DOH approves dengue vaccine - should we?

On March 30, 2016, a news outlet released an article about the dengue vaccine. About 24 hours after its publication, the article was pulled down.

Er, Happy April Fools’ Day?

The article was pulled down quietly. There was no erratum, no statement about why the link was taken down just a day after it went online.

What is going on?

Should I get out my tin foil hat?

Given the recent controversy surrounding the upcoming dengue vaccination program by the Department of Health, it makes one wonder if something is afoot.

This is a screenshot of the pulled-down article, courtesy of Google’s cache.
Click to enlarge.

I would never have noticed the disappearance of the article if not for the fact that the dengue vaccine was a matter of concern for me. It was just last February when I shared my second thoughts about DOH’s approval of the dengue vaccine in this MIMS article.


DOH dengue vaccine program: What Juan and Maria should know

When the government approves the use of a vaccine with a safety profile yet to be studied by WHO, it does make one weary. In my MIMS article, I said that “until WHO deems the dengue vaccine safe for public use, there is no need to wait with baited breath.”

MIMS dengue vaccine

Here’s a short excerpt from my MIMS write-up:

“Estimated projections by Sanofi Pasteur state that administering the vaccine as indicated to 20 percent of the population in endemic countries may reduce dengue burden by up to 50 percent within 5 years, as presented by Laurent Coudeville and Nicolas Baurin during the 64th American Society of Tropical Medicine & Hygiene Annual Meeting held in 2015. More data – and, ultimately, more time – is needed to prove that this forward-looking statement is more than merely hopeful.

I wrote this article about two months ago, published February 12, 2016. Since then, many things have happened – things I believe every discerning Filipino should know.


Fact #1:

A news article about the dengue vaccine being approved by the DOH despite the lack of WHO guidelines was pulled down

The article said, “A week before the Department of Health (DOH) starts administering the first ever anti-dengue vaccine to thousands of public school students, the World Health Organization (WHO) announced that it has not yet completed its review on the product.”

The pulled-down article mentioned the approval of a dengue vaccine by the Department of Health (DOH) despite the lack of guidelines from the World Health Organization (WHO).

Interestingly, the next day, the same news portal published this article on dengue:

new MB dengue vaccine article

New article, new sentiment. This is the new write-up published a day after the now-retracted article was released online.

The newer article – published the day after the currently-pulled-down article – mentions that an official of the WHO “expressed support” for the mass vaccination the DOH is planning to implement.

I have asked the author of the pulled-down article to enlighten the public about what happened. I am still waiting for his reply.


Fact #2:

DOH spent P3 billion on the dengue vaccination program

“So what?” you might ask. “The government should spend its money on vaccines that will benefit the Filipinos, right?”

Right. That’s why it is worth noting that DOH has spent on the dengue vaccine more than it did on all other vaccines of the Expanded Program on Immunization put together. In 2012, DOH spent only P1.8 billion on EPI. I doubt that the budget has doubled since then.

Your taxes are about to fund a vaccination program despite requests to reconsider from health experts who are concerned about the safety and cost-effectiveness of the vaccine.


Fact #3:

Children given the dengue vaccine may have a higher risk for severe dengue and hospitalization

As I mentioned in my MIMS article on the dengue vaccine, the vaccine trials point to a higher risk for severe dengue and hospitalization for children 2 to 5 years old if they are to be bitten by dengue-carrying mosquitoes three years after vaccination. This data was published in a 2015 article published in the New England Journal of Medicine.

How about for older children? Although the above study revealed no risk for severe dengue in older kids, information may not be enough to come up with a conclusion. After all, WHO has yet to establish guidelines that take into consideration the safety profile of the vaccine.

WHO has explained what the possible risks are in this dengue vaccine Q&A.

DOH will start its dengue vaccination program next week involving elementary students. I am crossing my fingers and praying for the sake of every child who receives the vaccine.


Fact #4:

The Philippine College of Physicians abruptly cancelled a forum on the dengue vaccine

The forum, scheduled March 31, was cancelled at the last minute due to the controversy surrounding the vaccine. Speakers were invited to tackle important concerns about the vaccine, including cost-effectiveness and safety issues.

It was the first time the Philippine College of Physicians (PCP) had to cancel a forum, an anonymous source revealed.

PCP has led the way in many important health battles, such as the stem cell treatment controversy. The organization has consistently carried the flag for ethical and compassionate medical practice.

Given their strong views on medical ethics, I wonder why PCP cancelled the forum on the dengue vaccine. Who asked that it be cancelled? Why?

These are questions that need to be asked and, eventually, answered.


The ethical choice

I reveal to you these facts because the Filipinos are at risk. There is an ethical way to implement a vaccination program involving a new vaccine – one that does not put people in harm’s way.

WHO will be convening soon to discuss the dengue vaccine. It won’t be long before they release guidelines based on an objective review.

We can wait until then, can’t we? We owe it to the Filipinos to keep them safe, don’t we?

Filipinos are smart. Present them with facts and they can spot the difference between a sad conspiracy theory involving stupid tin foil hats and a legit concern that needs to be addressed.

Filipinos will know the difference between a vaccination program and an experiment.

Don’t get me wrong: The dengue vaccine could be all that it promises to be. However, prudence is called for.

As is the case with any new drug, taking precautions is the rule. Pommeling through with a vaccination program despite the warnings of researchers and the lack of long-term studies  is the opposite of taking precautions.

Pulled-down articles and cancelled forums aside, I’m hopeful that stakeholders are doing everything they can to do this the right way. I’m hopeful that our Health Department will listen to the many health experts airing their educated viewpoints which are supported by research that cannot be disputed.

We all have to remember that regret, after all, always comes last.

I’m a doctor, I don’t practice, and it’s okay

Is it your first time to visit my blog? Welcome! My name is Stef and I’m a doctor.

I studied medicine, graduated with Latin honors from the University of Santo Tomas, and passed the physicians’ board exams. No, I don’t currently practice medicine. Yes, I used to.

I now write for a living. You’re probably thinking, “What a waste! You studied medicine for nothing! And you’re an honor graduate, to boot! Que horror!

non-practicing doctorIt’s such a common sentiment among doctors who chose nonclinical careers that it should be on a shirt. (Thanks to my fellow doctor-writer, Aidz, for this idea.)

I bet you’re clucking your tongue and shaking your head like some telenovela villain, too, and I don’t blame you. Here, let me share with you a common scenario in my ten-or-so years of life as a writer:

New Acquaintance: Oh, so you’re a doctor? What’s your specialization? (smiles broadly)
Me: I didn’t specialize. (smiles)
New Acquaintance: (raises brow) Ah. Where do you practice, then?
Me: I don’t practice anymore. I’m a writer now.
New Acquaintance: (frowns) Really? Sayang naman ang pinag-aralan mo.

At that point of the conversation, a really nasty part of me is generally tempted to say, “Considering what you think of writers and how shortsighted you obviously are, mas sayang ang pinag-aralan mo.”

The stigma of the non-practicing doctor: a study in mythology

These are some of the myths I eventually debunked as a doctor who chose to write for a living. (If you haven’t yet, I recommend that you click that link and read it first.)

follow your dream

If you’re a doctor who’s on the fence about being one, this is for you. If you’re someone who might not know how to act or what to say if you meet a doctor who tells you s/he’s not practicing medicine, then this is for you, too.

Myth #1:

Doctors who don’t practice medicine are wasting their education

Fathoming Fertility: When there's still no bun in the oven

Rich or poor, single or married, male or female, every single person on earth started out as a baby – a blessed bundle of joy, effortlessly stealing the show with every innocent coo and cry. Family, after all, is where the promise of a bright future begins. But because of fertility problems, there is always one couple out there who craves a baby more than anything but has a very slim chance of having one.

Helping build familiesDoctors and patients get together and discuss fertility problems to share hope during a seminar on infertility.

Infertility: Keeping mum about not becoming a mom

Infertility remains a common problem, affecting about one out of every ten couples. Surprisingly, many don’t want to talk about it.

“There are many barriers to treatment, including embarrassment and concerns about treatment safety. About 50 percent are also unaware about where treatment centers are located,” explains Dr. Rudie Frederick Mendiola, President of the Philippine Society of Reproductive Endocrinology and Infertility (PSREI), during a seminar on fertility awareness.

Fact: Many couples are embarassed about their fertility issues.

Even after overcoming the unfair stigma of infertility, many couples wax pragmatic about getting help. “Seventy-seven percent believe it’s expensive [to get treatment for infertility]. Forty percent believe employers don’t allow time-off for fertility treatments.”

Exposing the truth about Herbalife & Formula 1 Nutritional Shake Mix

Have you ever used any Herbalife product in the past? Until a few days ago, I never planned on opening the container of Formula 1 Nutritional Shake Mix that Herbalife gave me, to be honest.

To say I’ve had second thoughts is an understatement. First of all, Herbalife uses a direct-selling model for marketing, which I try to steer clear of because it sounds a lot like the many scary pyramiding scams I see on the news. Secondly, I like eating actual food, not powder shakes.

Herbalife Formula 1 Nutritional Shake MixTo drink or not to drink, that is the question.

So when I peeled off the seal from my Herbalife Nutritional Shake Mix, it felt like I was about to open Pandora’s box. To satisfy my curiosity (and to find out if my dread was justified), I interviewed Rosalio Valenzuela, General Manager of Herbalife.

***EDIT: In case you don’t finish reading this, please be informed: I’m not an Herbalife member and I don’t sell these products.


Herbalife: 3 Important questions to ask

Caveat: I already knew the answers to some of my questions but I wanted to know what Mr. Valenzuela would say. Here’s what went down and I’m not going to sugarcoat it.

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