Philippines: PCV Introduction and
Experience
Dr. Enrique A. Tayag
Assistant Secretary
Department of Health
Philippines
Outline
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Evidence
Communications and Advocacy
Role of professional Organizations
Role of Partners
Barriers and how to overcome them
Main challenges
Key messages to other countries
Pneumococcal Conjugate Vaccines
• The World Health Organization recommended the
inclusion of pneumococcal conjugate vaccines
(PCV) in childhood immunization programs in
countries with under 5 mortality of >50/1,000 births
• The World Health Organization recommended the
use of two pneumococcal conjugate vaccines: PCV
10 or PCV 13 based on country’s circulating
serotypes
Health Statistics
Number of children born every year (NSO 2010)
Number of poor children <5 years old (NHTS 2011)
1,782,981*
3.6 million
Top causes of death in children <5 years old (DOH, 2009) **
1.
Pneumonia
4,570
2.
Diarrhea
2,063
3.
Accidents
1,162
* Births based on civil registration and does not cover under registration.
Thus, to cover unregistered births, NSO estimates the 0-11 months old
infants nationwide by multiplying 2.7% to the total population.
** Excludes neonatal causes
Pneumonia and Sepsis
• Pneumonia was the leading cause of illness,
hospitalization and deaths among Filipino
children under 5 years old in 2010 & 2011.
• The average number of pneumonia cases in
children under 5 years in 2010 & 2011 was over
340,000 per year.
• The estimated Case Fatality Rate for Sepsis in
children up to 13 years was 44%
• The estimated Case Fatality Rate for Pneumonia
in children under 5 years was 1.8%
Vaccine Costs
• It costs <$50 to protect a child from
disseminated tuberculosis, hepatitis B
infection, diphtheria, pertussis, tetanus, polio,
and measles.
• In 2012, roughly $42 million was allocated to
cover costs for childhood vaccines including
syringes and needles.
Philippine Experience
Communications and Advocacy
• Philippine Foundation for Vaccination, Inc.
organized yearly campaigns on World Pneumonia
Day and World Meningitis Day.
• Burden on Pneumonia and Pneumococcal
Invasive Disease contextualized on achieving
MDGs and Universal Health Coverage.
Philippine Experience
Partnerships and Linkages
•Universal Health Care espoused Public-Private
Partnership even for Public Health
•Recommendations on inclusion of PCV vaccines
fostered by WHO recommendations, independent
local researches, childhood immunization
schedules from foreign and local vaccination
advocates
Philippine Experience
Overcoming Barriers and Challenges
•Enhancing disease surveillance for Invasive
Pneumococcal Disease
•Designing Cost-free PCV impact study
•Balancing Benefits of Vaccination with Integrated
Management of Childhood Illnesses
•Accessing Cheaper Vaccines from World Market
•Promoting Social Benefits of Vaccination
•Engaging Partners to achieve common Goals for
Child Survival
Philippine Experience
Program Implementation
• In 2013, PCV 10 2-dose, single syringe vaccine
was introduced following prevailing WHO
requirements
• Initially, only 300,000 eligible infants in 2 regions
with high burden of illness were identified because
vaccine was not cheap ($55 per child).
• In 2014, another 300,000 eligible infants from 4
regions with high burden of disease will be given
PCV 13
PCV 10 or PCV 13?
Actual Procurement
2012
2013
PCV 10 was procured through UNICEF
when it was a cheaper then than PCV 13.
PCV 13 was procured also through
UNICEF when a WHO WPRO study
demonstrated that PCV 13 was more costeffective than PCV10.
regarded as a better use of health care resources.
Incremental outcomes of (i) using PCV10 (compared to no
vaccination),
usingofPCV13
(compared
to tono
Table
2. Incremental(ii)
outcomes
(i) using PCV10
(compared
novaccination)
vaccination), (ii)
and (iii) using
PCV13 and
compared
to PCV10.
using PCV13 (compared
to no vaccination)
(iii) using PCV13
compared to
PCV10. Abbreviations:
b, billion; m, million.
Abbreviations:
b, billion; m, million. *
Number vaccinated with 3 doses
Total vaccination cost
Health care costs saved
Productivity costs saved
IPD cases prevented
Non-IPD pneumonia cases prevented
Deaths prevented
Acute otitis media cases prevented
DALYs prevented (undiscounted)
DALYs prevented (discounted)
Total net costs (undiscounted)
Total net costs (discounted)
* WHO WPRO study
PCV10 vs
nothing
55.6 m
$3.14 b
$0.27 b
$70.1 m
36300
303000
12900
28 m
1.15 m
0.711 m
$2.8 b
$1.84 b
PCV13 vs
nothing
55.6 m
$3.33 b
$0.473 b
$51.2 m
63200
621000
24400
18.3 m
1.37 m
0.839 m
$2.81 b
$1.84 b
PCV13 vs
PCV10
$0.19 b
$0.203 b
$-18.9 m
26900
318000
11400
-9.66 m
0.215 m
0.128 m
$5.85 m
$4.56 m
Philippine Experience
Key Lessons
• Before trying All Things New, Answer these
questions: Can It Work? Will it Work? and
finally, Is It Worth It?
• Vaccines will NOT save Lives. Vaccination
saves Lives.
• Survival from any endeavor entails Variation,
Selection and Adaptation.
Fun walk for World Meningitis Day
April 24, 2010
The Finish Line