In the Philippines, a Dengue Vaccine Scandal Fuels Distrust Over COVID Inoculations

“I don’t think it’s safe,” she told VICE World News.

But her husband, Jeffy, a long-distance truck driver, quickly disagreed.

“I heard on the radio that the vaccines from the U.S. and the U.K. are safe,” he said. “I’m not sure about the ones from China and Russia.”

These disputes are increasingly common in the Philippines, where a past scandal over a vaccine for the mosquito-borne dengue virus has fueled suspicion over COVID-19 inoculations.

In 2016, the Philippines launched the world’s first mass vaccination campaign against dengue fever, a potentially lethal tropical disease spread through the bites of infected Aedes mosquitoes. A year before the rollout of the vaccine, called Dengvaxia, the Southeast Asian country reported more than 200,000 dengue cases and 600 deaths, a near 70 percent increase from the previous year. Children are particularly vulnerable, and the vaccination campaign targeted 800,000 young people.

Panic set in after the manufacturer of Dengvaxia, France’s Sanofi Pasteur, announced in 2017 that those who received the shot without having been previously infected with dengue could be at risk of developing a severe variant of the disease if they are infected.

The Filipino public was soon bombarded with news about children whose deaths were linked to the vaccine, though an official investigation has been inconclusive and deeply politicized. The Department of Health under the new administration of President Rodrigo Duterte halted the program, Dengvaxia was banned in the country, and the government pursued criminal charges against company officials.

Sanofi has defended the safety of the vaccine. Dengvaxia was approved by the U.S. Food and Drug Administration last year in children ages 9-16 in areas where dengue is endemic, and where there is a confirmed prior dengue infection, according to the Centers for Disease Control.

But in the Philippines, the damage was done. 

In early 2019, a measles outbreak was declared in Manila and nearby provinces after cases surged 550 percent compared to the year before. By the time health authorities declared the outbreak over, more than 23,000 children contracted measles and 415 died from the vaccine-preventable disease. By September 2019, polio also resurged in the Philippines due to what experts said was vaccine skepticism.

Today, only 66 percent of the population is willing to be inoculated against COVID-19 if the vaccine is readily available, a survey released in November showed. 

A government nurse who has gone house to house in Metro Manila’s densely populated communities told VICE World News that convincing parents to vaccinate their children was difficult.

“The parents challenge us with something they read on Facebook or online or what they see on TV,” said the nurse, who preferred not to be identified because of the sensitivity of the issue. “Some parents who are mad at us even made their dog chase us.”

But she added that some people just want to know more about vaccines or be visited in their homes instead of having to make the trek to health centers.

Dr. Tony Leachon, who used to advise a government task force on COVID-19, said the percentage in the November survey is low considering that a minimum of 70 percent of Filipinos need to be vaccinated to approach herd immunity.

“This is a huge problem,” Leachon told VICE World News. “The shadow of that particular Dengvaxia controversy is in the minds of the people right now. The government must not repeat the mistake of the past administration which was to fast-track approval of a vaccine.” 

Leachon added that because of the Dengvaxia scare, the government must be as transparent as possible in its selection and acquisition of vaccines. 

“Now that there’s vaccine hesitancy, the only way to sell the vaccine to Filipinos is to show them the efficacy and safety data,” he said. 

In a recent study published in the medical journal The Lancet, scientists observed that confidence in the importance, safety and effectiveness of vaccines has plummeted in many places, including Indonesia, Pakistan and South Korea. But in the Philippines, there was a dramatic drop in vaccine confidence after the Dengvaxia scandal, from 93 percent in 2015 to 32 percent in 2018. 

The Philippine government is finalizing deals with China for the delivery of 25 million doses of the Sinovac Biotech vaccine by March 2021, and it is also exploring the acquisition of 10 million doses of the Pfizer vaccine. 

The Philippine Secretary of Health and a spokesperson for the president’s office did not immediately respond to requests for comment. 

But there may be a silver lining. The severity of the pandemic in the Philippines has brought life to a halt in one of the worst outbreaks in Southeast Asia. Like millions of Filipinos who have been repeatedly told that the vaccine is the way out, Bongcasan said she might reconsider her skepticism, but only if “everybody” gets the shot too.