Waiting for boosters

Pre-pandemic in the final week of September, malls and supermarkets would already be filled with early shoppers. Over the weekend, however, I visited several large malls and the crowds were still depressingly sparse.

Regardless of the pandemic response strategy, Delta is dampening hopes for a significant improvement in the fourth quarter that will bring some cheer to Christmas 2021.

Except in one of the malls, there was the sad, conspicuous absence of Christmas carols, which we used to hear as soon as the ’ber months started.

This is despite the fact that COVID vaccination has been concentrated in Metro Manila, in an effort to revive economic activities.

Weak consumer confidence these days is not just due to the livelihood losses arising from the pandemic, but because of fears of infection in public places.

This is bad news in a consumption-driven economy. With Delta untamed, how do you get people to return to indoor dining, to try on apparel in department stores, to visit hair / nail salons and massage spas again?

A reliable system of certifying establishments with fully vaccinated employees will help. But a bigger confidence builder in the time of Delta will be a sense of personal protection from infection.

This will arise not just from full vaccination, but from getting a booster shot. Especially for those who got the Sinovac jab.

And if the government wants to reopen schools, and bring families back to indoor dining establishments, minors will have to be vaccinated soon, while the elderly and immunocompromised will need third doses.

President Duterte, who bewailed “selfish” wealthy nations for beginning to administer boosters while much of the developing world (the Philippines included) is scrounging for vaccines, may have to be selfish himself and turn his back soon on the poorest countries, most of them in Africa, to give Filipinos COVID vaccine boosters and third doses.

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Since the rollout of vaccines, health experts have stressed that no jab provides 100 percent protection, that at best they prevent severe and critical illness requiring hospitalization that could lead to death, and that breakthrough infections are possible.

The experts have also stressed that fully vaccinated people can still be carriers of the virus, meaning they can infect the unvaccinated and vulnerable. And flu viruses like the COVID-causing SARS-CoV-2 tend to mutate.

The vaccines have largely met expectations: infections dropped dramatically in places with high inoculation rates.

And then the variants of concern came along: first Alpha and Beta, from the UK and South Africa, which fueled a deadly surge in our country from March this year, when vaccination was just starting, until May. That surge ruined hopes for a summer economic bounceback.

Now we have the even more contagious Delta, which brought horrific death to India before spreading around the globe.

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Many of us have had personal brushes with the ongoing Delta-driven surge.

I know one private office in Metro Manila, where the staff is 100 percent fully vaccinated and masking and distancing are observed. The other week an employee tested positive for COVID. He remains on home isolation together with his partner, from whom he is believed to have gotten the virus.

Another employee, who completed her jabs about two months ago after recovering from COVID, is on home isolation due to flu-like symptoms and diarrhea and is waiting to be tested.

Both employees are below 60 years old; one has asthma and other comorbidities; both received Sinovac. Another co-worker, also a COVID survivor who is 60 and asthmatic, together with her son who is a health frontliner, also got infected recently, with mild symptoms. Both were fully vaccinated with AstraZeneca when they got infected again.

Still another employee, a health buff in his 50s, got infected despite being fully vaccinated with Sinovac.

Elsewhere, I know a couple in their 50s who are fully vaccinated with Sinovac, who rarely went out of their home and had even groceries delivered, but still got the virus. The husband has been hospitalized for several days now as his oxygen level intermittently drops dangerously.

In another office, I know an employee who had a breakthrough infection despite being fully vaccinated with Pfizer.

As we are seeing in countries such as the US where there is strong resistance to COVID vaccines, the Delta variant is turning this crisis into a pandemic of the unvaccinated – including minors, who were initially excluded from inoculation because they had shown strong immunity to SARS-CoV-2. Now there are increasing reports of critical and severe pediatric COVID cases, and even deaths.

As for breakthrough infections, the risk seems highest among seniors and those with comorbidities.

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Those vaccinated with Sinovac have a greater need for boosters.

Being a believer in Chinese medicine, my mother and I are fully vaccinated with Sinovac. But we have to acknowledge scientific studies showing that the Chinese-made shot has lower efficacy than Pfizer and Moderna. The vaccine maker itself is recommending boosters for its jab.

Our government will have to set aside a substantial amount of funds for boosters in the 2022 national budget.

And it will have to consider proposals from the medical community that health frontliners – at least those assigned to COVID-dedicated wards who were vaccinated with Sinovac – be given boosters ASAP. There aren’t many of them. We’re seeing an acute shortage of COVID health frontliners. Some are falling ill, and others are simply quitting to protect themselves and their households from illness and possible death. I don’t think giving them boosters so they can continue tending to COVID patients will cause much resentment.

Indonesia has done this for its doctors and other health frontliners who were vaccinated mostly with Sinovac, after hundreds got infected this year, with several deaths. Last month the country launched its booster program for a targeted 1.5 million medical workers, using Moderna shots.

Thailand, which has had the same problem with its Sinovac-jabbed medical workers, rolled out its booster program also last month, using the Pfizer-BioNTech vaccine.

Sinovac Biotech, maker of the vaccine called CoronaVac, has cited studies indicating that a third dose of its jab gave a greater boost to its efficacy than an mRNA shot from Pfizer and Moderna. The sooner the study passes global peer review, the better for the company and its vaccine.

I wouldn’t mind getting a CoronaVac booster, but I’m not a health frontliner who is constantly exposed to COVID patients and who may prefer mRNA boosters.

My main concern is how soon I can get my booster. I’m sure I’m not alone in waiting for a third dose.