March 15, 2021 — March 1, 2021 was a historic day for the Philippine General Hospital as it became the first hospital and its director, Dr. Gerardo Legaspi, the first Filipino officially vaccinated for the government’s COVID-19 vaccine roll out. The launch happened a day after the Philippines received 600,000 doses of the Sinovac CoronaVac vaccine donated by China.
Along with Dr. Legaspi, Food and Drug Administration (FDA) Director General Eric Domingo, infectious disease specialist and DOH Technical Working Group member Dr. Edsel Salvana, MMDA Chief Benhur Abalos, Vaccine Czar Carlito Galvez Jr., and UP College of Medicine Clinical Assoc Professor Dr. Dominga Padilla were vaccinated at the PGH.
They were joined by at least 756 frontline healthcare workers from six other hospitals in Metro Manila where simultaneous roll outs of the said vaccine were done. These were the Lung Center of the Philippines, Dr. Jose N. Rodriguez Memorial Medical Center and Sanitarium (Tala), Veterans Memorial Medical Center, Philippine National Police General Hospital, and V. Luna Medical Center.
After being immunized, Dr. Legaspi stressed that the Sinovac vaccine is safe and assured his fellow medical frontliners that the FDA and the Vaccine Expert Panel will not approve a vaccine for use unless it has been proven safe and effective.
Meanwhile, Dr. Salvana said that it would be best for health workers to receive the vaccine that is available now to have themselves protected against COVID-19. Dr. Padilla likewise encouraged health workers to consider taking the vaccine now to avoid getting infected and go back to their normal way of life sooner.
A total of 124 health workers were vaccinated on this first day of the ceremonial inoculation program that continued in the next two days until all doses were used.
Meanwhile, the Astra Zeneca vaccine roll out in PGH started on March 8 at 7:30 am shortly after the arrival of the vaccines that day. The AZ roll out will be until March 19, 2021.
The PGH Vaccine Deployment Program has prioritized about 6,000 health personnel and employees, including senior faculty, professors emeriti, and retirees following the guidelines set by the Department of Health and World Health Organization.
It envisions to vaccinate all its prioritized healthcare workers by the end of March.
Before the rollout, PGH conducted simulation not only of the vaccination and monitoring of adverse affects but also of the arrival and storage of the vaccines with their room and cold storage requirements and their preparation.
The Philippines is the last in ASEAN to rollout its vaccination drive despite having the second highest number of cases and with a surge in cases daily. As of March 15, coronavirus cases in the country was recorded at 5,404 COVID-19 cases – the 4th biggest single-day tally in the country since the pandemic began.
The Philippine General Hospital will start COVID vaccination to children with co-morbidities aged 12 to 17 on October 15 together with five other government hospitals.
This is after the Inter-Agency Task Force for the Management of Emerging Infectious Diseases approved the proposal under a “phased approach” using vaccines granted Emergency Use Authorization by the Food and Drug Administration.
To be prioritized for vaccination under this age group are those having heart, kidney, respiratory, and other immune problems.
DOH Undersecretary Maria Rosario Vergeire explained that the staggered rollout of vaccines among kids was needed to manage both risks for children with comorbidities and supply of available doses which remain limited in the country.
The other participating hospitals are Philippine Heart Center and National Children’s Hospital in Quezon City, Philippine Children’s Medical Center, Pasig City Children’s Hospital, and Fe Del Mundo Medical Center.
It should be recalled that the PGH was also one of the hospitals that rolled out the government’s COVID-19 vaccination program for its healthcare workers on March 1 with PGH Director Gerardo Legaspi as the first Filipino to get vaccinated. He was joined by other government officials and PGH officials.
February 28, 2021 — Philippine General Hospital (PGH) Director Gerardo Legaspi presented the preparations being done for the COVID-19 Vaccine Deployment for the hospital’s healthcare workers, employees, and other priority groups during the 40th Stop COVID Deaths Webinar entitled “How Will Health Workers Be Vaccinated Against COVID-19?” held on Feb. 12, 2021. Other presentors were Dr. Lito Acuin, Hospital Chief of the Asian Medical Center who shared the plans in private hospitals and Dr. Christia Padolina, City Health Officer of Navotas City, who talked about the preparations for the Navotas vaccine roll out.
The core message of all the presentations is the need for a systems approach for the whole country and within institutions in coordination and compliance with the protocols set by the Department of Health. The operative words are macroplanning with the DOH for prioritization and other guidelines and microplanning within the concerned institution leaving nothing to chance but with flexibility and attention to the littlest details.
For PGH, Dr. Legaspi presented the details of what he described as a “good but flexible plan” composed of subteams to support the planning and deployment. With Dr. Homer Co as Microplanning Coordinator, the subteams include Profiling, Registration, Logistics, Risk Assessment, and Communication; Community Engagement, Information, Education, and Communication; and Management of Adverse Effects.
“The primary goal is to protect people who directly handle COVID patients and people who support them, including outsourced staff who work in the hospital with the basic criteria that is anyone within the confines of the four walls of PGH. With a second tier of vaccinees that include professors emeriti and retirees, the list is estimated at 6,000,” Dr. Legaspi stated.
To guide the process, a MicroPLanning Document which contains all the necessary information and details was prepared. The first in the four-step plan was the generation of a masterlist as basis for the procurement of the right quantity of vaccines at the right time to ensure minimal or no wastage; identification of verification; checking for risk factors and eligibility; getting formal intention to receive or decline vaccination; and getting a vaccinations card with unique encrypted QR code to be used during actual vaccination day that includes a vacinee’s co-morbidities, medications, and treatments.
The preparations for infrastructure, manpower, and supplies fall under this step. Planning for the physical layout on the actual day of the vaccination included the screening, actual vaccination, and monitoring; and managing adverse effects following immunization (AEFI). Identifying bottlenecks during vaccine deployment is part of the plan.
The second step is the registration of the vaccinees for eligibility and intention to be vaccinated and the scheduling for vaccination. An alternative method of enrolling online for senior faculty, retirees, and Professors Emeriti using the PGH EMR Radish was provided.
Step three is Vaccination #1 (first shot) of eligible and consenting employees to be followed by the monitoring of AEFI onsite and monitoring and surveillance of long-term AEFI. With monitoring of AEFI identified as one bottleneck, Dr. Legaspi said more people will be assigned to this area, and with the inoculation itself seen as a quick step based on the simulation, an upscaling of the Monitoring Unit has been prepared.
The final step, Step 4, is Vaccination #2 for those who completed Vaccination #1 or step 3 and monitoring for both short- and long-term AEFI.
To ensure that everything will go on smoothly as planned, simulation exercises not only of the actual vaccination and monitoring of AEFI but also of the arrival and storage of the vaccines, with the cold storage and temperature requirements to keep them in ideal condition, and vaccine preparation were held.
During her synthesis of the presentations, UP Manila Chancellor Carmencita Padilla stated that transparency, reassuring messages, and the series of infographics and other information campaigns have raised the trust of the community on vaccination from 76% to 93% during the preregistration.
Wearing preferably surgical masks even for non-healthcare workers in high-risk settings and vaccination for the companion of senior citizens (A2 + 1) and pregnant and lactating women were among the policy updates and recommendations presented during an Aug. 18 Department of Health townhall meeting.
The presenters were DOH Undersecretary and Spokesperson Dr. Rosario Vergeire; UP College of Medicine professor, pediatric infectious disease specialist, and DOH Technical Advisory Group member Dr. Anna Lisa Ong Lim, and health social scientist and DOH interim National Immunization Technical Advisory Group member Dr. Nina Castillo-Carandang who discussed the latest expertguided recommendations for adults, children, and pregnant and lactating women.
With the resurgence in COVID-19 cases, of which a sizeable number was traced to the more infectious Delta variant and other variants, the three panelists emphasized that the updated policies were urged by experts through the Philippine COVID 19 Living Recommendations.
The panelists reiterated that the Prevent, Detect, Isolate/Quarantine, Treat, and Reintegrate (PDITR) plus Vaccination Strategy is still effective and works for all places, situations and populations. This strategy, according to Dr. Vergeire, also includes the triage system being followed by the local government units, which is dependent on the vital role played by the Barangay Emergency Response Team and Barangay Health Workers.
The recommendation to switch to surgical mask for non HCWs whenever feasible is based on the capacity of such masks to provide increased protection. For HCWs not directly taking care of COVID patients and suspects, surgical masks, face shields or goggles, and standard PPEs are advised.
Meanwhile, vaccination for one companion of an A2 (senior citizen) is allowed provided he/ she is from the same household and a caregiver and/or relative. In addition, a companion of the A3 (with co-morbidities) may be allowed for vaccination if they are immunocompromised, such as cancer patients, transplant recipients and those undergoing immunotherapy. Dr. Vergeire announced that these recommendations will soon be adopted as a national policy.
Drs. Vergeire and Ong-Lim stated that except for the Sputnik V and Gamaleya vaccines which are not recommended for pregnant and breastfeeding women, all other vaccines can be given for breastfeeding women, women in the 2nd or 3rd trimester of pregnancy, and for the first trimester for highrisk pregnancies after appropriate counselling. However, it was explained that booster shots are not yet advised because they are still being studied, and due to the high percentage of Filipinos who have yet to be vaccinated.
For children, both said that only Pfizer has an Emergency Use Authorization for ages 12 and above. In the Philippines, utilizing the ring or cocoon strategy to vaccinate qualified adults in households will also lead to protection for children.
Dr. Ong - Lim pointed out that home isolation is advised for asymptomatic and mildly ill children with clearance by doctors and with their and the local government unit’s monitoring. In instances where home isolation is not possible, children should be accompanied by family members if there is a need for facility-based quarantine.
For workers, Dr. Vergeire urged that all activities be held in open air spaces and in other places with proper ventilation that allow for 6-8 air changes per hour. She added that the use of exhaust fans can be helpful. Inside public transport, there should be no recirculated air and with open windows of at least three inches opening.
She cited the experts’ recommendations against the use of air purifiers, ionizing air filters, foot baths, misting tents disinfection chambers and UV lamps. She cautioned against the use of wand-like UV lamps that are bought in online stores because these don’t give protection and that UV lamps used in hospitals and clinics are the only ones authorized for use.
Dr. Vergeire also announced the suspension of the shortened sevenday quarantine and testing protocols for asymptomatic fully vaccinated close contacts.
Dr. Nina Castillo Carandang repeated the need for vaccine equity, to counter and not contribute to vaccine misinformation, rely on trusted sources, such as WHO, DOH, and health experts/health professionals, and conduct factchecks, that are necessary for practice of good information hygiene.
“Fake news spreads faster than COVID, we need to be proactive, think of what to like and share as we have a duty to have a positive impact to others and a responsibility as creators and shares of accurate information,” she intoned.
