Media hardly noticed: Poor implementation of country’s vaccination program
By Jeraldine PascualVaccines proved highly effective in turning around the
spread of disease in various countries. But the negotiations
to secure the supply, the procurement and purchase, and
the actual administration of the vaccines were mired in
government muddling.
One would have expected the administration to undertake all efforts to secure the supply of vaccines for Filipinos, ensuring the people would receive the most effective brands, based on records established in other countries. The public also expected the program to be conducted in an efficient and orderly manner.
Alas, this was not the case. The vaccine program suffered from the same poor implementation that marred almost every aspect of the government’s pandemic response, including the delayed development of testing mechanisms and later contact tracing. The last two measures were never appreciated by the president or anyone else in government, the vaccine was something he understood. This was something he said so himself. And yet, the same problems hobbled the quick start of the program to immunize Filipinos against the worst effects of COVID-19.
Indeed, the vaccines proved highly effective in turning around the spread of disease in various countries. But the negotiations to secure the supply, the procurement and purchase, and the actual administration of the vaccines were mired in government muddling.
To each his own plan
The uncoordinated approach to secure vaccines was the first indication of future troubles. On December 15, 2020, Foreign Affairs Secretary Teodoro “Teddy Boy” Locsin accused Health Secretary Francisco Duque III of “dropping the ball” and causing the failure of a deal to procure at the earliest possible time doses of the US-manufactured Pfizer vaccine — which Locsin and Ambassador Jose Manuel Romualdez were working to secure.
The president was quick to put Locsin in his place, saying that only the “vaccine czar” was authorized to negotiate for vaccines. But the situation made clear that Cabinet officials did not have the kind of internal discussions to clarify who would be responsible for what tasks.
This lack of coordination was already on clear display when Inter-Agency Task Force (IATF) officials released contradictory statements about the rate of testing that was being done in 2020. The clarification also made clear who the President favored in his official circle. But there was no evidence that coordination improved in 2021.
This was followed by the clandestine vaccination of some members of the Presidential Security Group (PSG) with then-unapproved Sinopharm, a China-manufactured vaccine. President Duterte himself made the revelation on December 26, 2020, but other officials who spoke claimed inoculations had been conducted as early as September. Dr. Eric Domingo, director of the Food and Drug Administration (FDA), admitted to the media that he could not get any information from any of the officials in Palace, including the PSG, so as to take the necessary action on illegal inoculations. Evidently, the policy requiring an emergency use authorization (EUA) was selectively applied, a serious issue which the media did not report more fully.
Government fails to follow its own plan
To review the missteps, CMFR retraced the coverage in the news of the government’s preparation for the vaccines in the first quarter of 2021.
On January 30, government released the “Philippine National Deployment and Vaccination Plan for COVID-19 Vaccines” to the public. The document detailed the steps according to a set schedule. It could have served as useful reference for journalists and the public to evaluate whether government was following its plan.
But apart from reporting the seven phases described in the executive summary, the media actually ignored the document. Since the media did not check how faithfully the government followed this plan, they simply reported what officials had to say about the process and procedures, with no reference to schedule or steps identified in the “Plan,” unable to call government officials to task.
Vaccines to arrive suffered delays
Retired General Carlito Galvez, chief implementer of the National Task Force Against COVID-19 (NTF-COVID) and appointed “vaccine czar,” announced proudly that the country would receive in mid-February 2021 Pfizer and Astrazeneca vaccines. The Presidential Spokesperson then, Harry Roque, even called this a Valentine’s Day gift for Filipinos.
The whole month passed without the said vaccines, and Galvez’ reason was that the COVAX Facility required legislation for an indemnity fund before delivering these. Only the Inquirer and Rappler checked out this excuse, pointing to evidence that officials involved in vaccine negotiations knew about this requirement in 2020.
At any rate, Galvez joined the rest of government cheering the first donated 600,000 doses of Sinovac which arrived on February 28, 2021. FDA had initially held back from issuing an EUA for Sinovac because the agency had not received the Phase III clinical trial data. But on February 22, the FDA approved the EUA for Sinovac. It held back its recommendation for Sinovac’s use for frontliners, citing the study in Brazil which showed a relatively low 50.4% efficacy of the China-manufactured vaccine among the country’s healthcare workers who were directly exposed to COVID-19.
Despite this warning, the IATF, the policy-making body on COVID response, gave the go signal for Sinovac use for frontliners on February 26, citing the recommendation of the Department of Health (DOH) and the National Immunization Technical Advisory Group, a recommendatory body advising on vaccine and immunization policy that few even knew about. FDA then concurred with the decision. It was clear in these actions that officials were acting on the expressed preference of the president and the DOH for the use of Sinovac.
No less than the president attended the arrival of China’s donation that the media covered as a red-carpet event, with much fanfare by his officials. Duterte was quoted on that occasion to say how he did not like vaccines produced by “white people.” As for the Western brands that came later, he either arrived late or skipped welcoming these altogether.
Journalists dutifully followed the ceremonies in the first hospitals to get the vaccine, noting the initial low turnout on the first day of vaccinations. Reports also cited in-house hospital surveys that showed a drop in the number of healthcare workers willing to be inoculated when they were informed that only Sinovac was available on Day 1.
Reports also quoted those who opted to take the available vaccine for their protection, along with government officials who seemingly jumped the line to persuade the public to take the available vaccine. Engrossed in the rollout, journalists did not provide the context of the deals involving other brands that fell through, priming public acceptance of the government’s decision to promote Sinovac.
Last in the ASEAN to acquire vaccines
At any rate, the country was the last in the ASEAN region to acquire vaccines — all of them donations in the first few months. The Philippines rolled out COVID vaccinations on March 1, 2021, delayed by two weeks from its original target.
Since then, the government’s vaccine policy has suffered from disjointed, vague, and confusing messages. Without the necessary coordination among themselves, officials ended up contradicting each other or starting actions without informing one another. These included important issues such as the mandatory vaccination of those physically working in offices or work sites; identifying comorbidities and conditions which disallowed vaccination; and repurposing second dose shots as first doses to cover more of the population.
In general, reports did include findings to explain the real reasons for the lapses or inadequacies of the program. When officials issued contradictory statements, the media did not describe the resulting public confusion.
The lack of policy evaluation was evident in the different directions taken by vaccine procurement. Galvez had admitted himself that he had secured supplies of Pfizer and Astrazeneca, announcing specific dates for their arrival. Both had the necessary EUAs issued in January. But this was seemingly overturned by a sudden unavailability of supply. Instead, Sinovac doses donated by the People’s Republic of China dominated the early stage of the program, with Duterte’s clear preference for Sinovac reported by the media. Later, when the country began paying for vaccine supplies, Sinovac proved to be more expensive than other brands.
Meanwhile, as the rollout identified the sectors who were given priority, local government units (LGUs) implementing the inoculations had to prepare master lists of their constituencies. And some LGUs took longer than others.
Delays contributed to the further erosion of the already fragile levels of public confidence in the vaccination program before it even began.
The slow start of the program was hampered by the lack of an effective and expanded communication campaign. The failure of the government to invest heavily on public information left Filipinos confused, uninformed, or misinformed about the benefits of vaccines. The Dengvaxia controversy in which public officials openly demonized the vaccine played a part in the general decline even in the application of traditional vaccines against childhood diseases already used in the country before the pandemic.
Without a public information campaign, word of mouth and testimonies from family and friends were the main source of information which convinced or failed to persuade people to get vaccinated.
The media also failed to fulfill its obligation to fulfill its public information role. Coverage mostly described the procedures in vaccine sites and tallies of administered doses. Media did not independently check how successful the different LGUs were in inoculating their constituents. Reports also failed to note the different challenges LGUs on the ground.
Vaccine Hesitancy
Journalists did not note the absence of a campaign to counter vaccine hesitancy. It did not check whether the IATF had determined the real reasons for vaccine hesitation or resistance. Media did report proactively on the facts about the efficacy rating of different brands, perhaps because government had pushed for Sinovac which had only 51 percent efficacy to protect against hospitalization and death from COVID.
The president himself did not help his own prescribed solution to succeed. Mindless, misinformed, or simply irresponsible, Duterte talked about the vaccines having the effect of “resurrect(ing)” the inactive virus in the inoculated, an egregious piece of misinformation that reports did not bother to correct.
Media picked up faithfully whatever Duterte said, whether to threaten jail terms or contemplate restrictions for those refusing inoculation. Reports also carried his suggestion to vaccinate hesitant Filipinos while sleeping. Such punitive pronouncements led to potential super-spreader events, as witnessed in the flocking of hundreds to vaccination sites the day before the implementation of another enhanced community quarantine in August.
Aside from the fear of being prevented from going out, some of them claimed that the unvaccinated would not get financial aid or “ayuda.” In reporting these events, media readily quoted claims of local chief executives that rampant misinformation was to blame, without emphasizing that Duterte himself contributed to the panic.
Lapses in media coverage
The media’s tendency to follow the most accessible vaccination events pushed aside opportunities to provide more in-depth analyses of the program. The pandemic may have held back the media from reporting more on the large-scale and devolved implementation. Coverage was limited to whatever was happening in the capital and major cities in the country.
Media could have concentrated on LGUs in selected areas. It would have been easy enough to work with freelance correspondents. The coverage of implementation in different parts of the county would have given a sense of collective experience that could have shared lessons and learning opportunities.
Missing the nitty-gritty of implementation
Media did not ask government sources to describe how actual distribution was going to be done, and what safeguards were taken against loss or waste of vaccines. Reports did not check out the actual distribution chain so as to prevent preferential advantage for some areas based on political alliance.
Some local governments’ requests for more doses from the national government made news, but this was reported in piecemeal fashion. News organizations did not refer to vaccine trackers created by ABS-CBN and Rappler to identify vaccination trends or patterns across regions.
Media submitted to government attempts to spin the news. Galvez had repeatedly boasted that the Philippines was one of the top-ranking countries in ASEAN for accomplished vaccination, only detailing the number of doses administered and not the actual target population covered.
The shift of the government’s goal from “herd immunity” to “population protection” also made news, with little question from reporters. Only InterAksyon immediately called it out, pointing out that despite the term change, the objective was the same, and that changing the goal was only an attempt to cover up the slowness of the program. The threat of emerging variants compelled the government to increase targets from 70 million to 90 million, but Galvez admitted that this new target could only be met in 2022.
With supplies stabilizing in the last quarter of the year, the national government launched a series of vaccination days in December 2021 to catch up with its targets. As reported in the media, the first round was plagued with a lack of volunteers and data encoders, confusion over walk-ins and allegations of expired vaccines being used. The second round was halted by Typhoon Odette, the strongest tropical cyclone to hit the country this year.
The government was aware that the bulk of doses would be coming in later in the year and during typhoon season, but they did not present clear contingency plans. Media failed to flag this lack of foresight and the obvious negative outcomes it caused.
Media fails to hold government accountable
In September, Senator Juan Miguel Zubiri raised his concern that the national government was not attending to the multiparty agreements of LGUs to procure their own vaccines from manufacturers. Galvez denied this, claiming that vaccine manufacturers no longer wanted to pursue such agreements and that the bulk of the expected supply in the latter part of the year would suffice.
Such a statement went unquestioned by reporters who had just seen the massive disruption caused by the Delta variant, which no one could have predicted. Surely, the loss of lives and the near collapse of hospital systems caused by the Delta surge make imperative alternative plans for procurement of additional supplies. Indeed alternative options should have been part of government’s response. Media would have been right to persist with questions about the consideration of different plans, given different challenges.
But journalists were satisfied with simply recording the exchange. Such reports served little purpose except to record what officials said. Reporters should have followed up with both Galvez and Zubiri to explain the basis of their positions.
Media had not examined the funds allocated for vaccines and actual expenditure. Sinovac was reported as having been overpriced; and yet, government has decided to procure the brand more than others.
On December 11, 2021, reports cited Secretary Locsin’s allegation that Secretary Duque dropped the ball once again, this time for the acquisition of special syringes required for the administration of Pfizer vaccines. Duque defended that he was only observing proper pricing as allowed by procurement rules. The Palace promised a resolution to this infighting, which it has not made public to date.
These were the kind of questions which were left unexamined by the media. Few officials will open up on these sensitive issues. Media however should have shown greater persistence in breaking down the walls of silence and tracking down the evidence themselves.
Going into the third year of the pandemic, government has not improved its performance. And yet media have held back on critical coverage that could hold the government accountable. Unsurprisingly, Filipinos do not have enough reason to be confident about better days ahead.