Carving a path out of the present crisis will need a series of responses beyond vaccination, and will need to include long-awaited progress in testing, surveillance, and upgrading of health facilities. In-depth piece by Sofia Tomacruz:
‘Who are the people you need to chase so that the doses you deploy have the greatest impact possible?’ asks a DOH adviser
Sofia TomacruzIn the months since coronavirus vaccines have become available in the Philippines, one question has been raised countless of times for health and pandemic officials to answer: When will the Philippines reach herd immunity?The question – posed by government officials and lawmakers in congressional hearings, press conferences, and late-night presidential speeches – suggests that reaching this target offers a neat end to the health crisis. But what if that’s not the case?
For half a year now, when discussing the future course of COVID-19, health and pandemic officials have often cited the estimated 60% to 70% of the population that needs to have immunity from either prior infection or vaccination. But, just recently, experts have raised the estimated herd immunity threshold to
80% to 90%, on account of increased transmissibility of the virus brought about by the Delta variant, among other factors.It remains a moving target. Whether a range of 80% to 90% will be the threshold needed to achieve herd immunity will be impossible to know with headtopics.com
certaintyas the virus still evolves and transmission still continues.Although having a clear target for vaccination can provide both a sense of hope for the public and accountability for government, experts Rappler spoke to say herd immunity shouldn’t be the only goal we strive to achieve to be able to exit the pandemic.
Carving a path out of the present crisis will need a series of responses beyond vaccination, and will need to include long-awaited progress in testing, surveillance, and upgrading of health facilities.GoalpostsThe trouble with treating herd immunity as the only goal the country needs to reach is that it can overlook people most vulnerable to COVID-19. There has been increasing pressure on pandemic officials to meet this goal by the end of 2021, with many groups calling for the immediate expansion of vaccination to cover more Filipinos and the rest of the working population.
Health experts haven’t budged on the prioritization of groups to receive the COVID-19 vaccine.Dr. Anna Ong-Lim, a pediatric infectious disease specialist and member of the Department of Health’s Technical Advisory Group, cautioned against focusing on herd immunity as the only goal to reach, saying it can neglect efficiency in favor of speed or scale all to reach a target number – whether that’s 70% or 90%.
Speeding up vaccination to achieve targets by the end of the year, but failing to reach high-risk groups like the elderly (A2) and people with comorbidities (A3) across the country will still likely see the Philippines dealing with the same problem of overwhelmed health systems in the future. The two groups are among the most vulnerable to developing severe illness and dying. headtopics.com
Lim said a major target the country should work to achieve alongside reaching herd immunity was ensuring that all people in these two priority groups who are able to get the vaccine are vaccinated.“We’re not just talking about pure numbers here,” she told Rappler. “We’re after deploying to maximum benefit. Who are the people you need to chase so that the doses you deploy have the greatest impact possible?”
Latest figures from the National Vaccine Operation Center accessed as of Sunday, September 20, showed that out of 8.48 million senior citizens in the A2 category, only about 4.2 million received both doses of a vaccine. Among the 7 million part of the A3 group, 6 million received their second dose.
Dr. Maria Quizon, an epidemiologist and member of the National Immunization Technical Advisory Group (NITAG), asserted “it is really worth the effort to get the highest percentage of vaccination among the subpopulations at [high] risk.”The primary objective of vaccination isn’t to achieve herd immunity, but to prevent hospitalizations and deaths due to a disease. Data has shown that all available vaccines in the country continue to do that with effectiveness against severe disease and death holding up.
“The danger of putting in mind that ‘It’s herd immunity and we have to reach a certain percent’ is we tend to say, ‘Grab any Tom, Dick, and Harry’ that we can add to that percentage, and then you miss on that particular population that really you’re supposed to protect,” Quizon said in an interview in August. headtopics.com
“Assuming that we do get herd immunity, there may not be many people getting sick, but there would still be many people getting the severe type [of COVID-19], and worse, dying,” she added.Lim said : “So long as your vulnerable populations are protected, then you have very low risk of healthcare capacity being overwhelmed and therefore it’s not an issue for an economy to remain second.”
Duration of immunityThere are likewise several other factors that complicate the path to herd immunity solely through vaccination.One question that remains unanswered as of the moment is how well vaccines work against transmission of the virus, which is key to reaching herd immunity.
Aside from this, the duration of immunity from vaccines is not yet known for certain, while doses aren’t being rolled out around the world as fast and wide enough as they need to while the virus continues to evolve.“There is almost a false sense of security if you reach this magical number, magical percentage – and of course we want more people vaccinated – but it has to be shared around the world because you won’t be safe if it’s just your population,” said Maria Van Kerkhove, the COVID-19 technical lead of the World Health Organization (WHO).Read more: Rappler »
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