The Department of Health has reported 5,123 cases of measles/rubella for 2025, which is 32 percent higher than 2024 when 3,880 cases were recorded. The death rate was 6.32 percent, equivalent to 60 deaths, higher than the year before.

Measles/rubella are not the only communicable diseases that are preventable with vaccination. The National Immunization Program lists the following as essential vaccines: BCG (for tuberculosis) and hepatitis B at birth, Pentavalent (diptheria, pertussis, tetanus, hepatitis b, polio), polio vaccines, PCV (pneumococcal vaccine)from 6-14 weeks, and MMR (measles, mumps, rubella) at nine months and one year.

The desired vaccination coverage is 95 percent, which gives herd immunity for the population. This refers to the protection of the population from disease outbreaks, either due to vaccination or natural immunity. It is obvious with the high measles/rubella infection rates that we have not attained herd immunity. Hence, the DOH is playing catch-up especially in the Mindanao regions where the majority of cases were reported.

It is apparent that misinformation and disinformation about vaccinations has played havoc with our vaccination program which before 2018 was highly successful, leading to very few cases.

The Dengvaxia controversy has obviously impacted all vaccinations with the tendency of Filipinos to lump all vaccines together, leading to refusal of parents to have their children inoculated. Vaccination rates have not recovered from the precipitous drop in vaccine confidence that resulted in yearly measles outbreaks since 2019 up to the present. In addition, there was a polio outbreak at about the same time. Polio had almost been eradicated until the drastic fall in immunization rates of all childhood vaccines resulted in several cases.

While the first set of Dengvaxia cases have been dismissed by the courts, the Public Attorney’s Office continue to file more cases, and recently, in addition to the criminal cases filed, civil suits have been filed as well. Unless and until all these cases are resolved, we will continue to have low immunization rates and communicable disease outbreaks year after year.

Meanwhile, in the United States of America, its Centers for Disease Control and Prevention (CDC) has released new guidelines for mandatory childhood vaccination which are routinely covered by health insurance. It emphasized that the USA is aligning its vaccination policy with peer nations, meaning other highly developed countries, where less prevalent communicable diseases are seen. Its new recommendations still include the following vaccines: measles, mumps, rubella, polio, pertussis, tetanus, diphtheria, Hemophilus influenzae B (HIb), pneumococcal disease, human papilloma virus (HPV), and varicella (chickenpox).

Note that all these vaccines are recommended by the DOH as well as the others cited above due to the high prevalence of these diseases in our country. We should not compare our vaccination policy against those of developed nations, since we face more communicable diseases than they do.

For the “non-consensus” vaccines, immunization will be based on high-risk groups or populations, or through shared clinical decision-making between the medical caregiver and the parents. These include respiratory syncytial virus (RSV), hepatitis B, dengue, meningococcal and hepatitis A vaccines.

Note that these diseases are more prevalent in the Philippines due to low socioeconomic status, maternal-child transmission and generally poor hygiene associated with poverty. Hence, these vaccines are still recommended as mandatory for Filipino children. We also have a high rate of HIV transmission now which predisposes these immunodeficient individuals to various infections.

On the other hand, the DOH is pursuing a different policy with regard to hepatitis B vaccination in health professionals. It insists on general Hepatitis B vaccination in pathologists and medical technologists, and even requires annual boosters and annual hepatitis B titers. This policy ignores the immunity concepts that inform vaccination decisions.

Firstly, there are individuals who don’t respond to hepatitis B vaccines (non-responders) of which I am one. I’ve had the entire series of three hepatitis B vaccinations but didn’t develop immunity (no titer). Giving additional vaccinations will not induce a response in these individuals, but it does increase the risk of vaccine reactions.

Requiring annual hepatitis B titers is misinformed. Immunoglobulin titers generally wane over time. However, it doesn’t mean these persons are not protected. Our immune systems still retain “memory” cells that rapidly reactivate the immune system should the person be challenged by hepatitis B virus. This is the so-called “anamnestic” response that rapidly scales up immunoglobulin production when encountering the virus. The immunity therefore, is lifetime, unless the person becomes immune-incompetent due to other factors.

We understand the necessity for childhood vaccinations but don’t see the point of repeated hepatitis B vaccinations or requiring titer tests. It only underscores the lack of understanding of the immune system.

The DOH should concentrate its vaccination efforts on childhood diseases and leave the health professionals well enough alone. Or be the laughing stock of the world.