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Philippines was gripped by a fear of vaccines. Now there’s a measles crisis. 

Filipino children suffering from measles share beds inside a crowded room at a government hospital in Manila, Feb 7, 2019.
Filipino children suffering from measles share beds inside a crowded room at a government hospital in Manila, Feb 7, 2019. (Francis R Malasig/EPA-EFE/REX/Shutterstock)

MANILA — Doctors in the Philippine capital are battling an acute measles crisis, with more than 4,000 cases and 70 deaths so far, that has been blamed in part on an unwillingness to immunize babies after a scare surrounding a separate vaccination program last year.

The Philippines crisis comes as the United States is also dealing with new measles outbreaks, especially in parts of Washington state where the anti-vaccine movement is strong.

Health and government authorities are now pleading with parents to vaccinate their children, noting that unvaccinated babies have accounted for a vast majority of the deaths.

The number of measles cases last year soared by 547 percent, according to the Philippine Pediatric Society, to more than 5,000 confirmed cases. And that number is climbing even higher in the first months of this year, causing chaos in children’s wards and overwhelming doctors in both urban and more rural parts of the country.

“Do not be lulled and complacent about it, because infants really need that,” President Rodrigo Duterte said in a speech in late January. He added vaccines are “good, and . . . for the health of the person.”

The spread of the disease is a huge setback to a country that had been on its way to eliminating measles in 2010, and it underscores the dangers of movements against vaccinations. Just over a decade ago, in 2005, the Philippines had almost no deaths from measles, according to the Philippine Foundation for Vaccination.

It also follows a global wave of measles outbreaks — with 6.7 million cases worldwide in 2017 — including in parts of the United States and Europe, similarly fed by conspiracy theories and misinformation.

The Health Department first declared the measles outbreak in metropolitan Manila in early February and has since expanded it across other areas on the islands of Luzon and the Visayas. Cases have increased 122 percent compared with the same period last year. Manila, a chaotic, crowded city dotted with high-rises and slums, is home to 12.8 million people.

But experts say the country has already been fighting the spread of the disease in more rural parts of the archipelago, where doctors struggle to get communities vaccinated. The Philippines’ UNICEF representative, Lotta Sylwander, said the agency has been working with the country’s Ministry of Health to raise the alert level “for some time now.”

“But it seems like it was not until it reached Manila [that] it was declared an emergency and a very urgent problem,” she said.

Health Secretary Francisco Duque and other members of the medical community attribute the newfound fear of immunization to a dengue vaccine scare last year.

The controversy began in 2017, when pharmaceutical company Sanofi Pasteur made a sudden announcement that its Dengvaxia vaccine could lead to severe cases of dengue among those who had not contracted the disease before. This threw concerned parents and the public into a frenzy, as Dengvaxia had been administered to more than 8,000 public school students in a mass immunization program the year before.

The political blame game that followed included an investigation from the Public Attorney’s Office into the deaths of 39 children. Its officials prematurely linked a fraction of those deaths to the vaccine, and health professionals later slammed the office for being unqualified to draw such conclusions.

A global wave of measles cases fed by conspiracies has health officials worried

The media, too, has been accused of adding fuel to the fear. The Center for Media Freedom and Responsibility found that three major newspapers concentrated on the “politics” of the scare, and it said a broadcast network sensationalized the issue by running footage of emotionally distraught parents.

The media watchdog said local news outlets should have highlighted that the Public Attorney’s Office findings “were not conclusive, and as such, should not have been given so much prominence, if it was to be reported at all.”

What the Health Department identifies as “vaccine hesitancy” also comes amid a resistance to immunization in the West. Lulu C. Bravo, executive director of the Philippine Foundation for Vaccination, said the country has had its fair share of vaccination skeptics — but they never had much impact until the dengue vaccine controversy.

“The anti-vaccine group was also being felt in the Philippines . . . But it is not as huge as in the U.S. or Europe,” she said. “The Dengvaxia [scare] really gave a fatal blow to our vaccination program.”

She described how the foundation’s health workers were being called “child killers” when they went into communities, because so many people had heard Dengvaxia caused death.

“They were being lambasted, insulted when they [went] into communities to do their deworming,” she said, referring to campaigns to distribute medication to combat intestinal worms. “They were being shunned out.”

Health authorities say they are focused on a mass immunization campaign to counter the steep rise in measles cases. According to local media reports, they are forming measles “fast lines” in government hospitals. The armed forces are helping to deploy medical personnel to conflict and hard-to-reach areas.

“While we consider it necessary to bring to account those who are responsible for the loss of confidence in the vaccination program . . . it is more important for all of us to come together to support the efforts to get our children vaccinated as quickly and completely as we can,” said Esperanza Cabral, a former health secretary and co-organizer of Doctors for Truth and Public Welfare.

UNICEF’s Sylwander warned, however, that a massive advocacy campaign, ideally led by well-known personalities in the Philippines, is needed to counter both the mistrust of vaccines in more urban communities and the lack of awareness in more rural areas. While the spike in measles deaths and media coverage have prompted more parents to inquire about vaccinations and their benefits, actual vaccinations continue to lag, she added.

“We don’t really see a dramatic increase,” Sylwander said.

Mahtani reported from Hong Kong.

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