Aquino Administration Defied Experts' Advice on Dengue

A group of physicians and scientists not long ago have expressed concern regarding the Philippines' handling of the Dengvaxia fiasco. The confusion apparently is leading to a disturbing refusal to other proven life-saving vaccines. The problem of course stems from the fact that those who are responsible have not been held accountable. As a result, people think of the dengvaxia fiasco as bad medicine when in reality, it is really a case of incompetent and irresponsible politics. More than a month ago, Reuters reporters already found that the "Philippines did defy experts' advice in pursuing dengue immunization program".

Reuters shared the following excerpts from the recommendation made by the experts at the Philippines' own Formulary Executive Council (FEC):

  • “Based on the available scientific evidence presented to the Council, there is still a need to establish long-term safety, effectiveness and cost-effectiveness,”
  • "Dengvaxia should be introduced through small-scale pilot tests and phased implementation rather than across three regions in the country at the same time, and only after a detailed “baseline” study of the prevalence and strains of dengue in the targeted area."
  • "Dengvaxia should be bought in small batches so the price could be negotiated down... ...the proposed cost of 1,000 pesos ($21.29) per dose was “not cost-effective” from a public payer perspective.".

These recommendations were all ignored and the Aquino administration went ahead with a mass vaccination program without even waiting for the results of the international clinical trials.

The problem with the dengue vaccine is now attributed to an antibody-dependent enhancement of the disease. In a paper published in Science, it has been shown that "risk of severe dengue disease is highest within a narrow range of pre-existing anti-DENV antibody titers". The following diagram illustrates why Dengvaxia should not be given to those have not had a dengue infection before. It leads to a more severe econd infection. Dengvaxia administration therefore requires screening so that only seropositive individuals receive the vaccine.

Above copied from CMDVI report

The problems are therefore clear. And now, the Philippines has hundreds of thousands of young children who have been vaccinated without knowing whether these children are seropositive or seronegative. The mass vaccination was premature and was a huge mistake.

The maneuvers for damage control and abdication of responsibility have only led to a circus that neither exacts accountability from erring public officials, nor protects the children who have been exposed to harm. The science is clear. What is muddying the waters is the lack of accountability of government officials. We can trust safe and proven vaccines but we cannot and should never trust an arrogant, irresponsible and most of all, incompetent administration. Sadly, the same administration likewise pushed a half-baked gigantic basic education reform, similarly defying experts' advice.