No confidence in vaccines: the measles epidemic in the Philippines

Measles cases have had a global outbreak in the last year. In the Philippines alone, the number of measles cases has increased by 266%. The Southeast Asian country first declared a home in Metro Manila, which reported 196 cases in January. The disease has now spread to five regions in the Philippines, killing 203 since the beginning of the year. This is not the first time the Philippines has been affected by a measles epidemic. Large-scale epidemics also occurred in 2011 and 2014.

Measles is a highly contagious disease that spreads easily to unvaccinated children and adults. Clinically, measles occurs in the form of fever and rash accompanied by cough, runny nose or conjunctivitis. Measles is very dangerous because it can make children susceptible to pneumonia, which often leads to death. Children under five are at greatest risk of contracting the disease and account for 70% of measles cases. In the Philippines, non-governmental organizations (NGOs) are working to help unvaccinated children.

The United Nations Children's Fund (UNICEF) and the World Health Organization (WHO) are working with the Philippine Department of Health to provide financial, technical and logistical support for the control of the epidemic. The measles, mumps and rubella (MMR) vaccine provides almost 100% protection against measles and has been shown to be extremely safe. This vaccine provides ongoing measles protection and is provided free of charge to children and families by the Philippine government.

However, parents refuse these services, resulting in a decrease in vaccination rates of up to 30% in some communities. The Department of Health attributed the current measles epidemic to "vaccine hesitancy", a delay or refusal of the immunization service even though it was easily accessible.

INVESTIGATIONS AND INSURGENCY

Mistrust of vaccines comes from the promotion and administration of Dengvaxia, a vaccine aimed at preventing dengue fever that has been deployed among tens of thousands of Filipino children in 2016-2017. . The vaccination campaign came to a standstill at the end of 2017 because of concerns expressed by the Office of the Attorney General that the virus could lead to serious dengue infections if the person had never contracted dengue before .

The Bureau's investigation into dengvaxia has resulted in criminal proceedings against more than 30 health officials. The finding was challenged, however, by external health professionals who stated that the Attorney General's office was not qualified to make this opinion. The deaths attributed to the vaccine have also been challenged by the DoH.

Media coverage of dengvaxia has created widespread mistrust of vaccines, prompting parents to avoid vaccinating their children. The DoH estimates that "in the last year, more than 2.5 million children under five have missed their vaccine. Since the survey, the Ministry of Health is also striving to obtain support from local communities for its public health initiatives. It is still unclear how the political climate will change in response to the epidemic. The government is actively responding by providing accurate information on vaccines and strengthening routine vaccinations to improve community coverage of the disease.

The political uprising in the southern Philippines has also contributed to lower vaccination rates. The WHO estimates that in some conflict areas, only 7% of eligible children were immunized against measles in 2018. Rates were particularly low as a result of the five-month battle between government forces and groups of children. 39 Insurgents affiliated with the Islamic State in Marawi in 2017. The conflict The availability of health facilities available in Marawi has been significantly affected, with buildings either caught between two fires or used as housing. for displaced persons within their own country. Although health facilities have been largely repaired with the help of WHO, compatibility and training in disease surveillance and immunization are still ongoing.

REPERCUSSIONS OF A REGIONAL FLAMBEE

Regional neighbors have expressed interest in contributing to efforts to combat the measles epidemic in the Philippines. The WHO said there was a moderate risk of spreading measles internationally, especially in South-East Asian countries. Several cases of measles have already occurred in the region as a result of trips to the Philippines.

The risk of spread varies by country. For example, in 2017, Bhutan and the Maldives eliminated endemic measles. This goal has been achieved through the Regional Strategic Plan for Measles Elimination by 2020, developed by the Regional Office for South-East Asia (WHO). The strategy was to increase immunization coverage in each country by more than 95%, establish effective surveillance networks, carry out laboratory tests and establish linkages with each country's public health programs. However, some countries in South-East Asia will have difficulty eliminating measles by 2020. Since 2014, Viet Nam, Thailand and Myanmar have all had outbreaks, mainly due to low vaccination rates.

According to UNICEF, the number of measles cases worldwide has increased by 48.4% over the 2017-2018 period. This has resulted in an increase in the global demand for MMR vaccine, resulting in delays in the purchase of new lots. In the Philippines, NGOs are helping to generate the required 6 million doses of MMR vaccine. But if the epidemic continues to spread in Southeast Asia, the demand for vaccines may not be met.

At the same time, the measles rate in the Philippines is increasing, particularly among the large population of unimmunized children who are at high risk of contracting the virus. The government is actively working to make more vaccines available, but the current perception of vaccines by the public is undermining their efforts. If the epidemic in the Philippines is not under control, it is likely to spread to other countries in South-East Asia where vaccination rates are low, causing public health problems, depleting public resources and has tragic consequences for the victims.