Confusion, blame game fuel Philippines’ Dengvaxia vaccine scandal

Relatives display pictures of children, who supposedly died after getting injected with the anti-dengue fever vaccine Dengvaxia, during a Senate investigation about the vaccine in Manila. (AFP)
Updated 17 April 2018
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Confusion, blame game fuel Philippines’ Dengvaxia vaccine scandal

  • Several measles outbreaks have struck the nation, claiming at least 13 lives, since the controversy began
  • Certainty about the children’s cause of death may remain clouded because post-mortem diagnosis of dengue can be a tricky process

IMUS, Philippines: Melinda Colite shakes with rage as she clutches a photo of her grandson, who she says died after getting the anti-dengue fever vaccine at the heart of a bitter scandal in the Philippines.
While Dengvaxia’s maker Sanofi has said unequivocally that its world-first vaccination is safe, Philippine authorities disagree publicly over whether it could have contributed to children’s deaths.
The resulting confusion has prompted a dangerous plunge in vaccination rates in the Philippines for other diseases.
It has also added to a swirling political battle, fanned by bloggers who back President Rodrigo Duterte and have an audience of millions of Facebook followers.
“The blame game has taken over the main issue,” Ronald Mendoza, dean of the Ateneo de Manila University’s School of Government, said. “It may be doing damage to public health rather than protecting it.”
Health authorities have said child vaccination rates against illnesses like measles have dropped by as much as 25 percentage points over the previous year as public anger and mistrust has grown in the Dengvaxia case.
Several measles outbreaks have struck the nation, claiming at least 13 lives, since the controversy began.
The trouble started last year, shortly after the Philippines gave Dengvaxia to some 837,000 students as part of a public immunization campaign.
Sanofi hailed the vaccine as a breakthrough in combating dengue, which kills hundreds in the Philippines every year, mostly children.
But the company set off a panic when in November it said a new analysis showed the vaccine could lead to more severe symptoms for people who had not previously been infected with dengue.
It prompted Manila to halt the campaign and left hundreds of thousands of terrified parents wondering if their children were at risk.
Sanofi has repeatedly said the vaccine is safe, noting in a March statement: “No causal-related deaths were reported in 15 countries after clinical trials conducted for more than a decade with 40,000 subjects involved.”
“There continues to be no evidence that any deaths have been causally linked to our vaccine,” it added.
But that has not stopped allegations emerging of vaccinated children dying of super-charged cases of dengue after getting Dengvaxia.
“It could not have been anything else. He started complaining of frequent body aches after his third injection,” Melinda Colite, 55, said of her 12-year-old grandson Zandro.
As of last week, 65 deaths have been reported to authorities and are under investigation, the health department says.
Different branches of the Philippine government have disagreed openly about potential risks of the vaccine, leading to confusion for the public.
“We cannot conclude at this point that Dengvaxia directly caused the deaths,” Health Secretary Francisco Duque told lawmakers in February, referring to the cases of 14 children who received the vaccine.
However, after additional potential cases emerged, the government assigned its legal service that represents the poor, the Public Attorney’s Office, to take up the matter.
Its chief lawyer, Persida Acosta, told lawmakers in February: “They (death certificates) said they were (killed by) acute respiratory arrest, encephalitis, appendicitis, septic shock. All of those are mimics of severe dengue.”
Certainty about the children’s cause of death may remain clouded because post-mortem diagnosis of dengue can be a tricky process.
The most accurate and widely used way of testing, called RT-PCR, relies on genetic material that degrades quickly after a person dies, especially in warm climates like the Philippines, virus expert Benjamin Neuman said.
“The challenge of determining a cause of death by RT-PCR can swiftly move from difficult to impossible,” he added.
It is also unclear if this type of testing has been used in the cases under investigation.
Supporters of the president have been eager to assign blame for the Dengvaxia scandal to his predecessor, Benigno Aquino, who has criticized Duterte’s deadly anti-drug crackdown.
Though the vaccination campaign was approved and launched under Aquino’s administration, it continued for a time under Duterte.
Well-known blogs have posted entries calling for Aquino to be jailed and questioned whether the vaccine is a “time bomb.”
Ruth Jaime, whose 12-year-old grandson Alexzander died due to a blood infection months after his last dose of Dengvaxia, says the situation is clear for her.
“Of course, no one will admit what caused his death,” said the fishmonger in her home west of Manila.
“If you had a healthy child and he dies after getting an injection would you not attribute his death to that?”


Japan PM Abe open to summit with N. Korea’s Kim

Japanese Prime Minister Shinzo Abe 9L) and North Korea's Kim Jong Un. (AP)
Updated 10 min 37 sec ago
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Japan PM Abe open to summit with N. Korea’s Kim

  • Trump in his own UN address earlier Tuesday pointed to his “bold and new push for peace” and saluted Kim’s courage

UNITED NATIONS, United States: Japanese Prime Minister Shinzo Abe, a longtime hard-liner on North Korea, said Tuesday he was willing to meet Kim Jong Un after the once reclusive leader’s historic summit with US President Donald Trump.
Abe, who one year ago warned at the United Nations that the window for diplomacy with North Korea was closing, took a more open but still cautious tone in his latest address to the world body.
But he said that any summit would be devoted to resolving a decades-old row over North Korea’s abductions of Japanese civilians — a deeply emotive issue for much of the Japanese public on which Abe built his political career.
“In order to resolve the abduction issue, I am also ready to break the shell of mutual distrust with North Korea, get off to a new start and meet face to face with Chairman Kim Jong Un,” Abe said in his UN address.
“But if we are to have one, then I am determined that it must contribute to the resolution of the abduction issue.”
He stressed that no summit was yet in the works — and appealed to Kim to show his own readiness.
“North Korea is now at a crossroads at which it will either seize or fail to seize the historic opportunity it was afforded,” Abe said.

North Korea kidnapped scores of Japanese citizens in the 1970s and 1980s to train the regime’s spies in Japanese language and culture.
Japan’s then prime minister Junichiro Koizumi traveled to Pyongyang in 2002 and 2004 to seek a new relationship with the current leader’s father Kim Jong Il and was told by North Korea that remaining abduction victims were dead — a stance adamantly rejected by Japanese family members and campaigners.
Speculation has been rising that Abe could meet with Kim, who reportedly told Trump during their summit in June in Singapore that he was willing to talk to arch-enemy Japan.
With South Korea’s dovish President Moon Jae-in also courting Kim, fears have risen in Japan that it could be shut out of any ultimate resolution on North Korea if it refuses dialogue.
Trump in his own UN address earlier Tuesday pointed to his “bold and new push for peace” and saluted Kim’s courage.
It was a far cry from a year ago, when Trump stunned assembled leaders by threatening to “totally destroy” North Korea and belittling “rocket man” Kim.
Despite Trump’s upbeat assessment of his own diplomacy, many analysts are skeptical on how much North Korea has changed, saying the regime has already conducted the tests it needed to build its nuclear and missile programs.
North Korea would be sure to press its own demand in any summit with Japan — an apology for Tokyo’s harsh 1910-1945 colonial rule over the Korean peninsula.
Beyond any moral dimension to an apology, North Korea would be hoping to secure badly needed cash. Japan paid South Korea some $800 million in loans, grants and credits when it established relations in 1965.

Abe will meet Wednesday with Trump, with whom he quickly formed a bond after the tycoon’s shock election victory. But Japan fears growing friction with Trump over trade.
While Trump has directed his fury on China, he has frequently complained about a deficit with Japan. US Trade Representative Robert Lighthizer and Japanese counterpart Toshimitsu Motegi have been meeting to address US complaints about trade barriers.
Abe devoted much of his address to trade, saying that Japan supported 856,000 jobs in the United States — more than any country except Britain.
Noting Japan’s limited natural resources, Abe said: “The very first country to prove through its own experience the principle that exists between trade and growth — a principle that has now become common sense — was Japan.”