More than a million doses of much-needed coronavirus jabs arrived in the Philippines this month to help the country begin a nationwide inoculation drive. But mounting reports of line-jumping have prompted a rare rebuke from the World Health Organization and partners, which warned that vaccine supplies could be “jeopardized” and the Philippines could end up having to pay for the donated jabs.
The first-ever batches containing 600,000 shots of China’s Sinovac vaccine and nearly half a million doses of the United Kingdom’s AstraZeneca jab arrived in the Philippines this month. Donated by the WHO’s global COVAX Facility, an alliance ensuring vaccine availability for non-wealthy nations, the AstraZeneca batches were reserved for front-line health care workers as part of the agreement. More than 13,000 people have died in the Philippines since the pandemic started a year ago, and hospitals are now dealing with a second wave.
But the limited doses, which are barely enough for 1.7 million medical front-liners in the country, has not stopped the powerful and wealthy from cutting the line. President Rodrigo Duterte’s top officials, nine mayors who were entrusted with vaccines, celebrities, and ordinary people with connections have all received jabs.
While difficult to determine the scale of line-jumping, interviews with medical professionals, social media posts reviewed by VICE World News, and the government’s own statements point to a growing problem that authorities are struggling to control.
In a televised speech late Wednesday, Duterte himself acknowledged the conditions set by WHO and its COVAX Facility, ordering health authorities to investigate.
“I understand fully the psyche of a Filipino. ‘Come here. Cut the line here.’ That’s it. That’s the Filipino style. The problem here is that we’re still in the first group [of health workers],” he said.
Philippine vaccine czar Carlito Galvez Jr., a former military general, also begged the public to follow the prioritization rules this week.
“Most importantly because it is our moral obligation to allow our front-liners to be the first to receive the protection they need and deserve, especially amid this surge,” he said in a statement on Thursday.
On a recent day at a clinic in Bacoor City in a province several hours from Manila, healthcare workers lined up to get the first batch of AstraZeneca vaccines, a small portion of the hundreds of thousands donated to the Philippines through the COVAX Facility.
A doctor shared screenshots with VICE World News of an Instagram story in which someone who does not work in healthcare received one of the precious shots. The individual, who is identified as an architect named Daniel Aleido, said his sister was a front-line worker and that “using some privileges can’t hurt.”
“Using some privileges can’t hurt.”
He did not respond to a request for a comment, but also claimed in the post that the Department of Health was informed of his vaccination.
Dr. Ivy Marie Yrastorza, a Bacoor City health officer, said she was not aware of the incident but that a task force would investigate.
“We targeted healthcare workers and we’re strict with the screening, unless they duped us and pretended to be healthcare workers,” she said.
A spokesperson for the city said the Philippine Department of Health will issue a show cause order against Aleido to explain in more detail why he received a vaccine.
A staff member at the Veterans Memorial Medical Center, the largest military hospital in Manila, told VICE World News it is common knowledge at the hospital that vaccines are offered to people under a traditional form of patronage known as the “padrino system” in which connections and friendships can be called in for favors.
“Doctors and staff bring one or two people as ‘paki-suyo (favor) and padrino (buddy system)’, you know our culture,” said the person, who spoke on the condition of anonymity for fear of reprisals at work. “Honestly, it is hard to avoid this.”
The hospital has been under scrutiny since a lawmaker from Quezon City, Representative Angelina Tan, got vaccinated at VMMC where her son is a doctor. But Tan said she was vaccinated because she is also a physician.
The hospital later clarified that its staff is entitled to enlist up to three family members for vaccinations, a plan it said was approved by the government but that critics say it is misguided.
In a now-deleted Facebook post, lawyer Kaiser Cordero thanked a “dear friend” Dr. Almira Grajo, a resident at VMMC, for his early vaccination. Grajo did not respond to a request for comment, but Cordero told VICE World News he decided to get the Sinovac shot out of an “instinct of self-preservation.”
Sinovac jabs do not come through WHO’s COVAX Facility, but they are still supposed to go to frontline health workers.
Dr. Johann Mea, VMMC’s spokesperson, said the hospital will investigate reports of line-jumping, while maintaining that they adhere to the guidelines set by the government.
In a more publicized case, an actor received a donated AstraZeneca shot in a vaccination site in Parañaque City. He is not a healthcare worker, but a city official defended his vaccination and said he is part of the second-tier priority group.
A Department of Health official acknowledged on Monday that the problem existed, but said that the number is “insignificant.”
“This has been observed across the globe. There has been a jump in the queue and we cannot avoid this oftentimes, sometimes it happens,” health undersecretary Leopoldo Vega said in a TV interview.
On March 4, WHO Philippines representative Dr. Rabindra Abeyasinghe warned that the Philippines could lose millions of free vaccines in the pipeline from the COVAX Facility if the priority rules are not observed. The county office declined to comment further when asked what would trigger such a dramatic step.
But Gavi, the vaccine alliance partner working with the COVAX Facility, said it would investigate any use of donated vaccines outside the program agreed to by COVAX and the partner country.
“If misuse is determined, countries will be held to account and will be required to reimburse COVAX,” a Gavi spokesperson told VICE World News in an email Thursday.
The government finally acknowledged the risks in a statement Thursday, admitting the country stands to lose some 44 million future doses of vaccines from the COVAX Facility if the practice continues.
But healthcare workers on the ground are losing patience and growing frustrated with the laissez-faire approach to line-jumping.
“I have colleagues who haven't been vaccinated yet. Our vaccine supply is very limited for now and it’s not enough for healthcare workers in the country,” the doctor who shared the Instagram story screenshot said.
Dr. Arnel Hope Castillo, who recently passed the physician board exam and started practicing as a “moonlight doctor” or those who do not have hospital affiliations, was not yet vaccinated.
“As of now, we don't have enough vaccines for all. That’s why vaccines were supposed to be given to individuals who are probably more exposed to the coronavirus. I believe we should stick to the guidelines.”
“Honestly, I am disappointed.”