Yellow Pad

An otherwise comedic story if not for its disastrous effect could have well happened in the Philippines.

A clinic in West Virginia blundered and injected 42 people not with a COVID-19 vaccine but with an experimental antibody cocktail. (Also, the procedure for the use of the antibody treatment was wrong. It is administered through infusion, not inoculation.)  This tragedy was attributed to a “breakdown in the process” and to “human errors.”

And across the United States, the vaccine distribution is plagued by the lack of resources and logistical complications. A typical story is that the vaccines are available but are stored in hospitals and not given to the most vulnerable people. Worse are accounts of health workers who have refused vaccination.

As a consequence of all this, the US government sorely missed the goal of having 20 million people vaccinated by end-2020. By year end, the Centers for Disease Control and Prevention reported that 2.8 million people received the first dose of the vaccine. Even assuming that this was a conservative report, we would still conclude that the performance was way below the target.

It goes without saying that such problems pertaining to disorganization, inefficiency, and incompetence are more pronounced in the Philippines.

So, is it a blessing in disguise that Philippine vaccination is not right out of the gate? Not really.  The point though is that we must learn the lessons from the front-runners. But more importantly, we need to internalize lessons from our own experiences in fighting COVID-19, especially our failings.

Many lessons have to be learned in rolling out our vaccination program. I emphasize a few, namely:

First, do not treat the first-generation vaccines as silver bullets. The efficacy of the first vaccines has been established in clinical trials, but the real world is different. By all means, have the approved vaccines, but be prepared for twists and turns. The ultimate success of the vaccine depends on factors that we cannot predict like the actual and long-term effectiveness of the vaccines.

A fine difference exists between efficacy and effectiveness. Here’s a relevant passage from Carl Zimmer, “2 Companies Say Their Vaccines are 95% Effective. What Does That Mean?” This was published in The New York Times on Nov. 20, 2020 and updated on Dec. 4, 2020:

“Efficacy is just a measurement made during a clinical trial. ‘Effectiveness is how well the vaccine works out in the real world,’ said Naor Bar-Zeev, an epidemiologist at the Johns Hopkins Bloomberg School of Public Health.

“It’s possible that the effectiveness of coronavirus vaccines will match their impressive efficacy in clinical trials. But if previous vaccines are any guide, effectiveness may prove somewhat lower.”

The second lesson, which follows from avoiding the temptation to devote all efforts and resources to the vaccination program, is to do well in previous tasks. The truth is, much still has to be done to improve the Philippine capacity for case finding, testing, screening, quarantining the infected and those with symptoms, and contact tracing. The vaccination program must go hand in hand with the above interventions.

The third lesson is to have effective strategic communication. Strategic communication — one that is clear, accurate, transparent, and persuasive — is in fact the strategy.

Again, the Philippines is wanting in this area. Different authorities contradict one another. Worse, some officials are the carriers of fake news. Remember the statement of President Rodrigo Duterte that gasoline can be used as a disinfectant against COVID-19? He was probably joking, but it was a bad joke. Some folks take his every utterance seriously.

Moreover, effective communication must convince the population to get the COVID-19 vaccine. We have to contend with the sad reality that a significant number of our people fear vaccination, borne out of experience. Thousands of families, especially their schoolchildren, suffered from what is known as the Dengvaxia controversy.

Despite the advance warning from some quarters from the scientific and health community, the Department of Health in the previous administration swiftly introduced Sanofi Pasteur’s questionable Dengvaxia vaccine against dengue. Eventually, but with the damage already done, Sanofi warned that the vaccine posed a higher risk of a severe case of dengue for previously uninfected persons.

Fourth, recognizing that the virus cannot be annihilated soon despite the introduction of the vaccine, we have to continue adhering to the protocols of self-protection, especially physical distancing. But social compliance depends to a significant extent on how leaders themselves follow the rules.

A survey and study done by the University College London showed a decrease in social compliance (and Brits typically abide by rules!) when the public found out that their leaders avoided or violated the rules. Making excuses and using loopholes make things worse in gaining trust.

The administration thus should no longer tolerate and should condemn actions such as the Chief of the Philippine National Police having a mañanita (early morning party) and the President’s Spokesperson enjoying the company of dolphins during a strict lockdown or singing loudly in a bar during community quarantine. Pinoys also follow their leaders’ example.

Last but not least, we must recognize that the vaccination program must be a whole-of-society approach. The government, the private sector, and the civil society organizations must coordinate efforts and unite in common strategies for the transparent acquisition and equitable distribution of the vaccine.

Up to now, apart from receiving general pronouncements, the public is not fully informed about the framework, goals, and strategies for vaccine allocation and distribution. We need a bipartisan effort and a broad coalition that will rally around transparency, accountability, equity, and efficiency in the formulation and implementation of the vaccination program. 


Filomeno S. Sta. Ana III coordinates the Action for Economic Reforms.