).

But as records from the PHO show, that is easier said than done. 

Documents from the PHO acquired by Laguna Now indicate a drop in the MMR vaccination coverage in the last three years. Officials and experts blamed the phobia generated by the Dengvaxia controversy as a key reason for the decline. MMR is the most commonly used vaccine against measles, mumps, and rubella. It is generally accepted as safe if administered properly.

San Pedro City had the lowest MMR vaccination coverage among the six cities of Laguna, the records show. In 2016, only 43.67 percent of the 9,002 San Pedro residents eligible for the MMR vaccine were given the shot. The percentage decreased slightly the next year,  to 43.33 percent, but dropped to 36.62 percent in 2018.

Among the Laguna towns, Bay had the worst vaccination coverage. It was the only town in the Top 3 with the lowest rate in those three years: 39.49 percent in 2016, up 41 percent in 2017, then down to 36.06 in 2018. Calauan had the lowest coverage in any of those three years, at 28.67 in 2016, followed by Luisiana with  29.78 percent, also in 2016.

The total MMR coverage of the six cities fluctuated: 61.24 percent in 2016, going up to 64.14 in 2017, but dropping to 60.43 percent in 2018, the year the Dengvaxia controversy was at its height. 

The total coverage of the 24 towns was more dismal: 51.92 percent in 2016, increasing to 54.97 in 2017 but dropping to 47.11 in 2018. Province-wide, the total MMR coverage stood at 58.26 percent in 2016, increasing to 61.14 percent in 2017, but dropping to 56.07 last year. 

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While these figures are not too far off from those in other provinces, these are way below the coverage target of the national government, which is between 85 and 90 percent.

MMR and other vaccines are administered on nearly 88,000 members of the “eligible population,” mostly children, which is 2.7 percent of the province’s total population of 3.2 million.

Dengvaxia scandal

Health officials and experts attributed the decrease in vaccination coverage to the fear spread by the Dengvaxia controversy, which erupted in November 2017 after the DOH stopped using the dengue vaccine. Its manufacturer, the French pharmaceutical giant Sanofi Pasteur, disclosed that Dengvaxia posed risks to people who had not been infected with the dengue virus. Subsequent claims by officials blamed Dengvaxia for the deaths of several people claims that heightened the fear against vaccines in general.

Adelona Esquejo, a barangay health worker in Barangay Pooc, Santa Rosa City, told Laguna Now that getting children vaccinated has been difficult because of the Dengvaxia scare. “We would explain over and over again the importance of vaccines and the legitimacy of MMR and other vaccines,” she said. 

“Before the scare, we had no problems making them come to the center for their shots. There may have been a few stubborn ones especially those who have many children but that was it,” Esquejo said. “Since Dengvaxia, people became a bit skeptical.”

Yumie La Torre, a nurse at the City Health Office (CHO) of Cabuyao City, said parents were afraid to get their children vaccinated. “Most of the parents here nowadays do not believe the Department of Health programs especially when it comes to vaccination,” she said. “They are afraid that their children might fall ill, as what they saw with Dengvaxia.”

These assessments were echoed by Dr. Christina Marquez, a pediatrician at the private Santo Tomas General Hospital in Batangas who told Laguna Now that there has been a “noticeable decline” in parents vaccinating their children due to the Dengvaxia scare. She said their fear overcomes the desire to immunize their children even though they had vaccinated their older children before. She cited the case of a grandmother who brought her one-year-old grandson to the clinic after being infected with the measles virus. “I asked her why didn’t she have the boy vaccinated and she told me that it was because of the news about Dengvaxia,” Dr. Marquez said. “So there was fear and it had a big effect.”

Or, as La Torre put it, “some parents now are being blinded” by this fear.

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Lack of information hobbles immunization program

AS a result of the measles outbreak, health workers are now working harder to try to reach more children and more communities, including those who have been administered the Dengvaxia. “We should not wait for our children to fall ill before we decide to get them vaccinated,” said Yumie La Torre, a nurse at the City Health Office (CHO) of Cabuyao City. 

The DOH and the CHO surveillance team conduct regular monitoring and providing medical assistance to children who had been vaccinated by Dengvaxia. There is also a mandated “Dengue Express Lane” in hospitals that will assist these children. Dengue kits are also given for free. This includes insect repellant, medicines for fever, a thermometer, oresol, and soap for protection.

“For now, we are doing campaigns to inform and convince parents to vaccinate their children,” La Torre said. School-based immunization campaigns are also ongoing. The CHO in Cabuyao, in response to the measles outbreak, now plans a vast investigation and assessment of the crisis. “We are giving Supplemental Immunization Activity (SIA) for Cabuyao children who do not have complete vaccines,” La Torre said.

According to Provincial Health Office head Dr. Rene Bagamasbad, the province is still in what he called “preventive stage” because of the government’s efforts to vaccinate. “Ever since the vaccine became available, the PHO ensured that it will be available to the public through rural health offices,” he said. Bagamasbad encouraged local government units to approach subdivisions and communities with basic health literacy and offer vaccines.

But the percentage of the vaccinated population remains  low despite the province’s compliance with the National Immunization Program that requires the complete vaccination of a child as young as two, Bagamasbad said. These vaccines are always available in public health centers and rural health offices in every city and municipality of the province, he emphasized, although he admitted that there is still the challenge of reaching distant communities. 

Low health literacy among Lagunenses is a problem, he admitted. In most cases, especially in the poorer areas, vaccines and their importance are not thoroughly explained. “As much as possible, we explain to the people the importance of vaccines but there are people who would rather not bring their children,” he said. 

Misinformation and the widespread paranoia concerning Dengvaxia didn’t help. “Prevention will always be better than cure,” he said. “Educating the people about vaccines and health in general can really go a long way.” (Laguna Now)

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