Dengue Vaccine FAQs for Doctors

Is the dengue vaccine safe? Is it effective? What happens if a patient receives only one dose instead of the recommended three? Can it be given to a two-year-old?

Because of its novelty, the dengue vaccine is the subject of many pressing questions, not to mention heated arguments. Even doctors who have been practicing for decades still have queries about the dengue vaccine, which is why coming up with a few informal FAQs have become a priority for me.

dengue vaccine FAQs

I know you must be so confused, what with the Department of Health having procured the vaccine for 1 million children in a three-billion-peso vaccine program despite still-ongoing trials (ethics in research and politics, anyone?), so let’s take a look behind the curtain and find out all that we can about the first-ever dengue vaccine: CYD-TDV (brand name Dengvaxia by Sanofi Pasteur).


Question #1: Is the dengue vaccine safe?

Because of the dichotomy of opinion on the subject of safety, the best people to ask this are those who have nothing to gain from the dengue vaccine – those who happen to be experts on epidemiology and evidence-based medicine.

Health through ballet: a pro weighs the pros and cons

Tutus, ballet shoes, leotards – I've worn all of them at one point in my life and I bet that many of you females out there have, too! Of course, I wear them only because they look great… not because I dance ballet.

Ballet Manila“Should I learn to do arabesques and pirouettes? Is ballet a great way to stay limber and fit, or is it too painful an art form?” I asked myself as I stared with awe at ballet posters in Aliw Theater.

Too many questions – and who better to enlighten me than the first Filipina to become a prima ballerina, Miss Lisa Macuja-Elizalde? (Spoiler: I'm also giving away one month’s worth of free classes at Ballet Manila!)

Walking the talk: Making 2016 a healthy year

It wasn’t until I took a peek at my archives today that I realized my blog was a little more than four years old! I did not expect it to last this long – health, after all, is something many of us think of only when we have problems about it.

Oftentimes, health becomes an issue after sickness makes it one.

That is why many of us don’t like spending money and time on health if we’re healthy. Going to the gym becomes important only when we start gaining weight. Investing on health insurance starts to matter only when we get diagnosed with hypertension or high cholesterol.

Healthier PHHere’s a token I received which will forever serve as a reminder of what I should (and could) do: build a healthier Philippines.

But trends are changing. Millennials are actually more particular about health (see number 7 in this listicle by Business Insider). They love eating healthy and getting physical.

Even games have evolved, requiring gamers to get off their butts and head out to catch monsters (kaway-kaway to fellow Pokemon Go trainers), turning technology that was once pro-couch-potato into a fun tool for unintentional fitness.


5 Healthy changes in 2016

Before I annoy you with my official endorsement of Pokemon Go as the innovative answer to many health woes (save for the safety issues due to careless use), I’ll dive into my list, which details five healthy things that happened to me this year. I share this with you in hopes that my story inspires you to share yours – we are, after all, shaped by the company we keep.

Rude awakening: Sleep specialists realize many doctors know zilch about sleep

Here’s a question for all my doctor-colleagues: How many of your patients did you refer to another doctor in the past year? Of those, how many were referrals to a sleep specialist?

None? Nada? Could it be that the number of referrals you made to sleep experts is the same amount you know about sleep medicine – that is, zero?

I hope not. Abnormal sleep has been a silent contributor to many lethal illnesses, including intractable hypertension, stroke, and heart attacks. Not making a referral to Sleep Medicine is tantamount to missing out on an opportunity to save a patient’s life.

MIMS sleep medicineAfter a chat with a sleep specialist, I learned a few surprising things about sleep medicine… such as how many doctors don’t know much about it. Check out this screenshot of my MIMS article.

By the way, a patient who snores does not necessarily have obstructive sleep apnea (OSA), and vice versa. If there’s snoring, however, it is a good reason to consult a sleep expert – chances are, OSA is hiding under the covers.


Sleep medicine: Why it should matter to all doctors

Should I blame you if you didn’t know that you could (and should) refer your patients to sleep experts? Probably not. Sleep Medicine is a relatively young field of specialization in our country, with less than 50 sleep specialists in the Philippines to cater to the millions of Filipinos who are suffering from parasomnias and other sleep disorders.

But other than having a horde of doctors who look like zombies from lack of sleep, what is the harm in doctors not prioritizing a good snooze?

“After training, doctors have this notion that they could sacrifice sleep. They then carry that mentality when it comes to their patients,” says Dr. Virginia de los Reyes, president of the Philippine Society of Sleep Medicine, Inc. (PSSMI), during the 2016 World Sleep Day forum at the Lung Center of the Philippines.

World Sleep Day 2016Doctors tell colleagues to wake up during the World Sleep Day forum: We shouldn’t be snoozing on sleep-related health problems.

It’s not just about sleep. It’s also about public safety. When a doctor feels no urge to underscore the importance of a good night’s sleep, his patients stay ignorant and misinformed.

“Think of all the pilots and drivers who feel sleepy,” says Dr. de los Reyes. Then, think of all the people who have entrusted their lives to sleep-deprived pilots, drivers, train engineers, and many others whose profession banks on mental vigilance.

Think of all the lives in danger simply because nobody – not even their own doctors – has bothered to tell them that sleep is of utmost importance, not only to their own well-being but also to the lives of others.


Even physicians misunderstand sleep

“Many doctors think sleep disorders are not urgent,” says Dr. de los Reyes.

Aside from underestimating the urgency and importance of sleep, physicians also misinterpret sleep-related trends and statistics. “Most doctors [have a tendency to] profile patients. They expect patients with obstructive sleep apnea to be obese males.

“However, we’re Asians. Because of our Asian features, we don't need to be overweight to get sleep apnea. If you have a very young patient with hypertension, you usually find that he has sleep apnea if you have the initiative to check.”

Ridiculously enough, sleep specialists often become the butt of jokes, almost all of which are due to ignorance and miseducation.

“There are many basic things that even medical schools overlook [about sleep medicine] that it’s so difficult to change the mindset of these institutions.”

“We say we are sleep experts and they say, ‘So, you’re an expert on sleeping?’”

You might be surprised when you learn about the many other myths still rampant in the medical community. Check out this article I wrote for MIMS on why it’s time for doctors to wake up from their stubborn misconceptions about sleep.


Sleep medicine: definitely not dozing off

Only sleep specialists were invited to attend past sleep forums organized by PSSMI. More recently, doctors from other specialties are being asked to participate.

“The discussion [on sleep] should not be limited to sleep doctors only. In our forums, cardiologists now talk about heart problems related to sleep. Psychiatrists talk about how sleep disorders are related to psychiatric issues. Occupational health experts discuss sleep conditions and work safety.”

Aside from working with different specialists, PSSMI partnered with different brands that specialized in sleep, such as Uratex.

“Each doctor caters to two million patients. It’s obvious that we need help. One thing we do look at for good sleep is the quality of the bed,” says Dr. Keith Romeo Aguilera, PSSMI treasurer.


The art (and science) of sleep

Now that you know the importance of a good night’s sleep, it’s time to find out how one can sleep peacefully and comfortably.

These guidelines on how to choose the perfect mattress might help you and your patients. Everyone should know this because we sleep on our beds daily! “You spend seven hours of the day in bed. That's a huge chunk of your life,” says PSSMI Vice President Dr. Agnes Remulla.

Here’s to better sleep and better mornings. None of us don’t want to look like zombies, that’s for sure.

Because celebrations are healthy (or are they?)

Last week, I was a little crazier than usual.

I wanted to go to Jamba Juice to buy a fruit shake with a caffeine booster. I was coughing like a dog and I had ten deadlines – I knew I needed something natural yet chemically spiked (yep, loved ‘em paradoxes) to get me through the day. It was raining but, the hero that Stanley Chi was, he volunteered to go get my drink for me.

After thirty minutes, he was back. I heard his footsteps, then a splashing sound followed by a really succinct series of cusswords.

It dawned on me that he just dropped it. He dropped whatever it was that he bought for me, the magic juice supposed to make me feel well enough to work.

I didn’t know what came over me but I exploded like a bomb long overdue for detonation.

I screamed. I cried. I threw a major fit.


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