50 years of life-saving immunization

One life every six minutes. According to a study published by the Lancet, one of the world’s most prominent academic journals, that is how many lives vaccination has saved for the past fifty years – an estimated 154 million, with infants making up a significant majority of it at 101 million.

Such is the triumph of the Expanded Programme on Immunization (EPI) that is credited with the complete eradication of smallpox in 1980, a monumental achievement that was secured only six years after the initiative was established by the World Health Organization (WHO). Today, every country, including ours, has a national immunization program. The Department of Health established our own Expanded Program on Immunization in 1976.

As the EPI marks its 50th year, I had the remarkable opportunity to be a part of our country’s commemoration of this important health initiative as a returning moderator for this year’s Health Connect Webinar. As a long-time advocate of health and the objectives of immunization, it was a pleasure to be amid our country’s leaders, experts, and key stakeholders in public health, discussing effective collective action at the Health Connect Media Forum, a platform by the Pharmaceutical and Healthcare Association of the Philippines (PHAP).

Improving immunization information

Among the key objectives laid out by Mr. Teodoro Padilla, PHAP’s Executive Director, for Health Connect was to “strengthen collaboration among stakeholders and improve vaccination coverage rates of vaccine-preventable diseases.” Admittedly, there is much to be done – according to 2023 data, we are at 62.3% coverage and the target is 95%. The discussions that followed from the attendees emphasized the need for health literacy and education.

I believe the media plays an important role in the whole-of-society approach to promote the level of health literacy in our country. Indeed, we are uniquely positioned to effectively disseminate accurate and timely information in educating and protecting our community. 

Dr. Fatima Gimenez shared with the group stories from the Bangsamoro Autonomous Region in Muslim Mindanao (BARMM) that illustrated where our efforts can be best applied and would be truly appreciated. According to data she cited, there are low coverage rates for vaccines in BARMM. Their first course of action would be to host information dissemination sessions. “We gave lectures about measles and pertussis to parents, teachers, nurses, and learners.”

This effort swiftly resulted in almost 2,000 children being immunized. Following this was another session with parents, who welcomed them with questions and willingness to know more. An emotional Dr. Fatima told us, “People were hungry for information, and the parents in particular were clearly willing to know how to protect their children.”

It was a moment that resonated with me and evoked memories of my work at Bantay Bata 163.  My years as head of the organization working for the many victims of social and domestic abuse instilled a notion in me that the protection of children is not an objective exclusive only to parents and guardians, but to the community as well.

The need for more public health education initiatives was emphasized. Additionally, these initiatives would work better if we included a personal interface with parents and local health workers. “BARMM has a low coverage rate. We need to listen better, what really are their concerns? Let us expand our reach,” said Dr. Fatima.

Ms. Rachel Alcalde-Dumlao, Community Operations and Insight Manager of Reach52 was able to share their findings with us regarding barriers to child vaccination, which primarily point towards complacency, safety concerns, cost, and other barriers such as “parents having too many children to manage, migration, and religion.” 

If we want to change the tides, Ms. Rachel continued, we must employ consistent and more effective vaccine education initiatives.

Vaccination as protection for every age

But immunization is not a healthcare routine concerned with children alone, as Dr. Faith Villanueva, Adult Immunization Committee Co-Chair of the Philippine Society for Microbiology and Infectious Diseases, diligently reminded us. She cited as well a study revealing that the top five causes of death among adults are actually related to infectious diseases. 

Dr. Faith shared with the group ways to better promote the participation and eagerness of adults to be vaccinated, including the best practices in health information. “Vaccination should be patient-centered care, with respect for the patient’s autonomy and right to self-determination, privacy and confidentiality, and informed consent,” she added.

As Dr. Faith pointed out, “We have an aging population. A large chunk of our population are those that belong to the workforce, and as we age, our immunity will weaken.” 

Indeed, catch-up immunization must be integrated into the healthcare routine of those most vulnerable, such as our lolos and lolas. As Dr. Shelley de la Vega, Director of the Institute of Aging at the National Institutes of Health pointed out, “healthy aging requires a life course approach to immunization.”

Building on the discussion on healthy aging, Carmona City was cited as one of the successful LGUs on the matter, for its 97.8% vaccination coverage among its senior citizens. Mayor Dahlia Loyola herself attended the Health Connect webinar and shared their strategy behind this milestone in public health. 

Mayor Dahlia shared with us that it all begins in the “provision of supportive environments” such as incentive programs and awareness campaigns, before adopting projects such as free transportation and mobile vaccine centers to improve vaccine accessibility and utilizing the city’s health workers down to the barangay level for effective community engagement.

Celebrating the power of partnerships

I truly admire the Carmona City local government unit’s apparent commitment to this cause, which has translated to higher budget allocations for vaccine efforts, as Mayor Dahlia revealed to us. From this collaborative undertaking, the city now finds “zero cases of measles, polio, diphtheria, and neonatal and maternal tetanus” – a big win for families and the community.

Meanwhile, the Raising Awareness on Influenza to Support Elderlies (RAISE) coalition has been making strides in its partnerships with LGUs such as Quezon City and Las Piñas City, to deliver free vaccinations for senior citizens.

It was heartening to see that throughout Health Connect, the interaction between speakers and other attendees alike reinforced each other’s commitment to EPI’s goals: to improve our vaccine coverage rates and secure equitable access to vaccines for every member of our community, across cities, sectors, and other barriers.

This is summed up well by Mr. Teodoro’s message -– our celebration of EPI’s 50th year is also a celebration of “the many lives that were saved, partly due to vaccinations. We celebrate the partnerships that are being forged because of our commitment to bring accurate health interventions.” 

From the six illnesses that were the EPI’s focus during its inception, there are now 13 universally-recommended vaccines across age groups, and 17 more context-dependent vaccine recommendations. 

It is encouraging to know that this initiative continues its deeper integration into the public health sector. Hopefully, there may come a future where no member of our family or community will fall to a preventable disease. To navigate us into this future, I put my trust in our experts and leaders. 

As Dr. Faith said, “It is humanly possible, it is very doable, and it can be a reality.” We’ll get the jab done!

 

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