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Japanese Encephalitis: Doctors Discuss Vaccine Shortage and Price
  • There is no shortage when it comes to the Japanese encephalitis (JE) vaccine, says Sanofi Pasteur during a press conference held today, September 13, at the Dusit Thani Hotel. International pharmaceutical company Sanofi Pasteur is the only licensed manufacturer of the JE vaccine in the Philippines.

    “There's no scarcity [of the JE vaccine],” says Jervin B. Papelleras, the country regulatory affairs head of Sanofi in the Philippines. “There's a regular supply. But it just so happens there is an increase in demand. We're trying to address that issue.”

    SmartParenting.com.ph then later asked Sanofi to clarify how it was addressing the supply issue. Papelleras replied, “We are adjusting our supply requirement and coordinating closely with our production to close the gap at the soonest time possible.”

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    Dr. Sally Gatchalian, vice president of the Philippine Pediatric Society (PPS) who was part of the expert panel at the event, added, “We have the vaccines available already. Ako personally, I have the vaccine in the clinic.” 

    Dr. Gatchalian also addressed the alleged price hike of the JE vaccine. “As far as I know, pediatricians do not change the cost of the vaccines only because there is high demand. Hindi naman po ito parang isang commodity. Our price is actually consistent and constant. Whether there is a demand, there is no demand, the vaccine costs the same.”

    Last May, Smart Parenting asked several pediatricians for the cost of the vaccine at their clinics. The average price ranged at P3,000. 

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    On the issue of overpricing, Sanofi does not determine the selling price of the vaccine at clinics and hospitals. Papelleras explains, “Every point of the distribution level, may pricing kasi ‘yan. So there’s a charge for the distributor, then charge ng distributor to the doctor, then the doctor charges his or her patient, and that’s where the range of the prices come from. May iba’t ibang prices ‘yan from the source down the line sa patient. Every distribution point, nagkakaroon ng dagdag.” 

    Papelleras adds, however, Sanofi will review its manufacturing price to help ease the reported overpricing. The company is licensed to manufacture the vaccine, but not to distribute it. In the Philippines, the authorized distributor of the JE vaccine is Zuellig Pharma Corporation. 

    The cost of the JE vaccine is currently not regulated by any governing body, which opens the opportunity for overpricing. In the Philippines, the Maximum Drug Retail Price law makes sure that essential drugs are sold at a constant, reasonable price. These drugs are listed under the Government Mediated Access Program. The JE vaccine has yet to be included in this list.   

    However, the Department of Health (DOH) is currently working on including the JE vaccine in the national immunization program by 2018, which will make it more readily available and less costly to acquire. 

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    Other issues addressed at the press conference:

    Is there an outbreak of Japanese encephalitis in the Philippines?
    There is no outbreak, says Dr. Gatchalian. She reminds the public to stay calm and avoid panicking. “JE is a public health threat. But the majority of cases are asymptomatic (showing no symptoms), and only 1 in 250 infections will actually manifest with severe disease.” 

    JE cases have gone down this year. “JE confirmed cases nationwide [is at] 133 as of August 26, [which is] 44% lower than the same period last year,” Health Secretary Paulyn Ubial told Rappler. Nine people had died of the disease so far in 2017, which is lower than the same period in 2016 when 13 died.

    Because it’s already the rainy season, is it too late to vaccinate my child against JE?

    Dr. Gatchalian explains research has shown JE to be endemic in the Philippines, meaning it occurs all year round. So your child can get vaccinated against the disease any time of the year. “In private practice, we can actually administer the vaccine at any time,” Dr. Gatchalian says.   

    However, Dr. Mari Rose Delos Reyes, president of the Philippine Society for Microbiology and Infectious Diseases (PSMID), who was also part of the panel, adds that vaccinating children should not be a “reactive” decision. “We don't wait for the news that there is an increase [in JE cases],” she explains. Children should be vaccinated “as soon as the child reaches the age for which the child is qualified for vaccination,” says Dr. Gatchalian. (Find details on JE vaccine age recommendations here). 

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    How long will it take before the vaccine takes effect?
    “Usually, it will take some time for your body to develop antibodies. But, by about two weeks you can actually already establish your protective antibodies,” says Dr. Gatchalian. Citing research, she adds, “by one month after the vaccination, you already have very high protective antibodies, up to about 90 to 95 percent. ‘Yun ang pinakita sa mga pagsusuri. One dose pa lang ‘yun, even for children.” 

    Where can I get the vaccine?
    Only purchase the vaccine from your physician, says Dr. Gatchalian. “When mothers come to us, and they have [the vaccine] in their bags or nasa pocket nila, we do not administer the vaccine,” she adds. Buying from unauthorized sellers does not ensure that the vaccine was properly handled and stored. “A mishandled vaccine or improperly stored vaccine is not an effective vaccine.”

    The Food and Drug Administration (FDA) recently released an advisory warning the public of purchasing the JE vaccine from online sellers and unauthorized distributors. “Consumers availing from these unauthorized distributors or retailers are at risk of buying vaccines of poor quality, compromised by non compliance to the required standards of FDA, or, worse, at risk of buying counterfeit products,” the advisory stated.

    Can the vaccine be administered to pregnant women?
    No, says Dr. Gatchalian. Just like the vaccine for measles, which contains the live but weakened virus of the disease, the JE vaccine is not recommended for pregnant women. 

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