COVID-19 vaccination in the Philippines

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COVID-19 vaccination in the Philippines
Resbakuna logo.png
Logo of Resbakuna,[a] the national COVID-19 vaccination campaign of the Philippines
COVID-19 vaccination in the Philippines.svg
COVID-19 vaccination in the Philippines (second dose).svg

Vaccine rollout by region (as of June 22, 2021)

  ≥1000000
  500000–999999
  100000–499999
  50000–99999
  25000–49999
  10000–24999
  ≤9999
DateMarch 1, 2021 (2021-03-01) – present
LocationPhilippines
CauseCOVID-19 pandemic in the Philippines
TargetImmunization against COVID-19
Organized byDepartment of Health (DOH)
Participants8,407,342 total doses administered[1][b]
Outcome5.67% of the Filipino population has received at least one dose of a vaccine
1.95% has been fully vaccinated

The COVID-19 vaccination program in the Philippines is an ongoing mass immunization campaign against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus that causes coronavirus disease 2019 (COVID-19), in response to the ongoing pandemic in the country.

The Food and Drug Administration (FDA) has issued emergency use authorizations (EUA) to 8 COVID-19 vaccines (in chronological order): Pfizer–BioNTech, Oxford–AstraZeneca, Sinovac, Sputnik V, Janssen, Covaxin, Moderna, and Sinopharm. There are eight other vaccines on order for the program, at varying stages of development.

As of June 22, 2021, about 8,407,342 total vaccine doses have been administered throughout the country. 6,253,400 individuals have been vaccinated across the country, with 2,153,942 receiving the second dose.[1][2][3]

Background and timeline[edit]

A doctor from Amang Rodriguez Memorial Medical Center in Marikina receiving his first dose of CoronaVac
Vaccination site in Caloocan.

The COVID-19 Immunization Program Management Organizational Structure was formed on October 26, 2020 to facilitate the distribution of COVID-19 vaccines in the Philippines, however this was replaced by a vaccine cluster within the Inter-Agency Task Force on Emerging Infectious Diseases (IATF-EID) by November 6, 2020. Carlito Galvez Jr. was appointed to lead the cluster[4] under the title of vaccine czar.[5] The Philippine National Vaccination Program and Implementation Plan was also approved by November 6, 2020.[4]

Preparation[edit]

Organizations involved[edit]

The COVID-19 Immunization Program Management Organizational Structure was formed on October 26 with the intention of it overseeing the distribution of COVID-19 vaccines once these became available. However, by November 6, the vaccine body was abolished and replaced with a vaccine cluster within the National Task Force Against COVID-19 of the Inter-Agency Task Force on Emerging Infectious Diseases (IATF-EID). The vaccine cluster is distinct from the national task force's COVID-19 response cluster.[6]

The Food and Drug Administration (FDA) on their part is the agency tasked to review and approve the use and commercial distribution of COVID-19 vaccines in the Philippines[7] as well as the issuance of an emergency use authorization for the same.

Delivery plan[edit]

The national government planned to rollout its vaccination program around February expecting the delivery of vaccines from Pfizer's vaccines sourced from the COVAX facility and the first batch of Sinovac's vaccines, consisting of 50,000 doses.[8] The delivery of Pfizer's vaccines was delayed due to documentary issues.[9]

The government plans to start a full rollout or mass vaccination for the general populace around late 2021.[10]

Regulatory approval[edit]

Under normal circumstances, drugs and vaccines are reviewed for approval by the Food and Drug Administration (FDA) under a period of six months. President Rodrigo Duterte to fast-track the government's medical response to the pandemic signed an executive order on December 2, 2020 which allowed the FDA to grant emergency-use authorization (EUA) to COVID-19 vaccines and treatments.[11] An EUA for a particular vaccine would authorize the government to buy said vaccine and allow to use the same for the vaccination program. An EUA would not authorize the commercial use of such vaccines or consent the use of the vaccine for personal use.[12]

The EUA approval process by the FDA is covered under FDA Circular No. 2020-036.[13][14]

A EUA granted for COVID-19 vaccine or drug remains valid if it fulfills three conditions:[14]

  • Based on the totality of evidence including data from adequate and well-known controlled trials, it is reasonable to believe that the drug or vaccine may be effective to prevent, diagnose or treat COVID-19.
  • The known and potential benefits of the drug or vaccine...outweigh the known and potential risks, if any.
  • There is no adequate, approved, and available alternative to the drug or vaccine.

The EUAs validity ends one year from the lifting of the public health emergency status declared in response to the pandemic or one year from the date it was registered if a COVID-19 drug or vaccine gets fully registered with the FDA.[14]

Among the conditions for a vaccine manufacturer to secure an EUA in the Philippines is to obtain prior EUA in its country of origin or other countries with a "mature" regulator.[15] No manufacturer would be allowed to obtain a EUA in the Philippines first. For the purpose of the FDA's EUA approval process, the following foreign regulators are considered as "mature":[14]

Vaccine manufacturers applied for EUA[edit]

The FDA announced that three vaccine manufactures namely Pfizer–BioNTech, AstraZeneca, and Sinovac have inquired on the process of obtaining an EUA in the Philippines.[15]

Rollout[edit]

Dr. Gerardo Legaspi officially becomes the first recipient of a COVID-19 vaccine in the country on March 1, 2021

The Philippines' vaccination officially began on March 1, 2021 shortly after the arrival of the first batch of vaccines from Sinovac. Prior to the official roll-out, a dry run was conducted to ensure that the vaccines, especially temperature-sensitive ones, would be rolled-out with minimal problems.[16]

In February 2021, the Food and Drug Association recommended against the usage of Sinovac vaccines for health care workers due to its low efficacy rates in trials on health care workers in other countries. It has recommended its usage instead to the vaccine to the working population and military personnel.[17][18]

The National Immunization Technical Advisory Group (NITAG) on February 26 has approved the use of the Sinovac vaccine to health care workers.[19] Health care workers are still allowed to not take the vaccine and wait for a more effective vaccine.[20] Philippine General Hospital (PGH) employees demanded for a better vaccine and an increase with their hazard pays.[21]

On a press conference, Presidential Spokesperson Harry Roque stated that health care workers can refuse the Sinovac vaccine and wait for the vaccines from Pfizer–BioNTech, Moderna, and Oxford–AstraZeneca while still being prioritized but other prioritized groups shall only get what is available in their locality.[22]

The rollout for the Philippines' national vaccine program began on March 1, 2021, shortly after the arrival of 600,000 doses of Sinovac's vaccine.[23] Philippine General Hospital director and doctor Gerardo Legaspi officially became the first recipient of a COVID-19 vaccine in the country.[24] The initial batch will cover around 50,000 military personnel and 250,000 health workers.[25] As of March 3, 2021, vaccinations has been limited to Metro Manila and to health workers.[26] However, select government officials were vaccinated in a bid to boost confidence on the vaccine.[27]

On March 6, 2021, Oxford–AstraZeneca, under the COVAX facility, began the rollout. Health workers who refused Sinovac's vaccines were prioritized.[28][29]

In May 2021, the rollout of vaccines from two manufacturers began. The rollout of Gamaleya's vaccines began on May 3 with five cities of Metro Manila; namely Makati, Manila, Taguig, Parañaque, and Muntinlupa.[30] The deployment of Pfizer started on May 12, beginning in two cities in Metro Manila (San Juan and Makati).[31]

Vaccine supply[edit]

Summary[edit]

Summary of vaccine procurement, donation processing, and approval (by the national government)
Vaccine Progress Doses ordered Sourced from donations
(including pledges and from COVAX Facility) 		Approval Deployment
Pfizer–BioNTech phase III clinical trials 40 million[32] 2.4 million[33] Green check.svg January 14, 2021[34] Green check.svg May 12, 2021[35]
Oxford–AstraZeneca phase III clinical trials 17 million[36] 2.5 million[37] Green check.svg January 28, 2021[38] Green check.svg March 6, 2021
Sinovac phase III clinical trials 25 million[39] ~1 million[40] Green check.svg February 22, 2021[41] Green check.svg March 1, 2021
Sputnik V phase III clinical trials 20 million[42] 15 thousand Green check.svg March 19, 2021[43] Green check.svg May 3, 2021[30]
Covaxin phase III clinical trials 8 million[44] – Green check.svg April 19, 2021[45] Pending
Johnson & Johnson phase III clinical trials 6 million[46] – Green check.svg April 19, 2021[45] Pending
Moderna phase III clinical trials 25 million[47] 250 thousand[48] Green check.svg May 5, 2021[49] Pending (expected by June 2021)
Sinopharm phase III clinical trials – – Green check.svg June 7, 2021[50] Pending
Novavax phase III clinical trials 30 million[51] – No EUA application submitted[52] Pending
Arcturus phase II clinical trials – – No EUA application submitted Pending
Clover phase II/III clinical trials – – No EUA application submitted Pending
EuBiologics[53] phase I/II clinical trials – – No EUA application submitted Pending

By acquisition[edit]

Vaccines on order[edit]

By the national government[edit]

The Philippine government has been negotiating with various foreign vaccine manufacturers to secure the country's COVID-19 vaccine supply. These manufacturers include Sinovac Biotech (China), Gamaleya Research Institute of Epidemiology and Microbiology (Russia), Moderna (United States), and Pfizer (United States).[54][55] The private sector, with government sanction, has secured at least 2.6 million vaccine doses from British-Swedish manufacturer AstraZeneca.[56] The government also has secured 30 million doses from American firm Novavax which would be supplied from the Serum Institute of India.[57][58]

The government plans to secure 161 million doses from at least seven firms by the end of 2021.[59][60] The procurement efforts of the national government have been a subject of various controversies.

The national government through the Department of Foreign Affairs responding to the request of Germany and the United Kingdom to be exempted from the Philippines' prevailing cap on the deployment of nurses abroad in exchange for vaccines.[61] The United Kingdom declined the offer refusing to link the vaccines to negotiations on the deployment of Filipino health workers to their country. The proposal was also opposed by labor group Migrante International.[62]

By local governments[edit]

Local government units in the Philippines, from individual municipalities and cities and provinces has allocated part of their budgets to procure their own supply of COVID-19 vaccines.[63]

Along with private companies, local governments had to procure vaccines through cooperation with the national government which led to some members of the Congress questioning urging the national government to allow local governments to procure vaccines unilaterally. However, the government pointed out that only national governments could directly procure vaccines through the World Health Organization's COVAX facility and that third-party private firms and local governments had to sign a tripartite deal with the national government and member vaccine manufacturer.[64]

Vaccines sourced from donations[edit]

The first vaccines acquired by the Philippine national government was from Sinovac. The first batch of Sinovac's vaccines consisting of 600,000 doses were received by the Philippines on February 28, 2021 with the country expected to receive a total of 25 million doses.[65] Vaccines sourced through the COVAX facility is also funded through donations by foreign countries.[66] The IATF-EID approved the Philippines' participation in COVAX on July 24, 2020.[67] The country is the recipient of vaccines from Pfizer–BioNTech and Oxford–AstraZeneca through the platform.[68]

The Philippines also engaged in talks with Israel to obtain a possible donation of excess vaccines from the Middle Eastern country.[69]

The Philippines will be among the first recipients of the 80 million doses of COVID-19 vaccines the United States would be donating to various countries through the COVAX facility.[70]

The Philippines is among the countries receiving COVID-19 vaccine donations from Japan.[71]

Local production[edit]

Five local firms are in negotiations with foreign organizations to set up vaccine manufacturing sites in the Philippines as of March 2021. The origin of these foreign organization include China, India, South Korea, Russia, and the United States.[72] South Korean firm EU Biologics has a partnership with Philippine vaccine distributor Glovax Biotech Corp. since 2012. The two companies plan to set-up their own vaccine production hub in Clark.[53] Other interested foreign parties include the Gamaleya Research Institute of Epidemiology and Microbiology of Russia and a university research unit based in the United States.[72]

Philippine company United Laboratories launched a program known as "Vaccine Self Reliant Philippines" which includes plans to set up a vaccine manufacturing plant by 2023.[73]

By vaccine[edit]

Sputnik V[edit]

Russia commits to deliver the first doses of Gamaleya's Sputnik V COVID-19 vaccine to the Philippines around April 2021. The Philippines and Russia are also negotiating regarding a plan to set up a production facility for Sputnik V vaccines in the Philippines.[74] The first batch of Gamaleya's vaccine, consisting of 15,000 doses, arrived on May 1, 2021.[75][76]

Moderna[edit]

In early March 2021, the Philippine government secured 20 million doses of Moderna's COVID-19 vaccine through a tripartite agreement with Moderna and the private sector led by businessman Enrique Razon.[77] The government ordered an additional 5 million doses in late March.[47] The first batch of Moderna's vaccine, consisting of 249,600 doses, is seen to arrive by June 27.[48] More shipments are expected in July and August 2021.[78]

Oxford–AstraZeneca[edit]

A worker unloading the shipment from COVAX at Villamor Air Base in Pasay on March 4, 2021

A shipment of 487,200 Oxford–AstraZeneca COVID-19 vaccines under COVAX's facility arrived in the country on March 4, 2021.[79] An additional shipment of 38,400 doses arrived in the country on March 7, totalling a number of 525,600 doses from COVAX's facility.[80] 2 million additional doses arrived in the country from COVAX's facility on May 8.[81][82]

Pfizer–BioNTech[edit]

The delivery of Pfizer–BioNTech COVID-19 vaccines to the Philippines has been subject to delays.[83] Health Secretary Francisco Duque has been alleged to have "dropped the ball" on a Pfizer vaccine deal which could have secured 10 million doses by as early as January 2021.[54] The first batch of the Pfizer vaccine, consisting of 193,050 doses through the COVAX facility, arrived on May 10.[84] 2.28 million additional doses arrived in the country from COVAX's facility on June 10.[85]

Sinovac[edit]

A Chinese military transport vehicle dropping off Sinovac's "CoronaVac" in Villamor Air Base in preparation for the mass vaccination in the Philippines

Plans to secure 25 million doses from China's Sinovac have also been subjected to scrutiny in Congress due to its reported efficacy rate. The efficacy rate of the Sinovac vaccine has varied by country; Turkey has reported an efficacy rate of 91%[86] while Brazil has reported an efficacy rate of 78%.[87] The Department of Health said that Sinovac's vaccine satisfy the World Health Organization standards of at least 50 percent efficacy rate while the FDA pointed out that Sinovac is yet to publish an official and published scientific report on their vaccines efficacy rate and that the clinical trial for the vaccine is conducted in different countries and the efficacy rate per country will vary.[56][88][89] Following the approval for emergency use authorization on February 22, the first batch of Sinovac vaccines, consisting of 600,000 doses, from China's donation to the country arrived on February 28.

The first batch of procured vaccines by the government reached the Philippines on March 29 came from Sinovac with previous received vaccines coming from donations.[90]

Progress to date[edit]

Vaccination priority groups[edit]

The Philippine government released a priority groups list for the national vaccination program in February 2021 as approved by the Interim National Immunization Technical Advisory Group. The list include three main categorizations, with utmost priority provided for populations under "A" categorization.[91] As of June 15, 2021, people under priority groups A1 to A5 are being allowed to receive vaccination.[92]

Vaccination priorities[93]
Category Priority group
A1 Frontline workers in health facilities both national and local, private and public, health professionals and non-professionals like students, nursing aides, janitors, barangay officials and health workers, and outbound Overseas Filipino Workers and their immediate families (since May 27, 2021)
A1.5 City and Municipal Mayors, BARMM Chief Minister, BARMM Wa'lī, and Provincial Governors (Pursuant to IATF Resolution #: 115B-2021)
A2 Senior citizens aged 60 and above
A3 Persons with comorbidities not otherwise included in the preceding categories
A4 Frontline personnel in essential sectors including uniformed personnel and those in working sectors identified by the IATF as essential during ECQ; local executives[c] (since March 19, 2021), judiciary employees[94] (since April 5, 2021), Filipino seafarers[95] (since April 12, 2021) BPO employees and COMELEC employees including Olympic coaches, athletes, and delegates (since May 21, 2021), private sector workers, government employees, and informal sector workers and self-employed (since May 27, 2021), workers in the Entertainment industry (since June 7, 2021)
A5 Indigent population not otherwise included in the preceding categories. Homeless population.
B1 Teachers, social workers
B2 Other government workers
B3 Other essential workers (e.g. grocery store workers, bank workers, retail workers, mall workers)
B4 Socio-demographic groups at significantly higher risk other than senior citizens and indigenous people (e.g. persons deprived of liberty, persons with disabilities, Filipinos living in high-density areas, students)
B5 Overseas Filipino Workers
B6 Other remaining workforce
C Rest of the Filipino population not otherwise included in the above groups

Changes and additions[edit]

  • March 19, 2021 – Local executives (provincial governors, city and municipal mayors, and barangay captains) are reclassified as essential workers or under the A4 category.[96]
  • March 29, 2021 – Specific comorbidities defined for category A3. People with the identify comorbidities are prioritized for vaccination over people with other comorbidities not specified.[97]
  • April 5, 2021 – Inclusion of judiciary employees under A4 category.[94]
  • April 12, 2021 – 13 Essential workers sub-groups under A4 category defined.[98] This include elevation of Filipino seafarers to A4 category from either B3 (other essential workers) or B5 (overseas Filipino workers) categories. Applies to both seafarers working domestically and those deployed overseas.[95]
  • May 21, 2021 – Front line employees in the BPO industry and in the Commission on Elections (COMELEC) including Olympic coaches, athletes, and delegates pursuant to IATF Resolution No. 116–2021.[citation needed]
  • May 27, 2021 – Included in A1 Category are outbound Overseas Filipino Workers and their immediate families and included in A4 category are private sector employees, government employees (including GOCCs and LGUs), and informal sector employees and self-employed individuals pursuant to IATF Resolution #: 117-2021.[citation needed]
  • June 7, 2021 – Workers in the entertainment industry particularly hosts, actors, and production crew were added to the A4 category.[citation needed]

Vaccination centers[edit]

On February 14, 2021, the Armed Forces of the Philippines announced that 46 locations have been identified to serve as vaccination centers for the vaccination program. 30 out of these were already accredited by the DOH at that time.[99]

Controversies[edit]

Black market[edit]

In January 2021, during the time when only the Pfizer–BioNTech vaccine had an emergency use authorization, it was reported that an alleged black market of smuggled vaccines from China has established itself in the Philippines. The demand for the vaccines is particularly high for Chinese nationals in the country, especially those employed by Philippine Offshore Gaming Operators (POGOs). The doses are reportedly sold at inflated prices, considerably more expensive than the standard price of the same vaccines in China.[100]

In late March 2021, the FDA released an advisory cautioning the public against fake vaccines and that vaccines which had emergency use authorization are not authorized to be sold commercially. Although as of that date, there are no reports yet of fake vaccines proliferating in the country as per the FDA.[101]

Line jumping[edit]

The DOH reported in March 2021 that a number of individuals had jumped the line to get the vaccine, becoming vaccinated despite being otherwise ineligible to do so.[102] These include several local government officials, prompting the Department of the Interior and Local Government (DILG) to issue show cause orders against them to explain why they were vaccinated,[103] and actor Mark Anthony Fernandez, who was vaccinated despite not belonging to a priority group for the vaccine.[104] Fernandez, for his part, claimed that he had underlying health conditions that otherwise made him eligible.[105]

The issue has raised the concerns of the Commission on Human Rights,[106] and has also led to the WHO warning the Philippine government that it risks losing access to its share of vaccines provided by COVAX if the practice continues.[107]

A number of suggestions were floated to address line jumping, with Senator Franklin Drilon urging the government to ramp up the country's vaccine supply,[108] and Representative Precious Hipolito, who represents the second district of Quezon City, filing a bill that would amend the Philippines' COVID-19 vaccination law to criminalize the practice.[109]

Vaccination of the Presidential Security Group and President Duterte[edit]

This section is an excerpt from Philippine government response to the COVID-19 pandemic § Military and PSG vaccination controversy[edit]

In 2020, members of the Presidential Security Group (PSG), Cabinet officials, a senator, and the Special Envoy for Public Diplomacy to China received vaccines without clearance from the Food and Drug Administration (FDA) or the Department of Health (DOH).[110]

Duterte said in December 2020 that some members of the military received COVID-19 vaccine from Chinese manufacturer Sinopharm despite the vaccine not yet officially approved by the country's health authorities.[111] A few days later, it was reported that some members of the PSG had also received vaccines from an unknown manufacturer.[112][113] Defense Secretary Delfin Lorenzana said that the vaccine used by the security group were smuggled.[114] Brig. Gen. Jesus Durante III said that members of the PSG were vaccinated as early as September 2020 and Duterte said that PSG personnel administered the vaccines themselves.[115] Presidential Spokesperson Harry Roque urged the public to "just accept" that some soldiers have received COVID-19 vaccines.[116] On December 28, the Armed Forces of the Philippines said that the PSG members were the first ones to be vaccinated to "protect" Duterte.[117]

On December 29, FDA Director General Enrique Domingo said that the DOH and the FDA were not consulted over the inoculation of soldiers and other government officials.[118] On December 30, Durante said that he will take "full responsibility" for the vaccine administered to the PSG.[113]

In 2021, criminal investigations and hearings were ordered by the National Bureau of Investigation,[112] the FDA,[119] and the Philippine Senate over alleged irregularities with the vaccinations.

On January 4, 2021, Duterte ordered the PSG to either not attend any congressional meeting regarding the unauthorized vaccination or stay quiet during such a hearing, contradicting the Presidential Spokesperson who said that the PSG will submit to any investigation.[120] On January 5, despite Duterte's threat of a potential "crisis" if senators questioned his military bodyguards, the Senate opened an investigation for the unauthorized use of COVID-19 vaccines.[121][122] On January 6, Senator Sherwin Gatchalian said he found nothing wrong with giving vaccines to PSG members since they were considered frontliners, though he acknowledged and took issue with the fact that the vaccines were brought into the country illegally.[123]

On May 3, 2021, President Rodrigo Duterte received his first dose of the Sinopharm COVID-19 vaccine despite the latter not receiving an EUA from FDA. The FDA only issued a one-time compassionate permit for 10,000 doses of the vaccine for the PSG.[124]

But due to public outrage, President Duterte apologized for taking the vaccine that has not been authorized by the FDA for emergency use and asked the Chinese Embassy to take back its donation.[125]

See also[edit]

Notes[edit]

  1. ^ A portmanteau of Tagalog words resbak (to take revenge) and bakuna (vaccine); literally, "to take revenge [on COVID-19] with a vaccine"
  2. ^ 6,253,400 of these have only been administered with the first dose, while 2,153,942 have been fully vaccinated.
  3. ^ Local executives (governors, mayors, and barangay captains) were considered as frontline personnel

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