PHILIPPINE health authorities reported 4,393 coronavirus infections on Tuesday — bringing the total to nearly 2.8 million — as total deaths exceeded 42,000.

The Department of Health (DoH) said 135 more patients died, while recoveries increased by 8,470 to 2.7 million.

There were 53,642 active cases, 74.8% of which were mild, 6.7% did not show symptoms, 5.8% were severe, 10.37% were moderate and 2.4% were critical, it said in a bulletin.

The agency said 53% of intensive care units in Metro Manila were occupied, while the national rate was 47%.

Twenty-eight duplicates were removed from the tally, 22 of which were reclassified as recoveries, while 97 recoveries were relisted as deaths. Five laboratories failed to submit data on Oct. 24.

The Philippines targets to inoculate at least 50% of its adult population by yearend.

Presidential spokesman Herminio L. Roque, Jr. on Monday said the country had given out 56.3 million coronavirus vaccines as of Oct. 25.

He said 25.96 million people or 33.65% of adult Filipinos have been fully vaccinated against the coronavirus.

In Metro Manila, more than 17.69 million doses have been given out, Mr. Roque said. Nearly 8.4 million residents have been fully vaccinated against the virus.

DoH earlier approved a plan to give health workers and other priority groups booster shots against the coronavirus to prevent a resurgence in infections.

The government is seeking to give out the third dose by November or December, Health Undersecretary Maria Rosario S. Vergeire told an online news briefing on Monday.

The booster shots would be given out as soon as the Food and Drug Administration issues an emergency use authorization to existing vaccines, she said. The authorization for most vaccines does not cover booster shots.

Some countries have ditched their COVID-zero strategy and are now aiming to live with the virus through higher vaccinations.

The Health Technology Assessment Council recommended the booster shots to DoH.

People who have been injected with AstraZeneca, CoronaVac and Moderna vaccines were advised to use Pfizer shots as their booster shots. AztraZeneca can be used for people injected with CoronaVac, the council said.

Those who were given Pfizer and Janssen vaccines should receive the same brand for their booster, it added.

People with an impaired immune system should get a third dose of the same brand at least 28 days after being fully vaccinated.

These include people being treated for leukemia, human immunodeficiency virus or HIV, those getting an organ transplant and patients with a rare disease and on dialysis.

The council said it had “considered the best available evidence” in endorsing booster shots, including their effectiveness against COVID-19 variants such as Delta; delivery and logistics, including supply; and cost per dose.

The primary goal of vaccination against the coronavirus is to protect against hospitalization, severe disease and death according to the World Health Organization. “Booster doses may only be needed if there is evidence of insufficient protection against these disease outcomes over time,” it said on its website.

The degree of waning immunity and the need for booster doses may differ between vaccine products, target populations, circulating SARS CoV-2 virus, in particular variants of concern, and intensity of exposure, it said.

“For some vaccines, restricted booster indications have been included into the product label of some jurisdictions,” it added.

The WHO also noted that during a period of continued global vaccine supply shortage, equity considerations at country, regional and global levels remained an essential consideration to ensure the vaccination of high priority groups in every country. “Improving coverage of the primary vaccination series should be prioritized over booster vaccination.”

“To date, the evidence remains limited and still inconclusive on any widespread need for booster doses following a primary vaccination series,” the WHO said. — K.A.T. Atienza