1.Dermatomyositis following COVID-19 vaccination: A case report and review of vaccine-associated autoimmune phenomena
Mark Andrian O. Yano ; Geraldine T. Zamora
Acta Medica Philippina 2025;59(Early Access 2025):1-4
The COVID-19 pandemic has underscored the vital role of vaccination in mitigating widespread morbidity and mortality. Nevertheless, the global vaccination campaign has also brought to light rare but notable immune-mediated adverse events. Vaccination is inherently immune stimulatory, designed to provoke a robust immune response, and in rare instances, this heightened immune activity may unmask or trigger autoimmunity in genetically predisposed individuals. Proposed mechanisms include molecular mimicry, epitope spreading, and bystander activation, all of which can disrupt immune tolerance and initiate autoreactive responses. This case report explores a potential link between COVID-19 vaccination and the onset of dermatomyositis, adding to the growing body of literature examining the rare but important phenomenon of vaccine-associated autoimmunity.
Human ; Male ; Middle Aged: 45-64 Yrs Old ; Dermatomyositis ; Covid-19 ; Vaccines
2.Health protocol practices and personal preventive measures among fully vaccinated individuals with comorbidities in the National Capital Region, Philippines during the COVID-19 pandemic: A mixed-method study
Maria Luisa Olano ; Matthew Spencer T. Ho ; Mareeya P. Yumena ; Diana Leah Mendoza ; Patricia Anne C. Ty ; Erin Grace B. Villanueva ; Christine Rozien M. Palayad ; Jaye Kirsten U. Melchor ; Chrissea B. Custodio
Acta Medica Philippina 2025;59(4):26-41
BACKGROUND AND OBJECTIVE
The Philippine Inter-Agency Task Force for the Management of Emerging Infectious Diseases implemented health protocol guidelines to reduce the risk of COVID-19 transmission. Individuals with comorbidities were advised to take precautionary measures due to their increased vulnerability. This study aimed to assess the relationship between knowledge, acceptance, and adherence to health protocols among fully vaccinated individuals with comorbidities in the National Capital Region, Philippines.
METHODSThe study employed an explanatory-sequential mixed-method design. The quantitative phase involved an online survey with 384 respondents. The survey included questions on socio-demographic profile, COVID-19 knowledge, acceptability of health protocols, and adherence to preventive practices. Chi-square Test of Independence and Pearson’s Correlation Test were used to analyze the data. Semi-structured interviews were conducted with 11 participants, providing rich insights into their personal experiences. The interview transcripts were analyzed using Colaizzi’s descriptive method with the aid of qualitative analysis software (MAXQDA), ensuring a rigorous approach to thematic analysis. The integration of the two phases was achieved by connecting quantitative results with qualitative insights, creating a comprehensive understanding of the phenomena under study.
RESULTSFindings showed that the relationship of sociodemographic characteristics and level of knowledge (Gender pCONCLUSION
The study suggests that multiple factors contribute to non-adherence to health protocols. Recognizing these holes and weaknesses in the COVID-19 pandemic response stresses the need for national leaders to place urgency on properly implementing preventive measures and providing health education to the masses during public health situations. Collaboration from all sectors is crucial in addressing public health crises. This study can be a valuable resource for future researchers, local government units, and policymakers in prioritizing public health care and pandemic preparedness.
Human ; Comorbidity ; Covid-19 ; Public Health Practice ; Vaccines
3.A narrative review of pneumococcal conjugate vaccine choices for greater access and protection against pneumococcal diseases in the Philippines
Maria Margarita M. Lota ; Ma. Rosario Z. Cadeping ; Fernando B. Garcia jr. ; John Robert C. Meddina ; Jeremiah A. Serrano ; Carlo R. Lumangaya ; Vicente Y. Belizario jr.
Acta Medica Philippina 2025;59(4):151-158
BACKGROUND
Pneumococcal vaccination has been widely used for the prevention of pneumococcal disease, with two types of vaccines available since 2009. With the World Health Organization (WHO) recommendation of incorporating pneumococcal conjugate vaccines (PCVs) in National Immunization Programs (NIPs) worldwide, a ten-valent PCV (PHiD-CV) was initially introduced in the Philippines in 2012. This, however, transitioned to the use of the 13-valent PCV (Prevnar) subsequent to the recommendation of the Formulary Executive Council in 2014.
OBJECTIVEThis review aimed to present evidence on pneumococcal disease and vaccine inclusion in the Philippine NIP from 2005 - 2021.
METHODSThis narrative review compiled articles on Pneumococcus from January 2005 to October 2021, sourcing literature from databases such as BIOSIS Preview, CAB Direct, Embase, Google Scholar, and others.
RESULTSIn the Philippines, there was a shift in prevalent serotypes of Streptococcus pneumoniae among children under five following the introduction of PCV13 in the National Immunization Program in 2014, with serotype 14 becoming the most common by 2018, and a significant reduction in isolates reported in 2020, where only serotypes 5, 19A, and 23F were identified among invasive strains. The immunogenicity results of a potential vaccine candidate should be factored into the overall evidence when conducting a reassessment of PCV.
CONCLUSIONAs part of the decision making about the inclusion of the PCVs in the NIP of the Philippines, various factors such as local epidemiology, vaccine supply, cost, and programmatic characteristics must be careful weighed. Enhancing laboratory and surveillance capacity are essential to provide evidencebased decision-making in terms of existing serotype distribution and antimicrobial resistance (AMR) profile in the country. With the introduction of a new affordable formulation of a 10-valent PCV offering a comparable serotype coverage, the reassessment of choice of PCV with the consideration of all three formulations, namely PCV13, PHiD-CV, and SIIPL-PCV, may be warranted.
Bacteria ; 10-valent Pneumococcal Conjugate Vaccine ; 13-valent Pneumococcal Vaccine ; Pneumococcal Vaccines ; Philippines
4.Demographics, injury patterns, and management profile of animal bite cases in a national infectious disease and research facility
Mark Joseph Castellano ; Johanna Beulah Sornillo ; Nobuo Saito ; Akira Nishizono ; Beatriz Quiambao
Pediatric Infectious Disease Society of the Philippines Journal 2025;26(1):3-11
BACKGROUND
Rabies remains to be a neglected tropical disease in the Philippines, with the country reporting a higher number of cases compared to its counterparts in Asia.
OBJECTIVETo describe the demographics, animal bite characteristics, and post-exposure prophylaxis of animal bite patients coming in for care at the Research Institute for Tropical Medicine (RITM), a large government referral center for infectious diseases, and animal bites.
METHODSElectronic patient records from January 1, 2018 to December 31, 2019 were obtained from the National Rabies Information System (NaRIS) database of the Department of Health, and summarized using applicable descriptive statistics.
RESULTSA total of 14,614 patients were included over the two-year study period, and more than third of the patients were children below 15 years old, while more than half were adult males. Lower extremities were the most frequently affected area, while with children, more than a third of exposures were in the head and neck areas. Intradermal route was mostly used for the post-exposure prophylaxis, while WHO prequalified vaccines were utilized in more than 90% of the patients. Only 55.7% of patients completed the prophylaxis regimen at RITM.
CONCLUSIONThese findings reflect the significant exposure of children from animal bites, and the non-compliance of patients to the prescribed post-exposure prophylaxis.
Human ; Animals ; Rabies ; Post-exposure Prophylaxis ; Rabies Vaccines
5.Clinical profile of pediatric patients with COVID‐19 admitted to Southern Philippines Medical Center before vaccine rollout
Rica Marie B. Andico ; Ameleen B. Bangayan ; Jo-anne J. Lobo
Southern Philippines Medical Center Journal of Health Care Services 2025;11(1):1-3
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Vaccines
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Covid‐19
6.Hesitancy towards COVID-19 booster vaccine and its associated factors among geriatric patients in a tertiary hospital in Region 1
The Filipino Family Physician 2025;63(1):26-32
BACKGROUND
The COVID-19 pandemic significantly impacted global health, especially among older adults at higher risk for severe illness. Despite the benefits of vaccination, booster vaccine hesitancy posed a barrier to optimal protection in the elderly population.
OBJECTIVEThis study aimed to identify factors associated with COVID-19 booster vaccine hesitancy among geriatric patients at the Family Medicine Outpatient Clinic of Region 1 Medical Center.
METHODSAn analytic, cross-sectional study was conducted with 183 geriatric patients aged 60 and above who had received the primary COVID-19 vaccine series. Data were collected using a 25-item questionnaire addressing sociodemographic information, medical history, COVID-19 knowledge, and vaccine attitudes. Statistical analyses, including chi-square tests and logistic regression, identified factors influencing booster vaccine hesitancy.
RESULTSThe majority of participants were between the ages of 60-69 (66.7%, n=122) and predominantly female (69.4%, n=127). High hesitancy rates were notably observed among elderly females (75.6%), individuals with lower educational attainment (79.7%), and single individuals (93.3%). Other significant factors included hypertension (76.5%) and the absence of prior influenza (81.5%) or pneumococcal (75.9%) vaccinations.
CONCLUSIONThese findings highlight the critical need for targeted educational efforts to mitigate COVID-19 vaccine hesitancy within specific subgroups, particularly elderly females, those with lower education levels, and individuals with certain health conditions. By implementing personalized outreach and emphasizing the advantages of vaccination, stakeholders can enhance vaccine uptake and improve health outcomes for this vulnerable segment of the population.
Human ; Vaccination Hesitancy ; Public Health ; Covid-19 ; Vaccines
7.Assessment of knowledge, attitudes, and practices on coronavirus disease 2019 vaccine among high-risk pregnant and lactating women: A cross-sectional study in a Philippine tertiary hospital.
Iris A. SORIA-ARIKAN ; Valerie P. TIEMPO-GUINTO
Philippine Journal of Obstetrics and Gynecology 2025;49(3):161-170
BACKGROUND
Coronavirus disease 2019 (COVID-19) infection is still a problem in our country for the past 2 years. The pandemic severely affected the immunocompromised and high-risk group of patients, such as the pregnant and lactating women. Research shows that this group has higher risk of being critically ill as well as dying. However, there are only a few studies on how COVID-19 vaccine is perceived among this vulnerable group. Hence, this study aims to assess the knowledge, attitude, and practices on COVID-19 vaccine among high-risk pregnant and lactating women. Moreover, the results will be used in crafting health policies that affect this specific group of patients.
METHODOLOGYA prospective cross-sectional study was conducted on high-risk pregnant and lactating women who sought antenatal consults at the High-Risk Clinic in a tertiary training hospital for a 1-month period. Participants were asked to answer a validated questionnaire assessing their knowledge, attitudes, and practices on COVID-19 vaccine. They were also asked about their sociodemographic characteristics, co-morbidities, history of COVID-19 infection, and vaccination status, as well as the source of their information regarding the vaccine. Descriptive statistics was used to summarize in this study. In addition, frequency and proportion were used for nominal variables, median and range for ordinal variables, and mean and standard deviation for interval or ratio variables. MINITAB 20 was used for data analysis.
RESULTSA total of 323 high-risk pregnant and lactating women were enrolled in the study with an average age of 29 years old. Socio-demographic characteristics of the participants showed that they were high-school graduate, single, mostly financially disadvantaged, and resides in Cavite, Laguna, Batangas, Rizal and Quezon area. The majority have diabetes mellitus as their co-morbidity, were not infected with COVID-19 and had already been vaccinated. The significant source of information of vaccine information was mainly from social media. The study presented that more than 90% were aware that COVID-19 vaccine was recommended by professional organizations, however, only 55%–59% only agree that it is safe during pregnancy and breastfeeding. The result also conveyed a positive attitude toward vaccination as the pregnancy progresses, as well as during lactation. As to practices, 80% of the participants were told by their health care providers to get vaccinated and 72% of them reported vaccine side effects. Furthermore, 58% of the participants would recommend vaccination during pregnancy while only 54% will recommend it while breastfeeding.
CONCLUSIONAssessment of knowledge, attitudes, and practices of COVID-19 vaccine among high-risk pregnant and lactating women gave an understanding on how a vulnerable population perceives vaccination. In general, this research study presented high percentage COVID-19 vaccine awareness and acceptance; however, it can also be seen that there is a mixed perception regarding vaccine safety during pregnancy and lactation. Strategies to improve health literacy which are evidenced based that can be carried out by a health care provider could be established to achieve maximum vaccination coverage among high-risk group of patients.
Human ; Female ; Coronavirus ; Covid-19 ; Vaccines ; Pandemics
8.Cost-effectiveness analysis of various Coronavirus Disease (COVID-19) vaccines against emerging variants of concern in the Philippines.
Haidee A. VALVERDE ; Clarence C. YACAPIN ; Paul Matthew D. PASCO ; Joana Ophelia M. REAL ; Jaifred Christian F. LOPEZ ; Hannah Eleanor CLAPHAM ; Yi Zhen CHEW ; Chris Erwin G. MERCADO ; Siobhan BOTWRIGHT ; Madison SILZLE ; Hilton Y. LAM
Acta Medica Philippina 2025;59(14):37-48
OBJECTIVES
During the early COVID-19 pandemic (2020 to mid-2021), the Philippine government relied on nonpharmaceutical interventions such as lockdowns and Enhanced Community Quarantine (ECQ). With the emergency use authorization of vaccines, assessing their potential impact became essential. This study develops a Philippine model to evaluate the epidemiologic and economic effects of COVID-19 vaccination, estimating its impact on mortality, hospitalization, and mild/asymptomatic cases under various prioritization strategies, including booster doses and the presence of variants of concern.
METHODSA dynamic transmission model (DTM) with an SEIR (Susceptible-Exposed-Infected-Recovered) structure was calibrated using local data, including case numbers, deaths, seroprevalence, vaccination coverage, and intervention costs. The model’s outputs informed a cost-effectiveness analysis (CEA) from health system and societal perspectives over a two-year horizon. Incremental Cost-Effectiveness Ratios (ICERs) were calculated, with costs adjusted to 2020 prices and discount rates of 3%-10% applied. Sensitivity analyses, including one-way and probabilistic approaches, assessed robustness, while a budget impact analysis (BIA) estimated government expenditures in 2020 and 2021.
RESULTSWithout vaccination, daily cases could have peaked at 400,000 between February and May 2021. A vaccination campaign was projected to reduce cases to around 20,000, significantly lowering mortality.
From the health system perspective, the estimated cost without vaccination was PhP 14.46 trillion, with 93.83 million QALYs. With vaccination, costs dropped to PhP 2.36 trillion, while QALYs increased to 101.79 million. From the societal perspective, costs were PhP 14.68 trillion without vaccination and PhP 2.38 trillion with vaccination, with the same QALY outcomes.
CEA results confirmed that vaccination was cost-saving, with ICERs of -PhP 1,520,727.28 per QALY (health system) and -PhP 1,546,171.63 per QALY (societal). Sensitivity analyses supported these findings, with oneway sensitivity analysis showing minimal impact from parameter changes and probabilistic sensitivity analysis confirming cost-saving outcomes. The BIA estimated government expenditures of PhP 983.45 billion in 2020 and PhP 1.47 trillion in 2021 for the vaccine scenario, lower than the no-vaccine scenario.
CONCLUSIONIndeed, our modeling has shown that COVID-19 vaccines could mitigate the spread of COVID-19 and provide good value for money.
Human ; Covid-19 ; Cost-effectiveness Analysis ; Vaccines ; Philippines
9.Social media promotion of a telehealth-based vaccine delivery system at the outpatient department: A quasi-experimental study.
Ronan Aldous M. Catanghal ; Jardine S. Sta. Ana
Acta Medica Philippina 2024;58(13):69-75
BACKGROUND AND OBJECTIVE
COVID-19 pandemic gave rise to an increase in demand for pneumococcal and influenza vaccines. Several approaches to improve vaccination rates among different populations were investigated to address this need. Social media may be used as a platform to promote and improve vaccination rates. The study aimed to determine the effect of social media promotion, on the number of patients requesting vaccination in a government tertiary hospital.
METHODSThe study was conducted using a quasi-experimental design. A telehealth-based vaccination delivery system was established. The need for vaccination against flu and pneumonia was then promoted on a social media platform during the first month of the study. Posters on the risk of not being vaccinated and safety profile of vaccines were added on the second month. The number of requests for vaccination for each month was compared. Social media metrics of the two months of the study were likewise described.
RESULTSA total of 23 requests for vaccination were recorded, 11 on the first month and 12 on the second month. When a boost in advertising for the posts was implemented, twice as many requests were made during the third week of the second month as compared to the previous month (5 vs 10). Social media promotion with poster showed higher average in reach, engagement and comments per week than without poster. The mean differences among the social media metrics, however, were not statistically significant.
CONCLUSIONPromotion with posters resulted in a slight increase in number of vaccination requests. Further increase in requests may require a more refined social media promotional strategy.
Influenza Vaccines ; Pneumococcal Vaccines ; Telemedicine ; Telehealth
10.Effectiveness of the InfoVax Strategy using infographics and infomercial on influenza and pneumococcal vaccination promotion among residents of barangay Pinag-Isang Palad, Commonwealth, Quezon City: A quasi-experimental study.
The Filipino Family Physician 2024;62(1):98-105
BACKGROUND
A community survey on the immunization status of residents in Barangay Pinag-Isang Palad, Old Balara, Quezon City, reflected a low immunization rate of 8% for influenza and 6% for pneumococcal vaccines. Exploring ways to increase awareness on vaccination is important to improve the delivery of primary prevention.
OBJECTIVEThis study aimed to compare the effectiveness of infomercials versus infographics in promoting influenza and pneumococcal vaccination among residents of Barangay Pinag-Isang Palad.
METHODSA quasi-experimental study design using systematic sampling where one group of respondents was assigned to the infomercial intervention, and the other group to the infographics intervention. Each participant completed a self-administered 25-item questionnaire assessing perceived barriers to influenza and pneumococcal vaccination. Wilcoxon signed rank test was used to compare within group changes in scores pre- and post-intervention. Mann-Whitney test was used to determine between group differences in post-intervention scores.
RESULTSA total of 70 respondents representing 70 households in the barangay participated in the study. Respondents were mostly from the 26-35 age group, females with high school education in the service industry, with < P23,381 average monthly income, and good self-reported health status. Comparison of the pre- and post-intervention mean scores of both groups (infomercial and infographics), showed statistically significant change in post-intervention mean scores from baseline. However, comparison of the post-intervention mean scores between groups was not statistically significant. Identified barriers in both groups were challenges in affordability and accessibility of influenza and pneumococcal vaccines.
CONCLUSIONThis study showed that the InfoVax Strategy, using infomercials and infographics, can be effective tools in improving perceptions on influenza and pneumococcal vaccination among residents of Barangay Pinag-Isang Palad. The findings of this study can be applied to communities having similar characteristics. Healthcare providers may improve perceptions on vaccination and subsequent uptake by distributing infographics or playing infomercials aside from public health lectures. Vaccination will help prevent loss of earnings and incrased medication consumption. The local health unit needs to evaluate and address the identified barriers of affordability and accessibility.
Vaccination Promotion ; Vaccination Hesitancy ; Influenza Vaccines ; Pneumococcal Vaccines


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