Government would meet more success in its future vaccination efforts for Covid if it involved private hospitals in procuring and administering the vaccines for the disease, and increased awareness on the dangers of long Covid. This was the opinion of members of the Advisory Council of Experts (ACE) led by Go Negosyo founder Joey Concepcion as suggestions were put forward on how the government can proceed with bivalent vaccines.

Concepcion had earlier sent in a letter to the Department of Health (DOH) the recommendations from members of ACE, which is composed of the country’s foremost authorities on medicine, public health, epidemiology, economics, research and data analytics, and provide expert insight and guidance to the private sector. “We remain the government’s ally in its vaccination efforts,” said Concepcion.

Among these recommendations was for private hospitals and other healthcare facilities to enter into agreements to procure bivalent vaccines. The vaccines can then be sold at cost and administered by healthcare professionals as part of the hospitals’ corporate social responsibility efforts. The proposal will also allow anyone to receive the vaccines even as they may fall outside the priority-queueing system that was used in the government’s previous vaccination efforts.

The proposal seeks to address the lack of Certificate of Product Registration of the bivalent vaccines and help the DOH achieve higher vaccine accessibility and coverage, as well as unburden the government and allow it to focus on the vulnerable sectors of society.

Past private sector initiatives include the August 2021 lockdowns to stem an impending surge in cases, as well the A Dose of Hope vaccine procurement program that secured millions of doses for the country despite restrictions in supply and regulatory roadblocks. It also led efforts to reopen businesses as the pandemic became more manageable.

Already, the hospitals belonging to the Metro Pacific group have committed to the plan to procure the vaccines and sell them at cost and with a minimal administration fee. Dr. Benjamin Co, Chief Medical Officer of Metro Pacific Hospital Holdings, believes that the other private hospitals’ capability to do the same will depend on their manpower capacity and vaccine storage and logistics, as well as approval from the DOH and the LGUs.

Dr. Co said that the plan to use private hospitals and clinics makes sense. “Majority of those willing to get the vaccine are also those willing to pay for it. Patients also feel more comfortable getting vaccinated in the healthcare setting rather than having to do it in a mall or school or wherever else, because the facilities for monitoring post-vaccination problems are better assured in a hospital than in a mall or makeshift vaccination center,” he said. Patients also feel more confident that highly trained healthcare professionals will administer the vaccine for them, he said, and that they would be assured of the quality of storage and handling of special vaccines like mRNA.

Storage and handling can be a challenge for hospitals with fewer resources, however. “Note that the mRNA vaccine will require storage at temperatures at less than minus 20 degrees Celsius, and once removed from storage, will be thawed at 2 to 8 degrees Celsius, where the hospital/clinic should maintain this temperature,” explained Dr. Co. 

When initially thawed, the vaccines will be good for one month, but once the vial is opened, and its contents diluted, it is good only for the next six hours. “This is one vaccine where proper storage is key to maintaining stability of the contents in order to retain its potency. Without the preservation of proper cold chain and logistical preparation, it would be more wastage of vaccines,” said Dr. Co.

For Vaccine Expert Panel member Dr. Rontgene Solante, who is also the chairman of Adult Infectious Diseases and Tropical Medicine at San Lazaro Hospital, while vaccine wastage related to low booster takeup has led to doing away with the priority sector system, giving the vaccines to people who want it is but one of many strategies to increase coverage. “There are pockets of strategy to increase vaccine coverage among the population at-risk, focusing on the benefits of additional protection with bivalent vaccines,” he said. 

First, said Dr. Solante, is for the private sector to require all employees with comorbidities to get the bivalent vaccines, second is to incentivize vaccinations among senior citizens, and third is for the general population to become aware of the dangers of long Covid. “Long covid … is now considered an important cause of morbidity due to long-term complications such as brain fog, chronic fatigue and mental health, which can affect productivity and quality of life,” he said.

Both doctors agree that bivalent vaccines can provide significant protection.

“It has better and broader protection against Omicron VOCs (variants of concern) and its subvariants, both in getting the infection and developing severe infection,” said Dr. Solante. He added that bivalent boosters add 50 percent efficacy against severe disease from Omicron.

Dr. Co, who was also chief of the Pediatric Infectious Diseases section at the University of Santo Tomas, offered that published studies have come out recently showing that the bivalent vaccines continue to show efficacy at protecting high-risk patients from hospitalization. “While we do not have a perfect vaccine at the moment as none of those in the market are transmission blockers, the vaccines work at making the disease less severe when we do get breakthrough infections,” he said.

Dr. Co added that bivalent vaccines’ efficacy must be considered in the light of the economic impact on health at a time of a pandemic. “Lockdowns alone do not work at decreasing the risk of future surges. The virus continues to evolve and survive and co-exist with us. We need to remember that while we cannot be one step ahead of them, we can prevent the virus from [becoming] debilitating,” he said.

“I think we’ve come to a point where people already know how to keep from being infected,” said Concepcion. “Our job now is to make sure they have the means to keep protecting themselves from severe illness and death.”