After a full year of vaccinating its population against COVID-19, the Philippines has over 63 million fully vaccinated Filipinos.
And yet, the country continues to face challenges reaching vulnerable senior citizens, one of the high-risk groups that must be prioritised for COVID-19 vaccines, as recommended by the World Health Organization.
While nearly all eligible individuals of the target priority populations of the country (93% of healthcare workers and 92% of people with comorbidities) are now protected against severe illness caused by COVID-19, around 2.4 million senior citizens have yet to receive even a single dose of COVID-19 vaccine.
The World Health Organization (WHO) Philippines continues to support the Department of Health (DOH) and key sub-national areas by providing technical expertise on improving the vaccination coverage of priority groups and the rest of the general population.
WHO, DOH, and other partners have been advocating for local chief executives (LCEs) to invest in bringing vaccination services closer to the communities. To prevent the loss of lives in the next surge, vaccinating vulnerable populations is the most impactful intervention the country can do now amid the easing of restrictions.
These vulnerable groups include senior citizens, people in geographically isolated and disadvantaged areas (GIDA), and those who do not have any easy and affordable means to go to vaccination sites.
As of 30 March 2022, provinces with the highest number of unvaccinated A2 (senior citizens) include Cebu, Negros Occidental, Batangas, Cavite, Bulacan, Negros Oriental, Nueva Ecija, Iloilo, Leyte, and Laguna.
WHO teams collaborated with senior health authorities and provincial government officials to identify ways to use existing resources to reach vulnerable populations and address concerns on vaccine safety and access.
The following best practices show the commendable resourcefulness and dedication of regional, provincial, and local government units to find solutions to protect their constituents.
Reaching the unreached: Iloilo's People Power Resbakuna towards Alert Level 1
Iloilo Province Governor, Arthur Defensor Jr., presents the COVID-19 situation and vaccination coverage updates in the province, including its COVAC Plan 2021-2022. The provincial government has strengthened its vaccination efforts by doubling its response capacity, allotting and augmenting resources, incentivising the vaccinees, providing free transportation services, partnering with different sectors, adopting house-to-house campaigns, and positioning vaccination sites strategically. © WHO Philippines/K. Vitug
The Iloilo Provincial Government implements its COVID-19 Vaccine Deployment and Immunization Plan (COVAC Plan) 2021-2022. This plan aims to ensure that all the eligible citizens of the Iloilo Province will have free, effective, safe, and high-quality vaccines against COVID-19.
In its effort to double the capacity of its COVID-19 response workforce, the provincial government has allotted a budget of PHP 50 million every three months to support the augmentation of vaccinators deployed to different municipalities of the province.
"We are mobilising our entire bureaucracy, including all the municipalities and a component city, the private sector, civil society organisations, non-governmental organisations, and all the volunteer groups in the province to make COVID-19 vaccines accessible for all people of Iloilo,” said Iloilo Governor Arthur Defensor Jr.
The province has admitted that reaching senior citizens has been challenging. Therefore, besides implementing barangay-level outreach strategies to vaccinate as many of their constituents as possible, they also utilise other mechanisms to encourage their people to get vaccinated.
"In the province of Iloilo, we continuously implement initiatives to encourage our seniors to get vaccinated, such as providing incentives, financial assistance, and free transportation services to the vaccination sites. This is part of our Suyod A2 strategy that aims to reach those A2s who have not received even a single dose of lifesaving COVID-19 vaccine,” said Governor Defensor.
Closer-to-home vaccination strategies of the Provincial Government of Bulacan
The Bulacan Provincial Health Office team, headed by Dr Hjordis Marushka Celis, shares its best practices to reach communities with the WHO team. According to Dr Celis, vaccination teams have been going to the barangay level for closer-to-home vaccinations. © WHO Philippines/K. Vitug
Some areas in Bulacan Province have deployed Bakuna Buses to coastal and geographically isolated and disadvantaged areas to increase the accessibility of COVID-19 vaccines.
Dr Hjordis Marushka Celis, Bulacan Provincial Health Officer, mentioned that other municipalities could replicate this strategy. The province also plans to implement other approaches to cover the “last mile.”
The Bulacan Provincial Government collaborates with the Department of Interior and Local Government to conduct house-to-house surveys to identify vaccinated and unvaccinated individuals. The data gathered from this survey will help inform the operations and strategies of the municipalities and barangays in reaching those that are not vaccinated yet.
“All the 24 local government units in Bulacan are currently building on their inventories of vaccinated and unvaccinated individuals by conducting house-to-house surveys. We are currently consolidating preliminary data to help the barangay captains reach their constituents who remain unvaccinated against COVID-19,” said Dr Celis.
Highlighting the need to inoculate zero-dose unvaccinated senior citizens through advocacy
Members of the City Health Office of General Trias answer questions on the vaccination coverage of senior citizens in their city. A WHO (Philippines) team visited the province of Cavite on 1 March 2022. The WHO team highlighted the need to inoculate zero-dose unvaccinated senior citizens. With WHO's support, more than seven LGUs drafted key strategies to reach this vulnerable priority group in their respective municipalities as soon as possible. From left to right: Dr Jonathan Luseco, CHO of Gen Trias, Ludette Lontoc, DMO IV, Dr Lorelie Escario, OIC CHO of Trece Martires City, Ms Josephine Vicedo, PHN of Trece Martires City. © WHO Philippines/A. Batay-an
In the provinces of Cavite and Laguna, LGUs have been maintaining mega vaccination sites and have established mobile and barangay vaccination centres. In addition, they are focusing on running additional vaccination sites in frequented areas such as public markets, pharmacies, and barangay centres.
Both provinces will intensify more house-to-house campaigns to reach senior citizens, especially those who are home-bound, have no access to transportation, and live without means of support from relatives.
The Region 4-A Regional Vaccinations Operation Center (RVOC) committed to allocating 50 personnel per province for Batangas, Cavite, and Laguna to address these provinces’ lack of human resources. The 50 advocates or change agents will help in house-to-house campaigns for vaccine demand generation.
This approach will support the provinces as they work on the active master listing of senior citizens while working with the Office of Senior Citizen Affairs, the Department of Social Work and Development, and the Department of Information and Communications Technology to find these senior citizens. This initiative will enable the provinces to target the remaining unvaccinated senior citizens.
Inter-agency collaboration for vaccine demand generation and uptake
The Province of Leyte actively involved key government agencies in coordinating and working together to reach vulnerable populations for its COVID-19 vaccination rollout.
The province had regular inter-agency meetings to maximise each agency's available resources during the vaccination rollout. The Provincial DOH Office (PDOHO) is the overall lead for coordinating the vaccination rollout in the province of Leyte. In addition, their office coordinates closely with RVOC and the Eastern Visayas’ National Immunization Program.
The DILG coordinates communication and operations with LGUs. The Association of Municipal Health Officers of the Philippines, Leyte branch provide their medical practitioners to offset the lack of doctors and nurses in some municipalities in the province.
The province also sources additional human resources from the Bureau of Fire Protection and the Philippine National Police. In addition, through its Provincial Administrator and its Provincial Health Officer, the Provincial Governor's office works hand in hand with the DOH’s PDOHO. They coordinate vaccine supplies, workforce and operations of the vaccination rollout.
Other key agencies like the Department of Education and the Department of Trade and Industry also coordinate closely with the teams to ensure the safe reopening of face-to-face classes in schools and safe management of businesses, respectively. In addition, the DOH’s Health Promotion and Education Office continues to support vaccine demand generation, particularly reaching senior citizens, through active engagement in communities and communication through social media and support to barangay health workers (BHWs).
The threat of losing lives from more transmissible COVID-19 variants remains. Protecting the elderly now will save more lives and protect our health system and economy. Acknowledging local government units’ influence and power to save lives, WHO appeals to all local leaders to prioritise senior citizens’ vaccination urgently.