Turning doubters into defenders to fight a measles outbreak in the Philippines

Information and immunization campaigns aim to reverse plummeting vaccine coverage rates.

Maria Mutya Frio
A woman holds her daughter on her lap, Philippines
22 April 2019

MANILA, Philippines – Shirly Mendez, a 41-year-old grandmother from Bicutan in Metro Manila, never missed a vaccine for her five children when they were young. When her oldest daughter had children of her own, she followed her mother’s example and made sure they were vaccinated. Both mothers believed that vaccines would keep their babies safe from diseases.

But three years ago, the routine trips to the health centre stopped. Shirly was once again a mother to a one-year-old, and a grandmother to three more infants. But she was apprehensive.

Rumours and misinformation

“I became worried because of rumours spreading that children who were getting vaccinated in schools were getting headaches and stomach aches. I never took my children or grandchildren to the health centre to be vaccinated again,” she said.

Shirly’s scepticism was part of a larger trend in the Philippines – a decline in public confidence in vaccines. One survey found that in 2015, 93 per cent of people “strongly agreed” that vaccines are important. In 2018 that rate fell to just 32 per cent.

A woman sits with two children at a table, Philippines
Shirly Mendez feeds her youngest daughter Anika and her grand-daughter (right) in her house in Taguig City.

Cause and effect

Over the past few years, the Philippines has experienced chronically low rates of immunization. According to World Health Organization estimates, 2.6 million Filipino children under the age of 5 years are not protected from measles. This decline in vaccine coverage ultimately led to a recent measles outbreak in the country, with 28,362 reported cases and 389 deaths from measles from January to 5 April this year. This is a 369 per cent increase in reported cases within the same period last year, exceeding the entire caseload of 2018. Around 53 per cent of this year’s cases were children under five years old.

Misconceptions and misinformation about vaccines were only part of the problem. Supply and demand challenges, problems with vaccine management and forecasting, an inadequate number of health workers, and poverty all contributed to a health crisis that shows little sign of abating.

Many children from urban poor families, ethnic minorities, transient and highly mobile populations, as well as children living in remote and conflict-affected areas usually miss out on immunization.

"I saw on TV that there had been many measles cases and many had died."

Containing an outbreak

In response to the outbreak, the Philippine Government intensified its mass immunization campaign against measles, concentrating on areas with the highest reported cases, including metro Manila. At the Lower Bicutan Health Centre where Shirly goes, health workers saw a 60 per cent surge in the number of clients — more than 200 daily — who came to enquire or get their children vaccinated against measles.

“We were surprised by the rapid rise in number of parents who started believing in vaccines again,” said Marites Diaz, rural health midwife at the centre. “Our clients who hadn’t shown up at the centre for a long time were coming back to continue with follow-up shots to complete the required shots.”

Rural health workers are also going door to door in areas that are farthest from the health centre, working inwards to households that are closer. They give out brochures in Tagalog, the local language, and have one-on-one conversations with parents to explain how immunization protects children from diseases.

Women hold their children on their laps at a health centre, Philippines
Holding their children in their arms, women wait outside Lower Bicutan Health Centre to vaccinate their children in Taguig City in the Philippines.

The information campaign is empowering mothers like Shirly to vaccinate their children. 

“I saw on TV that there had been many measles cases and many had died,” said Shirly. “After the outbreak, I was afraid that my children would also get measles. That’s when I decided to take my children and grandchildren back to the health centre,” she said.

Health partners in action

UNICEF is supporting the Department of Health to respond to the outbreak and make sure that all parents and caregivers are informed about how important vaccines are. We’re working through multiple partners and channels, including:

  • Engaging local executives, youth groups and the private sector to collaborate on improving the country’s immunization coverage.
  • Using social media to shape positive public opinion on the safety and effectiveness of vaccines.
  • Expediting the procurement of six million doses of measles vaccine and five million doses of polio vaccine to supplement stocks in priority areas.
  • Providing tents to hospitals to accommodate the sudden surge in measles cases.
  • Developing and optimizing tools to help monitor immunization rates in the most at-risk regions of the country.

UNICEF Philippines’ immunization programme is supported by Al Waleed Foundation and by individual donors to the Champions for Children programme.

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