 Thank you so much and good morning, good afternoon, good evening po sa lahat ng nanonood ng 94th episode of the Stop COVID-Dets webinar series brought to you by the University of the Philippines. Thank you for being part of our credible online community and to all those who have just discovered us today, welcome po at sana po magustuhan po ninyo ang topic for today and for our succeeding webinars. Vaccination has proven to be an effective tool for controlling COVID-19 cases in the adult population, though reinfection is still possible. Vaccination of adults have reduced the individual risk of complications stemming from COVID-19 as well as its associated possible hospitalization from the disease. It also prevents transmission of the virus in the general population. However, recently, information campaigns po na karon po ng massive shift for vaccination. We have already tackled the one for our senior citizens today. We'll be talking about the pediatric population. Children can benefit from vaccination because they can also get very sick from COVID-19 and can have complications such as multi-system inflammatory syndrome, literature points to short and long-term complications po na from COVID-19 affecting also the children. Hindi lang po sa mga tatanda. Unvaccinated children can also contribute to viral transmission. So in today's episode, we will discuss updates on the pediatric vaccination campaign with another excellent panel of distinguished experts, some Dr. Raymond Francis-Sarmiento, director of the National Telehealth Center, National Institutes of Health, University of the Philippines Manila. Always a pleasure to be with all of you, mga ka-friday po natin, and always looking forward to Fridays and getting to host this webinar with my partner and also our adjunct research faculty from the National Telehealth Center, the special envoy of the President for Global Health Initiatives, Dr. Susie Pineda Mercado. Dr. Susie. Hi, good afternoon, Raymond. Kamusta po kayong lahat? Very nice to see everyone again. Sorry, I was not able to chat with you earlier. We used to really, Raymond, do a little chat with our regular participants. Masensyan na kayo kasi I have to call my mother. Anyway, kamusta po kayong lahat. I hope you're all in good health and enjoying relative freedom for those of you who are in the Philippines. Although, Raymond, our topic today is very nice, no? A vaccination of children. Kumapapansin nyo po. Meron tayong campaign kung saan, come your role si Raymond doon eh di ba? Parang siyang bosses ng doctor. We've been doing this little bit of a campaign for vaccination of children because it's really very important to vaccinate the kids, no? So, ito, today, alamin natin ang latest developments. As usual, we have an excellent panel for you, only the best for our Stop COVID Deaths webinar. But, Raymond, before we continue, akong nababahala akong nag-lockdown yung shanghaya. Nakita mo ba yan, Raymond? Yup, pati rin po yung mga continuing rising cases sa ating neighboring countries. So, it looks like it's a surge, pero yan ang tanong natin. Anyway, for our online community, kung meron mga bagong information, we will bring it to you once we have that information. But just monitoring the news, I'm not sure, Raymond, if it's exactly the same strain as what we had when we just finished our Omicron surge or it's a different one. But really, they're locking down shanghaya. So, I think na papanood niyan sa TV na talagang lockdown sila, hindi talagang makalabas ng bahay. So, sabi ko, at least tayo, hindi makakalabas. Tapos, nung naglusan up ng kontin, nakakalabas na kayo pati mga seniors natin, pati na rin yung mga bata. Pero yung mga bata mas maganda kung vacunado sila. So, that they can all have a more normal life, go to school so that the parents won't be so afraid. So, stay with us. We've got a great lineup of speakers and we are going to, I think, really update ourselves on the latest. So ito yung maganda mga speaker natin, mamaya na para medyo suspense. Pero maganda mga speaker natin. Sige, Raymond, over to you. Thank you, Dr. Susie. For those who are also joining us, lalo ang mga miembro ng Philippine Ambulatory Pediatric Association, welcome po. Patanin ang mga miembro ng Philippine Medical Association who are all watching us for today. Oh, Raymond, sorry. We want to welcome all the members of PAPA. Philippine Ambulatory, Raymond already said it and of course the PME, pati Presidentin ang PME, kasama natin ngayon. So, stay with us. Okay, Raymond, go ahead. The questions that we have posed mostly circled around, paano po ba yung pagbabakuna? Nangyayarin din po ba to sa mga sekwelahan? Kasan po ba po yung mga kowan ng assistance or additional information? Pero po ang katanungan na ibinigay po namin sa aming mga in-interview ay ilan taon na ang mga anak ninyo? How old are your children? How are they? Kumusta na sila? And na pagbabakunahan yun na ba sila laban sa COVID-19? Have they been vaccinated against COVID-19? Please watch this. So, we vaccinated na po. Ano, nagbabakuna ko sa roses, ice-covid, nga. Plan naman ako naram naman except na lang pagpulito. Ano, ito, agad ako. Ito, ay nakabakunahan. Ito, ay hindi po yung saktan. Or hindi na ako nakawangan COVID. Ito, isang lalaki at lumbabay, lahat na nabakunahan na. Yung unang bakunan nila, medyo nilagnat. Pero alo lang, mga isa dalawang araw lang, pero okay naman nula naman. Ano, bakunahan na po ako? Medyo po na tako, kasi di po naman ako sanay saan sa pagduturok ko ganan ko. Nung ano po, ang yunyari po, nung first vaccine po, nung tinurukan po ako, medyo po sumakit yung baligad ko. Pero nung kinabukasam po na wala ka naman po. O, madaming bawal kasi bawal yung mabas kung hindi ka puli-vaccinated and underage na. Halos lahat, pwede na, pwede na kong umasak sa mga mall and underage pwede na, since pabakit mo lang yung vaccination type mo akong. Yung second vaccine po, nung una po, wala po ako na rambaman. Kina-gabihan po nung araw na yun. Parang ano po nagtalagnat po ako na unti, linalamig po ako. Tapos kinabukasam po, na wala din po. Kailangan talagay, takot pa siya ako sa krayo. Alam na mga anak ko yun. Kailang wala akong choice kasi lumalabas ako yun, di ba? Alam naman na may project din ako. So, kailangan ako yun, ako yun bibili ng materialist, ako lahat. Ngusupong mangyari yung, ano po, bumalik na po yung face-to-face kasi kumasa na ipuakod doon. Gusto ko nang mag-face-to-face, since para sa akin di effective yung online learning. Since, ba, ano, marami na mga vaccinated na. Saka, may band na mga optional, pwede na nang, siguro mag-face-to-face. Magpabakuna na po para in the future po, baka mag-face-to-face na po, kakailanganin po yung vaccine. Yun kumakatulong po sa atin, madagdagan po yung protection natin laban sa virus na lumalaganap ngayon. Thank you very much. TVUP, I wanna hug these kids when they're so cute. You know, it's really important that we have the kids vaccinated kasi, although it has to be informed, the parents need to understand and the kids need to understand. But I was just reading earlier, Raymond, that yung rates ng mga depression, anxiety sa mga bata, antaas daw eh, all over the world it's very high and we did talk about this last time. But this is one of the reasons why we need to vaccinate the kids, para makalabas si Landy, feel better kasi dalawang taon na rin ahakulong. And speaking of dalawang taon, magdad dalawang taon na tayo, Raymond, our audience doesn't know, alam nyo po. Kami po nila, Raymond, nila direct, Gigi, Rika, everybody who's on this webinar, we have never met each other face-to-face. So I think two years in the making and as always, as we celebrate our second year anniversary, we would like to remember our frontliners. This webinar was really meant for all the frontliners out there who don't have time to really research on everything and can really pick up ideas from these little lectures given by our experts. Well, past year when we celebrated our first anniversary, we gave credit and we remembered our frontline workers who sacrificed their lives in this pandemic. And we want to continue to do that. So we are calling on all of you out there who have any friends or family members who passed away because of COVID-19. We are creating the COVID-19 Heroes Memorial. We have created that and we want to add. So please send us a high resolution portrait, full name date of birth date of death and the occupation. So it has to be a high resolution photograph. We don't want this anniversary to pass without giving due respect and remembering the sacrifice of those who we lost in the pandemic. Okay, Raymond, over to you. Thank you, Dr. Suzie. So it doesn't mean po, although obviously everyone is a bit fatigued and what with two years na po sa COVID, there are silver linings especially dito po sa ating online community. We hope to be able to continue to provide you with quality content week in and week out even after the COVID-19 pandemic. Naglalpa sana po natin ito. And just to reiterate ang ating po mga Filipino medical frontliners, hindi po natin sila makakalimutan. So we really would want to recognize them and maybe immortalize their selfless contributions po as part of our memorial. Just to let everyone know, our webinar can accommodate up to a maximum of 3,000 participants. So please join us in the Zoom to be able to fully experience the interactive program. Although there are times po kasi na mas madali po makakonek po sa YouTube po o sa Facebook. And so we will still be scanning and scouring po the comments section for any questions you may have. In parallel, please put in the chat box kung meron po kayong any comments or if you have any questions already prepared in advance, please feel free to put them in the Q&A section. At ito na po ang next sa part, marahay po nagtanong ang atipubang certificate of attendance ay naibigay na po kompleto, hindi pa po kompleto at least for webinar number 93. But for the previous 92 webinars po, kinumpleto na po namin. So if you have watched at least 50% of the webinar duration but did not receive any certificate para po dito. We will ask our team again kasi marahay po talaga ng chichek. Marahay din po kasi nagmimesage din po doon po sa ating email which is stopcovidets at up.edu.ph para po sa inyong certificates of attendance. We'd like everyone to participate din po, lalo na po dito po sa ating mga 660 plus attendees sa Zoom. To participate sa Zoom poll, doon po sa mga gusubong mag-participate sa menti meter, medyo more interactive na gumagalaw po. Okay din po yun, nga gawin nyo lang po especially for the first timers please open an internet browser. Go to www.menti.com and then when prompted you will be asked to input the code 17531114. That's 17531114 for you to be able to participate in our fun quiz. The same questions posed in the Zoom will be the same questions po na may kita po sa menti. And then finally ang ating po format today, very very simple, our standard panel discussion format. Speakers will be presenting a set of reactions of people weighing in sharing their personal experiences and then the Q&A session. Kung meron ma-invitahan na mag-join po ang aks ng question po nila live to any of our experts po na hindi po natin madali makua so we are very very grateful for them. Please sana po paunlakan nyo po kami at you'll be able to ask those questions to our speakers. Doctor Susie. Okay thank you so much Raymond excited na yung mga mahiileng mag-menti. Maganda yung mga tanong natin anyway. Let's get started and let's start with our opening remarks. We have the president of the Philippine Ambulatory Pediatric Association with a message for us. She is the chair of the medical training office at Medical City and is a practicing ambulatory pediatrician. Pero ito po ang Papa, Philippine Ambulatory Pediatric Association hindi po lahat sila pediatrician, may mga family med, may mga general practitioners. We'd like to welcome all of those who are watching us from Papa and thank you for joining us today. Okay so let's have the message from their president Doctor Edna Sara Clemente Morada. TVU people, please go ahead. Good noon everyone and if you are from overseas, good morning, good afternoon or good evening, whichever applies. Welcome to the special edition of the sub-COVID deaths webinar series entitled Bata Bata Pakonado Kanamba. Just recently I asked my nephew whose son is six years old, that very question in our title and to my surprise the answer was no to the COVID-19 vaccination. He was courageous enough to tell me that he and his wife are scared of the eventuality of this experimental vaccine being injected to their son. I spent a little more time with them in this regular well child visit, more explanations, more patience and more empathy. And so all the more I feel the prick in my heart that webinars such as this should be brought down to the grassroots level, the families where our patients are, where our children are. The parents, grandparents and caregivers of our children would be the conduit for our children's vaccination for without their understanding and giving of consent, our children are left in the dark fending off their protection. To date, most governments are applying the COVID vaccine program for kids. Our government started off with vaccination over 12 to 17 years old, then now the 5 to 11 years old. Our goal is truly to protect them. Moreover, our desire is for our children not to contribute to viral transmission. The benefit outweighing the cost comes as an easy cliche to think of when we handle patient education, but let us as healthcare providers handle this well, whether we are at our homes, clinics, neighborhoods, cafes or wherever. We as members of our organization, the Philippine Ambulatory Pediatric Association Incorporated, are one with the organizers of this event in advocating for the best interests of the child. I hope that this webinar, number 94, will achieve its purpose of shedding light why we need to vaccinate our children. Thank you. Okay, thank you very much. Thank you very much, Dr. Morada. She wanted to join us, but unfortunately, it's coinciding with another event. Now, it's a very special day for us. She's here, Dr. Susie. Oh, Dr. Morada is there. She's on mute lang sorry. Maybe we could have her speak a few words. Oh, sorry. Sorry, ma'am. I wasn't muted pala. So, when you said that I was somewhere and I said, oh, I have to open my camera and said hi, hello to everyone in this webinar. Very timely webinar. Thank you po. Okay, thanks so much. Thank you very much. And we will have you on the panel later. So, maraming salamat. Okay, so that's Dr. Morada. And then we have another message from a very special friend. It's okay na. Paburito nyo po. And very, very active during this pandemic. We really like the partnership that we have had with the Philippine Medical Association. And Dr. Benny Achenza has actually been, what should I say, a driving force behind the national vaccination base for children. And we asked him to come. And give us a special message. Pinaulakan naman nyo tayo. So, let's welcome Dr. Benny Achenza, President of the Philippine Medical Association. Benny, go ahead. Thank you for that kind introduction. So, kina po ako at bilang isa rin pediatration for 27 years. At nagbabakuna po for the last 30 years. On behalf of the Philippine Medical Association, National Officers and Board of Governors, we'd like to congratulate the Organizing Committee of these 94 webinar entitled Bata Bata, Baccunato Kana Ba, your great contribution to our community as a milestone in the time of pandemic. As our country, the Philippines is now on alert one with one of the lowest number of new cases of COVID-19 in our region. This was attained through the public-private partnership in our effort to vaccinate more than 70 million of our population. One of the agenda of this webinar is to give pediatric vaccination updates and to encourage our children from 5 to 17 years old to be vaccinated. Since January 12, 2021, the Philippine Medical Association is taking part in the following steps in participation in the vaccination program of DOH and IATF. We conducted an information campaign to increase the public awareness as to the need for the vaccination. We assisted vaccination compliance with the government list of priorities. We monitored the effects and adverse reactions of patients already vaccinated and we reported to the Department of Health whatever adverse reaction, other information gathered by the individual doctors during and after vaccination. On March 20, 2021, the 119 compound societies together with eight specialty divisions, 90% specialties, 39 affiliate societies, supported and participated the National Vaccination Rollout. On May 27, 2021, the PMA launched sabakuna na kaisa PMA-led voluntary campaign for health professionals that consists of the nurses, med tech, pharmacists, and tech midwives to help in the vaccination drive. On August 23, 2021, PMA joined the vaccine solidarity movement and we pledge that we will be in the forefront of that advocacy and increasing the trust and confidence in vaccination even after this pandemic. We will speak and educate individual families and communities about the value of vaccination. We are proactively participating in that undertaking aim to improve the vaccine trust, confidence, and coverage. On November 21, 2021, the PMA campaign for the whole family vaccination which encouraged a dolly sense 12 to 17 years old to be vaccinated. The Philippine Medical Association is the one who suggested that DOH and ITF NOVO, the National Vaccination Day which was launched by the president together with the representative of PMA me, the World Health Organization, UNICEF, Local Government Units, and DOHs. And on January 25, 2022, Secretary Calves announced that the initial rollout and pace implementation of pediatric 5 to 11 years old group began on February 4, 2022. The Philippine Medical Association expresses its full support for the Department of Health and the National Task Force against COVID-19 in their program providing the COVID-19 vaccines for ages 5 to 11 years old. As mentioned by our joint statement of the Philippine Pediatric Society and the Pediatric Infectious Disease of the Philippines, COVID-19 directly affects children in addition. The pandemic already adversely affected the growth, mental health, learning, and health-seeking behavior of children and their families. Thus, the Philippine Medical Association reiterates the benefits of vaccinating children 5 to 17 years old. The direct benefits include it prevents SARS-CoV-2 infection which includes protecting against severe disease, hospitalization, severe or long-term complications like the multi-systemic inflammatory syndrome of children or mis-see. Another indirect benefit is to reduce the likelihood of transmission will consider the contribution of children in community transmission. And lastly, partially protecting for the disruption of classes and providing safer in-house learning. Thus, the PMA proposed to DOH and IIT FNOBOL that COVID-19 vaccine for 5 to 17 years old group can be directly available in pediatric hospital-based clinics to preserve the cold chain. We must strengthen the foundation of the primary health care system in our respective community. We must teach our children, our youth, together with their parents and let them involved in health-related activities like vaccination. Katulad ko po sa clinic talaga po, ini-encourage ko ang aking mga patient at nakakatawa, even yung mga pacienti ko po na may comorbidity sila po kung punta sa clinic for their medical certificate. Again, thank you, University of the Philippines and the National Telehealth Center. Mabuhay po ang Philippine Medical Association. Mabuhay po ang National Telehealth Center and the PMA working together as one. Magandang tanghali ko sa yung lahat. Thank you very much to Dr. Benia Chen sa All the Philippine Medical Association. Our country is very, very fortunate. Nasi Benia yung Presidentin ng PMA. Kasi nakikita nyo dun sa aura niya na he's able to bring everyone together and that's really what we need and I think that's the thing that has helped us get through where we are now. Saludo ko, Benny, always very inspiring to have you here na paunakan mo kami na you're here nga kasi malapit sa puso mo to. Hindi pa naman completely tapos na as you said there are many other vaccinations that our children need but really the role of the Philippine Medical Association in fighting this pandemic has really been top-notch and it's because of your leadership. So thank you so much, Benny. So over to you Raymond. Dr. Suzie, thank you. Just echoing the sentiments of Dr. Suzie. Maraming salamat po, Dr. Benny Achenza. Right now, we'll move on po sa ating fun quiz. Maybe we can have both on Zoom and Mentimeter ang ating pun dalawang katanungan. It's a little bit unorthodox kasi po isa po in English at lang isap mamang po ay in Filipino but never de-less na po. Understandable especially for those who are based outside of the Philippines. The first of two questions is as follows po which COVID-19 vaccines can be given to children? Is it Pfizer? Is it J&J? Is it Sinovac? Or AstraZeneca? Hindi po talaga nilista yung mga all of the vaccines na meron po yan pero may isap po yan na talaga nga malalaman nyo po na tamang kasagutan. Yung po ang pwede po ibigay sa bata ha? Hindi mga lumilipat. Hindi mga pwede po ibigay sa bata po. Okay, so while we are waiting I'd like to greet those from Tuao District Hospital in Kagayan RSU Cabaro-Guis in Kirino, the city of the Philippines in Pasay City, Corazon Loxin, Montaliba, Memorial in Bacolod Negros Occidental, the LG of Consolation in Sibu, Sambuanga City Health Office in Sambuanga Del Sur and all of those that are in the chat po. I don't know if you are unable po to put in sa ating zoom poll kasi I'm seeing the questions po here sorry the answers here in the chat but hopefully you are able to put your answers in the zoom po or in Mentimeter. Our second question for today ay dapat pa bang pabakonahan ang mga bata na COVID-19? Ang question po is yung bata di pa nabakonahan na COVID and then madali ng putang o-o, hindi or e-one so yung po ang options po natin also like to greet those from the National Center for Global Health and Medicine in Japan from Chunin Hospital in Taipei, Taiwan the Ministry of Health in Bandar Seribigawan in Brunei ngayon tayo Hock Royal Clinics in Vietnam our friend from Algeria those from Mumbai, India Lunichi Alley University of Bleeda 2 obviously is from Nigeria those from University of Haile Saudi Arabia Prince Sultan Military College of Health Sciences in Damam in Saudi Arabia also and Quasim University in Burrida in Saudi Arabia King Saoud Bin Abdulaziz University for Health Sciences in Jeddah those from Stockton, California Burbank, California Edmonton, Alberta in Canada and St. Eustaceous Auxiliary Home Foundation Netherlands Antilles we will not be closing po muna just yet ang atin po ang fun quiz answers po to the questions so I think they're still very very much engaged but I think for some reason they're not able to put it in the zoom as we move on to our very first presenter okay thank you very much thank you very much Raymond and for those of you who have questions we have the Q&A box and it's just my pleasure to introduce I would say when we write the history of this pandemic she is probably the most effective clinical communicator and we've had her a couple of times we bring you only the best speakers so we would like to introduce someone you've met before she's been with us a number of times and I hope you agree with me na among the clinicians she's probably the best communicator we've had so we would like to welcome Dr. Annalisa Onliem who is a member of the DOH Technical Advisory Group for Pediatric Infectious Disease and she is also faculty of the University of the Philippines and the College of Medicine so let's have Anna Anna, welcome thank you ma'am Susie for the very kind introduction and the kind words it's a pleasure to be with the team once again I really enjoy engaging with this community talagang sulit na sulit yung oras natin umaabut talagang nalampas alastos kasi very engaged ang ating audience and they really have a lot of questions and very practical once at that and my understanding is we're reaching out to people who are really in the front lines and so ang ating tanong ngayon for today na gusto natin saan ang mapagusapan ang mas maayos ay yung usapin tungkol sa pangbabakuna na mga bata si Dr. Dee Dee started off this discussion with a story that I think many of us can relate to kasi I'm sure meron tayong mga kaibigan kamag anak na kung kukumustahin natin sila na mismo magsasabi sa ating na medyo nagaalangan sila or kinakabahan sila to make that decision about having their kids vaccinated and maaring nang gagaling ito from many different factors pwede kakulangan sa kakaalaman pwede nga gala ng takot or kabah and I hope with this session we'll be able to take off from what I'll be discussing to explore those topics para pagkatapos itong pag-uusap natin meron tayong pagkakataon to share our knowledge with the people we come to interact with and really encourage for kids to be vaccinated so let me get my slides online and just walk you through the questions that we'd like to answer which are very simply while Anna's getting that online sorry na kawin pa lang ako while Anna's getting her presentation online please use the chat box the Q&A box for your questions kaya kita ko na marami kayong mga tanong so we have some experts for going to other experts o Anna yun na pala so use the Q&A for all your questions and we're going to ask our experts to try to answer them in the Q&A box but we'll also save some for the open forum so thank you thanks for the save so we're just going to be going through a couple of very simple questions kasi I'm sure marami na rin nakakaintindi to pull sa bakuna sa ating audience but I just like to make sure that we all are aligned with respect to the answers to these questions so first why should children be vaccinated and then we'll go on to a brief discussion of what has been the progress so far and then go on to the critical question of what should we watch out for so I always like to start with this situation or para na iintindihan natin yung context kung na saan na tayo ngayon globally hindi pa rin bumababa ang case counts actually parang I would say very blessed tayo sa Pilipinas kasi halos 2-1 ng mababa yung number of cases natin and in fact kung tayo ay na sa PGH di pa parang nakakapanibago nakit-face-to-face na tayo nababawasa na yung mga pacientes sa bayanihan ward nagbubukas na yung iba mga services natin and I think that's the situation in the entire country pero alam ba ninyo nag globally medyo matindi pa ang tama talaga ng COVID over a million cases are still being registered daily with over 6 million cases registered to date with over 6 million deaths and kung titig na natin ang global map so this one is cumulative medyo ang kulay natin na sa dark range tayo ay pinatawag na medyo we have a high incidence and this is very understandable kasi siguro yung isang unique factor sa Pilipinas is the fact that we never really closed our borders totally atanggap pa rin tayo ng atin mga kababayang bumabalik sa Pilipinas and of course hindi may iwasan na kahit na mayingat na mayingat tayo yung sa tinatawag the door four door strategy at tinatest at kinakwarrantine natin yung mga umuwe mayroon at mayroon pa rin mag falls negative sa testing and yung iba naman na palitaan tinatin nige sumunod sa tamang quarantine and naging dahan sila at na palitaan na na mayroon na kasi na nilang ako na magpag-lapit naka-lapit sa Pilipinas nangay nangay sa 3.6 million cases and unfortunately we still we also had no quite a number of deaths si Dr. Rasouci mentioned at one of the reasons why this top COVID webinar was really put up issue. So marami dito sa mga nangamatay ay kakilalan natin kay vegan ka-familya ka-trabaho and hanggang ngayon goal pa rin natin na ma-pigilan ng mga kaso at mga naman matay. If we look at the graph showed in the bottom part of the slide, you will see that we are currently at the down or at the tail of a very huge peak but this followed initially a surge in September of last year that was eventually attributed to the spread of the delta variant of concern. Syempre pagkatapos niyan inaabot din ang ponting panahon pago bumababa ang kaso. Karang diwan mga dalawa ang gandang tatong buan niyan na pago nag-denormalize and by God's grace ang pagbababan ang kaso talagang sumabay din sa Christmas holidays and well kung isipin natin whether my surge or wala talagang magkikita-kita ang mga tao over Christmas lalo na nito nang nakaraang taon da, dalawang taon na tayong hindi nag-pukumpul-kumpul and really it was very hard to get people to stop getting together in any case nangyari at nangyari okay lang sana kung kakaunti lang yung uptake pero ang problema sumabay siya sa introduction ang Omicron which then really drove these cases to the point where we were dealing with hundreds and thousands of cases on a weekly basis. Siguro ang kagandahan na lang nito is Omicron relatively was less severe compared to the previous BOCs. If we look at the demographic data you will see that most of the cases are really clustered around the more mobile working population so between 20 to 59 years old and most of the deaths are clustered around our more senior members of the population who presumably will also represent the ones who have most comorbidities. Ang pag-uusapan kasi talaga natin ay mga bata so we're interested to find out what happens to kids and you will see here that the cases are really quite low and the deaths as well. So overall about 11% of cases and about 2% of the deaths belong to the pediatric age group. So kung sinasabi natin ang ating motivation to vaccinate is to prevent severe and critical disease and to decrease the risk of death, kung titig na natin yung global data siyempre maraming kaso kung titig na natin ang local data siyempre maraming kaso bakit we break it down, parang teka lang ang kung titi lang naman ang mga bata na nagkakasakit o naman matay. So bakit natin sila kailangan bakunahan? Nakakamay mababago ba kung idinagdag natin doon sa mga binapakunahan natin? So this table shows us some reasons why we would encourage vaccination. Siyempre unang-unang na yung individual protection. We know that the vaccines are quite effective in protecting against severe and critical disease and death regardless of the age group. Meron ding evidence ngayon na lumalabas na meron siyang impact on transmission and ngayon na nakikilala na natin na merong mga complications na lumalabas pagkatapos magkasakit, gusto rin natin na maiwasan to mga complication na ito by providing the different age groups with vaccination. So in adults, tipikali ang iniiwasan natin ay yung mga sequela ng matinding COVID so may mga kilala tayo or meron tayo mga naging pasyente na pagkatapos sila magkakovid ay hindi na talaga bumalik sa normal ang kanilang health status. Puntitig na natin ang global data, you will see in the literature that there is a high risk of mortality even post discharge coming from sequelae of COVID. We also know that there is documentation of the phenomenon called long COVID which is increasingly being recognized as a complication of the disease. There are also now studies coming out about the impact of COVID on neurocognitive functions which are only now being recognized. Sa mga bata ang problema na dinadala ng COVID ay yung tinatawag ng BC and this is recognized even among kids who had mild or asymptomatic infections. Hindi kay lang ang maging severe ang pinagdaanan na COVID para magkaroon ng MIS-C anywhere from two to four weeks down the road. And so protection against the health impact of COVID is a primary reason for pushing vaccination for all age groups including children. Pero para sa mga bata, mahalaga din yung effecto ng COVID with respect to their development as individuals. So nakita natin na isa ang Pilipina sa mga bansang pinakamatagal ang panahon ng school closures and we actually ended our last school year na face to face noong March of 2020 at nito lang November of 2021 nagsimulang magpilot for about 100 schools, 5,000 students and this is a drop in the bucket when you think about the number of the school going population which is 27 million. So nito pa lang tayo nagsimula ng pagpasok na banggit kanina ng ating mga speakers na malaking problema ang mental health and isa ito sa mga pwedeng sagutin ng pagbabakuna ng mga bata na mabibigan sila ng pagkakataon to become more mobile and the indirect impacts of societal closure can also be addressed by providing kids with protection should they be allowed to become more mobile. Ang isa pang kailangan natin isa iperish that every age group has a contribution to the return to pre-pandemic activity and economic stability and even as we keep the health considerations in the forefront, we have to also remember that COVID did not only place an impact or push it, place an impact on health but also on all aspects of our community like including economic activity. So sa Pilipinas, meron tayong sistema para masubaybayano ang mga bakunang ipinapasok natin sa ating national program and matapos mabigyan ng emergency use authorization ng Philippine FDA ang bakunang nag-apply para ma-isama sa programa sumusunod ang H-TAC to evaluate whether this vaccine is going to be beneficial to society should the programs choose to procure it. And basit dun sa ating H-TAC evaluation, there is a positive recommendation for DOH to implement a vaccination program for the adolescent population. This covers the 12-17 year old age group at ang kanilang mga bakunang approval para isama sa ating programa ay yung pinatawag na mRNA vaccines which include Pfizer, BioNTech, and Moderna. Para naman sa mga younger populations aged 5-11 years old, iisa palamang or rather there are two vaccines that have been granted EUAs which is the Pfizer, BioNTech, and Sinovac. I'd like to specify of course that Sinovac starts their EUA at 6 years old, hindi sa up yung 5 years old, pero nag-iisa palamang yung my positive recommendation galing sa H-TAC which is the Pfizer, BioNTech vaccine. Sa ngayon pinag-aaralan pa rin o pa tulay pa rin pinag-aaralan ng H-TAC kung they will come up with a positive recommendation for Sinovac implementation. So ano pa yung pinag-mulan ng mga recommendation nato ng FDA and H-TAC? We will be going through a couple of studies looking at efficacy and effectiveness but before we start on those discussions, I'd like to review once again with you ano pa pinag-kaiba ng efficacy and effectiveness hindi kasi yan magkatulad kahit na magkatunog yung mga salita. When we talk about efficacy, this refers to how the vaccine performs in controlled clinical trials. This is ideal conditions. Pwede mong piliy and ponsay nyo yung mga paciente. Ano ang kanilang characteristics? Ka ilan mo sila susubay ba yan? Ano ang gagawin mo sa kanilang test procedures? Ano ang babantayan mo sa kanila? And siyempre, dito talaga nang sisi mula. Ang lahat ng mga bakuna, gusto natin maganda ang safety and efficacy data. Unang-una pa rin ang safety kasi kahit efficacious, kahit maganda ang performance sa clinical trials kung hindi ligta sa bakuna, wala yung pakinabang sa atin. So safety and efficacy data come first, then eventually as the vaccines are used in wider settings in the community in the real world, you get to generate the effectiveness data. Now karaniwan, bago mapigyan ng TUA ang isang bakuna whether it is for the adult or the pediatric population, kailangan mag-submit ng efficacy data ang manufacturer. Karaniwan na kukuha ito sa mga phase 2, phase 3 trials. And dahil na sa situasyon natin ngayon na meron tayong pandemia at kinakailangan natin ma-access ka agad yung mga bakuna, kahit na ongoing pa lang yung phase 3 trials, tinatapos pa lang siya, nakita natin ang maganda ang visa at safety record dito mga bakunang to and therefore binigyan na nang tinatawag na emergency use authorization. So dahil matapos nung ginamit siya ng mga iba-ibang programa, nagkaroon naman ang effectiveness data that typically supports also the good efficacy and safety results that we already got from the controlled trials. So when we look at the efficacy data, the safety and efficacy data that supported the EUA for particularly the mRNA vaccine, so I'm referring specifically to Pfizer, maganda naman yung mga information na nakukuha natin. So for the adolescent population, this is 12 to 15, the Pfizer mRNA vaccine showed a favorable safety and side effect profile with mainly transient mild to moderate reactogenicity. So karaniwan ang inirereport ay injection site pain, fatigue, and headache. So tulad nung mga kabataan na narilig natin kanina sa interview si Sanders, si Miguel, si Lois, sabi nila, sabi nila, di ba kong ting sakit, inantuk sila matapos yung isayata. I can't remember if it was Miguel or Sanders, si nabi nila nilagnat siya, matapos mga bakunahan the following day. So typically ganun lang, it's not very different from what we adults experience when we were also vaccinated with this mRNA vaccines. Now, eto yung safety or reactogenicity profile. Ano naman yung immunogenicity or yung capacity to produce a protective response? Sabi nung mga pagaaral, the geometric mean ratio of neutralizing titers after those two for the 12 to 15 year olds was actually higher, 1.76 compared to that of the 16 to 25 year old participants. If we compare the antibody response ng mga bata, compared nung sa mga adults na parehong 30 microgram dose ang pinanggap, mas maganda pa ang response na 12 to 20 pa, rather the 12 to 15 year old population. And the safety record was quite good because dun sa kanilang binantayan na magkakaroon ng sakit after nabakunahan, no COVID cases were identified in the vaccinated group, but 16 cases occurred among the placebo recipients. So eto yung pinangbabasihan na sinasabing efficacy was 100%. So let me just put this all into context. This is a clinical trial setting. Ang ginawan nila matapos makatanggap ng ikalawang dose yung mga paciente, tinignan nila kung ilan ang magkakaroon ng sakit may predetermined cut-off, kung umabot na mga about 100 or so cases, ina unblind na yan. At tinignan kung sino yung natamaan yung vaibakunado o hindi. And dito sa dataset na to, nakita nila avalahat ng mga natamaan ay hindi bakunado, kaya pwede nilang ikalpulan ang vaccine efficacy is 100%. Alam natin, siyempre in real life, mas may variation ito da, iba-iba na mga paciente tumatanggap ng bakuna, pwede nga iba yung mga schedules ng pagtanggap, pwede nga iba-iba ang kanilang mga health status, pero as I will show you later in the effectiveness data, makikita pa rin natin na maganda ang safety and effectiveness, hindi lamang efficacy kundi effectiveness or real world protection. Now, looking at the 5 to 11 year old age group, makikita natin na maganda rin ang resulta ng safety and efficacy. So ano ginawa nila dito sa trial na ito, nag-invita sila ng 5 to 11 year old participants, ang tinanggap na mga batang ito ay one-third lamang ng dose na tinatanggap ng 12 to older, dahil ito yung naging resulta ng tinatawag na dose finding or dose ranging status, na magiging mapisa para sa age group na ito. 10 micrograms sa nilaman ng bakuna for 5 to 11 years old, dose 12 and up receive a 30 microgram dose. They saw that based on the neutralization assays, the 5 to 11 year old participants also had very good geometric mean titers, so their zero conversion was very good, nag-react sila ng maayos sa bakuna at kanilang antibody levels ay katong bas nung mga 16 to 25 year olds, which is our standard population. Nakita rin nila na mas marame dun sa mga hindi na bakunahan ang nagkaroon ng sakit. So in comparison to just 3 out of 14-15 participants who were vaccinated who got sick, 16 of their 736 placebo recipients got COVID after they received the second dose. So therefore the conclusion here is that COVID vaccination for the pediatric age group 5 to 11 year old was found to be safe, immunogenic and efficacious. So sabi natin magandang efficacy data, pero totoo bang maganda rin ang effectiveness data, ano pa nangyari nung ginamit na natin ito sa larger population. So this dataset comes from the US and they were looking at the adolescent population who received two doses of COVID vaccine. Again the mRNA vaccine is the only one that has an EUA for this age group. So this is particularly again the Pfizer data and you will see that yung effectiveness o yung visa niya laban sa hospitalization so this is a real life outcome was comparable for that 16 to 18 and the 12 to 15 year old age group. Yung need for ICU or life support was also very good. Pwanti tignan natin comparable din siya dun sa older population and if you will look at the rate of ICU admissions, napakababa nung mga admissions dun sa vacunado kung para dun sa unvaccinated and therefore the conclusion was if you look at the 12 to 18 year old age group, two doses of the vaccine were highly effective in reducing hospitalization and critical illness in this population. So this is real life data observing what's happening to kids who are being admitted to the hospital. Para naman din sa 5 to 11 year old age range. Tandaan natin na itong 5 to 11 year old approval was is really very recent sa Pilipinas nito mga nakaraang 1, halos nakaraang 2 buon lamang natin siya na i-roll out ng maayos and even in the US this just was rolled out late last year so we're just still starting to get the data and they looked at the impact of two doses of the Pfizer vaccine on Omicron. They saw that maypakinabang siya na for the 5 to 11 year old age range, the rate is about 31% among children in this age group and 59% among persons 12 to 15 years. So let me just put this once again into context. Tandaan natin na si Omicron medyo kakaibang variant itong lumitao na ito, magaling siyang lumusot sa ating immune system, meron siyang capacity to have immune escape and karamihan naman kasi din sa ating by the time na umikot si Omicron ay nakalampas na ng aning nabuan from the time we were vaccinated. So maaring ito yung dahilan kung bakit medyo mababa kung para dun sa clinical trial data yun nakikita natin protection. Isa pang kailangan ihighlight is that this is transmission of infection or rather this is infection across all different types. So whether this was mild, moderate, severe or symptomatic, ito yung number na kinokot. We have to realize that when you're talking about a subset of severe and critical disease and death, the numbers are still very, very respectable. Maganda ang nakikita natin risulta among all age groups. So kung meron naman tayong maganda ng evidencia para suportahan ang programa ng pagbabakuna para sa mga bata, ano na ang nangyayari sa atin sa ngayon. So I'd like to thank Dr. Aemon for sharing his access to this data and if you will look at this table coming from the DOH, you will see that we've already administered or the program has already administered over 140 million doses and out of the 239 million doses that are available in the country, over 180 million have already been deployed. So I think this is very, very encouraging for a program that only started in March of 2021. So magiisang taon pa lang tayo sa bakunahan natin and yet ang laki na nang nakukover natin population. And if you will also consider the fact na tayo ay halos ang pumapasok sa isip ko and na malimose, di ba? Kasi talagang by the time that we were accessing doses, marami na nang na una sa atin and we had to make do with whatever was left behind. Maganda na ang takbo ng problema natin na yun. Hindi na dahil pulang ang doses available kung hindi, paano natin siya ida download efficiently. Kasi itig na natin na almost 240 million doses ang nero natin sa Pilipinas, 180 million palamang ang na-deploy and 140 plus million palamang ang na-ituturok. So marami pang pwedeng ibigay at marami pang pwedeng pangbigyan. Ang ating data will also show that karamihan ng mga na-iturok ng bakuna ay nakapocus dito sa NCR+. If you combine the population of NCR Region 3 and Region 4A, it makes up about 38.7 million based on the most recent Philippine census. Pero do you realize that out of the total distributed, 45.8% ang na-ibagsak dito sa mga areas na ito. So kung baga, saturated or maganda naman ang coverage natin dito sa mga NCR plus areas. Pero that should also tell us na medyo mababa ang coverage ng ating remaining areas or regions in the Philippines. So now I'd like to show you the breakdown for priority group. So alam natin na yung A subgroup talagang pinatarget natin kasama na dito yung mga frontline healthcare workers with comorbidities are seniors. Meron tayong pinatawag na pediatric A3 which is the pediatric population with comorbidities. And unfortunately medyo mababa pa rin ang coverage natin dito. So kailangan pa natin yung pangpursigiduhin. If you will look at the age groups, rather the coverage per age group for well individuals, medyo maganda-ganda na yung coverage natin for 12 to 17. Umahabot na halos ng 80%. Yung nakokompleto natin two doses. Pero ang ating 5 to 11 na nagsisimula pa lang barely 10%. So not even 10% yun ako cover natin as fully vaccinated. So once again this shows us how much more work we need to do. So aside from understanding the need for vaccination and understanding our targets, Marami kasi ang nagdadalawang isip or mayroong mga nagdadalawang isip kasi kinakabahan sila about the potential for adverse events following immunization. So it will be good to understand what should we be watching out for. This latest data coming from the end book shows us that out of the 140 plus million doses that have been provided in the country, katinyi lang talaga yung nakikita natin AEFI reports. So hindi man lang siya ahabot ng 25,000 reports out of 140 million doses. Lalu-lalu na kontitig na natin yung pediatric population na napakakonte nung ating AEFI reports. So if you put this together that's about 3,800 reports, karamihan ay non-serious. May kakaunting serious at kontitig na natin yung breakdown nung serious. Karamihan ay nau-hospital sila dahil dun sa mga dizziness, fever, increased blood pressure and so on and so forth. So ito ay mga tinatawag na causally related pero only needing minimal support should they have been hospitalized. Sa atin ang mga 5-11 year olds over 500 reports have been received, 20 have been tagged as serious with 12 hospitalizations and most of the reactions have been or most of the serious reactions have needed hospitalization because of allergies and one case of GDS. So siguro before I leave this topic, siguro I'd like to talk a little bit about causality assessment. Kasi madaling pagbintangan ng bakuna, pagsasabihin natin ay may naramdaman ka after vaccination. Halos automatic iniisip ng mga tao na dalayan ng pagbabakuna. Pero we have to understand that not everything that happens after vaccination is caused by the vaccine. May mga pangkakataon na napapasabay lang, co-incidental rather than fossil and it requires a lot of evaluation to be able to assign causality relationship to a vaccine and say na yung talaga yung pinagmulan ng problema. I like using a very exaggerated example to bring home the point and maybe what we'd like to do as a result of this webinar na pakarami po natin participants, baka pwede natin gawin maya-maya si Doc Raymond magpaparapol and sasabihin niya, sige dahil napakarami natin mga suke na naga-attend ng ating webinar ang gagawin natin pagkatapos nito Pupuntahan ni Doc Raymond, bag bibitit siya ng team at pupuntahan niya sa bahay, ito mga nanalo at dun na siya magbabakuna, home service hindi na kailangan pumila pa yung paciente. And habang siya naman ay nago-observe after vaccination na kita niya na ba, unti-unti na lang nagbago ang pula yung buhok nung kanyang binakunahang paciente. So, siyempre sa kanyang isip, sabihin niya ba ang kaiba naman ito, pero you would not even think to attribute that change in hair color to the vaccination kasi ano ba naman ang relation nun. Pero dahil very generous si Doc Raymond, sampu ang kanyang pinarapol at sampu ang pinuntahan niya, aba lahat pala nung sampung binakunahan niya nagbago yung kulay. So, pag kaganoon na medyo iisipin mo na sandali lang baka may postal relationship, hindi lang nakakatulong para maka-iwa sa sakit, meron pang free hair coloring pag binakunahan natin using this brand. So that happens, meron talagang mga pagkakataon na dahil inobservahan na natin sa dami ng mga nabakunahan, dung pala nating nakikita ito mga very rare side effects of change in hair color or in pediatrics ang na-observahan natin ay yung Mayo Card Diabetes. Pero dahil meron natin systema that captures all of this information, nakikita natin ito at napibigyan natin ang advice ito mga risk populations who need to watch out for these problems. So, kahit nagbinanggit ko kani na nang maganda ang safety record dahil maliit lang yung population na ito, yung ating very rare side effects, very rare adverse events have not been picked up. And only over time and more doses were adverse events following immunization such as Mayo Card Diabetes or TTS or what they call thrombocytopenic thrombotic syndrome or the blood clotting syndrome associated with the vector vaccines, these were picked up. And that's really because we have a system to pick these up. So in the Philippines, ano na ba nakikita natin? Meron tayong mga nagsisimulang reports about Mayo Card Diabetes and as of now, ang ating number is about 11 cases with two cases of very card diabetes. Again, this is in the context of ano nga ba yung denominator natin kanina? Hundreds and thousands of doses. Kaya sinasabi natin this is a very, very rare event. Looking at other countries, kareho ang kanilang data. In the UK, paggano kasi akit ka ng COVID, you have 40 per million cases who will eventually end up with Mayo Card Diabetes. Kung pinakunahan ka, your chances of getting Mayo Card Diabetes after being vaccinated can range anywhere from 1 to 10 depending on the type of vaccine you got and whether it is the first or second dose. Pero kung titig na natin yung 12 to 17 year old males, ano ba risk nila nang mag-develop ng Mayo Card Diabetes matapos magkakubin? 450 cases per million infections. Pero kung nabakunahan ka, ang risk ng Mayo Card Diabetes is 77 cases per million in the same age group. So it is one sixth of the risk of getting the same problem after you get vaccinated. In the US, you have similar data. Actual disease can provide risks of death, sequelae, and other complications but typically you only expect anywhere from 2 to 70 Mayo Card Diabetes cases per million second doses. So napakarareer na adverse event and makikita natin to for specific groups and of course we see this as a balance between risk and benefit. So I hope I've given you information that will help you communicate with your audiences, communicate with the people that you care for about why kids should be vaccinated. Gusto natin mabigyan sila ng protection and gusto rin natin mabigyan sila ng paraan to move about normally in the community. Marami nang bakuna, marami nang nabigyan ng bakuna at maganda ang ating safety record. Pero dahil alam na natin na meron mga adverse events following immunization, meron tayong system ngayon para mabantayan ang ating mga pabataan, na sana naman ay ating maing courage nabang pabakuna. Thank you very much. Okay, thank you very much. That's Dr. Anna Onglim. Alang galing talaga ni Anna. Parang gusto nyo pano rin ulit, you can watch the playback. Kasi, I think tama ka Anna, the challenge is for the frontliners na ito mga audience natin, they actually have to explain to patients. Paganda yung mga binigay ni Anna ng mga reasons kung bakit ito safe at siya bakit siya effective. So thanks so much Anna and I think you'll see how our audience appreciates your excellent presentation. Salamat and I think if you have some time you can take a look at the Q&A box and answer some of the questions if you're not that busy before we go into Q&A. Okay, let's, Raymond, over to you. For our next speaker, mahusay din po ang susunod na speaker natin. Thank you Dr. Suzie. Thank you. I actually appreciated the very out there na example ni Mamana. Nila gano, nila gano. Ito yung people na. Pag nakita ka magbabagawang polay ng mga. Nice, very good example di ba? Thank you so much. For our next speaker naman po, she would be talking about, it's more really on the COVID-19 vaccination of pediatric population but from a different perspective, her role is as head of the paediatric hematology oncology section po at the Philippine General Hospital. Matagal na po natin siyang nakasama and we're very lucky to have her again on the webinar. So please welcome back to the webinar si Dr. Patricia Alcasabas. Hello. Good morning. Good afternoon po sa inyong lahat. Sir Raymond. Suzie, salamat. Salamat po sa pag-invita ulit and congratulations Mamana. Ang ganda-ganda po ng inyong talk. So ang reaction ko po ngayon, tito po sa topic, ay ipakita naman po sa inyo. Bakit napaka-importante po na bakunahan po mga batang may cancer? And being a paediatric oncologist po, ito po ang aking advo kasi na ang 5,200 children, Filipino children who get cancer each year ay mabakunahan po natin para ma-protectahan po sila. So next slide please. So gusto ko po ang sabihin sa simula-simula pa lang hunang pandemic, pinapakita po na ang mga baka po na may underlying comorbidities po, ang unang natatamaan po ng COVID. In this systematic review po of 7,780 children, makikita po na 35% and may core morbidity at yung may mga immunosuppress state, previous slide po, at yung may mga including cancer at hematologic illnesses po ang pinaka marame. Pareho rin po ito, nang nakikita natin sa data po natin locally dun po sa Salvation Registry ng Philippine Pediatric Society, or in this a 559 children and a registered love from 2020 to 2021 na pinaka marame po doon, 30% ang may comorbidity ang pinaka marame doon ay top one ay ang may cancer. Next slide po. So ang mga bata po may cancer, sila na po yung unang tinatamaan at malibang po doon, ang COVID po nila ay mas malala. So dito po nang ongoing po ngayon sa mundo na registry ng childhood cancer patients, as of last night or the other day, 1,500 na po na tala from 51 countries. At makikita nyo po rito na 72% asymptomatic mild moderate pero 10.7% of 1,500 po ay severe meaning, kailangan po nila ng higher level of care at mas marami po ang oxygen support. And then 7.5% naman po sa kanila ang na-intubate. In contrast po sa systematic review na naman po ng mga batang walang cancer, 0.7% lang po ang na-intubate po sa kanila o na ICU. Next slide po. So kaya po ang mga batang may cancer at COVID po, mas malaki po ang chance nila na mamatay na dahil sa COVID. So dito din po sa registry na po, 3.6% po sa kanila po ang humanaw dahil sa COVID, compared naman po natin sa batang walang cancer sa international data set po of systematic reviews, 4,400 plus children, 0.1% lang ang namatay. Pero po kumparan nyo naman ang mga batang may cancer sa mga matatandang may cancer, unfortunately po mas halos triple po ang death rate po ng mga adult cancer patients. Next slide. Thank you. So gusto ko po nga ipakita dito, ano naman po experience po namin dito sa PGH, so si Dr. Paul Sting Ong ang graduate po at tinig nanyo po ang data from March 2020 to March 2021. At nakita po na may 40 cases po kami ng COVID, makikita po dito na 82% may cancer, 40% leukemia, 42% solid tumor po tulad ng brain tumor, bone cancer, and then may benign hematologic illness pang 18% tulad po ng ITP, may G6PD, ganun po. Doon po sa 40 po na to, marami po dito ang ng kikimotherapy, 32 patients. Next slide. Thank you. So gusto ko po nga ipakita na tulad po doon sa international experience, makikita po nyo na 5% po ang nang patientip po namin ang severe at 3% po ay kritika na na intubate, pero dalas sa teamwork po namin dito sa PGH, dahil po may COVID protocol po kami, naman ayos. Wala naman poong namatay sa COVID, may namatay po pero dahil po sa cancer. At ito po yung mga gamot na binigay po namin. Next slide. Thank you. Pero gusto ko rin nung makikita dito, hindi po sila pumanong sa COVID, pero ang laki po ng impact ng COVID po sa amin, kasi po dalawang patienti lang doon sa 32 na may cancer, ang natuloy-tuloy ang gamutan na putul po ang chemotherapy na Trentang patiente ang interruption po lasted from 24 to 35 days mean. Next slide please. So maliban po sa mga batang may cancer, yung mga cancer survivors din po ay at risk for severe COVID, bakit naman? Kasi po marami po sa kanila, anang karuna po nang tinatawag natin therapy related late effects. So yung mga na-affectohan po ang mga organs po nila dahil sa chemotherapy or dahil sa radiation or sa surgery. Halimbawa, may mga patienti po tayo na nabigay po ng antracyclines na nakaka-affecto po ng puso at nang kakarun po sila ng myocarditis or cardiomyopathy or heart failure. Pagdating po nila ng 20 o 30. Meron din po tayo na nagkarun po ng blockage sa heart or coronary artery disease, previous life po dahil po sa radiation. May mga patienti din po na nang karun ang scar, salang dahil po sa chemotherapy like bleomycin radiation. May mga patienti po tayo na yung pung na transplant, nalalo na may side effect po sa chemotherapy, yung pung mga ngayon, lagi po silang may medicines to bring down their immune system. So madali po silang tamaan ng COVID at maging severe. Next slide po. Thank you. So napaka-importante po na dito po sa 5,200 patients each year na Pilipino mga bata na magkakakanser, adolescent and children. Masana po ay bigyan po natin sila talaga ng COVID-19 vaccination. Panong nga ba ibigay? Ito po, personalize po talaga ang pagbibigay ng vacuna. So kung pupunta mo si Dr. Raymond nyo, kasama si Dr. Ray for very personal. So kailangan po natin consultahan po ang oncologist, hematologist, ating physicians para po sa tamang timing. So bibigyan mo natin ang nakikimu at ang cancer survivors. Yung cancer survivors po to check up, kitingnan kung kakayanin po. So pero ang nakikimu po, unang-unang halimbawa po kaka-diagnose lang niya na may cancer. Malaki po yung kanyang paa dahil may cancer siya sa buto. Pwede po siyang bakunahan, bago siyang ang kimu kasi alam nyo po, binabiopsi pa po sila, papadala pa po ang specimen for precise pathology reading. Kas titingnan pa po kung pumalat sa katawa, may cities ka, may MRI. So pwede po magbakuna bago magkimo. Pero po yung pinakakoma na cancer sa bata, yung leukemia, hindi po yan pwede bakunahan sa simula. Dahil po, marami po silang dina-daanan, ay bako po sabihin nagdudugu po yung biba, yung ipapong may lagnat. Dahil po doon sa nature ng sakit na leukemia, wala po talaga silang capacity to mount an immune response, pabibigyan po ang bakunas. So priority po sa kanila ay gamutan. Pwede po silang bakunahan at the later part of their therapy. Now what about those patients na nag-ikimuna? Kailangan po natin hintayin na malampasan na po nila, makar-recover po sila doon sa cycle nila ng chemotherapy. Para po hindi po magkapatong yung kung may rare side effect po yung bakuna, hindi po siya makakapatong o mag-overlap with a side effect po ng chemotherapy. Pangalawa, siyempre gusto natin mag-recover din muna who yung immune system from the chemotherapy, yung CBC po nila, dapat maganda na po yung dimpo side count. At ito po mga batang to, mas maganda po ang response nila sa bakuna pagwala hong steroids at walang infection. Kaya personalize po ang babakuna po sa mga batang may cancer. Kailangan po nila nilang kausapin, konsultihin ang kanila po ang oncologist, hematologist, or kanila mga doctor. Next slide po. So nabangit po yung Mayo Carditis na rare complication, kasi nakikita nga rin po na report po sa mRNA vaccine. Dahil po may chemo-drugs po na nang kukos po ng pericarditis, nang kukos po ng Mayo Carditis, kailangan po malayo po yung bakuna doon sa chemo. So may bakuna po tulad ng doxorubicin, nabinibigay po sa leukemia, sa bone tumor, nabinibigay din po sa lymphoma. Paganoon po, dapat magihintay po ng at least isang minggo, kasi dapat maganda po ang puso, di nakamaan ng chemo. Yung mga citara bin po, ito po yung nasa mga leukemia, AML, kailangan po maghintay na apat na linggo. At ito po ang targeted treatment na immune checkpoint inhibitors, mga six to eight weeks po. Next slide po. Thank you. So may, siyempre po, may mga chemotherapy po na talagang na didi-deplete niya po o nababawasa niya po yung ating antibodies at yung ating lymphocytes that produce antibodies. So pagbipigen po natin sila ng bakuna, kahit na anong bakuna, hindi tatalab. So kailangan po, yung mga nakakuha po ng chemotherapy tulad ng ritoximab, which is pinapatay niya po yung mga billing po sites, magihintay po ng aning nabuan minimun bako ko bigan ng COVID-19 vaccination. Yung mga na transplant po, magihintay ng 2-3 months. Next slide. Thank you. Now, yung po mRNA vaccines po, meron po silang component na PEG, polyethylene glycol, because dito po nilalagay yung nanoparticles ng vaccine. So may mga chemotherapy rin po kami na may PEG, although hindi pa huto FDA approved, pero nabibili po through other companies, for use in leukemia patients. Standard of care na po to sa Amerika. Pagkambata po ay may allergy sa PEG at nabigyan po siya ng mRNA vaccine sa may PEG, maari po talaga mankarun sila ng significant allergic reaction. So kailangan po, recommendation po ay bigay po ito sa hospital. Next slide please. Tapos po, ang recommendation po na American CDC is, in recommendation po, for example itong Italian group of pediatric hematologist ng colleges, is that there should be a third mRNA vaccine booster for immunocompromised patients, cancer patients, and of course yung family members po nila na, according to national guidelines, are eligible for the booster, they should also get the booster shot. Next slide. Thank you. So to conclude po, I hope napakita ko po sa inyo ang urgency po, bakit po mga batang may cancer? Ay dapat po natin talagang bigyan ng COVID-19 vaccination dahil po sila po ay at risk for severe COVID-19 complications, pangalap po na pukutun po ang gamutan po nila sa cancer at increase, at dahil dito baka po sila mag-relax kaadad. Yung COVID-19 vaccination with booster, recommendation po sa mga bata po may cancer, and even do ginagawa po lang talaga ang national guidelines natin for vaccination, marami na po mga iba-ibaing societies at iba-ibaing national working groups na may recommendations na po, na-follow na po namin. Napakimportante po ang timing po ng pabakuna sa batang may cancer po ay dapat personalize at discuss sa inyong po mga doktor. So maraming salamat po sa inyong attention. Thank you very much, Doctor Trish. Marami salamat po at dito po namin na cover yan, especially in our past webinars. But very thankful that you shine a light especially for those na mga bata po na meron po ang sakit na cancer. At paano po ba yung mini-strategy, especially mga magulang na medyo takot po na magpabakuna dahil nga po may sakit na yung kaadilang mga anak? So marami salamat po. Doctor Susie. Thank you very much Trisha. It's really quite refreshing to take a deep dive pre-month into a group of kids with very special needs. I know that during the pandemic parang unang muna ang COVID muna pero paano naman yung mga may sakit na kailangan ng tulong? It's really great. Thank you so much Trisha that was so enlightening. Maraming salamat. Okay, so our next speaker na ko. Pagburito nyo to, hindi lang dahil sa webinar na to, pero tayong kilala nyo po siya. And we were very happy to have her on the webinar. I don't know when, Raymond, maybe a year ago? I think that was last year. Last year. In fact, she said, alami yung ating person on the street, natin na sagit na ng program natin yan. Sabi niya, pag magkakawento tayo, dapat sa simula pa lang nakukonghan na natin audience, kaya nilipat namin yung person on the street to the opening and she was right. So let me just introduce. Someone you know very well because she's a very well-known broadcast journalist and she also covered the health beat for a long time on one of the major networks. Pero kilala po siya dahil siya isang mommy, at siya po ay magbibigay sa atin ang perspektivo ng mga nanae. Kasi tayong mga nasa front line, mas alam na natin yung mga kelangan sabihin. Pero ito naman, pakinggan natin yung pananaw ng isang nakakaalam naman pero merong mga pangamba. So I'd like to welcome back to our webinar, Ninya Corpus. Ninya, welcome to the webinar. Hello, good afternoon Dr. Suzy, Dr. Raymond and all the doctors who are here with us today. Thank you for having me again. Maraming salamat po. I'm here to talk about my experience bilang isang ina. So some of you may know I have three kids. I have a nine-year-old, a seven-year-old and a four-year-old. I'm a mom to three young kids under the age of 12. So dung kame papasok sa five to eleven-year-old pagdating sa COVID vaccines. Like most parents with young kids, I was very, very concerned about the COVID vaccine. Siguro mas madali sa akin kung pin-aged yung anak ko pero despite all I knew, despite covering the health beat for a long time and interviewing all the experts, I was still at the end of the day conflicted as a parent. Hindi pa rin ako 100% pagdating sa pagbabakuna ng aking mga anak. Okay, I just wanted to ask kung nakikita nyo ba ako sa screen, ako ba yung nag... Yes, we can see you. We can see you on the screen ninyang. Screen ko. Okay, nag-freeze pero okay, that's good that you can see me. Okay ka na ninyang, okay ka na. So can you imagine, ako, I would say na health. Advocate na ako, nag-interview na ako ng experts, pero minsan pa tina nung ko yung mga doctor, friends ko, na may mga batanganak like me yung mga below 12. Hindi lang sila ganong kakonfident. Hindi ko nang imimension, but kung yung mga doctor na kaibigan ko, hindi ganong kakonfident, how much more yung mga ordinary parents like us hindi ba. Pero may hindi mo kasi in the case of COVID, everything is so new, so nobody knew all the answers. And we had to make a firm decision based on uncertainty. So this is my experience as a parent. It was a question of, sabi nga nang isa ko pang doctor friend, anami ko nang doctor friend, sabi nga, do you want them to get just the spike protein or the whole virus? Sabi nga. I'd get the spike protein any day. So kung baga tina tanong nga, kung gusmo parte lang ba ng virus na yan, na makukuhang mo sa vacuna, gusong mga COVID makukuhang mo lahat ng virus na yan. Syempre mas gusto natin makuha yung lesser evil. Yung ipan naman may pag-iisip na, actually pumasokin to sa isipan ko, I will not deny it. Yung ibao na COVID na yung anak ko, na COVID na ako, yung immune na ako, hindi na ako magpapabakuna. Pero di ba nangakarinigran tayo ng mga historia na yung ibang tao nagka-COVID hindi naman isang beses, pwede kang mag-COVID ulit. So yun yung mga possibilities na sa isipan ko. So it was really at the end of the day, I had to weigh ano ba talaga yung mas beneficial para sa aking mga bakta, sa mga aking mga anak, despite all the uncertainties. So ito, I will just share a video of how it went for us for my 9-year-old and my 7-year-old na recently, last month, I think nagpapakuna against COVID sa kanilang school. So let me just share yung experience nila, panodin natin itong video kung sa anek pa bakuna sila na parang may birthday party. I'll just press play. Okay, that was very fast. What did you get then? A lollipop? So that was our experience. We saw all that, as you can see, it was a very pleasant experience for my kids who were also very scared, of course, going in there kasi na anything na injection related naman, di ba? But when they got there, everybody was very welcoming, everybody was smiling, yung mga naga-assured, naka-headband ng ano, ng mga animals, ganyan, and they played music videos and all that. So at least kahit pa pano, my kids and I, as a parent, felt better going in there and I felt that I was doing the right thing. So in my experience, after our vaccination, my kids were fine. They did not have any of those side effects except na sumakit lang yung arm nila sa area where it was injected. But they went about their usual activities, tako dito, tako doon. So it was really nothing, parang wala. So it gave me more confidence once again kasi na I saw what happened during and then after and then of course lahat tayo, sabi na natin uncertain future. But siguro, what can we do, di ba? We have to live, continue living with COVID and for me right now as a parent, I think it's really the best decision, the best choice for me to vaccinate the adults and of course our kids. So that's it. That's my experience as a mom of young kids. Thank you for watching and thank you for listening. Okay, thank you very much. Wala. Okay, there we go. Okay, sorry. So Raymond, ako muna. Ika muna, Raymond. Well, just really appreciative of the fact that Nina was able to share something a bit more personal. When we were trying to go ahead and plan for this webinar, we heard that there were, well, not just the information gathered, but more personal in terms of having children that have had COVID was still necessary for them to be vaccinated. And along with all of the information that was gathered. But so thank you, thank you for sharing that with all of our audience members here for this webinar, Nina. Okay, so maraming salamat, Nina. In fact, one of our participants, Raymond, is saying that's a depth ed. May I request for IEC materials with your clips that we can use in our vaccination campaign for depth ed. So we'll ask Nina if she's willing to share that. And also our materials, Raymond. So speaking of our materials, we are now, so Nina, una, thank you so much. Ondakan mo kami. We know you're very busy, but our audience loves you. You're gonna see they really like you. So you're gonna see in the chat. Okay. Sir, I hear this video if it would help the public. Yes. Yeah, thanks. You're part of our community. So please share, no? Okay, so we're gonna ask our guests to open their videos. So Anna, Trisha, Nina, Benny, I don't know if Diding is still here. Still here. Okay, so everyone open your videos because we're going to do a panel discussion. But Raymond is going to introduce information campaign materials. Go ahead, Raymond. Thank you, Dr. Suzie. Before we go into the RQ&A session, we'll be taking a very quick break and you've already seen this is part of our special public service announcement for today. Maari nabang mga pabakuna ang mga baka di ma, hanggang 11 taong ulang? Oo, nagsimula ito ng Pabrego. Oo, nagpabakuna na kami. Pero mga bata, magpabakuna na kayo. Stay safe and stay well. Mga bata, magpasama na sa Bakuna Center. Thank you so much, TVUP at the COVID Communication Public Service Announcement is one of the many creative outputs of the stuff COVID that's webinar team to push for the pediatric COVID-19 vaccination for children age 5 and up. We hope you can share this message to everyone po, lalala po yung mga magulang, mga guardians po, mga nagalaga po ng mga bata, so that they have more information with regard to protecting the children against COVID-19. Dr. Susie. Yeah, share natin Raymond, kaya ano, no, takat. Tagadep, edin. Yes, Joyce, I think was the name. Joyce. We'll send you the materials, Joyce. Mala na si Raymond. Okay, so we have everyone on the panel now. First of all, I'd like to thank everyone. This has really been such a informative session. And we do have, we do have some time about 10 minutes or so to have a little bit of a discussion. And I think, Raymond, in the presentations were all very good. And maybe what we should do is pick up some of the questions that are in the Q&A or the chat box. Raymond, what do you have? Well, I'll pick one, the one that Dr. Ana has indicated she wants to answer live. And this is from Mercedes. She who has been volunteering as a screener in LGU vaccination sites. And she's really appreciative of well, the communications being done by Dr. Ana, especially on how to deal with patients anxieties and misinformation. And she has been asked by patients and well, parents of those patients. There was, I hope I'm reading this correctly. There's an ex-undersecretary who had 17-year-old child but died recently. And ang tinuturupon dahilan ay ang COVID-19 vaccine for this unfortunate incident. So her question would be how should she or how would she answer the question just to be able to explain it a bit better to the patient and patient's parents. Dr. Ana. Yeah. Thanks Raymond for picking that question up. Actually ang hirap kasing sagotin sa chatte ang daming mga side issues na kailangan yung mayhima yung dito. So siguro at the most superficial level unang-unang we acknowledge that there is such a report. It's actually been discussed already by the Regional AEFI Committee. It is now with the National AEFI Committee and as I mentioned yung causality assessment ang mahalaga gene hindi natin sinasabit ang dahat na nangyayari after mabakunahan ay kasalanan ang bakuna pero kung nangyayari siya very near that time na nabakunahan ka siyemple iisipin mo it's a possibility and therefore the role of these AEFI committees is to try to figure out may causality nga ba dapat bang isipin na galing to sa bakuna o nagkataula so nandudun yan na yun so that's something we can communicate with our patients. Now pangalawa siguro kung nabigyan nalang natin ng let's say let's assume the worst case scenario at talagang related sa vaccine papano natin to sasabutin tandaan natin na itong binibigay natin sa mga bata yun tinatawag na mRNA vaccines halos wala itong association dun sa phenomenon ng blood clots or bleeding kaya nga medyo hirap silang yimayin itong kasong ito kasi unfortunately nangyari dito sa batang to more of a bleeding disorder hindi yung mayocarditis so para kung iisipin natin medyo malayo yata hindi naman natin inaasahan to mga Pfizer vaccines or Moderna vaccines na magiging cost ng bleeding most of the time kung meron man na ipapakitang adverse event na very severe it's really the mayocarditis and hindi naman yun yun nakita dito sa atin paciente pangatlo let's say nalang na masyada naman suertehin to batang ito at talagang galing sa vacuna again yung concepto na very rare with the chances you actually getting mayocarditis is less than the chance of being hit by lightning may ganoon yan may mga ganun klasing comparisons and of course ilan baka kailala natin sa talambuhay natin ang natamaan ng kid blood parang wala pa naman yata so siguro so broong suerte muna kumatamaan kari ng mga severe adverse events so it's just really to show that the adverse events are being recognized in this particular case medyo parang there's a real question about talagabang galing sa vacuna kasi tinitignan pa medyo it's out of the ordinary from what has been shared in the literature and even if we make the worst case assumption at related siya the events are really very rare now if you'll allow me to share ninya ninya kanina I find it so interesting kasi because she was highlighting several aspects na I think we might want to discuss also in the panel yun na banggit niya na siguro kung teenager na mas kaya niyang mag decision kaysa sa maliit na bata I think I'd like to explore that so may deteren siya nga ba kung teenager saka smaller kids tapos yun na banggit niyang example na may mga kinausak siyang doctors and the doctors are also about vaccinations so that's also something that's very important to highlight at di ba sinasabi natin healthcare worker recommendation is one of the driving forces for a positive vaccine update so tayo bilang healthcare workers dito sa audience na to we need to be able to with confidence na make these recommendations kailangan na intindihan natin yung bakuna and then yung nabanggit niya kanina yung feeling that she was doing the right thing ay I think one of the things that really resonate with parents is ayung kung maging kasalanan po dahil dinesisionan po yung pagkapahamak ng anakodal na bakunahan siya siyepin sinuban nang magulang ang may gustong mangyari no so it's a question of are you more comfortable with an error of omission hindi ko dinesisionan or an error of omission nagsisionan ko at may nangyari pero tandaan natin our deciding not to vaccinate is also a decision to increase the risk of our kids getting sick niba? hindi natin iliwasan nga natin yung decision para magpabakuna pero naging decision yun para itasang risk na magkasakatang ating anak so paano tayo mag-dinesision ng din yan parehong parehong may risk kaya ay thank you sinabi niya in the end na I felt I was doing the right thing parang she went through that process and maybe it will help to surface that to the patients that we talk to to help them process it at makagawa ng mag-dinesision Thank you Thanks Anna Let's get a quick reaction from Tricia and from Benny and also from Minya on what Anna just said So Benny ano ang reaction mo do sa sinasabi ni Anna about the doctors who are ill-t kasi ano yan parang sa tama si Anna parang actually kung ano sa sabihin ng healthcare worker pag may sinabi kayong conting duda times 100 yun sa utak ng patient So go ahead Benny Let's talk about that Yes, I will share the picture of my patient kasi this patient kasi is a 10 year old na with history of ano siya with his yung ano a patient with congenital hydrocephalus and dextroysculiosis Sibirysculiosisculiosis tapos after 3 years ngayon lang pumunta 2 years daw nagtag sa bahay kasi na tatakot yung yun lahat sila vaccinated na is a 10 year old na patient ko na after the operation wala siyang ano ang galing-galing niya wala siyang nararamdama wala siyang actually wala siyang maintenance kasi may VIP siya and then ang nakakatawa ay bakit magbabakon na siya kasi nakita po kaya sa TV tapos yung inyong poster sa Pilipi Pijati Society na inganyu siya siya mismo nagsabi sa parents niya kasi lahat vaccinated na siya nilang hindi nakakatawa kasi sila yung pumunta sa clinic at saka na inganyu sabi pa niya pwede ko bang e-post yung picture niya sabihin ko na siya e-patient ko na nakasurvive siya sa hydrocephalus na nang VIP patient siya na wala ng complication tumantawa siya kasi yung bang inanon nila yung utang naloob nila sa akin na dahil na siya na hydrocephalus tapos siya kailin siya despite na may nila sa doctor tapos sabi pangan nila ay Iyan ko sa inong sa mga patient sa mga kamananak nila kaya nang pupunta siya sa akin iven yung wala ko mo ang komorbidities kakapagapa na certificate ng ganun Ano naman, this video naman kasi automatic, tinanong ko lang kasi after three years na hindi po, two years na hindi po muntas sa clinic, nagpabakasin naman sila ng flu at kaya hepatitis A, tinanong ko lang siya, tinanong ko lang, this is a five-year-old patient. What do you know about the vaccine? I know that the vaccine protects you from diseases and viruses. Yes, the disease and viruses. Do you want to be vaccinated with COVID-19 vaccine? Yes, because first, I don't want to die. Second, I am afraid to die. Third, I am too young to die. What else? Is it all about dying? No, but... Then the second video is the brother seven-year-old. Tingyan yung deepiness. You are here to be vaccinated today. What is the importance of vaccination? So that I don't catch the disease. What else? And you don't catch it? How do you know about the vaccine? YouTube. Yes. What it says? It says the vaccine is filled with weaker viruses and it helps find the virus. Wait, I think I forgot it. I watched that two months ago. Two months ago? Do you want to be vaccinated with COVID-19 vaccine? Yes. Yes? I don't want to get sick and die. Tingyan yung nakakatawa. You are so cute. Nakakatawa kasi hindi isya iscripted. Dalang gali sa kaya tinangyong sumado. Sabi niya, hindi daw naman niya tinong nakita lang sa YouTube. Sabi ko tama. Budein tama ng information nakita niya sa YouTube. Ang gale nga lang. Yes. Thank you. That's very, very cute. I want to hug these kids. Wait, D-Ding is here before we go to Nina. We're going to ask D-Ding also has been seeing patients and we'll go to Patricia. Okay, go ahead. I wanted to continue ko anong sinabi ni Doc Benny yung nakita sa YouTube. Tapos niya, to my surprise, let me start off with the families diba? The families that you are with. I belong kasi to a very big family, 11 siblings kami. So, I thought that our messenger group would say na, okay, go na to your LGUs for the COVID vaccine. So, I share information there and all. And sometimes I have this, we talk about communication skills. Diba, akala ko. Nasabi ko na sa kanila. But one thing I've learned when I encountered my nephew for a well child visit. Oh ano, nababakuna nabakayo. Hindi pang anti. So, para, I felt a little bit guilty. Sabi ko, oh my, di ko pa pala siya talagang napaliwanag ng gusto. So, it is upon myself, you know, that me as a healthcare provider, as a clinician, we don't presume that everyone is understanding what is circulating around. And did you know why they don't like to be vaccinated? May nakita lang sila sa Facebook na story na video ng isang ina. Oh, yan, anak, pag jollybee tayo kasi magbabakuna ka na. Hindi nag-re-celebrate muna sila na una. Pag atapos, noon, or balikta, I'm not really quite sure na. Big lang na hospital ang anak, no? Seven-year-old. So, sabi, pinos ng pamaking ko, auntie, this is the one that I saw. One episode of a social media, a circulation, it is scared. My relative very much. Yeah, thank you, thank you for sharing that, Trisha, no? And that's why our ability to convince with the face-to-face discussion or whether it's a telehealth discussion or not. Actually, the healthcare workers have a lot more influence than social media but we have to use our influence. Okay, so let's go to Trisha and then I'm going to go to Nina. Nina. Okay, Trisha, ikaw, on experience ko naman. Ako naman, yung mga cancer survivors na patients ko na, hindi ko na nakikiti nila ko follow sa clinics. Kadini tumatawag na na lang kasi gusto nga nila na check-up bago sila magpacovid vaccine. But ang na-realize ko with this talk and trying to study for this talk, no? Is that we really need to empower and provide strategies for the pediatric oncologist and mutology so that they can have their patients vaccinated. Alam nyo po, walang social distancing sa mga vaccination sites. And a cancer patient na immunocompromise. You don't want to go to that area namin mga hundreds, no? But there is a way and there is a strategy. When we ask our families nito sa PGH about the vaccination, takut pa sila. So I think with Ma'am Anna's help, we can do something for our patients dito and then try to empower yung society of pediatric oncology and hematology to promote this as our advocacy. Thank you. Thank you Trisha, Nina. Can you address this issue about, nasabi na natin pero hindi pa lang, it didn't sink in. Kasi parang minsan naisip natin na. Basit nasabi ng minsan, yun ay oan, tiba? Can you talk about that Nina, you're an expert communicator. Paulit-ulit kay langan, tiba? Actually Doctor, that's true paulit-ulit kait minsan na kulit na. Although minsan, dependerin pa sa strategy ba ka minsan na ko kulitan na rin yung mga tao. And then mean, dependerin sa approach kasi alam ko na yan eh. Pero alam mo I feel, I still have uncertainty as a parent and could you please acknowledge these feelings that I have? It can't be, ah, maggang matakot, takut ako eh. So parang sa bata din, like when my kids feel uncertain piece or they feel scared, I don't brush it off right away and say ako ang tama. So I tell them, you know, your feelings are not bad. It's totally legitimate for you to have feelings of uncertainty or kung takut ka, it's fine. But let me explain to you why you need to do this. So matalino naman yung mga bata, minsan na underestimate natin sila. I don't understand kung pa na nag-work yung COVID-19 vaccine na gulat nga ako. Parang doctor kung mag-explain. So say ko, sa mga naman natutunan yan. Hindi ka naman nakindig ng webinar namin sa school. So I also want to thank the schools for doing a great job, the teachers. Kasi malaki rin yung influence ng school, yung teachers when they talk to the students. So I also appreciated na yung school na garon rin ang initiative na gawing open yung vaccination to the students and even to the siblings who wanted to do it there in that setting. So na-appreciate ko yung mga ganon. And also yung mga frontliners na, nakikwento rin sila ako na kasakip na rin ako. Yung anak ko na kaganyan. Parang na-acknowledge rin nila yung, may mga, may side effects naman palaga for some people. So at least it makes it more human for us. Ewan ko, I don't know but kasi we're not doctors. We're not in the medical field. But we're parents, we have all these feelings and sometimes it would also be nice that those feelings are recognized. And then, you know, we will listen naman to the experts of course. And of course beware of fake news yung talaga kalaban mo pag may isang nag-post talaga dyan na katulit po yung kinwento kanina. I have not seen that video. But I always tell my friends and my peers, the other moms would also ask me kasi nga dino, I interview doctors. Pag kayo maniwala sa mga fake news na yan, tignan yung kung san ng gagaling, esang tao lang yan, against kailan ba yung nagpabakuna, million na po yung nagpabakuna. So tama si doctora, yung maganda yung may references para lalo may intindihan, lalo na po sa mga barangay, sa mga community. Nag-ulat ako, manami pa rin pang hindi nagpapakuna ko niya, yung anak ng mananahiko, yung mananahiko hindi pa nagpapabooster, kasi na tatakot na o siya. So sabi ko ano ka ba, ay mas kontin ang ayan nagpapakuna ka, tapos ayaw mo magpapabooster. Sayang mga ganun ba, meron pa rin kahit na nagpapakuna na sila, yung iba, meron pa rin ganung mga feelings out there that I guess we need to be aware of para ma-explain ko natin sa kanila. Disclaimer lang yung kanina na sinabaki mga doctor, baka akala yung doctor ko, hindi po yung pedia ko nagsabi na uncertain siya, some of my very close friends lang na open sa amin na of my. Taorin naman sila. Pero pinabakunahan naman nila yung anak na. Yung doctor sila, sila rin nagsabi na, pero bilang magulang, dalawa kasi doktor sila, pero magulang din sila. So meron din silang parang conflicting emotions. And these are my very good friends. So sa aking lang sa sabi, hindi naman nila ako paciente or hindi nila paciente yung mga anak ko. Syempre yung doctor, sa sabihin nila yung anu talaga, yung tama, na ginawarin naman nila. So yung lang ko. Did you want to respond to that? I just wanted to pick up on Ninya's pointe. Hi Ninya, long time no see. Pero yung sinasabi mo, we don't want to devalue the anxiety and worry that people have. Kasi e alo pa naman talaga, dalawang taon pa lang naman natin kilalatong microb yung two. Si lo ko nakaringig ng COVID before 2020, tapos big lang sasabi natin ngayon, kailangan mo magpabakuna, medyo mapapaisip ka talaga. And we're not brushing these worries aside. They're very legitimate. I think yung challenge yung talaga sa mga clinicians is kung na talagang responsibility natin yung maging maalam, kasi tayo magpokommunicate ng information, parang no excuse na hindi natin to alam. Kailangan, well vers tayo. Tapos siguro in the same way that we ask our patients to look for reliable information, tayo re-enroll din natin yun, magkanap tayo ng reliable information for ourselves and to share. Yung napanggit mo ninya about the healthcare workers, communicating we on the level of queer friends, I'm sharing this anxiety with you. That's totally acceptable kasi siyempre lahat din naman, ganun din naman ang pinagmulan natin tanong. Parang mali naman, yata kung di tayo nagtanong hindi naman tayo, postakatanggap na lang and I think it's really very important for us to be active in terms of getting this information, processing it, understanding it and of course making sure what we get is very reliable. So challenging, challenging talaga. Thank you Anna. I wish we had more time but we don't have any more time. I just wanted to have a little bit of rejoinder. Actually it's about people's feelings, so sometimes it's not just the explanation but I think what Ninya is saying is sometimes patients just really want to be heard and that's why she said acknowledge it na parang huwag niyong wag natin sa sabihin ay, okay niyan, ang kainin niya, I like that and that means that we're dealing with people with emotions, with feelings and I think we don't have a doubt that's probably something wrong because all of us have had doubts about this, all of us. Wag tayong magsusabi na wala tayong duda, lahat tayong nag-gaduda. Dapat yung apok ng babakonahan, naggaroon ako ng duda eh. Parang this is a very normal reaction, this is a very unusual time in our history and so people have feelings and I think we just need to acknowledge it and answer the questions on the fans survey. Go ahead Raymond. Okay, thank you so much. Can we have it also on Menti para makita rin po ng ating mga? Thank you so much. For our first question, which COVID-19 vaccines can be given to the children? I will call on Dr. Anna although na kiningpukay na ba maalaman nyo po, yung paulit-ulit po na bakuna, type ng bakuna na nabangit po na. And ang tamang sagot na sinagot mas marami sa ating mga nanunood ay yung Pfizer vaccine. So siguro let me just qualify sa ngayon, meron yung EUA from Five and Up. Baka may mga nakarinig na may EUA na rin ang Sinovac para doon sa Six and Up. So sana maging partin na rin siya ng program. So the correct answer is Pfizer. Yung 11% sa Sinovac ay acknowledge baka medyo up to date nalaga kayo sa Barita at alam ninyong may EUA na. So malapit na rin sana siyang maisama sa program. Thank you, Dr. Anna. For our second question, dapat pabakunahan ang mga batan na COVID-19 na? Overwhelmingly po, 95% at least in Zoom and 98% po sa Menti chose po na yes, which is essentially po a message na rin nung mampun natin for this webinar. Alam din po namin, karamihan po sa inyo ay medyo busy po sa inyong mga schedule and something really that we have prepared beforehand or yung tinatag po natin SCD shorts yun po ay talagang very, very easy to consume. Maykili lang po siya ng mga videos, snippets po siya ng aming messages, and then finally, as all of our speakers are trying to gather their thoughts, we have on the screen our evaluation poll. Pwede po sa evaluation poll po natin, especially for those na makita po sa atin dito po sa Zoom. I hope you're able to see it in the Zoom po. Maybe we could launch it so that everyone can see it. Okay, thank you. Maramin ang mga sumasa ko tapo ng mga video. We have five questions here. Wala po kami hiwalain na isiniset aside or in e-mail po na evaluation poll. Ito lang po yung meron po. So we hopefully you'll be able to join and input your feedback for this webinar. Widok following statements. The panelists demonstrated knowledge of the topic. Number two, the panelists is use appropriate language with technical medical jargons and finally the panelists contributed to new perspectives and knowledge on managing virus-KCOVID-19 health issues. We will not be closing this evaluation poll at the end of the webinar as we move on to the final messages from our speakers. Dr. Susie. Thank you very much and we're at the top of the hour once we're going to ask what's your message to them? So let's start with our veteran broadcast journalist Ninya Corpus. Ninya, go ahead. Meron papaladok. Well, ang masasabi ko lang alam natin na meron mga uncertainties. Meron talagang wala ng 100% na vaccine kahit anong vaccine pa yan. But especially now dahil COVID-19 is very very new. I said it earlier we have to continue living and the best way for me right now as a parent to live in a more safe environment for me and my family is to have my kids vaccinated. It's a choice that I made and I think it's best for my children so I hope yung mga parents ko na nagdudu ngayon or meron pa rin mga agam-agam naramdamang parin po yun pero wala po kung pagsisisi pagdating nung panahon na babakunaan na rin yung isa ko pag nag-five na siya kasi four palang siya ngayon I think mas confident na rin ako at siya, marami rin naman kumapasok ng mga bagong information like Dr. Anna kanina mentioned na very very little adverse effects naman talaga as they've seen. So I believe her, she's the expert, hindi ako makikinig doon po tayo makinig sa experts tulad po dito. So maraming salamat for having this webinar for all of us. It's really very helpful po kaya mabuhay po kayo. Thank you very much linear corpus. Let's go to Dr. Trish. Ikaw, anong message mo? Wala lang message ko as part of my advocacy is about for our children with cancer na wag po matakot ang mga magula wag po matakot ang mga patas or makakaplano po tayo paano po kaya bigyan ang vakuna ng aayos. Thank you po. Okay, thanks a lot. Anna. I'd like to address the healthcare workers in the audience. Tandaan natin, napakalaki ng role natin dila ang tagapaghatin ng information and marami tayong makakausap ma-engage na mga nagaalala pa rin ngayong tungkol sa vakuna for themselves or for their families. And it's our role to make sure that we have the right information so we can communicate this information and then trapaho din natin yung alamin. Ano pa ang dina dala sa atin ng ating mga kausap? Ito ba ay knowledge gap or trust issue? Kung knowledge gap madaling sagutin, dibilyan lang natin sila ng information pero kung issue ng trust ng vakuna, medyo ito kailangan natin trapaho din at bilang healthcare worker all of us have a role to show that the intrinsic motives of the healthcare system ano ba naman, kung tito mo dung sa mga nangaylangan and hindi nating hindi magiging intention ng healthcare system or na sinomang health worker na mamahama ng pasyente. So doon tayo nang sisi mula at lahat ng decision natin na kaangkla doon. So sana magtiwala sila ang buro. Thank you very much, Dr. Anna. Let's go to Dr. Benny Atenza of the PMA. Benny, go ahead. The whole Philippine Medical Association na binubu-opo kami ng more than 88,000 na, doctor. Ay nakikisap ko sa ating pagpapakuna na ating mga kabataan at sinasabi ko natin, saipo mga vakuna at sinusagurado ko namin at sinabi ko kanina na ang lahat po ng vaccination centers na pinukuntahan may doctor doon as a screener, vaccinator and monitor. At inakasampo namin na lahat po ng ating mga kababayan ang ating mga magulang at pabukunahan ang ating mga anak kasi nang jana po ang vakuna nang sabi ko namin nang jana magpabakuna na po at sinasabi ko natin palagi na matakot sa COVID wag po sa vakuna. Thank you very much, Benny and Diding, the final word from you. Thank you, doctor Suzy. I'd like to say to our audience that we live in a beautiful world. So, ang incentive dapat natin is kusukupang mabuhay katulad na sinabi ng pacient ng Dr. Benny. I don't want to die. So cute, di ba? So maybe we cannot stop COVID but we have a role. Each one of us would have a role. So let's do it. Let's have our children vaccinated. Thank you. Thank you very much. That's Dr. Diding, Clemente Morada. And we are going now to our final summary which is from the Deputy Director of the Philippine General Hospital. We are going to welcome back Stella, Marie kaya nalimutan ko na naman. Jose. Lagi nang aalala yung legas. Sina yung sana yung ko sa legas. Sige, okay, go ahead Stella. It's a very enlightening webinar. Salagang ang gagaling ang speakers. They're all excellent speakers all of them. So I'd just make a short summary of what was said. Why should children be vaccinated? First of all, protection ng COVID-19, protection again, severe COVID-19. Also, we have to remember the impact, the new variants also protection against what we call long COVID. Now, when we vaccinate children, it also contributes to reducing community transmission, avoidance of isolation, quarantine, school activities, school closures and other indirect harms of lockdown. Salagang ang ating education system yung talaga yung sa time of the COVID kasi sobrang effect ng school closure. Also, when we vaccinate our children, there's a faster return to pre-pandemic activity and economic stability. So ang recommendation ng H-TAC according to Anna is Pfizer-BioNTech which is an mRNA vaccine for 5 to 11 years old. Sinovap an inactivated vaccine for 6 years old and above. Mayon, she spoke on vaccine efficacy and vaccine effectiveness. Efficacy means how, refers to how the vaccine performed in ideal situations. So these are clinical, controlled clinical trials. Now, effectiveness naman refers to how the vaccine performed in a wider population. I'd just like to make a short summary of this one. In vaccine efficacy of Pfizer for age 5 to 11 years old is 90.7 percent. So it is safe, immunogenic and efficacious. So the conclusion there is that from Anna, she said that two doses of the Pfizer mRNA vaccine were highly effective against COVID-19, hospitalization and critical illness. Ang question then, what has been the progress so far? So magugulat kayo na andami na palang total doses administered, 141 million. So the total vaccine deployed is 118 million. Pero the sad part is the average per the 5 to 11 years old ang coverage ay nasa 13 percent pa lang. So we have to exert more effort to convince the mothers to have their children vaccinated. On yung what should we watch out for sinabi ang mga adverse events na na if you think about it yung pain in the vaccination site, trash, pireksya, dc-ness these are mild symptoms, mild effects and the benefit certainly outrace the risk yung yung dapat natin kandaan. Mayan from Trish Alkasabas naman who's a very good chemo-onho pediatric consultant ang talagang message na pag natin pabayaan ang cancer patient if there's one thing that she emphasized that cancer patients are at risk for COVID-19. Makatita nyo na nagkakaroon ng critical illness yung mga cancer patients. So the mortality due to COVID-19 was 3.6 percent and in our data 40 cases of cancer patients 5 percent had severe illness 3 percent critical that they needed to be intubated 55 miles and 37 asymptomatic. Of the 30, eto yung paking ganyong of the 30 patient cancer patients dalo walang ang nakakontinyo ng chemotherapy. Yung na to sad, 28 ang hindi nakapatulay ng chemotherapy so their cancer can progress and that is so sad for each of them. So the cancer survivors are also at risk for severe COVID-19 infection. So ang sinasabi ni Trish COVID-19 vaccination for children with cancer number one timing is personalized wala tayong like the others na pwede kahit anong oras the newly diagnosed cancer patient you should administer the vaccine two or more weeks after the initiation of chemotherapy leukemia patients have poor immune response to the COVID-19 vaccine and patients with on-going therapy you have to allow them to recover from the acute organ toxicity due to the chemotherapy so hindi siya pwede ang parong sunod sa dot na machine kailangan may recovery period allow the immune system to recover so dapat din the absence of steroids and infection of course and then she also mentioned myocarditis of poor antibody response and the risk for allergic reaction but again in the isosoma total natin the benefit outwaste the risk so ang conclusion is Trish is children with cancer are at risk for severe COVID and there will be therapy yung chemotherapy interruption and they should receive also the COVID-19 booster in the timing of the vaccination should be discussed with the physician with the personal physician ngayon natutuwa naman ako kaya isni niya corpus ang daleng ng kanyang video pili ba ko sa mga anak niya anong mas gusto nyo yung spike protein o yung whole virus that is a very funny way of putting it and people will really remember ayon nila yung whole virus yung pankasakit ka na tanaka so it is the right physician to believe ako and do sa video that she presented nakakatulong na yung atmosphere in the school was playful it was like okay okay lang so nakita nyo walong umiak and I like her parting words ang sabi niya we have to learn to live with COVID yun yung talagang essence thank you very much Makdi Susi Doctor Stella Marie Jose the deputy director of hospital for an excellent summary and next week nakobi with us next week magandan tanong Raymond and I are monitoring the global events and when we open this webinar I just mentioned that Shanghai is under lockdown and one of our members said that it's not just Shanghai there are other cities so we are monitoring what is happening in the rest of the world so we can give you updated information about the surge ng COVID-19 sa Philippines o tapos na ba? We don't have a crystal ball but we're going to get very experienced people to give their very honest assessment of this so be with us and we'll bring you the best speakers over to you Raymond Thank you Doctor Susi and thank you for that wonderful break up and closing remarks from Deputy Director Stella Jose and that everyone is not asking but it's really top of their mind because everyone is worrying if we will be reverting back to how we were especially with China reverting to their 2020 time zone kumbaga and it's that something that is in our horizon so please do join us next week but before that we would like to thank the very hardworking team of the topics and choosing the speakers but really all around effort and team work with everyone Maraming-maraming salamat sa inyong lahat and finally ang ating mga webinars may nagtanong na po they are archived immediately after the webinar lahat po ito if you go to www.youtube.com forward slash TV UPPH you'll be able to see all 93 webinars ang ayan that brings to a close our webinar for this week makita kita po tayo again next week our friday from 12 noon to 2pm it's a date together we can stop covid deaths so keep safe, keep healthy see you online we'll stay with you until the coast is clear the other Spain before my fears the other lives before my tears but right behind the mask I look into myself and ask do I have strength to carry on my God, our Lord, my sister go on and leave you here to keep me strong I'm here to hold the line I'll keep my hand until my his name to read is fine to be afraid just hold on to the word he gave this time we'll come to pass because this salvation makes a last you carry you to see the break the other Spain before my fears the other lives before my tears but right behind the mask I look into myself and ask do I have strength to carry on my God, our Lord, my sister go on and leave you here to keep me strong I'm here to hold the line I'll keep my hand until my his name to read the other lives before my tears but right behind the mask I look into myself and ask do I have strength to carry on if you're here to keep me strong I'll keep my word his name before my tears pushing on the spite these things through another day