Fear, mistrust, and vaccine hesitancy: Narratives of the dengue vaccine controversy in the Philippines

Yu, Vincen Gregory; Lasco, Gideon; David, Clarissa C.

doi:10.1016/j.vaccine.2021.07.051

Cited by 23 publications

(16 citation statements)

References 30 publications

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“…under-utilization of health services), and vice versa [ 38 ]. In the case of the Philippines, however, the patterns of mistrust and spillover effects reflect the particular characteristics of the vaccine scare: with Dengvaxia being introduced by the DOH, but rolled out as a part of the school-based interventions under the patronage of the DepEd, respondents reported spillover effects of mistrust regarding school-based health interventions [ 22 ]. As a result, the DepEd experienced a more profound discrediting as compared to the DOH, leading to considerable tensions between these institutions.…”

Section: Discussionmentioning

confidence: 99%

“…Respondents in our study saw social media as playing a decisive role in spreading misinformation or emotionalized images (e.g. children allegedly dying from the vaccine) in the Philippines, leading to widespread suspicion of vaccines and the government [ 22 , 23 ]. Existing evidence suggests a relationship between social media and proliferation of public doubts, and the decline of vaccine coverage [ 40–42 ].…”

Section: Discussionmentioning

confidence: 99%

“…In a viral Facebook post, a blogger described Dengvaxia as a ‘genocide against Filipino children’, a phrase that gathered traction in traditional and social media and further fueled public uproar [ 29 ]. Shortly after the misinformation circulated on Facebook, allegations surfaced that Dengvaxia was linked to the death of a Filipino child, which the Philippines Public Attorney’s office investigated via a televised autopsy; other sources argued that the child had a pre-existing condition [ 22 , 23 , 29 ]. Despite many mitigating measures such as nationally televised dialogues, the creation of hotlines and close monitoring of Dengvaxia recipients, a widespread vaccine scare engulfed the country.…”

Section: Methodsmentioning

confidence: 99%

“…Several vaccine experts have affirmed the scientific soundness of the interim report stating that Dengvaxia poses an increased risk for seronegative individuals [ 30 ]. However, claims by some government officials that vaccinated children died due to a corrupt previous government’s adoption of Dengvaxia represented an example of a ‘weaponization’ of Dengvaxia [ 22 , 23 , 29 , 31 ]. Ultimately, vaccine confidence and vaccination rates plummeted in the years following the scare [ 2 ], leading to measles and polio outbreaks in 2019 [ 32 , 33 ].…”

Section: Methodsmentioning

confidence: 99%

“…While existing work has focused on how vaccine scares are experienced by the general public [ 22 ], qualitative exploration of how these scares have shaped narratives about vaccines, health programming, and the health system in general in the eyes of policymakers in the Philippines is lacking.…”

Section: Introductionmentioning

confidence: 99%

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Misinformation, infighting, backlash, and an ‘endless’ recovery; policymakers recount challenges and mitigating measures after a vaccine scare in the Philippines

Reñosa

Wachinger

Bärnighausen

et al. 2022

Global Health Action

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Background Vaccine scares undermine longstanding global health achievements. Remarkably little data has documented the lived experiences of policymakers working amidst vaccine scares and navigating their fallout. As a result, chances and challenges of large-scale national recuperation efforts are poorly understood. Objective This study aims to explore the perspectives of policymakers involved in ongoing efforts to boost vaccine confidence in the Philippines following a 2017 Dengvaxia scare and the current COVID-19 pandemic. Methods Between August and November 2020, we conducted 19 semi-structured narrative interviews with purposively selected policymakers from governmental agencies and non-governmental organizations in the Philippines. Interviews were conducted online, transcribed, and analyzed following the tenets of reflexive thematic analysis. Results We present results as an emerging model that draws on a chronology conveyed by policymakers in their own words. The Dengvaxia scare proved ‘a decisive wedge’ that splintered Filipino society and pitted governmental agencies against one another. The scare stoked distorted vaccination narratives, which were ‘accelerated rapidly’ via social media, and ignited feelings of uncertainty among policymakers of how to convey clear, accurate health messaging and how to prevent drops in care-seeking more broadly. Conclusions Efforts to regain trust placed exceptional burdens on an already-strained health system. Respondent-driven recommendations on how to reinforce vaccine confidence and improve vaccination rollout include: developing clear vaccine messages, fostering healthcare providers’ and policymakers’ communication skills, and rebuilding trust within, toward and across governmental agencies. Further research on how to build enabling environments and rebuild trust in and across institutions remains paramount.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Misinformation, infighting, backlash, and an ‘endless’ recovery; policymakers recount challenges and mitigating measures after a vaccine scare in the Philippines

Reñosa

Wachinger

Bärnighausen

et al. 2022

Global Health Action

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Economic optimization of Wolbachia‐infected Aedes aegypti release to prevent dengue

Hollingsworth,

Cho,

Vella

et al. 2024

Pest Management Science

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BackgroundDengue virus, primarily transmitted by the Aedes aegypti mosquito, is a major public health concern affecting approximately 3.83 billion people worldwide. Recent releases of Wolbachia‐transinfected Ae. aegypti in several cities worldwide have shown that it can reduce dengue transmission. However, these releases are costly, and, to date, no framework has been proposed for determining economically optimal release strategies that account for both costs associated with disease risk and releases.ResultsWe present a flexible stochastic dynamic programming framework for determining optimal release schedules for Wolbachia‐transinfected mosquitoes that balances the cost of dengue infection with the costs of rearing and releasing transinfected mosquitoes. Using an ordinary differential equation model of Wolbachia and dengue in a hypothetical city loosely describing areas at risk of new dengue epidemics, we determined that an all‐or‐nothing release strategy that quickly brings Wolbachia to fixation is often the optimal solution. Based on this, we examined the optimal facility size, finding that it was less than unitary elastic with respect to the mosquito population size, with a 100% increase in population size resulting in a 50–67% increase in optimal facility size. Further, we found that these results are robust to mosquito life‐history parameters and are mostly determined by the mosquito population size and the fitness costs associated with Wolbachia.ConclusionsThese results reinforce that Wolbachia‐transinfected mosquitoes can reduce the cost of dengue epidemics. Further, they emphasize the importance of determining the size of the target population and fitness costs associated with Wolbachia before releases occur.This article is protected by copyright. All rights reserved.

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“Respect my opinion and I'll respect yours!”: Exploring the challenges, concerns, and informational needs of vaccine‐hesitant caregivers and pregnant women in the Philippines

Reñosa,

Endoma,

Sornillo

et al. 2023

Public Health Challenges

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BackgroundDespite the instrumental role of vaccines, public confidence is declining, and anti‐vaccine movements have increased worldwide. With the goal of informing policy decisions and the development of interventions, we explore the concerns and challenges related to vaccine uptake (of childhood, maternal, and COVID‐19 vaccines) among parents or caregivers of under‐two children and pregnant women in urban and rural communities in the Philippines.MethodsBetween May and June 2022, we conducted combined in‐person and online interviews with purposively selected caregivers and pregnant women in the Calabarzon region (Naic, Cavite and Tanay, Rizal), and National Capital Region (Pasay and Muntinlupa Cities), Philippines. A total of 43 interviews were completed, audio‐recorded, transcribed, and analyzed according to the tenets of hermeneutic phenomenology.ResultsOur results, grounded on the social ecological model, underlined the interplays of contextual or logistical challenges on vaccine uptake, respondents’ overarching concerns about vaccines, and their informational needs that affected their vaccine decision‐making. Respondents described that the long‐established maternal and childhood vaccines no longer represent a high‐risk concern but highlighted their fears and hesitancy particularly to newer vaccines.ConclusionOur findings underscore the multilayered challenges in vaccine decision‐making among caregivers and pregnant women. The volatility of vaccine decision‐making necessitates rethinking the current immunization process, recalibrating the health workforce, and reinvigorating the health information delivery channels for more inclusive and responsive health care.

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Fear, mistrust, and vaccine hesitancy: Narratives of the dengue vaccine controversy in the Philippines

Cited by 23 publications

References 30 publications

Misinformation, infighting, backlash, and an ‘endless’ recovery; policymakers recount challenges and mitigating measures after a vaccine scare in the Philippines

Misinformation, infighting, backlash, and an ‘endless’ recovery; policymakers recount challenges and mitigating measures after a vaccine scare in the Philippines

Economic optimization of Wolbachia‐infected Aedes aegypti release to prevent dengue

“Respect my opinion and I'll respect yours!”: Exploring the challenges, concerns, and informational needs of vaccine‐hesitant caregivers and pregnant women in the Philippines

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