THE Department of Health (DoH) admitted that "roadblocks" have delayed the procurement of bivalent vaccines, but it gave assurances that the first batch may arrive in the first quarter of the year through donations.Health Department Officer in Charge Maria Rosario Vergeire said in an interview that the negotiations for the bivalent vaccines are continuing. However, the procurement process will now be subjected to the provisions of the government procurement act with the lifting of the state of public health emergency last December.The state of public health emergency allowed the emergency procurement of vaccines and other medical technologies for the country's Covid-19 response. "We are now reverting to the usual process of procurement under Republic Act 9184 as the [declaration of] state of calamity was not extended. That is the roadblock we need to study very carefully, as this won't be as fast as the emergency procurement," Vergeire said in Filipino.She added that the DoH is doing "all it can" to expedite the process, adding that while the government is negotiating for the vaccines, it is also processing possible donations from some countries and the Covax Facility. Despite the delay, Vergeire said that the Philippines can expect the bivalent vaccines in the first quarter of the year.She added that getting strokes after being vaccinated with the bivalent vaccine is "highly unlikely." A study found that the Pfizer bivalent vaccine has shown a potential link for ischemic strokes in patients 65 years or older.The US Food and Drug Administration and the Centers for Disease Control and Prevention flagged these possible risks, but recommended everyone to take these vaccines."Whatever the reactions we are seeing in the monovalent vaccines are also the same with the bivalent ones, so the recommendation of the FDA and the CDC is that there should be no change in the vaccination practice because of this result," Vergeire said.

PH ready to lift emergency

In a separate briefing, infectious disease expert Dr. Rontgene Solante agreed that the Philippines is ready in case the World Health Organization lifts the state of Public Health Emergency of International Concern for Covid-19.The WHO's emergency committee is set to meet on January 27 to decide whether to lift or extend the said declaration, which was announced in 2020.Solante, head of the adult infectious diseases and tropical medicine section of San Lazaro Hospital, said that the country "is not threatened anymore" by spikes of cases. "This is good news because it means that we have attained population immunity due to the number of people who were vaccinated with the primary series," he said.However, he urged the public that while cases remain manageable and hospital utilization rates remain low, they should still follow the minimum health protocols, such as wearing masks in high-risk settings such as crowded areas. They should also undergo immediate isolation if they get sick from the virus.Solante also urged the government to strengthen surveillance and promote the booster vaccination program instead of proposing additional restrictions to travelers due to case spikes in several countries, including China. Likewise, Dr. Tony Leachon said in a Viber message to The Manila Times on Wednesday that the country is ready to move out of a state of public health emergency."I think the Philippines is ready to move out from a state of public health emergency in 3 to 6 months time due to the low number of cases, deaths, [and the] positivity rate is less than 5 percent, due to combined vaccine and natural immunity," Leachon said. "The only thing that we are waiting for is the announcement of WHO on the directions due to the China surge. I expect that we will know this information in the first half of the year as we are strengthened by the procurement of bivalent vaccines."Leachon, however, recommended a strong disease surveillance, continuing vaccination and booster program for high risk patients, and public education to avoid another spike.