MANILA, Philippines — Irene Gasta, a mother from Davao, feels "guilty" that she got pregnant in a community filled with smokers.
"[H]abang nagbubuntis pa ako, marami na akong nakikita sa mga post sa Facebook patungkol sa [pneumonia]," Gasta told Philstar.com. "At isa daw sa mga main reason ay ang usok ng sigarilyo na maaari nilang malanghap. At parang guilty ako doon dahil marami talagang naninigarilyo sa amin at isa na ang papa niya."
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(During my pregnancy, I read a lot of Facebook posts about pneumonia, where one of the reasons is inhaling second-hand smoke. And I feel guilty because there are a lot of smokers in our area, including his father.)
Gasta's guilt turned into fear when her child was diagnosed with bronchopneumonia, a bacterial infection that inflames the alveoli, at just six months old.
"Simula noong nagka-pneumonia siya, every month na siya inuubo hanggang ngayon. Nawawala din naman," Gasta said. "Pero every 20th ng buwan, na-notice ko na inuubo na siya sa ganiyang araw."
(Since getting pneumonia, he has continued coughing every month until now. The coughing disappeared eventually. But every 20th of the month, I noticed that his coughing returns.)
She has since taken precautionary steps to protect her child from catching any further infections as the COVID-19 pandemic still lingers.
Gasta's son is one of around 60,500 children infected with pneumonia as of 2022, according to the Department of Health's (DOH) Field Health Services Information System report.
Health experts warned that these figures could rise this year because of the more relaxed COVID-19 protocols and low vaccine utilization.
Physician Anna Ong-Lim, University of the Philippines - Philippine General Hospital Infectious and Tropical Disease Division chief, lamented that people are not taking pneumonia seriously as do with COVID-19.
"For the past 36 months, our attention has been focused on COVID. But simmering in the background has been all of these vaccine-preventable diseases that, thankfully, decreased in prevalence because of the different interventions that we implemented for COVID but were just waiting for their opportunity," she said at a media roundtable discussion conducted by Glaxo Smith Kline Philippines in Makati City on Friday.
"And now that we have loosening of restrictions and 'return to normal,' we expect all of these vaccine-preventable diseases to once again gain their old footing. This means we have to exercise extra vigilance and pay more attention to how we can prevent these conditions, particularly pneumonia," she added.
Philippine Foundation for Vaccination president physician Maria Rosario Capeding said pneumonia has been the leading killer of children aged five years old or below since the time she started her medical fellowship in the 1990s.
"I have observed 'yung pneumonia is being taken for granted dahil laging sinasabi, 'Ah pneumonia lang ito,'" she said at the roundtable discussion. "But actually, if we really look deep, we have to assess that it's really a significant public health problem not only in our country but also in developing countries."
The DOH's report also stated that about 31,395 Filipino children who are under 5 years old have died due to pneumonia in 2021.
Ong-Lim likewise said that UNICEF data showed that a child under 5 years old dies of pneumonia every 43 seconds or around 2,000 children every day.
She also cited that the Philippines is one of the 15 countries that contribute to pneumonia cases globally which could be prevented by vaccines. Other countries include China and Indonesia, among others.
The common causes of pneumonia, a communicable disease infecting the lungs, include child wasting, indoor air pollution from solid fuels, second-hand smoke, low birth weight, child stunting and non-exclusive breastfeeding.
Low vaccine rate
Pneumonia can be largely prevented by inoculating a 10- or 13-valent pneumococcal conjugate vaccine (PCV), which became part of the DOH's national immunization program in 2015.
However, most vials are not reaching Filipino children. Ong-Lim cited UNICEF's 2023 "State of the World's Children" report, which found that the Philippines ranked fourth in the top 20 countries with the largest number of zero-dose children.
Zero-dose children are increasingly becoming a cause of concern in many countries where they have not taken a single jab.
"In remote rural villages, in city slums, in conflict and fragile settings, and in many other places around the world, far too many children are not getting the vaccines they need to protect them against serious disease," the Unicef report stated. "Their lives are often marked by multiple deprivations, with limited access to basic services, such as clean water, education and – crucially – primary health care."
Citing the DOH's data, Ong-Lim said only 3.6 million Filipinos took the PCV as of 2022, miles away from the target of 22.5 million. More than 20 million is needed to halt the transmission of pneumonia.
Capeding then urged parents to get the shot against pneumonia as vaccines helped societies overcome worse diseases such as COVID-19.
"We should consider vaccinations […] as part of our lifestyles," she said. "Dapat priority for mothers, for parents na i-consider na ang vaccination should be a priority rather than toys."
The World Health Organization recommends PCV to children aged 12 to 59 months. — Intern, Eduelle Jan Macababbad