THE government's approval of a plan to spend P7.9 billion for a nationwide vaccination program is a timely response to the immunization rates for children that have remained low despite recent gains. In a briefing this week, Health Secretary Teodoro Herbosa said President Ferdinand Marcos Jr. ordered the Department of Health to increase immunization coverage and approved an additional P2.3 billion in his agency's budget to fund vaccine acquisition and administration nationwide. In the same briefing, Malacañang press briefer Daphne Oseña-Paez said that in 2021, the Philippines ranked fifth among countries with zero-dose vaccinated children. By 2023, she added, the Philippines was no longer in the top 20, but the President wanted a higher percentage of fully immunized children. As part of this effort, a nationwide school-based immunization program set to begin in October will administer vaccines for human papillomaviruses, measles, rubella, tetanus and diphtheria to Grades 1, 4 and 7 students in all public schools nationwide. Herbosa, however, clarified that the vaccination was not mandatory and still needed parents' consent — and therein lies the rub. Having the funds to acquire vaccines is only part of the solution. A crucial component for success is to win over parents, many of whom do not see the need to have their children immunized or, worse, fear that vaccines can be dangerous. This notion — encouraged, in part, by the government's own high-profile campaign against the Dengvaxia vaccine — has kept immunization figures low. For example, while the country's fully immunized child coverage rate increased from 59.9 percent in 2022 to 62.3 percent in 2023, and the measles-containing vaccine coverage rate increased from 63.7 percent in 2022 to 69 percent in 2023, these are much lower than the 95 percent target for routine immunization among children. Teodoro Padilla, executive director of the Pharmaceutical and Healthcare Association of the Philippines, cites a United Nations Children's Fund (Unicef) report that attributes vaccine hesitancy in the Philippines to concerns about vaccine safety. A recent example of the dangers of vaccine hesitancy was the pertussis or whooping cough outbreak earlier this year, in which dozens of infants died from the highly contagious yet preventable respiratory tract infection. House Deputy Majority Leader Janette Garin, a former Health secretary, said vaccine hesitancy was the root cause of the rising cases of pertussis and measles this year. Clearly, any program to increase immunization rates will need more than just ensuring an ample supply of vaccines. Dr. Daniela Ramirez Schremmp, the pharmacovigilance medical leader at the Bill & Melinda Gates Medical Research Institute, puts it this way: "Every parent's decision to vaccinate their child plays a role, along with every program and initiative that makes the decision accessible and effective." In approving the new funding for the national immunization program, Paez said, President Marcos called for a strong media and publicity campaign to reach families, mothers, children and the youth about the benefits and necessity of vaccines. As the government goes about trying to promote the benefits of vaccination to skeptical parents, it could also draw from the experience of a study by Unicef, the Yale Institute for Global Health and Meta, which developed and tested five campaigns that targeted people ages 18 to 55 in the Philippines to increase confidence in routine vaccination. Information campaigns, the study found, are most effective when they: – Address prominent concerns surfaced by the community. The message was most effective when it directly addressed the most common concerns about vaccines. Even indirect incorporation of community concern could increase parents' likelihood of having their children vaccinated. – Couch the message in local languages. Campaign results highlighted the importance of the message in local languages. – Consider value-based messaging, especially when trust is low. One campaign sought to emphasize liberty and parental agency in the decision to vaccinate their children. Using messages like "The safety of your child is in your hands," the campaign attempted to show that parents are free to have their children vaccinated and that this is ultimately their choice. – Use testimonials and storytelling from trusted messengers. Storytelling campaigns in the Philippines confirmed that authentic testimonials and stories are powerful mechanisms for affecting change. It's a finding that was also borne out in previous campaigns. These messaging approaches demonstrate the power of social norms and storytelling and the importance of sharing information from trusted and relatable sources. The effort to boost immunization rates in the country — especially if it is well-planned and executed — is one we can all get behind, firm in the belief that every Filipino deserves a shot at lifelong protection from preventable diseases.
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