The Dengvaxia Scare: Politics Overtakes Public Health Policy

by Luis Adrian Hidalgo

THE DENGVAXIA issue generated more political heat than information about the vaccine and its effect on the disease it was designed to counter. Lawmakers jumped into the fray, conducting inquiries supposedly with the goal of getting to the bottom of the fiasco. But instead of giving the public a sense of assurance that something would be done to address the issues raised by the problematic vaccine, the hearings in both the Senate and House of Representatives only raised questions; not so much to find answers that could lead to solutions but to point fingers at alleged culprits. It was politicized from the very beginning. The hearings fueled public anxiety, especially among those parents whose children had been inoculated with the vaccine. Emboldened by some wild claims, reports on those families claiming that their children had died due to Dengvaxia began to multiply in the news media. The mounting number of such cases generated distrust, sowing discord not only between lawmakers and the government agencies involved, but also among persons in the medical profession who feared that the incident would undermine several years of trust-building for vaccines and the government’s national immunization program.
The careless actions of some led to serious repercussions, which could have been minimized, if not totally avoided, had the media been more circumspect in their coverage.
IN THE POLITICAL RUT Questions of governance only drew out the worst partisan reactions, not the kind of information that would help the concerned agencies move forward with an effective plan of action to address the fears of vulnerable communities. How can the public protect itself? Should it be wary of vaccines in general? What are the risks of not getting vaccinated? These questions should have been addressed in the hearings on the issue. But, as recorded by media reports, the proceedings were dominated by pointless talk and finger pointing — neither of which were helpful in helping citizens arrive at a better understanding of the issue and what to do in the face of the threats to the health of the country’s children. With the failure of lawmakers and other sources in the hearings in both houses of Congress to provide crucial information, the responsibility of doing so largely fell on the media. But at the height of the controversy in the first quarter of 2018, they fell into the trap of merely recording what everyone said, often in live broadcasts.
Screengrab from TVs’s Aksyon.
This approach to the matter was not helpful, as CMFR previously noted, as it was only limited to providing a quick recap of what was said about things of which the ordinary Filipino would most likely have a limited understanding. Much of the focus was on the statements of various sources, instead of checking leads which could have led to uncovering helpful information. This is not to say that the media did not quickly pick up the controversy, but that the coverage failed to provide the information needed to assuage the fears of the public and to prevent widespread resistance to their children’s immunization from childhood diseases.  The reports instead depended on the usual talking heads, among them officials from the Department of Health (DOH), lawmakers and the Public Attorney’s Office (PAO). The media’s reliance on the same sources hindered the emergence of helpful information that could have better informed the public about the issue. Neither did it help that the coverage focused on the politics of it all. Being a medical issue at its core, the media reports should have employed a more scientific approach on the matter and explained the science behind the fiasco, but these were noticeably lacking in the coverage. FOMENTING ALARMIST NOTIONS The careless actions of some led to serious repercussions, which could have been minimized, if not totally avoided, had the media been more circumspect in their coverage. In December 2017, then Justice Secretary Vitaliano Aguirre ordered the PAO to extend legal assistance to all possible victims of the controversial vaccine. The agency complied, and early into the issue in January 2018, PAO forensic experts claimed to have found a “pattern” in the deaths of four children who reportedly died within six months of receiving Dengvaxia shots. The media promptly reported this without mentioning that the PAO’s findings were not yet conclusive. The agency seemed to be more concerned with blaming the past administration rather than getting at the truth.  A number of medical experts in fact questioned the validity of PAO’s claims, which much of the media failed to note. Media did note the DOH’s more nuanced statements. It did not dismiss the claims outright and instead maintained that more rigorous studies must be conducted. That task would entail cooperation between DOH and the PAO, an idea that the latter rejected. This seeming friction between the two agencies did not go without notice from the media which included it in their reports. Media also noted PAO’s refusal to cooperate with the DOH, citing a “conflict of interest.” But in the end, media’s reporting of the PAO claims overshadowed the explanations and assurances of the country’s lead health agency. Capitalizing on the emotion and drama, many media reports gave prominence to the PAO findings, adding fuel to the fire of an already volatile issue.  CMFR jeered a five-part report by ABS-CBN 2’s TV Patrol for its one-sided and highly sensationalized reporting on alleged Dengvaxia-related deaths. The “Kabayan Special Patrol: Disgrasya sa Dengvaxia” which aired from January 23 to February 3, 2018 featured grief-stricken families in deep mourning. The reports relied solely on the statements of Dr. Erwin Erfe, chief of the PAO forensic laboratory, and did not include any DOH official or medical expert who could validate the PAO claims. The headline of one of the reports even insinuated a reprehensible act. It read: “Batang hinihinalang namatay saDengvaxia, ‘pinag-experimentohan?”
Subsequent media reports often quoted the PAO, which gave the impression that they were the authorities on the matter. The media also cited the explanations of the DOH. While the DOH provided scientific information, it was the statements of PAO that captured the public’s attention.  The repercussions were immediately apparent. Government efforts at controlling the dengue disease suffered a setback due to the Dengvaxia scare. And as early as the first quarter of 2018, the DOH reported outbreaks of other diseases such as measles in the Davao Region in January, followed by Zamboanga City in February, a village in Taguig City, as well as in Negros Oriental and Kabankalan City, Negros Occidental in March. By November, World Health Organization Philippines said there were 17,298 reported measles cases in 2018 — a sharp increase of 367% compared to 3,706 in 2017. DOH Undersecretary Enrique Domingo told the media that the Dengvaxia controversy had lowered immunization rates for preventable diseases like polio, chicken pox, tetanus and other diseases. “Our programs are suffering… (Filipinos) are scared of all vaccines now,” Domingo said. By giving prominence to wild claims such as hundreds of immunized children died because of the vaccine, media became an unwitting tool in propagating needless hysteria and mistrust of all vaccines, resulting in the resurgence of vaccine-preventable childhood diseases. As media attention on the issue waned in the course of the year, the reports shifted to providing routine updates on related developments, mostly about the filing of cases against key officials said to be responsible for the implementation of the anti-dengue immunization program and their responses to the charges. In print, for instance, CMFR noted that a majority of  dengue-related reports in the Manila Bulletin, the Philippine Daily Inquirer and The Philippine Star from June 1 to August 15 were on the Dengvaxia-related lawsuits, while the few news accounts that actually looked into the dengue situation merely reported the number of cases, with little interpretation of what these meant. Media also picked up the resumption of the House hearings on the Dengvaxia issue in November, noting that these failed to produce a committee report despite several hearings on the matter. Two additional hearings were called supposedly to address unanswered questions and to “tie up loose ends” surrounding Dengvaxia’s purchase and use in the immunization program — a matter which had occupied lawmakers since the inquiries began in December 2017. MOVING FORWARD An entire year of covering the Dengvaxia controversy from a political perspective yielded little helpful information. The media must move on from this and expand the discourse. To do that, they must avoid rote reporting and explore new angles that could lead to informative findings. Continued monitoring of the Dengvaxia issue is still necessary. But in addition to that, reports should now also look at the larger context of concerns about vaccines and immunization in general. Given the controversy’s repercussions on the government’s immunization efforts, the media could do so much more by educating the public and raising awareness about vaccine use so that the people can make informed decisions themselves.