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January 13, 2021

Roque: ‘If You Don't Want Sinovac...You Won't Be Forced’; Officials Differ On Vaccine Procurement Of LGUs, Private Sector

Roque: ‘If You Don't Want Sinovac...You Won't Be Forced’; Officials Differ On Vaccine Procurement Of LGUs, Private Sector A combination of The Philippine STAR and Associated Press file photos shows presidential spokesman during one of his press briefings and Sao Paulo Gov. Joao Doria presenting to the media a box of an experimental COVID-19 vaccine CoronaVac as containers carrying doses of it are unloaded from a cargo plane that arrived from China at Guarulhos International Airport in Guarulhos, near Sao Paulo, Brazil on Nov. 19, 2020.

Criticized for saying Filipinos cannot be “pihikan” or choosy when it comes to the brand of vaccine for coronavirus disease 2019 (COVID-19) they will get for free, presidential spokesman Harry Roque said on Tuesday, Jan. 12, that no one – including those in the priority list – will not be forced to receive a shot they do not like.

Roque also defended the government’s decision to procure the vaccine manufactured by Chinese pharmaceutical firm Sinovac Biotech Ltd., saying that all vaccines will pass through the Food and Drug Administration’s evaluation process, and once proven safe and effective, “hindi na po importante kung ano ‘yung brand (the brand will not be important anymore).”

Kung ayaw n’yo ng Sinovac, well, hindi kayo pipilitin (If you don't want Sinovac, well, you won’t be forced),” he said during a press briefing.

Roque previously said Filipinos should not be choosy with the brand of vaccine they would receive for free from the government, drawing flak from critics who insist that taxpayers deserve to select the type of shot to be injected on them.

The Philippines has secured 25 million doses of COVID-19 vaccine from Sinovac despite doubts about their efficacy. The first 50,000 doses are expected to arrive in the Philippines next month and are expected to be administered to health workers. There have been claims that the vaccine manufactured by Sinovac is only 50 percent effective against COVID-19 but officials say the rate is compliant with the minimum requirement set by the World Health Organization.

Roque said the vaccine developed by Sinovac is the only COVID-19 shot available from February to June. He said vaccines from Western manufacturers would only be delivered to the Philippines in July.

"From February to June, there is no other choice because only one vaccine will be available, the one that will come from China,” Roque stressed.

"If you are among the priorities, if you are a health worker, a senior citizen and you don't want that, you would lose your priority slot... You will have to fall in line with the rest of the Filipino population," he said.

Cabinet Secretary Karlo Nograles said in a separate briefing that members of the priority sector who refuse to be inoculated would be asked to sign a waiver stating that they understand the implications of their decision.

"If it's time for you to be vaccinated but for some reason, you don't want to be vaccinated, you waive your slot...we put you at the end of the line so the queuing system won't be disorderly," Nograles said.

Poe: Why Sinovac

Sen. Grace Poe underscored that Filipinos have every right to choose which vaccine to take as “it is their money the government is spending to procure the precious doses.”

Rich or poor, everyone should have access to a vaccine that is safe and effective, Poe said. “Making the people trust science requires transparency of the process and openness to questions to allay their apprehensions and allow them to make informed choices,” she added.

She warned that many questions still linger in the people's minds as to why the government sealed an agreement with Sinovac when it has not yet applied for any form of clearance from the FDA.

She recalled earlier pronouncements that government is not entering an agreement with US-based Pfizer Inc. or British-Swedish AstraZeneca plc because tests have yet to be conducted or concluded by the two giant drugmakers.

“This is outrageous. Why is Sinovac being favored when it only has 50 percent efficacy and the least transparency?  Who are they trying to favor or appease?” Poe asked.

She also urged the government to make public the list of persons to be vaccinated and to work with local government units (LGUs) to ensure that the vulnerable and disadvantaged sectors get the first shot of the vaccine.

The Senate Committee of the Whole on Monday started its inquiry into the Duterte administration’s mass vaccination program where senators were convinced that the government appears to be favoring vaccines from state-owned firms in China that are reportedly less effective and have not much published scientific data to support them.

Senators believe reports on the varying efficacies of different vaccines brands and the administration’s apparent bias to Sinovac and Sinopharm – two serums from China – may be one of the reasons behind the results of the survey showing that many Filipinos are not willing to get vaccinated.

“Our government should be working on building confidence in the vaccine program, instead on toying around with their announcements at the risk of increasing people’s aversion to the vaccine,” Sen. Joel Villanueva said in a statement.

Sen. Panfilo Lacson said it was not fair that Filipinos cannot choose their vaccines—at least from those made available by the government.

“It’s bad enough that the national government virtually controls which brand/s of vaccines to procure. Now Filipinos can’t even choose what will be injected into their arms?” Lacson lamented.

“Why will I choose a brand with 50 percent efficacy and without any application for emergency use authorization (EUA), against other brands with 79 percent and/or 95 percent efficacy and have pending EUA approval from the FDA?” Lacson said.

Read more: ‘Allow Cities To Choose COVID-19 Vaccines Based On Capability and Constituents’ Acceptance’; Roque Draws Flak

AstraZeneca: COVID-19 Vaccine ‘Highly Effective’ Prevention

Sen. Christopher “Bong” Go said the government must undertake a massive information campaign to educate the public on the vaccination program.

To allow or not allow

As this developed, officials continue to differ on whether LGUs  and the private sector should be allowed to vaccines on their own to avoid delays in the procurement process.

Nograles said even individuals who have the money to buy their preferred COVID-19 shot cannot do so for now as the vaccines won't be available for commercial use this year.

The Department of Health (DOH), the National Task Force Against COVID-19 (NTF), and the FDA noted they appreciate the initiatives of the LGUs but as mentioned by the vaccine czar Secretary Carlito Galvez Jr.  they cannot procure and roll out COVID-19 vaccines on their own.

“This must be coordinated with the national government, through the NTF and the DOH in a tripartite agreement involving local governments and pharmaceutical companies. This is meant to align the efforts of LGUs with the vaccine initiative of the national government which integrates and consolidates all resources and initiatives,” the DOH, NTF and DFA said in joint statement issued on Monday, Jan. 11.

Senators have urged the government to let the LGUs and the private sector procure their own vaccines given the delays being encountered at the national level.

Read more: Senators: Let LGUs, Private Sector Buy COVID-19 Vaccines; Palace Says Filipinos Can’t Choose Brand Of Free Shot

The FDA also clarified that the EUA it issued “does not cover the commercial use of the vaccines.”

“This means that manufacturers cannot sell directly to the LGUs nor to any entity, unless they are under the vaccine initiative of the national government,” the FDA said.

“Further, the DOH recognizes the equity issues raised on the distribution of the vaccine. We assure the public that the national government adheres to the principle of equity where delivery of services are biased towards the vulnerable and the disadvantaged,” the joint statement read.

Chaotic

DOH Secretary Francisco Duque III said on Tuesday that having decentralized procurement of vaccines for COVID-19 can be chaotic.

According to Duque, it remains unsure if the vaccines that the Philippines can get "within a given time" are enough so it is better if the procurement is centralized.

“It is not good if we will be fighting among ourselves for the vaccines,” he said in a radio interview.

Duque cautioned about the likelihood that the “highest bidder” will end up having the vaccines.

He also said this may result in the priority sectors, such as the poor, and healthcare workers, among others, being disregarded.

“If that will be free-for-all, those who are affluent and the bigger companies will be the ones to get the vaccines first.  It is difficult if there is no orchestrator,” he pointed out.

LGUs to augment national government efforts

But Nograles said the national government will only be paying for the vaccines of an estimated 57 million Filipinos as the initiatives of the LGUs and the private sector will cover for the 13 million. The government’s target is to vaccinate 70 million Filipinos against COVID-19.

Nograles disclosed that the Department of Finance reported this to President Duterte during last Monday’s Cabinet meeting.

“The DOF reported that we have P75 billion allocated for the procurement of vaccines for 57 million recipients.  When you add the 13 million Filipinos that will be covered by various LGUs and private sector vaccination efforts, a total of 70 million Filipinos should be able to receive the COVID-19 vaccine,” Nograles noted.

“The planned rollout of our vaccine is good news that impacts not only the health of our people but the economic well-being of our country as well,” he said.

Nograles stated there had been a discussion on the age whether those 18 or 16 years old above would be inoculated.

“Rest assured the national government will do its part and make sure that we have enough vaccines for herd immunity,” Nograles said.

 No monopoly

Roque also said the national government is not monopolizing the procurement of the vaccines.

Roque explained only national govenrments – not LGUs  and the private sector – are part of the World Health Organization (WHO)-backed COVAX facility , a platform that aims to ensure rapid, fair and equitable access to COVID-19 vaccines for people in all countries.

For the purposes of COVAX, he said a multilateral agreement is necessary for the LGUs and the private sector to buy vaccines.

Asked why the LGUs prefer the AstraZeneca, Roque answered that this is AstraZeneca is the one covered by the agreement under COVAX.

He said this is because the University of Oxford and AstraZeneca as well as the United Kingdom do no want only the rich to be able to buy their vaccine.

It takes time

WHO country representative Rabindra Abeyasinghe emphasized that it will take time to roll out the vaccines for COVID-19 because of the lack of global supply at present.

“There is going to be many types of vaccines that will need to be accommodated.  There are going to be different conditions for administration and storage of those vaccines,” he  said.

If the vaccines are used in a “very careful way,” Abeyasinghe believes the impact of the COVID-19 pandemic can be minimized and “hopefully” bring back economic activities.

“The key issue is the Philippines does have a (vaccination) plan. We are looking at early implementation and early maximizing the impact of vaccination,” he added.

Abeyasinghe reiterated the importance of contract tracing especially since the Philippines is expecting a surge in COVID-19 cases due increased mobility of people during the holiday season.

WHO is pushing for “early detection of cases, sharing of information to contact tracing teams, management of cases so that chains of transmission are interrupted.”

“This is critical. We believe that with the holiday season some of the cadres that were recruited for contact tracing are still awaiting contract renewals,” Abeyasinghe said, warning that this could hamper having an effective response to this surge.

Good on paper?

Senators found the Duterte administration’s mass vaccination program for COVID-19 presented by the Inter-Agency Task Force (IATF) for the Management of Emerging Infectious Diseases as clear and complete but they expressed doubts that it would survive implementation.

IATF officials led by Galvez presented the government’s mass inoculation plan before the Senate Committee of the Whole on Monday amid controversies over the smuggling and inoculation of unauthorized vaccines in the country.

Galvez told the senators the government aims to procure 148 million doses to vaccinate 50 million to 70 million Filipinos this year to achieve herd immunity.

The officials also presented details on the actual vaccination process, including the setting up of 4,512 fixed inoculation sites all over the country that should be able to vaccinate some 1.3 million Filipinos daily.

“If your presentation is as good as your implementation, then we would have no problem at all,” Senate President Vicente Sotto III told the officials towards the end of the eight-hour inquiry.

Lacson said he is hoping and praying that the government properly implement the vaccination plan they laid out before lawmakers.

“While the plan may sound good, the difference is in the implementation –  the reaction and responses to emergencies. Without proper execution, a plan no matter how good it is written and presented, won’t mean anything,” Lacson added.

Senate Minority Leader Franklin Drilon described the vaccination plan as “suntok sa buwan” or shooting for the moon, citing stumbling blocks that could make its target of securing 148 million doses of vaccines and inoculating 70 million Filipinos by the end of 2021 simply difficult to achieve.

Parang suntok sa buwan ang (They’re like shooting for the moon in their) vaccination program especially 148 million doses within the year.  The arrival of the vaccines is not even definite. How can they say that they will be able to purchase 148 million doses by the end of 2021 when up to now, we haven’t given any Emergency Use Authorization to any vaccine and we have not been able to raise, through loans, all the needed amount for the purchase of the vaccines?” Drilon said.

“The plan is good on paper. The plan is filled with uncertainties and it leaves too much to chance,” Drilon added.

The FDA said it is ready to issue an EUA within the week while Galvez told the panel the government has only secured 30 million shots from Novavax Inc. and the rest are still under negotiations with different vaccine makers.

Read more: Bulk Of COVID-19 Vaccine Supply To Come From Novavax; ‘50,000 Doses From Sinovac To Arrive First In February’

Galvez, however, expressed his optimism that the negotiations with other vaccine manufacturers, like US-based Pfizer Inc., AstraZeneca, and Moderna Inc. will bear fruit in the next few weeks.

Senators also pointed to the apparent bias of the administration to vaccines from China as shown by Galvez’s admission that negotiations are well underway for Sinovac even if the FDA has yet to issue an EUA for such vaccine.

“If only the government was able to make advanced purchases last year, similar to other low- and middle-income countries such as Indonesia and Brazil, maybe we would have a better chance of securing these 148 million doses of vaccines this year,” Drilon said.

He also said the funding is not even guaranteed at this point as the government has not fully secured the necessary loans to fund the P70 billion in the unprogrammed fund for the procurement of vaccines.

The government has allotted P82.5 billion for the purchase of the vaccines but only P12.5 billion is in the programmed appropriation – P2.5 billion will come from the General Appropriations Act and another P10 billion under the extended Bayanihan 2.

“Playing God”

Drilon, Poe and Sen. Francis Pangilinan also prodded the IATF to hasten the issuance of EUA and other clearances to allow the private sector and LGUs)to procure their own vaccines to help stop the daily deaths of Filipinos due to COVID-19.

“To be candid, we get more confused. The premise is that at least the EUA is a prima facie certification that the vaccine is safe and effective. In fact it’s because of the EUA that we would authorize its use for 70 million Filipinos. Why can we not use this prima facie basis to allow the LGUs and the private sector to purchase vaccines?” Drilon asked FDA director general Eric Domingo during the hearing.

“Why will that standard change when it is the private sector? In other words, you want to play God?” he said.

Poe also urged the FDA to speed up the processing of EUAs on applications for vaccines to dispel suspicions that officials are just waiting for grease money to fast-track approval.

“If the virus won’t kill us, then red tape and slow government action surely will,” Poe said.

While stringent processing is crucial especially if records on the trials of the vaccines are not transparent and regulators in the home country of the pharmaceutical companies are not perceived to be credible, the FDA should speed it up when it comes from companies and countries with a better track record, she pointed out.

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