Are the Philippines Department of Health and Local Medical Professionals Violating their Own Patient Bill of Rights and Informed with regards to Pediatric vaccination? No Matter How Well-Intentioned!

The School Vaccination Program will start on 7 Oct 2024 to vaccinate Grade 1 and 7 children with MR and DT, and Grade 4 girls with HPV. Parents will be notified of the program and asked to consent.

This is a long piece to discuss the upcoming planned school vaccination program which will start on 7th October 2024. Information about the program, and the infections the program is meant to address, and a discussion on informed consent are provided. Links for resources on vaccine safety are provided. I hope this article could be a useful resource.

To be clear, the DOH have stated that vaccination will only be provided to students whose parents / caregivers have provided consent for their child’s participation in the program.

I call for true informed consent to be provided to all potential program recipients, without any form of incentivization or coercion. Vaccine confidence can only be built when safety is beyond question! There is much work to be done!

Vaccine Laws in the Philippines

The Philippines has 3 laws which relate to the national vaccination program, which comes with an annual price tag of PHP7.9 Billion (USD141.9 Million):

Republic Act 10152, Mandatory Infants and Child Health Immunization Act of 2011, which provides for free mandatory basic immunization for infants and children up to 5 years of age covering 10 vaccine-preventable diseases; Tuberculosis, Diphtheria, Tetanus, Pertussis, Polio, Measles, Mumps, Rubella, Hepatitis-B (within 24-hours of birth and not later than 7 days), H. Influenza type B (HIB), and any others the Secretary of Health may determine.

The at birth HepB is considered mandatory. Often it is given to babies without any discussion with their parents or even requiring them to sign any consent. I only found out that it had been given to my daughter when she was born in 2009 when I saw the hospital bill. I have heard others share a similar experience.

Hepatitis B is a blood or sexually transmitted illness. It can be transmitted from an infected mother to her infant during childbirth (treatment in this case if the infection is known would be immunoglobulin). It cannot be transmitted via breastfeeding or via non-intimate social contact. Most people are able to clear hepatitis b infections and develop immunity; a small % may go on to develop a chronic case with possible liver complications. HepB vaccine is associated with increased incidence of autism, particularly in non-white boys. It is also associated with atopic disease; asthma, eczema, allergies.

Republic Act 11148, Kalusugan at Nutrisyon ng Mag-nanay Act (maternal health & nutrition act) covers maternal and early childhood nutrition (first 1000 days) and health, and encourages of breastfeeding. It also includes maternal pre-natal vaccination for tetanus and diphtheria and other vaccines as appropriate (Section 8.a.3), neonatal vaccines (Section 8.d.4), early childhood vaccines (Section 8.f.5), and adolescent female vaccines (Section 9.b).

Republic Act 9994, the Expanded Senior Citizen Act, which grants benefits and privileges to senior citizens (persons aged 60 and above). It includes provision of community-based health and rehabilitation programs for senior citizens (Section 2(4)). This act includes 20% discount and VAT exemption on influenza and pneumococcal vaccines (Section 4(1), and free provision of these for indigent senior citizens (Section 4(f)).

The Bakuna Eskwela Program of 2024

DOH will kick off a new round of pediatric vaccination with their Bakuna Eskwela program that will launch on 7th of October in public schools and continue on every Friday of that month.

Front page of the Department Memorandum for BARRM with interim guidelines below:-

The vaccines being offered are DT: Diphtheria-Tetanus, MR: Measles-Rubella, and HPV.

Diphtheria is caused by the toxin secreted by the diphtheria bacteria. Only some strains of Corynebacterium diphtheriae excrete the toxin, which causes the classic symptoms which includes the growth of a membrane over the patient’s throat. The Diphtheria Vaccine does not prevent infection or transmission, so it cannot provide herd immunity, however it counters the toxin and thus can prevent severe illness. Non-vaccine treatment includes antitoxin to block the effects of the toxin and antibiotics to kill the bacteria producing the toxin. Several children die each year in the Philippines from diphtheria.

Tetanus is caused by the toxin secreted by the bacteria Clostridium tetani, which lives in the gut of various animals and is excreted in their feces. Tetanus cannot be transmitted from person to person. The tetanus vaccine targets the toxin rather than the bacterium. Treatment for tetanus is symptomatic and supportive, it may include respiratory support, antibiotics, antispasmodics, and tetanus antitoxin. Alternative approaches can include high dose vitamin c. Cases of tetanus have been observed even in multiply tetanus vaccinated persons.

Rubella typically presents as a low fever and fatigue followed by a rash, and is not a serious illness for children, requiring only supportive care. The concern with rubella is that it can cause severe congenital abnormalities (congenital rubella syndrome (CRS)) if contracted during adulthood and in the first half of pregnancy. Rubella vaccine is given to prevent the incidence of CRS. The vaccine can prevent infection and transmission of rubella. Many people will contract and recover from rubella without being aware of it. If a person is concerned and planning pregnancy, they can test for antibody levels to check for natural immunity before considering any vaccination.

Measles is a highly contagious disease. Before the advent of vaccination nearly all children caught and recovered from measles by the age of 15. It is typically only serious in children with severe comorbidities or malnutrition. It may be treated with a single high dose vitamin A, which can effectively prevent most complications. A single dose of measles vaccine may be effective at preventing illness from infection, though two doses may be required to stop viral spread. There are recent concerns with the spread of vaccine strain measles (measles is a live vaccine); most of the recent outbreaks of measles in the US were vaccine strain. Further, there are concerns that the vaccine is no longer effective against the circulating wild measles strains.

HPV Vaccine is said to prevent cervical cancer caused by the Human Papilloma Virus of which there are many strains. If given to a women who has already been exposed to HPV (can be contracted from an infected mother or from sexual intercourse) it may trigger cancer, which is why it is given to preadolescent girls. Variants of this vaccine have been in use for around 30 years. While cancer rates are still decreasing in older women who have never received this vaccine, cervical cancer rates are increasing in younger women, though the role of the vaccine if any, in this increase are not clear. The vaccine is associated with many side effects including autoimmune conditions, POTS (Postural orthostatic tachycardia syndrome), menstrual irregularities, and reduced fertility. Mainstream medical literature generally denies a link stating insufficient data or too few cases to draw any conclusion.

Page 2, notification letters and consent forms will be issued. Lists of children to be vaccinated should be endorsed by the schools to the local health center.

Page 3, covers the requirement for an AEFI management plan, and Demand generation (Item 3). Demand generation includes engagement, discussion, social listening and feedback, and stakeholder involvement. Giveaways and contests for students, and incentives for health workers are encouraged. Demand generation activities are unlikely to include any discussion of risk, which might discourage potential recipients.

Page 4, again requires parental consent, and states that a quick health assessment will be done to ensure the child is healthy enough to be vaccinated. Could a vaccinator understand a child’s health within a few minutes? Following is the quick assessment form from Annex G. They only check for fever and date of menstruation (to determine if pregnancy may be a possibility).

To continue with page 4 of the main document, which discusses the conduct of the sessions.

Page 5, vaccination is indiscriminate. All children whose parents have given consent will be vaccinated regardless of their past vaccination history. While understanding that DOH wants to vaccinate children who have never been vaccinated, there is a concern of overvaccination with a child receiving far more doses than manufacturer recommended. Vaccines are not innocuous; they have permanent immune altering actions. Their use should be judicious, even if parentally consented.

Pages 6 - 12 deal with supply chain and logistics, AEFI monitoring and reporting, data monitoring and management, mop up activities (vaccinating children whose parents consented but who were not yet reached), and the roles of various agencies.

Annex A, provides Notification Letters to parents advising them of the vaccination activity that will be conducted, and requiring their acknowledgement and consent for their child to participate. If they refuse vaccination, they must sign saying they understand that by opting out of the required immunizations, my child may be at a higher risk from vaccine preventable diseases and I voluntarily choose to exempt my child from the required school immunizations.

Vaccine-Based Discrimination is Live and Well in Philippines

I know of children who have been denied attendance at private schools in Manila on the basis of their vaccination status, and even of a child who was denied entry on the basis of missing a single vaccine that their parents had decided was not appropriate for them.

Following is the consent form for HPV vaccine, which has the same general wording as that for MR and Td.

Rights of Patients and Informed Consent

DOH Memorandum No. 2017-0061, Issued on 3 February 2017 sets out the Rights of Patients. No. 6 on this list is the right to informed consent. Vaccination is a medical intervention. The DOH has required consent of the children’s parents / caregivers as is appropriate! However is that consent informed?

Informed consent is a principle in medical ethics that requires a person to have sufficient information and understanding before making decisions about accepting risk, such as their medical care.  It is a process of communication between a patient and their healthcare provider, allowing the patient to ask questions and accept or deny treatment.

Informed consent must include a discussion of benefits and risks, common and rare! The memorandum lists a range of immediately reportable adverse events under Annex J. If these are reportable it means that they could be expected in rare cases! Are these communicated to parents and children? Communicating such possible adverse events would surely give rise to hesitancy! Are parents advised who to contact and their recourse in case of injury?

Are “Antivaxers” the Enemy or are there Genuine Concerns with Vaccine Safety

This recent opinion piece calls for sterner action against people sharing anti-vax information. However, one of the things that is forgotten is that people typically only become distrustful of vaccines after they have experienced harm, either directly or for their children, loved ones and friends.

I am one of those people. I experienced a life-changing autoimmune adverse reaction following 5-doses of HepB vaccine, which I was told were compulsory for my allied health course practical while in university. I received 5 doses, because I didn’t show antibodies after the first 3 doses so they tried 2 more times before giving up. There was no discussion of risk or benefit at that time. That was the beginning of major changes in my health, which I have linked with those vaccines (I received very few vaccines - few were given in the 1970s, and only in early childhood). In the following years I went on to develop multiple autoimmune conditions, the result being that I am dependent on medication for the rest of my life, and to stay alive!

My oldest child has also had a life-changing permanent reaction, also to HepB, in the circumstance already discussed at the beginning of this article! Discussing with family members I also discovered that some of their children had adverse reactions. When one has such experiences, this triggers in depth research. That research reveals that vaccines are not a simple minor intervention; they have major permanent impacts on health and the immune system that go beyond the simple prevention of an infection that is usually mild for healthy people. Vaccines have risk! Considerable risk! Further, there have not been adequate safety studies on any vaccine! Their impacts when given repeatedly and in combinations are also unstudied. Children’s Health Defense, established by RFK Jr. is an excellent site to start researching.

I don’t want others to go through what I am experiencing. I want them to know that there may be some benefit, but also there is certainly substantial risk. Where there is risk there must be informed consent and there must be choice!

Risks differ from person to person and based on both their personal health and nutritional status, medical history, and living environment. Certain vaccines are safer than others (TB being one of these). All medical decisions should be made on a case by case basis, not on a one-size-fits-all. The way to remove vaccine hesitancy is to conduct proper and adequate studies on outcomes, to increase safety, not to force or mandate products.

Vaccine Pre-licensure and Post-Licensure Safety

ICAN have determined that none of the US CDC vaccines were licensed based on long-term placebo controlled trials. Click on the image to go to the source for a better quality image.

Book discussing vaccine history, development, safety. It is extensively referenced. It is excellent and scientifically based. Chapter 1, here.

Vaccine ingredients.

Lack of Vaccine Safety for Hepatitis B Given at Birth, 5:36 minute discussion by Aaron Siri.

Episode 347: Vaccine Experts Under Oath, 1 hour presentation with Aaron Siri and Del Bigtree. Excellent introduction into the status of vaccine safety. I would pray that public health officials who hold the health of this population in their hands would watch this and understand that more work needs to be done!

End Note

This article is written in good faith. I am not an anti-vax, I am prohealth, prosafety, prochoice!

• I want people to question each and every health decision!

• I want people to be provided with full informed consent on all and any medical interventions.

• I want people to make decisions should be made without any form of coercion / or incentivization that may stop their assessment of true risk-benefit.

• I want vaccines to be both safe and effective, and used on a case-by-case judicious basis.

• I want people to be respected for their personal health decisions without any form of discrimination imposed for that decision.

Lets make the People Healthy Again!