Delivering COVID-19 Vaccines to the Last Mile in the Philippines

For Vilma Campos, a mother of five from Quezon City, the Philippines, life has been better since her family received their vaccinations. “My daughter and my husband have gone back to work,” she said. “Life is no longer as hard (as it was at the beginning of the pandemic). I really hope we can all get through this pandemic.” 

Vilma worked as a child caregiver before COVID-19 hit the country in early 2020. With quarantine restrictions forcing everyone to stay home, her employer did not need her to watch their children anymore. Her husband and daughter had also lost their jobs because of the community quarantine restrictions imposed by local authorities. It was a trying time, they often did not know where the next meal would come from. The arrival of vaccines gave them hope.

For Marjunell Mendoza, resident of Cavite, access to vaccines has given her and her family a sense of safety and security. She brought her children to a vaccination center so they too could have greater mobility. “If all the children are vaccinated, we feel that that the risk of them getting infected or having severe symptoms is significantly less.”

“Some of our relatives are medical practitioners, they made us realize that we should protect, not only ourselves, but also our kids. At the height of pandemic, we really prayed hard for vaccines,” Marjunell added. 

“I got my child vaccinated against COVID-19 so that he can attend face-to-face classes,” said Bernadette Usog, a resident of Metro Manila.

Vilma, Marjunell, and Bernadette are among the millions of Filipinos whose lives have started to return to normal because of greater access to vaccines.

Vaccines administered

Over 15 months, the Philippine government had administered more than 153 million doses of vaccines, including more than 14.8 million booster doses to frontline workers, senior citizens, and the immunocompromised.  

The World Bank is supporting the country’s vaccination program and overall COVID-19 response through the Philippines Emergency COVID-19 Response Project (PCERP), which helped scale up national vaccination, strengthen the country’s health systems, and overcome the impact of the pandemic especially on the poor and the most vulnerable.

World Bank financing covered the procurement and deployment of 33 million doses of COVID-19 vaccines across the country. The project also supported pediatric vaccination for 7.5 million children.

The Philippine Department of Health (DOH) has reported that with 70 million doses, the Philippines had achieved 77.8% of its target vaccination rate by the end of June 2022. Ramping up vaccination has helped the country manage the spread of COVID-19, and allowed the country to open more economic activities, which is fueling recovery. By the end of 2021, the country’s economy grew by 5.6%, a rebound from a –9.5% contraction in 2020.

The employment picture has also started to improve, with the unemployment rate dropping to 6.4% in January this year from 8.8% in January in 2021, and 17.6% in April 2020 at the height of enhanced community quarantine (ECQ), the strictest mobility restriction. These numbers indicate that Filipinos have started to regain jobs after a long period of limited mobility and limited operational capacity among businesses.

Following a rapid surge in cases that peaked January 2022, the Philippine government lowered the quarantine restrictions in Metro Manila and several other provinces to Alert Level 1 beginning in March 2022, allowing greater mobility among citizens and allowing business and other establishments to operate at full capacity subject to minimum public health measures including masking, handwashing, and social distancing.

Reaching the “last mile”  

To achieve the goal of inoculating 80% of the population (or 90 million Filipinos), the government set its sights on ensuring people in the most geographically isolated and disadvantaged areas (GIDA) had access to vaccines.

Despite having many hard-to-reach areas, Tarlac province has already vaccinated 80% of its target population, but the province is trying to raise this number to 85%, focusing on senior citizens and residents in remote villages.

For Mayor Romeo Capitulo of San Jose, Tarlac, the physical difficulty of delivering vaccines to these areas is just one of the many challenges in extending vaccine coverage in remote locations.

“To get to our area, you have to be persistent and ford rivers,” Mayor Capitulo said. “We received help from different agencies—the DOH, the army, Department of Education. They all worked together to help us. There was even an instance when the vaccines had arrived but the people in the community were not around; they were hiding in the creek. We had to convince the people that this (COVID-19) is a different kind of a disease—that it is time to follow the DOH vaccination program.”

Apple Joy Capiral is a rural health midwife assigned to the national vaccination program in Tarlac province. “As early as 5:00 am, we prepare the vaccines and then start transporting them by foot,” said Apple. “We traverse rivers and hills with the heavy vaccine carriers. The impassable roads and bad weather are also a challenge. The journey may be difficult, but we enjoy it.”  

Apple also said, “It is a joy for health care workers to help the community. It feels great when the people in the community welcome us when we arrive. We feel happy and fulfilled when they accept the vaccination program and no one gets sick in the community.”

“I am grateful to our health workers and the DOH. Despite the difficulties, having to cross rivers, they are always there, untiringly doing their work,” Mayor Capitulo added. 

Department of Health Development Management Officer Maria Noel Borneo-Lim said, “We see the number of cases going down, and this is because of collaborative efforts... Let’s push on and not lose hope.”

Going forward, the World Bank will be supporting the coverage of booster doses to vulnerable groups and the rollout of primary vaccination in the Bangsamoro Autonomous Region in Muslim Mindanao.