The Philippine government is eyeing to start rolling out the coronavirus disease (COVID-19) vaccination program by the end of this month as initial doses of vaccines are expected to arrive this February. 

Vaccine czar Carlito Galvez Jr. recently announced that initial doses of Pfizer-BioNTech and AstraZeneca vaccines are expected to be delivered in mid-February through the COVAX facility. The government is aiming to inoculate 70 million Filipinos by the end of this year. 

As the public anticipates this vital initiative of the government against the pandemic, the question in mind would be:  How will these essential vaccines reach their recipients? 

Vaccine storage and distribution 

There are two strategies to store COVID-19 vaccines as these require specific storage requirements, said Department of Health (DOH) Undersecretary Maria Rosario Vergeire. 

Vergeire said for vaccines requiring 2 to 8 degree Celsius and -20 degrees Celsius temperature, the supplier will deliver the vaccines to the DOH rented private warehouse or to the Research Institute for Tropical Medicine (RITM), “which will serve as the government's centralized vaccine hub.”

“From RITM, the vaccines will be passed on to the regional warehouses or hubs wherein our DOH Centers for Health Development in coordination with our logistic partners shall deliver the vaccines to our local government units (LGUs),” said Vergeire. 

“The LGUs will then allocate vaccines to their implementing units, such as medical centers, hospitals, infirmaries, RHUs (rural health units), and private clinics where the vaccine will be administered to the eligible recipients,” she added. 

For COVID-19 vaccines that need ultra-cold storage or -70 degrees Celsius, such as those developed by Pfizer-BioNTech, suppliers will deliver the vaccines to private storage facilities that were tapped by the government. “Through a private distributor, the vaccines will be delivered to our hospitals and medical centers with cold chain capacity to store the vaccines,” said Vergeire. 

Galvez recently announced that they are in negotiation with 18 logistic companies for vaccine storage. Health authorities also inspected the facilities of First Pioneer Distribution Center of UNILAB in Biñan City, Laguna and Zuellig Pharma Corporation in Parañaque City, “which could potentially be used in the first wave of COVID-19 vaccine rollout,” said Vergeire. 

Vaccination team

The DOH said that vaccination areas must have a team consisting of six members that should include medical and other health workers. 

• Two members: either a doctor, nurse, or midwife for the screening and assessment of patients. 
• One member: either a volunteer teacher, social worker, or a medical student, or other health professionals who can educate the patient about the vaccine he or she will be receiving.
• One member: either a doctor, midwife, or a nurse who will administer the vaccine. 
• Two members: either a midwife, barangay health worker, or other health professionals who will document the patient’s vital signs and other vaccination-related activities. 

The vaccination team has a target of vaccinating 100 people per day. 

Priority groups

The DOH said that the frontline health workers, senior citizens, indigent population, and uniformed personnel are the priority groups to be vaccinated against the viral illness. 

“With the initial limited supply, frontline health workers and uniformed personnel are prioritized since they have higher risk of exposure while on duty and to allow them to continue fulfilling their duties in both the public and private sectors,” it said. 

“Vulnerable groups such as the elderly and the indigent population, are prioritized guided by the principle of equity,” it added. 

The local government units (LGUs) were tasked to come up with a masterlist to determine the residents who will fall under the priority list. 

“We need to have a line listing. So part of the requirements is to be able to list all our beneficiaries and it will help us monitor their second dose and also adverse events if these are felt,” said DOH Undersecretary Myrna Cabotaje. 

Cabotaje said that the primary goal of vaccination is to “reduce mortality while maintaining the most critical and most essential services. The next goal is to control and minimize disruption of social and economic functions.”

Vaccination proper

The vaccination activity will be by schedule to avoid crowding and maintain the minimum public health standards on the vaccination sites. 

“In our pre-registration, we have a vaccination date and time schedule so they don't come at the same time--- this is for crowd control,” said Cabotaje. 

“And we have a card with a QR code na dadalhin sa vaccination site... Ito ay para masiguro na maayos ang pagsasagawa ng vaccination ,” she added. 

A waiting area will be set up where patients will have to wait for their turn to get vaccinated. 

The next step would be the registration station. The individual’s QR code will be scanned and other necessary documents such as “health declaration forms” and “informed consent” must be submitted. 

Third step, the individual will now be moving to the “pre-vaccination health education and final consent” station, where he or she can ask questions about the vaccine and other related concerns such as its possible side effects. A video will also be played, explaining the COVID-19 vaccines. The individual will also sign a “final consent form.”

The individual will now go to the screening station, where his or her medical history will be reviewed and a physical examination will be performed. 

The next step would be the actual vaccination. A trained doctor, midwife, or nurse will administer the vaccine. After this, the health workers will now encode the details of the person’s vaccination in the immunization card. This includes the date of the first vaccination and when the second dose will be administered.  

For safety, the patient will be asked to remain in a designated area for “post-vaccination monitoring,” to observe if he or she will experience adverse reactions to the vaccine. 

“After vaccination, we keep them in the area for 30 minutes to 1 hour so that we will monitor the adverse events. This is a novel virus, hindi pa natin alam kung ano yung mga mangyayari and meron tayong mga standby teams that will be able to provide first aid or refer them to the nearest hospital  (if severe adverse reaction occurs),” said Cabotaje.