Vaccine Advocacy: Mission NOT Impossible

Post date: Jul 31, 2012 9:30:14 AM

by Dr. Carina M. Frago for the Philippine Foundation for Vaccination

“An ounce of prevention is worth a pound of cure.” This adage could not have been more apt when it comes to vaccines. Globally, 12 million children less than five years of age die annually from vaccine-preventable diseases. Without immunization programs worldwide, the death toll could be higher: 2.7 million are expected to die from measles, 1.2 million from tetanus, 10,000 from diphtheria and 800,000 from polio. Data from the National Statistics Office and UNICEF showed that 35 out of 1,000 Filipino infants die annually from vaccine-preventable diseases such as measles, tetanus, pertussis, hepatitis and meningitis. The launching of the Expanded Program of Immunization (EPI) by the World Health Organization (WHO) in the 60’s caused a significant decrease in disability and death from these diseases. Thanks to the government support and implementation of the EPI, compulsory basic immunization is provided by the local health centers. As the number of fully immunized children increased to about 80 to 90%, the infant mortality rate subsequently declined.

Despite these encouraging results, the Philippines has a long way to go in terms of achieving a fully immunized population. Essentially, limited resources pose problems in implementing a successful immunization program. While the EPI dramatically improved the health situation, it only covers BCG (for tuberculosis), DPT (diphteria, pertussis and tetanus), measles and hepatitis B.

It does not include vaccines against other potentially deadly diseases such as HiB vaccine for Haemophilus influenza type b, MMR for measles, mumps and rubella, varicella vaccine for chicken pox, flu vaccine for influenza, pneumococcal vaccine for Strep. pneumoniae, rotavirus vaccine for rotavirus diarrhea, meningococcal vaccine for N. meningitides, hepatitis A, and typhoid. Although most of these diseases are generally self-limiting, complications do occur after natural infection. Mumps may cause viral encephalitis (a form of brain infection) and sterility in males. Rubella also known as german measles results in congenital defects of the unborn baby or even abortion if a pregnant mother gets infected. Rotavirus is the most common cause of diarrhea which may cause death if complications of dehydration arise. Hepatitis A is a significant cause of death and morbidity especially among adults but the vaccine is recommended to be given as early as 1-2 years of age. Pneumococcal and Hib vaccines prevent serious infections like meningitis (brain infection) and pneumonia. Sadly, only the middle to upper income groups are able to afford and, thus, avail of these equally important vaccines.

Lastly, most parents are unaware of or misinformed about vaccines in general resulting in missed vaccine schedules. They should be educated about the importance of immunization so that it will be among their list of priorities. Also, it is never too late to complete one’s vaccine schedule. It should be emphasized that, contrary to popular belief, vaccines are not limited to children.

Adolescents and adults also need to be immunized. For instance, the population most susceptible to hepatitis B, a fatal disease associated with liver cancer, are those engaged in increased sexual activity and injecting drug use, health care workers exposed to blood and patients undergoing dialysis. Chicken pox may cause severe complications such as encephalitis if a person gets infected after 15 years of age. Pregnant women need a booster dose of anti-tetanus vaccine since maternal tetanus is responsible for at least 5% of all maternal deaths. The elderly group (60 years old and above) are also more susceptible to flu and pneumonia thus necessitating flu and Strep. pneumoniae vaccines.

No doubt about it, the entire population would benefit from vaccination. Fortunately, a fully immunized nation is an attainable goal but it will take the combined efforts of the health care workers, government, legislators, non-government organizations and the media. Thus, the Philippine Foundation for Vaccination, Inc. (PFV) ---a non-stock, non-profit organization which aims to protect and advocate for the promotion of vaccination as essential to disease prevention, was established in 2000. To fulfill its goals, the foundation works closely with government health care agencies, non-government organizations, and other relevant institutions in disseminating information and updates on immunization.

One of PFV’s achievements is organizing an annual national immunization conference participated in by medical and paramedical health care workers, health maintenance personnel, media and other socio-civic organizations. Aside from developing and updating a recommended schedule of immunization for Filipinos, it also conducts vaccine missions in schools and universities. In addition, it is instrumental in initiating resolutions and proposals for the possible legislation of mandatory hepatitis B vaccination of infants within 24 hours of birth and complete immunization as a prerequisite for school and job entrants.

This year, to further encourage vaccine advocacy, PFV is holding a contest on Best Immunization Practices in the Workplace/Community.This contest is open to any school, organization and institution dedicated to the promotion of vaccination.