[SPECIAL REPORT] Low acceptance of COVID-19 booster vaccines worries Lantapan’s health officer 

LANTAPAN, Bukidnon (MindaNews / 18 February) – By all indications, life has returned to its normal grind in this vegetable-producing town after two years of COVID-19 lockdowns that crippled economic and other human activities. In fact, most of the residents are no longer wearing face masks.

Dr. Jose Arlita L. Alsula, chief of the Municipal Health Office is worried that residents are no longer observing minimum health protocols. As of January 2023, she said, only 18.25 percent of those who have received the first and second doses of the anti-COVID vaccine have availed of booster shots.

Lantapan, which has 14 barangays, has a population of 65,974 as of the May 2020 census of the Philippine Statistics Authority. 

“We failed in explaining about the booster shots. They think they’re okay, they’re already comfortable with the first and second doses. But at a certain level, the effectiveness of the first dose will decrease, same with the second dose. I consider it a failure on our part to explain this to them properly,” Alsula said. 

Dr. Josefa Arlita L. Alsula, Municipal Health Officer of Lantapan, Bukidnon. MindaNews photo by H. MARCOS C. MORDENO

“They refuse to take the booster shots but keep going around. However, the level of protection of those who were vaccinated would go down. They think the first and second doses will work for them all throughout. That’s not the case,” she explained.

“When the Delta variant arrived, there were neither rich nor poor [patients] in our isolation facility. It hurts me because I know those people. We were helpless because the hospitals refused to accept them,” she added.

Alsula, however, clarified that when they started their vaccination drive, many residents wanted to avail of it.

“There were several takers but there was not enough vaccine. Through time, many vaccines arrived from the Department of Health (DOH), but many people who were anti-vaccine also emerged. So, this really emanated from vaccine acceptance,” she said.

“There was high acceptance at the start but we failed in terms of meeting the required number of vaccines. At the start we always had it in the gymnasium. As early as 4 a.m. people were already queuing,” she recalled.

However, since she knew the number of vaccines that arrived was not enough, Alsula said she was always tempted to hide because she knew that the people who had come to avail of it would be angry to know that they could not have it after all. 

“You can do nothing because those were the only vaccines that arrived. Towards the end, more vaccines had arrived but at the same time, many negative views about vaccination had also surfaced,” she said. 

“We have not even responded to the anti-vaccination claims. The DOH has not dealt with it face on,” she added. 

Nonetheless, Alsula is proud to say they were able to reach a 90-percent immunization rate for the target population. “Ninety percent is the national target.”

She said Lantapan is among the top five municipalities in Bukidnon with the highest percentage of target populations receiving the first and second doses.

According to data from the Provincial Health Office (PHO), as of Dec. 31 last year, Lantapan’s target population for vaccination was 54,318. Of this number, 51,569 or 94.94 percent received the first dose but only 47,634 or 87.69 percent availed of the second dose, the 5th and 6th highest, respectively, among Bukidnon’s 20 towns and two component cities.

Municipal Hall of Lantapan, Bukidnon. MIndaNews photo by H. MARCOS C. MORDENO

Bukidnon has a population of 1,541,308 as of the May 2020 census of the Philippine Statistics Authority. Its target population for vaccination was 1,244,370 of which 1,008,150 or 81.02 percent were fully vaccinated as of Dec. 31 last year. 

Low rate for booster shots

As of Dec. 31 last year, the local government units that reached a five-figure coverage for the first booster dose were Malaybalay City (26,976), Valencia City (16,157), Manolo Fortich (18,221), Maramag (11,221), and Talakag (10,628). 

In Malaybalay, 5,296 availed of the second booster dose, 3,441 in Manolo Fortich, and 2,698 in Maramag. The figures for the rest of the LGUs were lower than 2,000.

For the whole Bukidnon, 178,403 individuals received the first booster dose, but only 29,818 availed of the second dose for a coverage rate of 16.73 percent.

In Lantapan, 8,959 individuals had received the first booster dose but only 952 of them got the second dose. Nine other LGUs also recorded fewer than a thousand individuals who got the second booster shot.

“We’re only 18.25 percent in booster shots. That’s how low we are in terms of giving booster shots,” although “out of those who came here and heard me, about 80 percent submitted.”Alsula said.

As per the PHO formula, the percentage of booster dose coverage was based on the target population, not on the number of fully vaccinated individuals.

Alsula said she used the business permit renewal period as an opportunity to explain to more residents on a one-on-one basis the importance of getting booster shots.

The laboratory of the Municipal Health Office of Lantapan, Bukidnon. MindaNews photo by H. MARCOS C. MORDENO

Local businesses that want to apply for or renew their permits are required to obtain a sanitary permit and a health certificate from the MHO. A health certificate can only be issued to business owners, food handlers in particular, who pass the X-ray examination.

Alsula, however, said she was surprised that she received a letter from one applicant for business permit renewal alleging that she refused to issue such a permit to those who did not get booster shots. The complainant furnished copies of the letter to the town mayor and Civil Service Commission, and even warned of bringing the issue to the Commission on Human Rights.

“I am surprised by this complaint of ‘no booster, no business permit renewal.’ In the first place, I am not the one to renew, I will just issue the sanitary permit and the health certificate, never the mayor’s permit. I can only recommend on the basis of the health certificate and the sanitation permit.

“I can give you names [of the business permit applicants] and you can personally ask if I forced them [to take the booster shots],” she said.

“I cannot force the booster shots, but I cannot forgo the X-ray examination because it’s required under the Sanitation Code of the Philippines. It’s in the law, that’s already beyond me. The problem with some rich people here is they think they’re gods,” she said, adding that the same complainant attacked her on social media.

She cited that out of around 1,000 applicants for business permit renewal, at least 50 were found positive for TB.

Besides, Alsula said, they had to contend with religious sects that refused to accept vaccination. She named two of these groups.

“I can do nothing about their beliefs, be they Lumad or non-Lumad. But if they’d come to me, I’d really explain it to them,” she said.

Bai Matigpus Purita Lajera (center in front) during the meeting of the Kitanglad Council of Elders in Barangay Dalwangan, Malaybalay City on 31 January 2023.

Bai Tinangkil Herminia Saway, the Indigenous Peoples Mandatory Representative to the barangay council of Songco, said many residents of their village had availed of the vaccine. She said she herself had received the first and second doses but not the booster shot. She added that even her relatives who are firm believers in their culture as Lumad also submitted to vaccination.

Saway said she respects those who refuse to be vaccinated on the basis of their belief in culture, but added that “Magbabaya also told us to accept the genuine things made by man. Vaccines are genuine…I know of people who were not vaccinated and died.” (See related story)

Few health workers

Alsula said what greatly worries her is the town’s limited number of professional health workers – herself, another doctor who is assisting her, one nurse and two midwives – who can administer the vaccines. The barangay health workers can assist but cannot administer the injections.

She said they started giving vaccines in the barangays in November last year but had to again centralize it beginning January 2023 as the nurse and midwives had to renew their contracts with the DOH. “For the first two weeks of January, we had no human resource from DOH, so we’re really poorly manned.”

“If you’re managing a health care system like this one, would you not be afraid? I’m from here, I always care for my people, and they are my responsibility and I will do anything in my power to explain. But it wouldn’t be fair to point a knife at them (to make them accept the booster shots),” she said.

She recalled that one time she called her sibling in the United States and asked the latter between sobs to take care of her children if something happened to her.

Municipal Health Office of Lantapan, Bukidnon. MindaNews photo by H. MARCOS C. MORDENO

“With the advent of a new strain much more lethal than Delta, what will you do? It has no symptoms but it can be fatal as Delta or more fatal. Will you not be obliged to exert more effort? In the end, it’s us who will bear the burden. The hospitals will just say they’re already full. The nearest is the Bukidnon Provincial Medical Center. We can’t go to private hospitals because PhilHealth won’t pay them.

The medical center is located in Barangay Casisang in Malaybalay City, about 30 kilometers from Lantapan proper.

“So what will we do [with the patients], watch them in the isolation facility until they die?” she lamented. “We’re really working hard because the health workers would be overwhelmed if that situation happens again. I’ll retire if it happens again.” (H. Marcos C. Mordeno/MindaNews)

COVID-19 and culture: Why some Lumads in Bukidnon reject vaccines