 Good morning, good afternoon, good evening, everyone. Welcome to the 84th episode of the Stop COVID Dex webinar series brought to you by the University of the Philippines. Happy New Year po ulit sa inyong lahat at maraming salamat po for being part of our credible online community. To all those who have just discovered us for the very first time today, welcome po. And I'm sure malgugustuan nyo po ang aming mga pag-uusapan, not just for today but for all of our future webinars. Around the world, countries are expanding vaccination against COVID-19 to include children. May mga early reports na po on the variant such as Omicron pointing to more cases among younger age groups but they still need further study. May mga ilan din po mga bansa were in concern about childhood infections of COVID-19 has prompted quick rollouts of vaccination programs for children. In the Philippines, the Food and Drug Administration has approved the use of the Pfizer-BioNTech vaccine for children ages 5-11 years old. Local government units, schools, parents and families are preparing for a possible implementation starting in the first week of February. So if you are looking for the latest science-based and evidence-based information from the most distinguished experts, keep it right here. I'm 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 during our regular Friday lunch date and always looking forward to Fridays po because I get to share hosting duties with our adjunct research faculty, also the special envoy of the President for Global Health Initiatives, ang aking partner, Dr. Susie Pineda Mercado. Dr. Susie? Hello, Raymond. Good afternoon. Good evening. Pusan man kayong naroon. And hello, partner. How's it going? Okay. Nakawamagandang topic po natin ngayon, we'll be talking about vaccination for children. Actually, we've done this before, Raymond. That's correct. But now, and dito na, okay, so na and dito na, at siguro ako marami kayong mga tanuman. We hope that today will be a very enlightening webinar for you. Lahat tayong matututo sa ating mga dalubahas, our experts were here with us, here with us today. Raymond has mentioned that several countries are already vaccinating their children. And I think we'll hear a little bit more about that from our speakers. We'd also like to welcome all of the members of the Pediatric Infectious Disease Society of the Philippines. That's co-sponsoring this webinar. So we welcome our pediatricians, so our experts in infectious disease. Sama po kayong sa discussion mamaya, baka meron kayong mga huso-idag-dag, ubusong itanong, mahakatulung po yan ng malaki sa ating audience. So welcome everyone and stay with us. We've got a very exciting topic today. Raymond, over to you. Thank you, Dr. Suzy. We always start po by putting our discussion into context by presenting po what we call the person on the street video that's weekly prepared by TVUP. For this week's person on the street video, the question that we pose to the person on the street essentially, may alam po ba kayong mga pamilya na kahit mga bata ay nag-COVID-19 na? Sa tingin po ba ninyo ay dapat bakonahan na ang mga batang 5 to 11 years old? Please watch this. May mga alam po akong pamilya na ang mga anak ay nag-COVID. Right now, my daughter is COVID positive. She's 8 years old. It's pretty mild. She just had fever for one day. Then after that, walang. Before kasi nung nagseliplate kami ng New Year sa parents cost side cost. Hindi din namin alam kung san nang sanya nakuwa. Kalawang alam namin, usually 3 days sumalapas yung sitok mas kapag na-expose kay. That day, kinagabihal. Dun na gano, dun sumapas yung sitok mas nung mga anak namin. Sa aking paninaw, bilang isang magulang at isang social worker then at isang development advocate na rin. Lalo na sa rights and children's rights. Sa tingin ko, nararapat na mga bakonahan din yung younger children yung 5 to 11 years old. Definitely. Kasi wala silang protection against COVID. So any vaccine na puwede sa kanila is very appreciated. Since meron po ang 7 and 5 years old na anak. Ngapayag po ako din sa magbakunahan sila para makapagmoon na rin and magprotectan mo yung mga anak. Since ako, fully vaccinated, gusto ko rin na ganoon sila. O siyempre, yung ganung paninaw ay dapat backup by proper science. Siyempre, inasahan natin na yung bakuna ay dapat dumahan sa maayos na testing, sa maayos na pag-aaral. Sana maayos nilang may distribute yung vaccine natin. Sana yung procedures nila, especially bata maramiyan. Maayos nila in such a way na hindi na crowd sa vaccination sites. Gusto ko na mabakunahan din ang mga kabataan na masbata. Bilang magulang din ako ng younger children dun sa age range ng 5 to 11 years old. So I guess it's a good start also for 2022 na even though nag-COVID tayo, hindi naman tayo tinamaan ng masama. Almost 2 years na rin pong nasa sa bahay mga bata para makagala na rin po sila. At maiwasan din po yung nai-stress nila dali nakakulong sila sa bahay. Ako nga yung apoko last year na COVID positive, he was 7 years old at that time and it's a scare. It's really a scare for the family. So I know many of you have children in the home and lalo na yung frontline workers natin you're exposed. So minsan nagaalala din, di ba parang baka maawin nyo at baka mahawang mga bata. So today pagusapan natin yan at pagusapan natin yung protection na mabibigay ng pagbakuna. And what kind of preparations are being made para maging maayos naman kasi na rinig na natin sa ating person on the street. Mokong maraming gusto kong pabakuna pero gusto na maayos. Walang siksikan, malinao, kung panong gagawin and all of that. Anyway, I really appreciate that TVUPN. Salamat sa mga pumaig na mag-on-com na mga magulang to give their opinions. So Raymond, over to you. Thank you, Dr. Susie. So ito pung pagusapan natin. Not naman limited to just 5 to 11 years old. Obviously we'll be touching on the 12 to 17. But for the most part we want to be able to put out a webinar that's really geared for pediatric COVID-19 vaccination. And this is for all of the 2100 plus registrants for this webinar. And as you all know, our webinar can accommodate up to 3000 participants po. So please join us in the Zoom para po you could experience fully ito pung ating interactive program. If you're watching in YouTube and Facebook, you probably may have a little bit of different experience compared po dito sa ating Zoom. So hopefully you'll be able to join us in the Zoom. But we have prepared in po questions for you to be able to participate. Not just those who are in the Zoom via the Zoom po, but for those in YouTube and Facebook via Mentimeter. So for our Mentimeter for this week, we have two questions as always. But the code for this week will be 3197-713. That's 3197-713. You just enter www.menti.com into your browser and then the code so that you'll be able to participate sa ating fun quiz or ating pre-test if you will. For all those asking ang ating po mga certificates of attendance, medyo dahan-dahan pa rin po na ating siyang sinisend out. Especially for webinar number 83. Ito po yung last week, January 14th, marami na rin po ang nagtanong. Ito po ang itura ng ating electronic certificate of attendance that will be received and will be issued to those who have attended at least 50% of the webinar duration. Dr. Susie. Yeah, Reymal, I just wanted to greet all of our NCR, well, not just the NCR health workers, but all our health workers who are currently in the hospital. So we can see in the chat, they're actually watching from the pharmacy, from the ward and so on. And we know that it's tiring and it's difficult, but and ito pa rin tayo, no? We carry on and I hope that today, yung time na yung lunch break niyo, nakasaman niyo kami dito, ay meron kayong bago matututunan and of course, some of our regulars, Reymal, they're always eager for the Mentimeter. They want to join the quiz. So anyway, minabati ko lang, also all of our colleagues who are working in the provinces. So I saw here, we have our usual community watchers, yung mga na nunuod na sa Davao, sa Puerto Princesa, sa Osamis, talagang ano nagpapasalamat kami dahil kung hindi senyo, lang naman kami dito. And we hope na talagang mga katulong yung ating topic today. As I mentioned, magaling po ang ating mga speakers. Sige Reymal. Thank you, Dr. Suzie. For today's webinar, especially for those who are joining us for the very first time kasi napansin po namin, those who have been asking for certificates, ngayon lang din po nakasali, we will have a standard panel discussion format. That's for the most part, our format for special topics such as this one and especially for touching about COVID-19 vaccination program. So after all of our speakers have presented, we have a reactor for today from the Department of Health and then that would be followed by a Q&A session where we'll be entertaining questions, not just in Zoom, but for those na ilalagay nyo po siya sa comment section po ng Facebook o ng YouTube. We try to monitor them as much as possible and then try to ask them po as part of our Q&A session. We also, kung mayroon po kayo makita small notification asking you to open your cameras and especially if you're willing to be a part of the live audience who will be asking a question to any of our resource speakers, asana po paunglakan nyo po kami at makasali po kayo sa discussion. So to get this webinar started po and set the tone for our discussion, we are very, very honored and pleased to have the president of the Pediatric Infectious Disease Society of the Philippines none other than Dr. Meann Bunin. Dr. Meann Bunin po. Ma'am? Hi, good afternoon Raymond at magandang tanghali po sa lahat. Sangala ng PIDSP, ako po ay nagpapasalamat sa nag-organisa ni tung palatuntunan upang mapagbigyan at talakayin ang pababakuna laban sa COVID-19 sa kabataan. Halos na sa pangalawang taon ng pandemya at batid nating lahat na ang target ng COVID-19 ay matatanda na nagdudulot ng matinding karamdaman na maaaring humantong sa matagalang komplikasyon o dikaya ipagpanaw. Nung wala pang bakuna laban sa COVID puso sa naging abala ang pamahalaan lalung-lalung na ang DOH nawa ng mga policiya at panuntunan upang maiwasan ng bilis ang virus. Ngunit mabilis gumalawang virus ang dami niyang tinamaan napagod ang mga doktor, nurses, at iba pang mga hens sa paggamot at pagaalaga sa mga nagsakit. Nahawa na rin sila at kinakailangan na din gamutin ang iba ng tuluyan ng nawalay sa hanay natin. Numating ang mga bakuna buhayan lahat ng luom. Inunang bakunahan ng mga healthcare workers, ang mga seniors natin, at yung may mga comorbidities. Nakakalungkot lang kasi halos maging isang taon na tayong nang bibigay ng bakuna. Marami pa rin ngayon na lang naghigpit ang pamahalaan, nagsisi pagtakbo sa vaccination centers para magpaturok. Nakakamanghang isipin na magpasanggang ngayon ang COVID-19 sa mga bata ay nanatiling banayag. Maliban na lamang sa mga bata may mga underlying medical illnesses at sa mga bata nagkakaroan ng komplikasyon natin atawag natin multisystem inflammatory syndrome in children or MISI. Dahil sa Delta variant umakyat ang mga kaso sa mga bata may mga barami sa mga batang edad 12 pataas ang na-hospital Upang mabigyan rin ng protection ng mga bata ng Oktober taon, sinimulan ang pagbabakuna sa mga batang may edad dosre pataas gamit ang bakunang Pfizer at Moderna mga bakunang may pahing tulip ng ating FDA na magamit sa nasabing edad. Dahil sa hindi maganda ang karanasan na nangyari sa pagbabakuna nalaban sa dengay masusing pag-iingat ang mga ginawan proseso ng DOH sa pagsisimula ng bakunahan sa mga bata. Sinimulan sa mga piling hospital upang masubaybayyan ng maayos ang kanilang magiging reaksyon sa bakuna lalo na binigyam prioridad kami nagulat ang karamihan dahil halos walang ininda ang mga batang na bigyan ng COVID-19. Malayo sa mga reaksyon na naramdaman ng mga matatanda ng nagsimula tayo ng bakunahan sa kanila. Sa ngayon, panibagong variant ang kinakaharap natin ang Omicron nalixi at mabilis kumala umaakiat na naman ng kaso ng COVID-19 sa mga bata. Napupununa naman ang mga hospital na nangalaga ng mga bata. Napapanahon lamang natalakayin ngayon ang inapurbahan pagbabakuna sa mga bata simulali mga taon. Sir, upang mapagandaan ang pagbibigay nito habang iniintay ang pagdating ng bakuna. Tulong-tulong tayong mga kinaukulan tulong-tulong tayong kumilos upang may dagdag tayong mabisang sandata para sa mga bata laban sa COVID. Magandang hapon po ole, maraming salamat po. Thank you. Maraming salamat po. Doc Mayan, President Pushan ang Pediatric Infectious Disease Society of the Philippines. At napakalaga po ng papil na ginagampanan ng ating professional societies katulod ng PIDSP sa pagbibigay ng linao ng iwanag sa ating mga doktor at sa publikon tungkol sa anong dapat nga win. Maganda po ang tema I thought it was very inspiring and again I'd like to and congratulate all of the members of PIDSP who are with us on the webinar. So Raymond, over to you. I think you're going to do your fun quiz now. That's true. May we enjoy more than 1,000 participants in the Zoom and obviously more in the YouTube and Facebook to participate in our opinion poll sa mga na sa Zoom po layalabas po sa inyong opinion poll two questions but for those sa mentee, it's okay, magot na po pala. Raymond, Raymond. Yes, yes. Pero pagtatanong mag-mentimeter. Apost lang natin uli sa chat. Ah, okay. Nguni ka kinyo ano. Thank you. I just did that. I think there are those who are asking. Okay. So may mga 90, almost 100 na po na sumagot sa mentee meter ng ating first question. Dito na rin po sa ating Zoom. A little over 200 are answering. The first question reads, sino ang dapat mauunang bakunahan sa mga bata na 5 to 11 years old? The options are, batang may mga comorbidity. Number two, batang mga anak na frontliners. Option three, batang na una sa listahan ng LGU. And option four, batang mga pumapasok sa iskuwelahan. So yun po ang four options po para sa ating first question, binabatirin po. Dito, Raymond, Raymond. Yes, yes. A di ba, isa lang ang sagot na tama kasi nabapaisip ako dito sa tanong mo. Ah. So, well, multiple choice po. Pwede po ang pumili ng morda. I think one more than one correct answer at least for this question po. But for the other question, isa lang po ang kasagutan. Okay. Stricto ko, just Raymond. Stricto. Yes, yes, again. So, we'd also like to greet those who are joining us from Benguet General Hospital, Latrinidad Benguet from the Department of Education in Batangas, Calabarson, from Tinambak Municipal Hospital in Camarinis Sur, from the Cebu South Medical Center in Talisa and Camp Navarro General Hospital in Sambuanga City in Sambuanga Delsur. Okay. For other question number two, question number two reads aling sa mga sumusunod na bakuna ang aprobado ng Food and Drug Administration para sa mga batang 5 to 11 years old. So, ang options po are Pfizer BioNTech, option 2, Moderna, option 3 AstraZeneca, option 4, Sinovac. So, naito nalaman po natin. So, you know, cute graphics. Kung saan po sila mas nag-gravitate po, ang please take note the question is for mga batang 5 to 11 years old. So, binabati rin po namin ang mga nanonod po sa amin kasa atin internationally from the National Center for Global Health and Medicine in Japan, from the Chonin Hospital in Taipei, Taiwan, Hospital Pontian in Malaysia, from Bangkok, Thailand, from Kanto City in Vietnam, University of Haile, Saudi Arabia, Lunichi Alive University of Lida, 2 in Algeria, the University of Fiji in Laotoka, Ruther Glen in Virginia, Stockton, California, from the Bronx in New York City, St. Catherine's, Canada, from Soyo in Angola, and from Panketal in Germany. Maraming, maraming salamat po. We will not be closing our opinion poll as we move on to our webinar proper for today. Dr. Suzie. Hi, okay, thanks. Thanks, Raymond. Okay, let's go straight to our first speaker and he's one of your favorites. Kila lang kila lang nyo po siya, I guess he doesn't need an introduction. He's the director of the Knowledge Management Information Technology Service of the Department of Health and he's been with us on the webinar a number of times and we always like to have him here. We're delighted when he's here kasi na pahosaip ko niya magpaliwanag at saka ano, parang, pag may mga tanong kayo nasasagut na kagad ang mga questions nyo. So we'd like to welcome other than Dr. Eric Tyag. Eric, welcome to the webinar. Magandang tangali, Suzie. Magandang tangali, Raymond. At sa lahat po na nanunuo, napikining sa programang ito. Magandang tangali po sa inyong lahat. Babating ko na kayo ng happy new year na na sandwich na naka rang happy new year at kung ay fat choice para ting na new year naman yung Chinese New Year. Umpisa na po natin at aking napong isy-share ang aking slides. Babil ang po at gagamin natin slide show. Nakikita ng muba. Yes, you had it for a moment. You had it for a moment anyway. Ayan. Nga nga. Yes, sir. Okay. Nga walao-galao pa. Okay, okay. Iingat kayo, baka mabasa kayo. Okay. Okay. So coming soon in a good place near you, COVID-19 vaccination for children five years to 11 years. Siyang po ang topic natin ngayong hapon. Okay. Dito po sa inyong yung screen pinakikita namin the number of COVID-19 cases and deaths as reported by the World Health Organization. This is by weeks. The confirmed cases as of January 17 has already reached over 326 million and the deaths over 5.5 million. The case fatality rate is now at 1.7%. Here we show you the top 20 in this first, in this slide we show you the top 10 the United States ranked number one with over 64 million cases and the deaths have now reached in the United States more than 843,000. Globally, I have already reported to you and this slide we show you also the number of persons who have vaccinated for 100 population or the percent the United States even though they have ramped up their vaccination is at 61.55% for persons who have vaccinated. The next slide shows you where the Philippines ranks. It's at number 20 with over 3.2 million cases and deaths of over 50,000. The persons who have vaccinated for 100 population in the Philippines in this report is placed at 47 per 100 population. The Philippines statistics authority sharing with us today and sharing with you the preliminary results of the leading causes of death for 2021. They don't have the numbers yet for December but that's of two days ago the leading cause of death is but COVID-19 that includes both the confirmed and probable COVID-19 cases is now the second leading cause of death. Over 99,000 reported please contrast this to 52,000 the Department of Health on the reports confirmed cases of COVID-19. Now what do we know about COVID-19 in children? Just like adults, everyone or every child is susceptible to COVID-19. The incidence in children is similar to that in adults is part no risk of exposure or even because of infrequent testing to confirm diagnosis and we know the reason why. Sinabi nga ka ni men ni Dr. Bunye Baniyan kaya manaman sa yung day at sa pagkat ayos sa mga batang sinisipon at inoobo hindi tayo magsususwet siya na COVID pala yun. Up to 18% ng laboratory confirmed cases are children. Ito ay basis sa paggaaral na ginawa sa maraming bansa. The number of reported COVID-19 cases in children are underestimated. Pinaliwan ng kungha dahil nga banayad po yung symptomas at malamang sa hindi hindi po na test. The incidence increases with increasing age. Ito rin po ang nakita nila sa mga paggaaral. COVID-19 infections in children occur following household exposures. So kung ang tingin po natin ay baka sa iskwela ham po lalo na sa mga bansa na nagmukas na ng paalanan marami pa rin nagkasakit na magabata sa age group na to sa household exposures lalo na kung merong adult na index case sa household na yun. In secondary attack is ang taas more than 75% ang naobservahan. Yung transmission from asymptomatic children na report na yan. So kahit pa ang symptomas yung bata pwede siyang manhawa. Re-infections pwede rin mangyare. The risk factors for COVID-19 in children include may infected household member tumanggap ng visita at may gatherings na ang mga kasama. Ay hindi naman yung mga kasamahan nila sa panilang bahay o tahanan. In settings where face-to-face education is allowed, alam nyo ba that children can get COVID-19 not because they attended the school but because the inconsistent must use. Asymptomatic infections can range actually from 15% to 42%. And children have similar symptoms as adults except that frequency varies. Typically fever, chills, cough pero kailin ang binanggit nakakatakot yung multisystem inflammatory syndrome in children or busy na parang toxic siya, syndrome yun parang yung kawasaki. So yan, may rashes na mula yung mata at marami mga organs ang na-affectohan. The underlying conditions at fire rates of hospital and ICU admissions. So, kung may comorbidity, manumang sa hindi yung bata ma-hospital at baka ma-ICU. Most children with COVID-19 nakakarecover naman si na in four weeks. Although it's rare children in this age group can die. Children will be susceptible to long COVID. So, three months later after naman nakakarecover si na they still have symptoms or there will be new symptoms and this will last for at least two months. That's long COVID. Here we show you the percentages or proportions of children. We divided the age group differently so that you can see how it differs from one region to the next. So, our age grouping here includes zero to four, five to eleven because that's our topic today. So, this is a special presentation for you for the age grouping. 12 to 17, 18 to 24, and so on. Let's look at the five to eleven. Overall, four percent of the total that have been reported will belong to the five to eleven years old. But look at the Cordillera Admissive Region. It's five percent higher than the national average and also region two. That's the Kagayan Valley Region. Now, maybe you want to ask were there deaths among this age group five to eleven? Yes. The total number of cases reported in this age group from January to December last year is over 100,000 cases and there were 133 deaths or 0.1% as our case fatality rate. The UNICEF reported just recently that at least 463 million children worldwide were unable to access remote learning. So if everybody thought parents out there that you are all right your child is one of those lucky enough to be recipients of remote learning, it is not so for millions of children worldwide because of the school closures. Now, benefits versus risk. In October 2021 the Global Advisory Committee on Vaccine Safety concluded that in all age groups the benefits of the MRA COVID-19 vaccines in reducing hospitalizations and deaths due to COVID-19 outweigh the risks. You can have many references and I'm citing that the most recent one that I got from the New England Journal of Medicine pertaining to an evaluation of the Pfizer vaccine by intact vaccine in children 5 to 11 years of age. There are conclusions. A COVID-19 vaccination regimen consisting of two 10 microgram doses of this vaccine administered 21 days apart was found to be safe, immunogenic and efficacious in children 5 to 11 years of age. But wait! The World Health Organization's questions everyone. Let's look at what the question is all about. The World Health Organization said that because of supply constraints on COVID-19 vaccines the focus should be actually protecting populations or subpopulations at highest risk of hospitalizations and deaths. The question is are children belonging to the age of 5 years, 11 years are in these subpopulations? What do you think? Another one, the WHO says that countries with few or no vaccine supply constraints should consider the issues of global equity when making policy decisions about vaccinating children and adolescents. Translation, many countries have not actually started their first doses for their citizens or even if they did, it's only marginal. Many are still ramping up their vaccination to at least achieve the 40% fully vaccinated target of the WHO by end of December last year and now the WHO has a new target 70% by end of June this year for all countries in the world. Now, there's another thing although the safety and effectiveness has been proven in many studies the stringent regulatory authorities that provide this indication should be followed through and that the maintaining education for all school age children should be an important priority this pandemic. Therefore, one of those indirect reasons why vaccination should be considered in this age group. Now, let's look at some of the countries where COVID-19 vaccination has started already for children 5 to 11 years old. There's the United States of America, Canada, Spain, France and in this part of the region, China and of course over there there's Venezuela, there's Oman, Saudi Arabia, United Arab Emirates and of course Singapore. Now we show you here for example in Spain they start in January they're now picking up they're now at 40% for the 5 to 9 years old but what is happening in Abu Dhabi you do not made an appointment for your children for the vaccine they're using Pfizer in Canada everybody was surprised because you found out managed to vaccinate 75% of 5 to 11 years old and they say the magic formula included clear communication, speedy mobilization and a culture of vaccine acceptance that's so high in repeated surveys in China they called on the little inoculated warriors as they ramp up their vaccination for children even younger than 5 years old and of course in Singapore they have already achieved 11.4% vaccine coverage for this age group in New Zealand there is buzz because some parents are taking government to court to stop vaccine rollout for kids even though the survey says that close to 70% approve of vaccinating children in this age group and the CDC in the United States serious problems rare in ages 5 to 11 these will provide confidence for vaccinating children 5 to 11 years old in the Philippines do we have plans for vaccinating children 5 to 11 years old on your screen the target for the 5 to 11 years old is 12.5 million may be more this can reach up to 16 million perhaps and the department of health agencies are anticipating in this proposed timelines and milestones that primary series will be done starting the first quarter of 2022 recited if it happens next month and of course this will include boosters as well for these children now exactly how are we getting ready for vaccinating these children 1 in December 23 the FDA issued an emergency use authorization to Pfizer that will be used for children 5 to 11 years old the PPS PPS actually publish a joint position statement on this but the health technology assessment council has yet to issue their guidelines so this is pending the NITI guidelines are also pending the NVOG the National Vaccine Operations Center guidelines are also pending the procurement of these appropriate Pfizer vaccines because they will come in different formulation is also pending but the town hall meetings for healthcare workers have been shared with this month next month I mean mobilization is planned and I hope local government units are implementing this already pre-registration is ongoing at least in the city of Manila signing up of vaccine team volunteers is ongoing perhaps in many areas still not necessarily for the 5 to 11 years and social media postings are being prepared or if not they are in your platforms now should be prioritized let's look at intently on what the joint statement I mentioned about from the Philippine Pediatric Society and Pediatric Infectious Diseases of the Philippines in areas with reported heightened local transmission prioritizing eligible 5 to 11 along in the A3 those with comorbidities remember which which one she chose in the opinion for A1 children of healthcare frontliners and of course they caution implementing agencies that due diligence must be applied to ensure vaccine equity and access now yes we know mother knows best e how can we prepare getting children ready for the jobs we need to be beautiful for a few days before we take them or visit to vaccinate the children we need to understand that this is protection for them and for their companions at home if they play will return to other children the unpleasantness of their first job or that's why the crew may not come back that's why we are understanding that and of course understanding that if we are understanding one of the doctors with me we should not be late we should give a little time to understand the memories the fear of the parents sure it would be better if we can show video so that they understand and we should not say we should say there is a whistle that they will receive how if the child is not now and will be vaccinated at the vaccination center so we need to have a clear view at the vaccination center so we will do the memories maybe we will cheer them and of course they will say that maybe there is an ice pack because the other sensitive may hurt may pain or this may not fall we will give them good things and we should have masks as you can see on your screen we will remember like what we did at CDC what should we do at the vaccination center so we will ask at the vaccination center at the vaccination center we will ask that there is guidelines because we don't have these questions when should we start when should we wait and we will know what happened in other countries where should we start at the high risk areas what is our target at all the children or may comorbidities who can get vaccinated the pharmacist can especially the good things can get vaccinated 18 years old can get vaccinated how are you at the private sector can get vaccinated you are not afraid that you may get vaccinated especially if there is a lot of people where should we get vaccinated will the DOH return door to door school there are a lot of people there are other places do we need an appointment we really need an appointment informed consent this is not hard may gisip ang magulang but may informed consent may gisip sila tuloy so baka i-delay nila yan papaling mga hospital mga bata sa hospital babakunan ba sila bago at papala naman po yung mga bata na na sa household sabay sabay silang babakunahan at yung boosters dapat na bang ihanda at, of course bako na para sabay sabay na kaya at patapusing ko po ang aking pakikipag-usap po sa inyo gawin natin maganda ang kinabukasan na mga bata tayo naging bata rin sana malasa po nila ang magandang bukas maraming salamat po magandang hapon thank you very much Dr. Eric Tayag from the department of health as usual an excellent presentation very comprehensive dami pung lamang nung sinabi ni you doc Eric Eric meron tayo mga questions na sa Q&A box you might want to answer them and even on the chat but you can see how our audience is appreciating your presentation so maraming salamat Dr. Eric Tayag sa mga paliwan at I think maraming parang you made a lot of things very clear so I think we'll proceed thank you Dr. Tayag, our next speaker naman po also another familiar face to everyone she is a consultant with the department of pediatrics specifically with division of infectious and tropical disease please welcome again to the webinar Dr. Marimel Pagkatipunan Dr. Rajing hello doctor nun everyone thank you Dr. Eric for the very engaging kasi ang galing nung explanation niya for the vaccination in children so my task for this afternoon is actually to share with you baka nga po kayo matakot nilang ano ko our experience in PGH regarding COVID-19 infection in children so this would actually I just want to show you the picture of the COVID infection in children in PGH so since PGH has been designated as COVID referral center for Manila and since last March of 2020 so halos mag-2 years na po tayo mayon so in pediatrics we had our own COVID ward initially just for 9-12 beds because we thought that COVID or SARS-CoV-2 is an infection mostly for adults okay so we also have our neonatal ICU COVID area for those babies who are born to COVID positive mother so for this afternoon I will show two slides on our experience on pediatric COVID management and then just a few slides on their vaccination status of these patients and also share with you our experience when we did the vaccination for the adolescents and then some of my recommendations so our data show in PGH so I divided it April to 2020 in December of 2020 we had a total of 114 cases in PGH we don't admit mild asymptomatic or mild cases if it is just for COVID but some of these cases may be admitted because of some other problems and we started during that time the start of April to do the PCR test but remember during the first half of the pandemic we just have a few several laboratories that can do the PCR so as you can see our probable cases so these probable cases the pink one or the red ones are actually they are they have presentation for COVID infection or negative in the PCR test so they are defined as probable cases the blue ones are the confirmed cases which means they have the clinical and the laboratory finding of COVID infection in children the MISI that was actually mentioned earlier we also received them but we only admit patients who are on the severe to because we can actually manage them most of the COVID infections in children at home because if they are mild we just send them home after so these are the admitted patients so as you can see when we had the surge for the adults initially in 2020 that was in July to September we also have surge of pediatric cases and they are also being admitted for severe case and then another surge that started by by December of 2020 and then another surge on March to April this was the South African variant and then the Delta variant was and surge was August September to October and then unfortunately again January is the omkron surge so in our hospital we had peaks again of cases so by age the probable cases which were seen last year were actually mostly on 2 to 5 years of age but for the confirmed cases majority are actually on the adolescent cases so that's from 11 to 19 years of age and in this graph you can see as you can see there's male predominance I don't know why okay so for the classification of cases as I told you earlier the asymptomatic cases are the ones that are admitted for other causes for example trauma burn or for surgical cases or emergencies and because our policy in the hospital is that we do all swab all these patients and do PCR test so we can actually cohort them and classify them if it is COVID or non-COVID asymptomatic cases being admitted were actually those who just need other for being managed for other problems but we have several majority of our cases are actually moderate to severe and these are the ones who really had the COVID infection now for admission per month this is just for last year I have this reported that the severity of the disease this one are also they are increasing every time we have the surge so like this one the April and then the August to September and the outcomes actually are very good in children majority would recover or directly discharge from the COVID words but we also have some mortalities and these are the ones who came in on their severe to critical stage of the disease now for the comorbidities almost more than half about 60 to 70% are actually with comorbidities majority would be your Hima Onko cases followed by neurologic cases and cardiac cases but about 38% from our data 38% of these children do not have comorbidities so they are apparently well and then have COVID so most common symptoms on admission would be difficulty of breathing or respiratory distress okay fever, abdominal pain and definitely the coughing and in children they usually have vomiting and diarrhea we also observe that in the different types of the surges for example the early first surge for the COVID infection majority would actually present with respiratory distress and fever which we have seen that they have more fever and coughing and respiratory distress and now in the omicron surge we have fever and diarrhea but most of them would still be admitted for pneumonia I just want to share with you that those babies born to COVID positive mothers okay from PGHR experience for the year of 2020 we only had 4 positive babies we do PCR tests for all babies born to mothers with confirmed COVID-19 through PCR tests majority of these mothers are actually asymptomatic but we have some who are also having moderate to severe COVID during delivery the discrepancy in the number of the mothers and the babies because some of the babies are twins or triplets we do the swap of these babies within 24 hours of life and if they are positive we repeat them again after 24 hours and observe these babies if they remain positive on the second swap we isolate the baby if the result is negative on the second swap then we do the RIDs baby and majority of these 7 cases for the last 1.5 years they are actually asymptomatic and are well now in PGHR the isolation for COVID patients so we transferred there last year of October and this is dedicated for COVID in infections so the 42 beds are now all in the start of January are already on full admission and we have increased our COVID beds initially from the 15 the initial limit but we are now on 25 to 28 beds and even more so the challenges for January actually is that our doctors and nurses and even the other staff are also getting sick themselves about half of our resident manpower actually were all positive for COVID this January so the manpower and also the facility capacity is one of the challenges so for January I would just like to show to you that this on this graph that starting the January 1 so you look at the red and violet 9 which was the moderate to severe critical types of patients so we have that shifting so at the start of January we only have those who are asymptomatic or admitted COVID confirmed by PCR and admitted for other problems but now we are receiving the moderate to critical cases that are now again due to COVID so vaccination status of all these pediatric patients definitely the 2020 there's no vaccination for anyone even for the adults but in 2021 we started vaccinating the adults and last November we started vaccination of the teenagers or the adolescent but all these patients that we receive since December to January all have no vaccination at all and this table I just want to show to you that the Pfizer vaccine that is that is allowed to be given to 5 to 12 years or 11 years of age is different from the one that is being used for the adults and the adolescent so as Dr. Eric Tyed have said and I hope it will be available by next week because we have to wait for this one now our experience for the vaccination of adolescents so that it can also be part of the guidelines for the vaccination of 5 to 11 so we started last November the process was well received we call all our patients we started with those with comorbidities and we did we do text them we use the Google Forms marami na po sa kanilang mo na parents really know how to answer the Google Forms and then we sent them informed consent and everything and we have very very few adverse reactions reported even who were pangako kaisa na sa adults but the challenges remain that number one, these high risk patients with comorbidities yung may mga cancer po kiba or may harjak problems with that last November only about 50% gave their consent and got their vaccine the parents fear for possible side effects because their children already have illnesses they cannot accompany the child because in vaccination of children or adolescent children it would involve the parents unlike in adults they can go by themselves next would be the child does not want the parent may want to vaccinate the child but the child doesn't want to and the parents themselves are not vaccinated so they don't want the child to be vaccinated another challenge is for these high risk patients or those with comorbidities we recommend longer observation time for them after the vaccination the original 15 minutes observation we extended it to 30 minutes because they have we might see up for some possible side effects so it may have some crowding at the monitoring area so that is one of the recommendation so are we as the vaccinators we in the government and also are they ready the patients themselves the parents number one number two the patient and the parent readiness to accept this vaccine and the awareness that the vaccine can give the benefits and then iba pa rin ko nandun na yung the day na magbaba ko na na pupunta ba talaga sila and can they go to the facility some of them they don't have the masahe the transportation and lalo na nga po ngayon paano natin sila palalabasin now the third would be we have to give them accessible facilities to be able to increase the uptake of the fascination so with that i would like to thank you and please keep safe everyone okay thank you very much to Dr. Jane Pagkatipunan maraming salamat no and thank you to all our doctors from PGH, makikita nyo po na talagang pinag-aaralan lahat ng mga patienteng ito mga pediatric patients natin we're really they're really studying trends tinitig na nila po ano talagang nangyayari kaya ano para maswerte tayo na sila Jane din na natulogin si Dr. Jane tama ba yan kasi talagang nagbabantay sila pinag-aaralan nila and i think we all benefit from this very close observation very scientific approach parang hindi haka-hakaalang tinitin ang talagang nila kung ano nangyayari sa bawat patiente hindi ko sabihin ang pinag-aaralan parang very serious we take it very seriously so thank you to Jane to the pediatric group and to the Philippine General Hospital Raymond did you have a comment looking at the presentation of Dr. Jane especially at the vaccination status kaya ano pala siya, tinatrak pa rin pala kaya ano kaya sabi kung ano parang ano ay mahusay talaga mahusay tayo dito sa Pilipinas we really have very good experts we're really studying things very seriously so kaya ni natin to talagang ano lang parang siyempre pang nakita natin mano merot na puno ang ICU ngayon parang nakakanon nakakamoment ako nakakamoment ako kasi sabi ko nga meron akong apoy so it becomes a little different when you think about it but the good news is that most of them are getting well and that we know more about how to manage these cases so let's go to our next speaker we have a reactor from the Department of Health palad ko tayo asa man natin ang director na ang disease prevention and control bureau of the Department of Health we'd like to welcome Dr. Razelle Nica Howe so Dr. Howe welcome to the webinar Thank you Dr. Suzie and Dr. Aiman for extending the invite again to DOH now to discuss naman what we have to expect in the coming weeks given all of the things that were discussed earlier I have a couple of slides really mostly just to summarize and inform kung ano po yung mangyayari in the next couple of days especially in terms of vaccinating now a younger population group for COVID-19 so I think we all know naman po na currently the Philippine government has made sure that we have access to vaccines in the country starting from the adults wherein we had eight types of vaccines so that we could implement appropriately the past couple of months we have also rolled it out to the 12 to 17 and what we're anticipating to start very quickly is now this vaccination program extending it po to the 5 and 11 years old so as mentioned earlier sa FDA po they have authorized the use of the Pfizer vaccine for this younger age group but as mentioned din po earlier magkaiba itong formulation nito ang pang younger pediatric age group versus the other Pfizer vaccines basically the main difference is a dilution o parang mas onting amount of the active substance iyong ibigay po to the younger age group and all of this will be part of the trainings that will be done to the implementers on the ground when we start the roll out visually din po magkita natin yung difference and this will be the ones that are for the 5 to 11 years old will be through a vial na orange yung cap para hindi po tayo magkaroon ng issues or confusions regarding pung ane yung appropriate na Pfizer vaccine to provide to this age group so also as I mentioned earlier when the parents will go to the vaccination sites they will be expected to show some proofs of relationship to the child meron naman po maraming po may sources of proof in birth certificate that's usually the best evidence but they're also in our guidelines other list of possible evidences and then of course the IDs and during the screening may explain po what the process will be yung pagpipirmahing po kayo din ang consent form at siya kayong child po ay papabigyan din natin ng ascent or parang pumapayag din siya after of course na mas screen nung mga health workers natin on the ground yung eligibility po nung ating pediatric population to be vaccinated so very quickly po if this roll out will be starting by the end of January so actually that's really the next couple of days po you'll expect a lot of news about this. It will be through a phased approach first starting with nilex sites in the NCR and this is usually how we roll out new groups and new vaccination plans. Pina try out po mo na natin to a smaller sample and then very quickly and gradually in expand din po natin to other parts of the country. So to make sure na po na hindi magkakamix up on the ground the recommendations will be giving the implementers are to have dedicated sites or dedicated teams and even dedicated days po para we lessen any chances of giving out the wrong vaccine to the recipient and all of our implementation plans have been adopted based on the many learnings that we've had from vaccinating the adults and vaccinating our older pediatric groups. Next week please expect that the DOH will be releasing the guidelines especially for our implementers. Trainings will also be happening next week including inside inspections and site preparations and a lot of similar activities like this wherein you will have discussions with the public on how they can access all of these vaccines. So really just a reminder po and a call to everyone here this vaccine is an additional tool katulong po natin yan to really make sure we can go back to all of our usual and essential activities as a society. All of these vaccines have been assessed by the FDA and even by our expert groups to be safe and effective and the government is providing their free. They have shown really to give out a lot of benefit in comparison to this and to have this protection for having severe na disease. So the way to access them would be through your sites such as the LGUs and the hospitals and you can sign up through the mechanisms available to this but as a reminder po to everyone that isang tool lang po itong vaccination so even after vaccination we should all remember to implement all of our minimum public health standards. Lalo na doon sa mga high risk na settings na yung closed kaya mga indoor, yung crowded dumadaming tao at siya kaya yung mga close contact o yung lalo na yung nakakahilabilo kayo sa mga ibang tao outside your household. Always always be implemented with masks with distancing yung paghugas ng kamay at yung pag may make sure na we have adequate ventilation or air flow. And as a special reminder po to everyone especially as we start vaccinating our kids to make sure that we also protect them from the other diseases. So of course not at the same time but this is just for a reminder to make sure na yung marami po tayong ibang sakit din na pinapabakunahan lalo na sa ating mga bata so make sure that we don't forget that vaccines in general protect against severe disease and death and that includes vaccines for all diseases and vaccine for COVID-19. Thank you very much po. Thank you very much. That's Dr. Nita Hao of the Department of Health very informative, very straightforward information about the vaccination process. So at this point we'd like to call in all of our guests to open their videos. So Dr. Hao, Dr. Jing, Dr. Eric and Dr. Mayan. So we will have our panel discussion but before that Raymond will go into a public service announcement. Thank you Dr. Suzie. Thank you in a session. We'll just take a very quick break for a special public service announcement today. Over to you.tvup. Sigurado ka na ba si Reservations natin? Oh naman. Bakit bis na bis ka? Oh, magiging escort mo ako eh. Mokong may date si Lolo. Ilagay mo kaya ito. Ang ganda naman. Maganda yan. Bakit natin? Ready ka na? Mom dad, alis si Lolo. Oh anak, after lunch. Sanalakad nyo po. Para sa atin lahat ito magpapapakuna kami dahil mahal namin kayo. Dahil mahal ko kayo, magpapapakuna ako. Thank you tvup, the COVID communication public service announcement is one of the many outputs of the UP research and title communicating COVID-19 in post quarantine Philippines. It's headed by the UP vice president for public affairs, Dr. Nanny Perna and funded by the DO-STP CHRD and the Department of Health through the AHEAD HSPR project. Dr. Susie. Thank you very much Raymond. I think you know what I want to do Raymond because in damning specific questions is a Q&A box. Instead of going into very general questions, what I'd like to do is to pick up on each of the questions on the Q&A box and some of those that are in the chat because they're very specific and I think people can learn a lot from the specific questions. Raymond, pick up in kayo natin yung mga nasa Q&A muna. Sa isayin natin sila, kahit na hindi upvoted, we have time eh. Sa sabi ko maraming questions na magaganda. No problem, no problem. We also have a few more questions coming in from the comments section so we'll call wala po ito. Hindi po sila na ilagay sa Q&A section. This question comes in from Caroline Butler question reads and this is our most upvoted question knowing that most children aged 5 to 11 have a robust immune response. What would be your advice regarding the timing of the vaccine if the child got infected in this last surge? Do we have any information regarding reactions to the mRNA COVID-19 vaccines among 5 to 11 years old especially for those who got omicron or other variants? Maybe we could ask go ahead sir. Okay, the current recommendations for those who have been exposed or infected is that they have to complete the period of quarantine or isolation and as soon as they have recovered which is described as having at least being without fever for at least 24 hours and improvement of respiratory symptoms. Otherwise vaccination can be delayed so as soon as you finish your quarantine or isolation you can actually get vaccinated and now if there are any qualms about this these are recommendations that only from the Department of Health and the authorities as well. Thank you. Over. Raymond kuning ko yung top question natin na from Dante Morales for 12 to 17 year old who had Pfizer vaccination five months or more before can they get the Pfizer booster which is the same dose for the adult in the country? Does DOH allow this? Can they get it during Pfizer vaccination for adults? Thank you. I think you will be with me on this ang alam ko wala pang wala pang schedule for boosters for 12 to 17 years old. Even though lang pas na sa limang buwan from their second dose. Not unless you can share doctor Anika any news about this if 12 to 17 can be included in the booster doses. Ang rejoinder ko po dito is we are currently following what is allowed by the FBA emergency authorization. So for now what the FBA allows is a booster for the adults. But tama ko that will actually be something we should expect. Siguro the answer lang is at this point it's not yet allowed by our FBA and it's not yet part of the implementation plan but that is still happening in the near future. Thank you. Thank you doctor Susie. There's a rejoinder from Caroline Butler. So the recommendations have been made based on past information on adults. But she's asking about children regarding especially information regarding reactions to the mRNA vaccines among children. And if there's any information on the 5 to 11 especially because there are issues from the past with regards to the deng vaccine po. Maybe we could ask the opinion of PIDSP doctor Ramean any information po on adverse reactions among the 5 to 11 sa mRNA vaccines po. Thank you Raymond. So we just have a data based on clinical trial which was done for Pfizer in children age 5 to 11 years old. And dun sa data ng yun ang nakita lang nilang most common reactions were vomiting and fever. Okay. I know everybody is a little bit anxious about the myocarditis which is rare adverse event which has also been an issue in children age 12 to 17 years old before Pfizer was rolled out. So this is the same issue among 5 to 11 years old and this usually happens on the second dose. But comparing this adverse reaction between these kids there were of myocarditis events in the 5 to 11 years old compared to the 12 to 17 years old. Okay. Thank you very much. Susie Raymond can add something to that. In my presentation the new England Journal they study there were no cases of pericarditis, myocarditis that were reported following 19 vaccination with the Pfizer-BioNTech. Thank you. Over. Okay. Thank you for that. We have a question from Emma Lianto. May I know the current recommendation covering interval between COVID-19 and routine vaccines. Is it still two weeks? I don't know who wants to answer this Jing or maybe Let's ask DOH Dr. Nika for that. Yeah. So our guidelines compared to the adult we still recommend 14-day interval for vaccines and mostly it's because of we want to check kasi kung may adverse event. Para hindi rin na confused na yung reason for an adverse event is a different vaccine from the other. For now we do that but actually some sites are also authorized if they deem necessary from their physician. So baka may explain it ng mating implementers. Thank you. Okay. Nika, I have a follow up question to that because I heard you saying baka kailangan magpakita ng birth certificate. Hindi ba pwede yung vaccination card nila sa ETI? Meron po Dr. Suzy na list of possible alternatives. I'll have to check that card from the ETI as a source but hindi naman po yung certificate yung required. Actually other ID's and other proofs are allowed. I think kasi sama kong yung documents but I'll have to check. Thank you. Okay. Thank you very much Nika. Raymond, ano pang napili mo question? Our other most upvoted question comes from Florence Alzate. The question is in case of adverse events, can the parents of the children expect assistance from the government? DPCB again. So in the vaccination program our financing support is for kung niya rin, kung sa kaling kailangan mo hospital so there's a fill health package to support any hospitalization necessary and there's also a separate adverse event following immunization benefit if it comes to have more severe presentations. So the support is through there and of course lahat naman po especially those who receive adverse events after investigation are referring to our hospitals and to our regional offices who facilitates as much as they can whatever is needed by that specific case. Thank you. Thank you. There's a question here from Cheryl Sakro. Do we have a new DOH template for medical certificate for patients with home morbidities in the age group 5 to 11 years old? As I sabi natin, unayin yung may home morbidities chiya ang anak na frontliners. So is there a template for that? How is that how is that how is that going to be managed? Anyone? So sa guidelines po natin include vaccine specific and age specific health screening form. Yung medical certification po kasi we don't require that naman for everyone but there are certain diseases where we require the certification. We don't have a standardized template but that certification has to include that the doctor recommends that the child will have the vaccine. Okay. Yes. So any recommendation of a doctor na may home morbidity yung bata pwede yung unayin yung. Yes. We did that with the adolescent vaccination that there should be a recommendation from the pediatrician or those with comorbids. They have to follow that. Gusto ko naman comment mam yung balik lang ako sa isang comment na ina na about the vaccine after a disease yung ganyang cases. Because this vaccine is under special recommendation and it's available in the government. So the principle kami on the side of PIDSP we also have the other vaccines recommendations di ba. We follow the principle of vaccination but for this COVID vaccine we have to follow our government recommendation kasi lagi yung kaming na tatangong ganyang. Kasi it's a program para hindi na hu tayo magkagulog sa mga anon natin we follow the government recommendations. Yun lang ko. Okay. Thank you Dr. Rajing. Since we have you, we have a question coming in from Dante Cecilio Valdes. The question reads is it rational to give COVID vaccine to cerebral palsypediatric patients? Do we still require them to be cleared by their pedia prior to vaccination? Yes, all patients with comorbid they have to be cleared by their pediatricians or those who are looking at or taking care of them and it is recommended the only contraindication for not giving a vaccine is if you have a adverse severe reaction from that vaccine and that's the only contraindication. So all the rest pwede na ako. How about this question from Riva Darabundo if a child is exposed to a COVID-19 positive family member and develops the same symptoms but it's not tested for COVID-19. How many days before he or she can get the vaccine? You finish the recommended isolation or quarantine. So yung mayan na po tayong guideline for that. So again katula din ang sinabi na Dr. Eric Kanina when you got the disease or even kailis na siya, exposed na siya sa household and develop the symptom. So again follow the isolation or the quarantine days before they would go for vaccination. So what is that that has changed Eric, ano ba yung number? How many days? So kung unvaccinated ka unvaccinated lang ang quarantine mo ay 14 days. Okay. 14 na araw so ay mo monitor mo yung araw araw. Kaya ang inihikayat namin na yung di magpapabakuna kasi kung bakunado kayo mas naisipo yung quarantine po. Okay, so Eric, after the 14th day pwede na magpabakuna yun? Oo, kasi yung quarantine niya hindi siya nagkaroon ng symptoms most likely hindi siya nahawa so pwede na siya magpapabakuna. Okay, good. I have a question here Raymond that I thought was interesting. Sige pa. This is probably for Jing, pag atibunan. I would like to ask this is from Joanne. I would like to ask if there are reported long COVID in previously admitted pediatric patients whether the common presenting signs and symptoms. I guess this is in relation to patients you have followed up over the year. So what do we know about long COVID in children? So far we have not the good news is we don't see much of the long COVID in children. Maybe remember our yung patients po natin medyo may sa PGH they may not follow up but we are doing a study on the long COVID in children so we will actively follow up all these patients especially those who had severe to critical na tapos nag recover sila. We will see if there's really long COVID also in children but so far po namin, very good na hindi kami masyado na nakakita for now. Okay, thank you. Thank you, Jim. That's good news. Ah, Raymond, may nakapang question dyan? Well, this one is more technical po and I'll direct this to Dr. Ramean. It's coming in from one of my former teachers and also former Deputy Director for Health Operations of PGH, Dr. Julia Taguilar. The question reads considering that the immune system in children is not as developed as in adults do you foresee that the decreased dosing given to the younger children may require earlier boosting as the levels of immunity may not last as long as in the older children or adults po. Ang hirap ng tanong may Dr. Sjo. Sa ngayon kasi Raymond wala patahayong dato siya. So, kailangan mo na natin tignan. Lahat naman nyan nang gagaling sisi mula nalag nating and then ibibigay mo yung second dose. Tintayin mo kung ano mga yayare kasi as it is right now sa 12 to 17 na sa America, nag-recommend na sila or nag-encourage na sila nang boosters. Ito na mas batapay yung bibigyan natin, subungkan mo na natin. Tignan mo na natin kung ano ibibigay na dato sa atin kapang kinampleto natin ng sa mga batang ito. Yon lang. Salamat. Can I add? Raymond, can I add? Go ahead, Director Erick. Okay. Okay. They're swinging immunity with the vaccinations just as already been established. It starts during the fifth month after completing the vaccination. That is the reason why booster doses were recommended. But of course we are gathering more data out there so that we can have a full understanding especially the impact of Omicron in past potential immune escape. Thank you, Director Tayag. Thank you. Meron ako, Raymond. May nakita mo. Go ahead, Dr. Susie. I'm congratulating. From Lailani Nashon. And this is because I also saw this in the chat. I'd like to ask for regarding kids with special needs. What would be the setup for them? Do they need to line up? Is there a priority lane for them? There was also a question earlier about in the chat about children with autism. So how are we going to, how are we organized to have children with special needs? So I think that's for Nita. Yeah. Thinking instructions we provide to the vaccination sites that they have to be wary of the specific situations wherein we have to facilitate better. So some of the things that vaccination sites do is to have priority lanes. Some also have dedicated days. Some do house to house. So really these, especially these are operational concerns. We leave it to the sound discretion of the vaccination site. And palagi naman po yung ating regional office na dibigay din ng advice asa ka nila. But definitely po we do advise especially for those who would have special considerations to be prioritized especially when they are already in the site. Thank you. Okay, thank you. Raymond, yung naman. Doctor Anika, there are, I'm consolidating just several questions into one here. The theme of all of the questions is regarding how to make it more enticing to the children para magpabakuna, may involvement mga children-related organizations, the use of theme parks, amusement parks, fast food chains, et cetera. And schools in the roll out what's the role of teaching and non-teaching personnel. That sort of thing. Go ahead. Sige, siguro I'll start answering this question by confirming that the planning process is multi-sectoral. So especially with our National Vaccines Operations Center, we do have private sector there. We have our fast food chains helping. And they've done a lot of help especially for the adult vaccination program. So definitely, especially these scale ups will happen as we progressively roll out pediatric vaccinations. So as I mentioned, this will be in a phased approach. So in the first few weeks, we will be starting with a couple of sites first to see if there will be additional implementation concerns we have to address before a more larger roll out. And similarly, like what we saw in the adult group, kapag parang pulido na lahat, lalo na this is a new group kasi na new population. That's when all of these demand generation activities will come in. Siguro mag-additional note lang ako dun sa mga theme parks and ano-ano. So currently in our National Guidelines, we also have specific rules about when to allow activities in these areas. Especially these will be for lower risk, lower alert level areas. Because of course, yung mga issues din of possible crowding in Kenyan. So definitely these can be explored. Yung sa schools, we've actually have discussions already with DEPED to do that once we go to the expansion phase. And of course once mag-resume face-to-face classes. So definitely all of these are in the works. Yung napo ay go back to the face approach. Now we don't, we won't expect that maybe in the coming weeks. Because we still want to try out first in a couple of sites. Especially for this younger age group with a different formulae. Thank you. Thank you. Raymond, I find a good question here and I've actually been asked this question kasi maraming, maraming nakakakogid ngayon ano at maraming COVID. The question is from Maria Victoria Jimenez. An unborn child in the womb is, is, is affected by COVID-19 virus if the mother is positive. So this is probably for Doc Mayan. Mam Mayan, idadal dagang ko lang din po kasi may question po regarding breastfeeding. Naipapasa rin po ba yun yung true breastfeeding? Yung, yung number one na tanong, tanong po ba is may transplacental transfer po ba ng Yes ma'am. Correct ma'am. Okay. So far kasi wala pa kong nababalitaan na parang may congenital congenital COVID dahil nakukasa na meron mga perinital ilang araw pagkatapos ipanganak yung baby nagkakakong perinital after birth. Yung breastfeeding actually sa totoo lang po inay-encourage pangapunamin yung mga nana'y na i-brestfeed yung baby kasi nakakatulong po ang breast milk e na kahit pa paano magkaroon ng panlaban yung baby. So we do not discourage breastfeeding dun sa mga mami na positive and then yung ihiwala'y mo yung baby. I think that's also the recommendation of the society concern about yung sa mga OB-Bion gene mga asapogs yon. So yun po, doctora Susi, yun po yung kasagutang ko dun sa mga katanungan nila. Nice. That's very important information. So if you're pregnant and you got COVID you don't have to worry marami kasi yun gano nabawari talaga sila kasi buntis tapos nakakovid and they don't know what to do about it. So don't worry. Susi. Yeah, go ahead Eric. Okay. Alam mo, isa sa eligible population na mababa yung vaccine coaguration pregnant women. Okay. Ang mababa, wala pang 30% yung nababakunan sa kanila. Kaya siguro ito yung tamang platform para palala sa pregnant women. Mababa ko na pa kaya pukayo lalo na at start ng 2nd trimester. Ang ni-re-recommend na sa 3rd trimester kasi you confer protection to your baby. Tapos Susi, naisip ako ang maalang maging malaking sa gabal dito sa pababakunan ng 5-11 pag ni-roll out siyan. Naisip ko ay yung mask kasi di ba kanina sa presentation kailangan may mask yung mga bata. Ayong mga masks natin abondan sa mga bata yung size na po yung kaya ito ay dapat paghandaan. At yung sinabi ni Dr. Nika na yung mga may mabuting kalooban yung mga sa private sector natin. Ay isa to sa maari yung pag-estipan at baka ma-tulungan yung kali sa DOH. Yung mga paman lang local yung mga sa mga bata lalo na lalabas ilang pagpabakuna. Over to you, Susie. Thank you very much for that. Yeah, go ahead. Yes. Port ko lang yung kemamean kanina. So, PG, that's why we do the testing for these babies for after being born. And we have senior po. It's usually prenatal after birth na yung exposure nila because maybe the mother or the other household members are infected. But for breastfeeding lahat po itong babies namin nito sa PGH we do rooming in para talagang makapag breastfeed lahat ng mothers. So, we really encourage breastfeeding. And there are several studies already showing that breastfeeding is safe. Kaya po even if you're infected yung mother and it has more benefit na than the rest of but still please follow the infection control. Nakamast pa rin si mommy kung ano siya kung infected pa rin siya or symptomatic. Nakamast wash your hands and then pag basalagi lang po as on demand nakukailangan niya magpasuso talagang yung lang niya kukunin si baby para magpasuso. So, that's please immunize sabi ni mama and in PGH data 80% of these mothers who who give birth and are positive they're unvaccinated. So, very, very ano nga po talaga na we really want this pregnant women to be vaccinated. Okay, so that's a very strong message for our front diners who are watching. We've been emphasizing vaccination of seniors but I think what we're saying what we're hearing from our doctors here is we have to take a special effort to have pregnant women vaccinated. I've also heard of a lot of women who are breastfeeding who don't want to get vaccinated. So, hindi po na dapat po nagpapabakun na kayo at na-renig nyo na sa mga dalubasa kung bakit na. Raymond, over to you. Meron ko parang nakuha dyan. Thank you, Doctor Susie. So, I'm just consolidating po yung mga questions po especially for from a public health perspective and policy-wise. Meron po dito, there are two questions policy-wise questions po. One coming in from Doctor Emilianto if parents are not available for the consent, who else are allowed to give consent? And the second question comes from Doctor Lulubravo, former NIH Executive Director, our pharmacist going to be allowed to give vaccines to the 5 to 11 population. Doctor Nika. Thank you, Doctor Raymond. So, yung first po, usually we follow yung meron po kasi tayo legal rules about kinship kung sino yung mga pwede yung sunod-sunod, I believe that's in the family code. I can't go lang into the details but that's usually followed and that's also what DSWD follows for example. Ang naalala ko at the bottom of that hierarchy of list is if at the end of the day DSWD representative can be the guardian of the child. The details na bang nalangpo nito you can see in the guidelines when it is going to be released. Do naman sa question about the pharmacists. Right now the roll out in pharmacies is currently limited only to healthy adults. So at this point hindi pa po especially for our children that may be something that can be explored in the future but right now po in terms of policy hindi pa po siya and thank you. Okay, thanks. Let me just follow Eric, go ahead. Go ahead Eric. Kaya nga important nating Susie na habang nagahanda tayo sa pag-rollout sa 5-11 kami ay nanandawagan sa Department of Health kami nying document ngayon sa mga pediatricians natin sa pagkata malaki-laki rin yung bilang nga mga batang babakunahan over 12 million. So kagaya nga hindi pwede yung mga pharmacies. So kakailangan talaga natin ang marangit sa ating hana para sa gano mag-bondon ang titp at mag-bakunan. Over to you Susie. Okay, thank you very much Eric. Mika, follow up lang do. I think that question about kung wala yung nana isinong pwede yung mag-bigay ng consent. Maybe we should have very clear instructions to families because of the number of OFWs we have in our country. The general public will not read the guidelines or will not go through the detail of that hierarchy. So siguro magandang talagang malino yung napagwala sinanay pwede si Tatay susunod pwede si Lola pwede si Yanad. Now this is very important information because if we just say read the guidelines I think that might be a big barrier for the family to give consent. So it's good to know na meron tayong listahan but I think we need to be very explicit about sino talagay yung pwede. And our OFWs will really appreciate that that can be disseminated through the Department of Foreign Affairs something like that. So anyway, okay, Raymond, one last question then we go to our is this one question is a little bit interesting just because this is a question that we've gotten numerous times not just for this. So for the 12-17 ang binibigay po ay Pfizer at Moderna but for 5-11 Pfizer palang po ang binibigay. So the question from Emil Villanueva why is Moderna not yet approved for that same age population and do we know if it's already being reviewed by the Food and Drug Administration? Thank you. Raymond, ako siguro and then our experts can actually also input but actually globally yung mga vaccines na pwede for lower than 12 are actually Pfizer, Sinova, Sinofarm and something a brand we don't know Soberana which is the one made by Cuba. So Moderna actually has not yet in other parts of the world at least to my understanding have a formulation for 5-11. So that may be the reason why it's not being implemented. The other vaccine branches as I mentioned I understand are also being reviewed by the FDA but at the end of the day we will be rolling out based on what has been approved by the FDA. Thank you. Okay, Raymond I think we're going to give our audience 5 minutes back of their time. Maybe before 2 o'clock yung acting New Year's Resolution na atapos nang impunto alas dos pero siya sagutin na natin Raymond yung Okay, so for our fun quiz for this webinar the two questions may we have the mente okay, there we go. Two questions sino po an dapat mau unang bakon naan sa mga bata na 5-11 years old ang options po natin batang may comorbidity batang anak ng frontliners batang nauna sa listahan ng LGU at batang mga pangapasok sa iskwelahan. So obviously we'll ask this to pediatric ID specialist mammean can you help us out? Raymond sa tanong na to ang unay natin yung batang may comorbidity and then susundan natin nung batang mga anak ng frontliners. Thank you Doctora Boony and then for our second question you've already heard this but we'd just like to reiterate kasi this is one of the we still receive questions sa with regards to ano po binibigay sa 5-11 but maybe we call us Doctora Jing pagkatipunan alin sa mga sumusunon na bakuna ang aprobado ng FDA para sa mga batang 5-11 years old Doctora Jing Our local so kailangan kung sundin natin yung ating sa bansa that is available and approved so that's that's just the Pfizer for now. Okay. Thank you so much Doctora Jing Doctor Susie before we go into our evaluation poll TVUP will be playing our stop COVID deaths shorts yung ating mga short videos po meron po hinihanda if you go to www.youtube.com meron po mga short videos hindi po siya literal na shorts pero short videos po siya snippets ng ating mga webinars para po mas easily consumable makikli lang po ito and something that if you go to YouTube or you're a YouTube madalas po kay sa YouTube mas makikita nyo po siya palagi at very very quick videos that's really a clip from the select webinars that we have had so while our resource speakers are essentially contemplating and gathering their thoughts for their final messages for our audience may we have on the screen the evaluation poll for our webinar for this afternoon. It's gonna work ha everyone hopefully to work at the time we arrive. It's gonna work ito po ang aming yung okay we have five questions I'm just waiting for the attendee this now numbering more than 1,300 to enter their answers there we go okay it's working what we should touch the end poll nobody touches it okay the end poll yes correct correct thank you the first question it reads the panelist is demonstrated thorough knowledge of the topic it's a four point likard scale strongly agree agree disagree and strongly disagree something is happening again anyway please wala na naman the second question the panelist were well prepared and organized number three panelist spoke clearly and audibly number four the panelist use appropriate language with technical medical jargons adequately explained and number five the panelist contributed to new perspectives and knowledge on managing virus key COVID-19 health issues okay while we're trying to make this work Dr. Suzy I'll turn the floor over to wala na naman bakit ganoan okay anyway it's working na so nobody touch anything para hain di ma frustrate yung I think audience okay so we're going to have our parting words for for audience and as you know our audience are frontliners I think we would like to hear from our guests what what your your main message is for them in relation to preparing for vaccination of children so we're going to start with Department of Health Dr. Niki Hao go ahead thank you Dr. Suzy well I think what I want to tell all of course all of our frontliners is we all understand we're now at the second year of the pandemic no so all of your work has been really valuable not just in terms of vaccination but even in response and this is the light at the end of the tunnel protecting everyone all the age groups will give us more confidence to really slowly reintegrate back into our work so I hope we all have your support to continue to implement all of these and also please be assured po na especially sa DOH and our office at the disease prevention and control bureau that everything that we do especially in terms of our policies are guided by evidence and are done in consideration of our countrymen and of course of our health sector and our frontliners so thank you very much po. Thank you very much Nikki for joining us we'd like to have now a message from the Philippine General Hospital from Dr. Jing Pagkating Jing sayo na As a frontliner myself sabi nung ako hindi ako na tutulog Obvious ba? But I really want to share that the data from our end as a frontliner to encourage everyone that we are doing our best to manage all this and give you the data our local data so it can support whatever program our DOH will be implementing so we ask for the vaccine and that would please support no vaccination and also as a pediatric infectious disease specialist as part of speed speed also we are always here to help everyone no about the the data no and also for the research so please support vaccination not only for the kids but also for the adults thank you very much Thank you very much This is Dr. Jim Pactipuna from the Philippine General Hospital We go to Dr. Eric Tayan Eric Over to you This is Eric Did we lose him? Mag-gandang happened here At marami salamat po at binigyan nyo kami ng pagkakataw na mailahad sa inyo po ang mga kaalaman Question lamang po ang mga nilad po sa inyo kailina ay ma-arimang bago sa mga susunod naaraw Habang abala po tayo na madagdagan ang mga Pilipina mababakunahan yung po ang mga batang lima ang ganami isan taong gunang mag-nating kalimutan na marami pa pungin din nakaka tikin nang kahit unang injection at siyang po ay kailangan natin pagtulungan hanapin convincing para na sa ganoon sila ay mga kasama na po natin sa fully vaccinated bag cost baka kailangan ng booster po at sa inyo mga frontliner sa ludo po ako at kaya nga ako sa aking sarili po ay may ang bagpoko ako po ay patuloy sa aking pababakuna hangkat maraming opportunity po dyan at ako po ay natutuwa sa pagkat nagagawa po po yan na makapagbakuna sa mga kasama ako rito sa central office at sa marami pang iba sa pagkat hindi po lahat na yung nabibigyan ang ganitong pagkakataw para magsilving lalo ng ngayon sa panahon ng pandemic sa mga kasama ako po sa inyo uwag po kayong mga bakon sa kaling kayong magboholong kailangan namin kayo sa pagkat paano may mababakunahan kung walang magbabakuna salamat po thank you Susie thank you Raymond thank you very much Eric well said and finally our co-host for the webinar we'd like to call on Dr. Mayan Bumi Dr. Susie Dr. Susie simple lang po ang aking ang gusto ang ipahayag na ang mga bakuna ay mabisa at ligdas para sa mga bata yun lang po ang gusto kung iparating sa ating mga healthcare workers at maiparating yun lang po marami salamat po thank you very much thank you to all our panelists we have a brief synthesis by the dean of the U.P. College of Medicine di kanop ko namin sa U.P. we'd like to welcome Dr. Charlotte Wendt I cannot start my video Good afternoon po at marami-marami salamat sa pagkakatao na ito na makasalo kayo dito sa stop COVID ako po ay mabibigay ng conti-synthesis so we actually started with the opening remarks of Dr. Mary Ann Buño was actually the president of PIDSP who gave us a background on the vaccination rollout in the past two years and even highlighted that cooperation and collaboration were really needed for the vaccination of the 5 to 11 years old population of children we actually thank PIDSP and PPS for the joint position statement on the vaccination children Dr. Eric Tyre as usual gave a very comprehensive and animated presentation with a review of the global COVID status cases with about 326 million COVID cases worldwide and about 5.5 million deaths with USA, India, Brazil, UK and France as top five and the Philippines ranking the 20th with 3.2 million cases and 52,000 deaths so COVID-19 is now ranked as the second most common cause of death in the Philippines in second only to Schemic Heart Disease even highlighted that children are also susceptible that 18% of lab confirmed COVID cases are actually among children and that children can always transmit the virus even if they're asymptomatic and therefore this prevalence can actually increase with increasing age and ang importante po ay sinabingan na ay masking because inconsistent masking is really the most common cause of transmission and not school attendance per se at while death is rare 133 deaths in 100,000 cases in 2021 malit nga po yun pero sinabingin po nyo na baka nga mayroong long COVID so kailangan pakingatan pa rin ho ang mga bata so governments really need to contextualize these vaccination programs given the supply constraint vis-a-vis the other vulnerable population especially the elderly who have not received their vaccination in other groups so lastly just reminded as the children really need to be prepared for the jobs hindi naman po pwedeng dadaling nyo lang siyang na hindi nyo piniprepare psychological yung mga bata kasi baka hindi pumayag magiiyakan sila siguro sa mga vaccination sites at magkakapilitan tayo don medyo mahihirapan ng ating mga healthcare workers and frontliners sa vaccination sites Doctor Nika how actually already outlined to us how they will operationalize the vaccination and even presented to us the special considerations and preparations being done by the DOH for the rollout of 5211 saying that there's going to be a pilot launch and maybe an expanded rollout given the experience of the initial rollout marami pa po tayong pa kailangan pagandaan 12.5 million ng ating 5211 years old kailangan natin bakunahan so hindi po bero yan so marang maraming salamat sa tvup kay director PGL Fonso kay B. T. Nemi Pernia ating dalawang hosts Susie Pineda and Raymond astagalagang bilib nabilib po ako sa kanila nga number 84 na po tayo pero nakita naman pang nyo ang kanilang energy ay nandad yan palin marang muna salamat of course sa speakers natin kay Doctor Bunyi Doctor Eric Tayag Doctor Jean Pagkatipuna ng PGH at dito kay Doctor Hao kay Doctor Pagkatipuna ayong kanya mga PGS experience ay isang napaka importante kasi ito yung mga evidencia na kailangan gamitin natin para wag tayong matakot at lalo pa tayong pagtingin ang pagbihalaga sa ating mga bata bagamat sinasabi nga niya po sa kanya presentation na tatlulang yun na karunang multi-system inflammatory syndrome nakita nyo po after one year nag four fold increase yung MIS at na three fold increase ang may moderate covid kaya hodo madame kaya hod siguro kailangan natin pag-isipang mabuti atong vaccination so may rami, marami salamat po again at ako ay nabigyan yung napakakataw na isintisize ito at ang bikin na closing remarks lagi kung sinasabi kaya natin ito mga Pilipino magagaling tayo kailangan natin talaga maipaliwala yung mabuti sa ating mga kababayan kung gano ka importante ang bakuna nakatakot doon sa sinasabi mga nakakatakot na reaction o side effect ng vaccine dahil kailang magtiwala sila sa ating gobyerno sa ating DOH sa ating mga frontliners na nabubuwis ng buhay tayo ang talagang gusto natin ay makaraos tayo ng maayos nito sa covid-19 at walaong kaduda-duda napag binagunahan natin ng five to eleven years old silang sa kanilang nakasalala yung kinabokasan natin bayan so kailangan natin sila ang talagang pagtuuna ng pansin marawin marang salamat po ok, thank you very much that's our Dean Charlotte Chong of the U.P. College of Medicine always very inspiring at napakawos ay nang kanyang synthesis parang skoyong two hours natin ay nalagay na sa isang maikling summary so ok, next week oh my, we have a good topic don't miss it and I'm sure you are experiencing this dilemma habang nag-surge anong ginagawa para sa mga emergencies panong inorganisa ang ating mga emergency room anong protection ng ating mga emergency room workers mga ambulance drivers so ito po ay pag-usapan natin dahil marami po kahit naman nag-covid nagkakarun pa rin ng mga emergency dahil sa iba-ibang mga sakit guest po natin ay president of the Philippine College of Emergency Medicine meron po tayong mga emergency room chiefs of the Philippine General Hospital East Avenue Medical City so pag-usapan natin how to manage emergency room in the time of COVID don't miss it and invite all your friends in the emergency departments to join us next Friday Raymond, over to you thank you so much Dr. Suzie and thank you for that wonderful synthesis and closing remarks from College of Medicine Dean, Dean Charlo Chong we'd also like to thank the very hardworking team behind the stop COVID-19 webinar series without each and every one of you we won't be able to churn out this quality content po and be part of our growing credible online community po and finally, all stop COVID-19 webinars are archived for viewing at the TV UP YouTube channel for your convenience it starts po, everything all of our webinars for webinar one up to webinar 83 and then after during this weekend webinar 84 po sana po, you'll have the time to watch them on the playback at mas matututupo tayo ulit with all of the learnings and the wisdom imparted by our resource persons po gaya po na nasabi ni Dr. Suzie mahalaga po yung ating topic for next week po especially for those well essentially po na in emergency situations we may be able to touch on those that have been affected by typhoon odette, so paano po ang kailang kalagayan so please watch out for that webinar I hope you can join us again next week, this formerly closest our webinar for this week we look forward to your company again next Friday from 12 noon to 2 pm, it's a date together we will stop COVID deaths so keep safe, keep healthy see you online do I have strength to carry on my God our Lord with this go on and leave you here to keep me strong I'm here to keep my until my his name to read is hold on to the word he gave this time we'll come to pass cause this salvation makes a last you'll carry you to see the break of day this time we'll come to pass cause this salvation makes a last you'll carry you to see the break of day the others pain before my fears the others laughs before my tears but right behind the last I look into myself and ask do I have strength to carry on my God our Lord with this go on and leave you here to keep me strong I'm here to hold until my head's dying my fears the others laughs before my tears but right behind the last I look into myself and ask do I have strength to carry on my God our Lord with this go on and leave you here to keep me strong I'm here to hold until my head's dying these things through another day