Perspectives on enhancing vaccination coverage and confidence in the Philippines

Vaccination plays a vital role in protecting against communicable infections like measles and their associated complications1,2. While vaccination doesn't guarantee complete immunity, the authors also highlighted that vaccinated individuals tend to experience milder infections compared to those who are unvaccinated1. Despite the availability of free vaccines for measles, polio, and pertussis through the national vaccination program3, the Philippines faced outbreaks of measles and pertussis across its islands in 20244. The Bangsamoro Autonomous Region in Muslim Mindanao reported 500 measles cases, while pertussis outbreaks were recorded in various parts of Luzon and Visayas, prompting several cities to declare states of calamity4,5. Additionally, despite successfully eradicating poliomyelitis in 2000, approximately 70 percent of provinces and cities remained at high risk of polio outbreaks3,4. Vaccination coverage in the country has seen a decline over the years, with the percentage of children aged 12 to 23 months who received all basic vaccinations dropping from 80% in 2008 to 70% in 20173. This decline in vaccine coverage and confidence among the Filipino population is influenced by various factors within the country. The dengue vaccine controversy, for instance, garnered significant attention as the vaccine's adverse effects came under scrutiny amidst political discord and widespread media coverage3. Similarly, the COVID-19 pandemic witnessed the rise of medical populism, with COVID-19 vaccine side effects and safety profiles becoming subjects of intense media attention, disinformation, misconception, and political scrutiny6. These challenges are further compounded by limited accessibility in disadvantaged areas and occasional vaccine stockouts across the country3. Therefore, addressing vaccine-preventable infections and enhancing vaccine coverage and confidence within the country requires a multifaceted approach. Firstly, addressing the common concerns of the Filipino population, such as adverse effects, disinformation, and misconceptions, must be prioritized in campaigns. Strengthening and enhancing educational and informational activities is crucial to meet the needs of the population regardless of age and background, targeting both children and their parents. Given the popularity of social media platforms like TikTok among the younger population7, collaboration between health institutions, social media companies, and social media influencers should be fostered to incorporate vaccine information in a manner that resonates with this demographic. Moreover, enlisting popular figures, including celebrities and actors, in educational activities to provide testimonials and underscore the effectiveness and importance of vaccines can be impactful. To ensure widespread access to reliable and truthful information, materials should be uploaded to social media and other internet platforms. Additionally, organizing regular town hall meetings on vaccination and its significance can help disseminate reliable information in disadvantaged areas with limited internet access. Secondly, health authorities can forge partnerships with trusted members of the community in their respective localities. This entails engaging and mobilizing community leaders, such as Barangay Captains and Barangay Health Workers, in vaccination efforts. Providing additional compensation can incentivize them to participate in door-to-door vaccination and education activities in disadvantaged areas. By bringing vaccination services directly to community members by their trusted members, accessibility and trust in vaccines can be enhanced, thereby reducing the financial burden associated with traveling to health centers and institutions and improving vaccine confidence. Thirdly, individuals can be further incentivized to avail vaccination services. For instance, vaccinated individuals could receive additional social and health support, encompassing childcare, educational assistance, occupational benefits, and financial aid. Additionally, parents of unvaccinated children could be offered paid leave from work to prevent disruptions to their occupational and economic activities. Fourthly, companies and schools can play an important role in encouraging their staff, students, and their families to undergo vaccination. This could involve offering them tax incentives and establishing collaborations with institutions providing the government's free vaccination services, such as the local government and department of health. Such initiatives would not only promote vaccination uptake but also contribute to safeguarding public health within the workplace and the wider community. Fifthly, it is imperative for the government and its institutions to ensure the uninterrupted flow of the vaccine supply chain. This can be achieved by strengthening collaboration between communities, vaccine companies, and key government agencies, such as the Bureau of Customs, Department of Health, and local government units. By engaging these stakeholders, policies and programs can be developed that are both timely and responsive to the needs and policies of communities. Sixthly, research and information system must be strengthened. Developing monitoring systems can help identify areas requiring additional attention, while research exploring factors and interventions to increase vaccination coverage and confidence should be prioritized. By integrating these efforts into priority research funding programs, the effectiveness of vaccination campaigns can be enhanced. Overall, the importance of vaccination in safeguarding public health cannot be overstated. Despite the availability of free vaccines and national vaccination programs, the Philippines continues to face challenges with outbreaks of preventable diseases and declining vaccine coverage. Addressing these challenges requires a multifaceted approach that encompasses various strategies and the involvement of key stakeholders. Conflict of interest statement The author declares that there is no conflict of interest. Funding The author received no extramural funding for the study. Publisher's note The Publisher of the Journal remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. Edited by Zhang Q, Pan Y, Lei Y