Ubial on continuing the dengue vaccination program: No regrets

By Leilani Junio

December 7, 2017, 6:57 pm

MANILA -- Former health secretary, Dr. Paulyn Ubial, broke her silence on Thursday, saying she does not regret continuing the dengue vaccination program.

"No regrets. Science is dynamic. We make decisions based on best current available information. If the information today was known then, I would have decided differently," Ubial said in a text message to the Philippine News Agency (PNA).

She said that there was no recommendation from the World Health Organization (WHO) when the Department of Health (DOH) proceeded with its dengue vaccination program in April last year.

"It is public knowledge that (then DOH secretary Janette) Garin launched the Dengue Vaccine Immunization program on April 4, 2016 and WHO position paper on Dengue Vaccine came out July 29, 2016. So how can she claim WHO recommended it?" she said.

At that time, Ubial was health undersecretary.

She further said that when she was designated by President Rodrigo Duterte as health chief, she attempted to stop the vaccination’s second and third doses.

"I stopped it when I took over. But eventually continued it due to the fact that WHO position paper came out July 29, 2016 that it was safe," she said when asked what made her decide to continue the immunization program.

She added that the Pediatric Society and other experts had also endorsed Dengvaxia to be safe.

Acknowledging the huge pressure on her part not to discontinue the program, Ubial said, "How could I allow PHP1.4 billion pesos worth of vaccines go to waste and deprive Filipino children who cannot afford private sector vaccination afforded by the Dengue Vaccine that is, at that time, considered safe?"

With recent developments surrounding Dengvaxia, she said she does not regret giving the "go signal" for the administration of the two remaining doses to recipients.

Ubial said she is willing to participate in the Senate probe on the implementation of the dengue vaccination program.

The controversy on Dengvaxia began when Sanofi Pasteur disclosed last Nov. 29 that the vaccine could cause a severe case of the disease among recipients who had not contracted dengue before getting it. This prompted the DOH to stop the dengue immunization program and the Food and Drug Administration (FDA) to withdraw Dengvaxia from the market.

Dengvaxia had been administered to more than 700,000 nine-year-old public school children in three doses, six months apart, starting April last year. The program focused on Central Luzon, Calabarzon and the National Capital Region, as well as selected cities deemed to have the highest incidence of dengue.

The WHO, meanwhile, clarified that its position paper on the dengue vaccine “did not include a recommendation to countries to introduce the dengue vaccine into their national immunization programs”.

In a statement issued in its website last Tuesday, the WHO said it outlined a series of considerations national governments should take into account in deciding whether to introduce the vaccine, based on a review of available data at the time, along with possible risks.

First, it said, the use of the vaccine “should only be considered in areas where a high proportion (preferably at least 70 percent) of the community had already been exposed to the virus; second, the vaccine should only be provided to people nine years of age and above; and third, people being vaccinated should receive three doses.”

“WHO acknowledged mid-April 2016 that these conditions appeared to be met in the three regions of the Philippines in which the dengue vaccination effort was already ongoing at that time – noting that the decision to roll out the vaccine had been taken by the DOH before WHO’s advice became available,” it said in the  statement.

Garin, meanwhile, said the dengue vaccination program was implemented “in accordance with WHO guidance and recommendations”.

“Even before the official release of the SAGE (Strategic Advisory Group of Experts on Immunization), there were ongoing meetings and consultations between experts, WHO and DOH technical officials,” she said, adding that they fully cooperated and consulted with WHO prior to the program’s implementation.

“With the desire to resolve this deadly virus, the Department started the vaccination program which has until now been seen to be strongly beneficial to nine out of 10 Filipinos,” she said, welcoming the probe of the Senate and the justice department to “answer all questions at the right time, in the appropriate forum”.

According to WHO, its SAGE will meet next week to “review the new evidence” on Dengvaxia. (PNA)