Dengvaxia, Fear Factor and Political Games

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THE DISCOVERY of Dengvaxia’s negative effects on some patients afflicted with dengue for the first time worked like a magnet for political gamesmanship. The report on the vaccine caused fear and panic among parents of immunized children. The emotional surge drew the worse kind of self-serving promotion on the part of some officials along with fault finding in the immunization campaign itself.

Some fundamentals relevant to the case should guide reporters: The vaccine has worked to prevent dengue infection in children, just judging from the lower number of reports on dengue deaths since the campaign began. This could be further validated by checking the record of cases in a number of hospitals around the country. Vaccine failure happens even in long established programs. Dengvaxia does not cause dengue. Only the mosquito bite causes the disease. The importance of dengue prevention has always been paramount in endemic areas.

 “Pattern” according to PAO

Unfortunately, instead of medical and scientific knowledge that could guide the policy makers as well as the parents about how best to protect the children concerned, the matter was more avidly pursued for the possible crime with which to charge former public officials. Such investigations should be pursued as appropriate, but it should not get in the way of providing solid scientific findings.

Department of Justice Secretary Vitaliano Aguirre directed the Public Attorney’s Office (PAO) on December 19, 2017 to extend free legal assistance in civil and criminal cases to all possible victims of injuries caused by vaccine related injuries, illnesses and death. The PAO office swooped on families of children who had died during a period and claimed that their autopsies implicated the vaccine in the deaths of five children.

On January 11, the Philippine Daily Inquirer reported PAO’s observation of the pattern in some of the deaths, providing it a banner lead story on the front pagewith the continuing story inside. (“Death of 5 children linked to Dengvaxia”) A photo of parents and relatives of the fatalities accompanied the rest of the story, filling almost half of the upper fold of page six. It cited the findings of Dr. Erwin Erfe, director of PAO’s forensic laboratory, on the massive bleeding in the brain, the lungs and enlarged organs of those who died. Erfe said the children fell ill after being vaccinated and died six months later.

At the end of the report, Secretary of Health Francisco Duque III was quoted saying: “Our panel of independent experts and the Philippine General Hospital have been tasked to monitor adverse events following immunization. We see [the] PAO’s efforts as complementary to our own and we would like to see the results of their probe.”

The Philippine Star and Manila Bulletin placed their reports on the front page (January 12) but led with Duque discussing the PAO’s findings, saying that DOH will compare this with the findings of UP-Philippine General Hospital when concluded.

Reports on PAO’s findings should have noted that these were not conclusive, and as such, should not have been given so much prominence, if it was to be reported at all, before the PGH experts were done with their investigation. Prominence given to inconclusive findings adds to the flow of misinformation

One-sided, Sensationalized

CMFR jeers TV Patrol segment “Kabayan Special Patrol: Disgrasya sa Dengvaxia” for its one-sided and highly sensationalized reporting on the alleged Dengvaxia deaths according to the PAO investigation. Aired from January 23 to February 3, the five-part series featured grief-stricken families of children who died, allegedly according to PAO, due to the vaccine. The reports showed distraught parents still in deep mourning. Interviewing children who had been inoculated, host Noli de Casto insinuated that they too could suffer the same fate. (“Batang hinihinalang namatay sa Dengvaxia, ‘pinag-eksperimentohan’?”)

Relying only on Dr.Erfe, the reports did not cite any DOH officials or any other medical expert who could evaluate the validity of the PAO claims. Reports of coroners were cited but with no explanation.

The Dengvaxia scare has already affected existing DOH-led vaccination programs. During a press conference, DOH Undersecretary Enrique Domingo said that immunization rates for polio, chicken pox, tetanus and other diseases have decreased significantly since December after news reported the negative effects of the dengue vaccine (“Dengvaxia row wreaks havoc on Philippine war on disease”)

Findings of PGH experts

On February 2, Domingo shared the initial results of the UP-PGH team tasked to investigate the deaths: three (3) out of 14 deaths were due to dengue despite immunization; nine (9) died due to other diseases developed after getting the vaccine, while the cause of two (2) deaths remain unknown. (“3 out of 14 kids died of dengue after Dengvaxia shot – UP-PGH panel”)

The media needs to remain vigilant and avoid spreading fear through alarmist, misleading, and poorly researched news. Scientific literacy is required in reporting issues of public health and disease prevention.