When Public Health and Politics Clash-Communicating about Dengvaxia Between Science and Emotions: An International Journal of Medical Toxicology and Drug Experience

ABSTRACT

Introduction: Dengue is one of top ten global health threats and is a serious burden in the Philippines. Dengvaxia immunization program was launched on April 2016 for children 9-14-year-olds in three regions with high statistics of dengue, hospitalization, and deaths. This was coincidentally the campaign period for national elections. Use of vaccine, once available, was part of a strategy to control epidemic. Current measures were inadequate. On the 30 November 2017, Sanofi announced an advisory that vaccine should not be used in those who are dengue naive otherwise they will have risk for severe dengue and additional hospitalization. What started as vaccine-vigilance information sparked a public outcry. This led to a series of parliamentary investigations, traditional and social media misinformation and disinformation vilifying the health decision makers and the company, and criminal charges filed against over 20 individuals by the state over alleged unproven vaccine caused deaths. Despite attempts to correct these narratives by a few health professionals, the damage to institution, the program, the product, and individuals have been done. The consequences of such actions of emotional approach without understanding the science have resulted in creating general vaccine rejection, hesitancy, other outbreaks such as measles, lowered confidence even with recent COVID vaccines. Objective: This aim to describe the situation at that time in the Philippines and extract lessons that will inform better risk communications during crisis. Methods: Literature analysis and environmental scans were undertaken. Results: Some of the important lessons learned are in risk management and communications. Adverse health product information should be announced with circumspect considering the level of health literacy and risk appreciation in a country. Partisan politics interfered with poorly understood science, fueled by imprudent comments by officials and health professionals who spoke out of turn, amplified by the media and created chaos. The fear was so palpable that enlightened health professionals refused to provide countervailing facts. While the vaccine is listed as part of WHO EML and used in many countries, Philippines has imposed a ban on the product. Reinstating the vaccine would be perceived as the government had back-pedaled on a mistake. In the meantime, the drama contributed to vaccination hesitancy and outbreaks. Conclusion: Public health decisions are policy and regulatory decisions anchored in ethical and utilitarian principles. Pharmacovigilance plays an important role in public health decisions but only if approached in a scientific and objective manner and in the context of a country's culture.