INTERIM NATIONAL IMMUNIZATION TECHNICAL ADVISORY GROUP FOR
COVID-19 VACCINES
RESOLUTION NO. 2
Series of 2021
“WHEREAS, on 30 January 2020, the World Health Organization (WHO) declared
Coronavirus Disease 2019 (COVID-19), a disease caused by a novel Severe Acute
Respiratory Syndrome - Coronavirus2 (SARS-CoV2), as a Public Health Emergency of
International Concern (PHEIC)”.
“WHEREAS, the Philippines since January 2020, has been responding to the COVID-19
pandemic and has implemented numerous interventions in response to the pandemic”.
“WHEREAS, the National Government intends to introduce safe and effective COVID-19
vaccine to:
a) reduce morbidity and mortality while maintaining the most critical essential services;
b) protect those who bear significant additional risks and burdens of COVID-19 to
safeguard the welfare of others;
c) substantially slow down rate of transmission and minimize disruption of social,
economic, and security functions; and
d) responsibly resume social and economic day-to-day operations and activities.
“WHEREAS, the Interim National Immunization Technical Advisory Group for COVID-19
vaccines adhere with the guiding principles of Transparency, Timing, Equity, Solidarity, Trust
and Priorities”;
“NOW, THEREFORE, BE IT RESOLVED that the Interim National Immunization
Technical Advisory Group for COVID-19 vaccines adopts the following recommendations:
a) Pre-registration in the PhilSys or National ID system as a prioritization criteria for
the general population (priority group C) is not recommended due to equity and
ethical considerations of favoring individuals with access to internet or registration
facilities. Additionally, cognizant of the current timeline for the country’s vaccination
program, the decision for the integration of the PhilSys system to the vaccination
efforts is recommended to be deferred until a clear operational plan together with the
possible incentives for the vaccination program is presented by the Philippine
Statistics Authority.
b) Absolute contraindications stated in the Emergency Use Authorizations (EUA) issued
by the Philippine Food and Drug Administration for a specific vaccine shall be
adopted by this body when recommending guidelines for its use. The ONLY current
contraindication to COVID-19 vaccination is an allergy to a previous dose of
COVID-19 vaccine and any of its components (Position Statements of the
Interim NITAG for COVID-19 Vaccine 1
Resolution No. 2
S. 2021
Philippine Society of Allergy, Asthma, and Immunology On COVID-19 Vaccines
and their Adverse Reactions, Feb 1, 2021).
c) Given the novelty of the vaccines to be deployed in the immunization program,
individuals belonging to special populations, such as the immunocompromised and
senior citizens with special conditions (i.e. bedridden, those who are in a vegetative
state, and those with limited life expectancy), must obtain clearance from their
attending physician prior to vaccination following a risk-based approach. The DOH
along with appropriate medical societies should provide guidance to physicians in
performing standardized patient assessment to determine suitability for vaccination.
d) Guidelines for health screening for vaccination shall follow clinical practice
guidelines of medical societies, which should be regularly updated based on best
available evidence. The recommendations from the Philippine Society for
Microbiology and Infectious Diseases (PSMID) including recommendations from
NITAG are adopted to develop the interim decision algorithm for the COVID-19
vaccination program:
a. Persons falling under the following categories should not be vaccinated:
i. Age < 16 years old
ii. Specific to mRNA vaccines, allergic to Polyethylene Glycol (PEG)
and/or polysorbate
iii. Severe allergic reactions after the first dose of the vaccine
b. Vaccination of persons falling under the following categories should be
deferred and rescheduled until resolution of specific conditions:
i. Persons presenting with symptoms such as fever/chills, headache,
cough, colds, sore throat, myalgia, fatigue, weakness, loss of
smell/taste, diarrhea, shortness of breath/ difficulty in breathing, and
rashes shall be referred to a physician for clinical evaluation. These
individuals may be vaccinated with the COVID-19 vaccine only after
full recovery from the acute illness as deemed by their attending
physician based on current management guidelines.
ii. Persons with a history of exposure to a confirmed or suspected
COVID-19 case in the past 2 weeks may be vaccinated only after
completion of the 14-day quarantine period.
iii. Persons who have been diagnosed with COVID-19 in the past 90
days may be vaccinated after 90 days from the last day of treatment.
iv. Persons who received convalescent plasma or monoclonal antibodies
for COVID-19 in the past 90 days may be vaccinated after 90 days
from the last day of plasma/ monoclonal antibody treatment.
Interim NITAG for COVID-19 Vaccine 2
Resolution No. 2
S. 2021
v. Women belonging to Priority A1 of workers in frontline health
facilities who are in their first trimester of pregnancy may be
vaccinated after the first trimester.
vi. Persons who received any other type of vaccine in the past 2 weeks
should be rescheduled after completion of two weeks interval.
c. Immunocompromised persons under the following category shall consult their
attending physician or a primary care provider to obtain clearance prior to
vaccination for appropriate patient education on the risks and benefits of
vaccination. Specific qualifiers indicated shall be considered in the
assessment of the health care worker.
i. For persons with autoimmune disease, if the patient is in remission.
ii. For persons living with HIV, if the patient’s current CD4 count is low
and if the patient is on treatment.
iii. For persons with cancer or malignancy, if the patient is undergoing or
have immediate plans for chemotherapy, or is in remission.
iv. For transplant patients, if the patient is on immunosuppressants or in
remission.
v. For persons who use steroids, if the dose and duration of steroid use is
more than 2 weeks or dose is higher than 20 mg daily for prednisone.
vi. For elderly who are bedridden, in a vegetative state, or with poor
prognosis such as those with limited life expectancy of less than 6
months.
d. Additional precautions must be implemented to the following:
i. Persons with a history of bleeding disorders or currently taking
anticoagulants should be vaccinated using a gauge 23-25 syringe.
Firm pressure shall be applied after vaccination to avoid formation of
a hematoma.
ii. Persons with a previous history of anaphylaxis, with allergies to food,
egg, medicines, and persons experiencing asthma shall be observed
for 30 minutes after vaccination.
iii. Persons who do not meet any of the criteria otherwise stated shall be
observed for 15 minutes after vaccination.
e. Persons falling under the following categories may be vaccinated with the
COVID-19 vaccine:
i. Breastfeeding women
ii. Persons who received immune globulins
e) Vaccine recipients shall sign two (2) copies of the one (1) page informed consent -
one copy shall be provided to the patient and one for the facility. To ensure that the
document is understandable by vaccine recipients, the informed consent shall be
written in simplified language and translated to local languages by the Centers for
Interim NITAG for COVID-19 Vaccine 3
Resolution No. 2
S. 2021
Health Development. Information on adverse events and other vaccine details shall
be carefully worded and written to ensure that the vaccine recipients understand these
important information. The IATF, NTF, and DOH logos shall be placed on top of the
informed consent. This document shall be made available online so that vaccine
recipients may download it in advance and sign it on the day of vaccine
administration after dialogue with the vaccine administrator. The Informed Consent
shall contain the following pertinent information:
a. Statement specifying that the vaccine recipient understands that the vaccine is
an investigational drug and that they were shown the fact sheet of the EUA;
b. Statement declaring that the vaccine recipients were assessed using the health
screening form to ensure that those who are at risk will be managed and
referred appropriately;
c. Name of the specific facility or the primary care provider that the vaccine
recipient may contact or visit for follow up after vaccination in case of any
symptoms; and
d. Statement disclosing that all data collected throughout the COVID-19
vaccination program will be used for public health purposes.
5. The use of liability waivers to indemnify manufacturers and other relevant
stakeholders such as the Philippine Government is NOT recommended due to the
possibility of contributing to vaccine hesitancy. However, recognizing that the said
document might be essential to complete supply agreements with the COVAX facility
or other vaccine manufacturers, the Bureau of International Health Cooperation and
the DOH Legal Service shall coordinate with concerned government offices to
finalize a document that is reasonable, ethical, and fair to all stakeholders.
6. In order to minimize vaccine wastage and prevent distribution of previously allocated
vaccines to non priority groups, vaccination sites shall prepare a quick substitution list
(QSL) consistent with the principle of prioritizing and protecting those who are most
at risk due to exposure.
a. To ensure accuracy of the allocation plan, and in consideration of possible
non-attendance of potential recipients -- each eligible health facility should
submit an officially endorsed number of staff for vaccination consistent with
Priority A1. This QSL should include students and temporary workers. It must
be ascertained that the potential recipients in the QSL are not registered in
other facilities .
b. The facility and staff for the QSL should be pre-identified with officially
documented rationale for choice of facility. Hospitals shall ensure that the
identified QSL facility is not part of those also eligible to receive vaccines in
the current batch.
Interim NITAG for COVID-19 Vaccine 4
Resolution No. 2
S. 2021
c. Geographical zoning should be implemented in development of pre-identified
quick substitution lists such as through districts within the National Capital
Region, by province/ highly urbanized city, or independent component city, or
other mechanisms in consideration of vaccine storage and travel time.
Prioritization for vaccine quick substitution list for priority group A1 shall
follow this recommended order:
i. COVID-19 referral hospitals;
ii. Hospitals with COVID-19 cases
1. Level 3 DOH Hospitals
2. Level 3 Other Government Hospitals
3. Level 3 Private Hospitals
4. Level 2 DOH Hospitals
5. Level 2 Other Government Hospitals
6. Level 2 Private Hospitals
7. Level 1 DOH Hospitals
8. Level 1 Other Government Hospitals
9. Level 1 Private Hospitals
iii. Temporary Treatment and Monitoring Facility (TTMF) for quarantine/
isolation;
iv. Other hospitals such (i.e. military hospitals);
v. Community facilities (i.e. Rural Health Units (RHUs);
vi. Standalone and other facilities; and
vii. Closed health institutions.
d. In cases of non-attendance during the vaccination day, the vaccination site
should first attempt to vaccinate other pre-identified staff for priority
population A1 within the facility which are scheduled on different days. After
exhausting the said list, the site can then tap the recipients from the
predetermined quick substitution list. Vaccinating the next priority groups
such as A2 for senior citizens and A3 for adults with comorbidities, or hospital
patients belonging to these categories shall be allowed only as final resort. No
hospital patient with active disease should be vaccinated.
7. To develop and secure QSL consistent with the prioritization framework, the DOH
through Field Implementation and Coordination Team, shall ensure frequent updating
and coordination directly with eligible institutions and vaccination sites.
Recommended documentations on validated numbers of eligible population and QSL
should be strictly requested prior to allocation.
8. Foreigners/ Expatriates belonging to the priority populations such as but not limited to
senior citizens and persons with comorbidities shall be included in vaccine allocation
consistent with their priority group. Likewise, a standardized appeal process for
prioritization shall be developed by the DOH and NITAG to address the concerns of
Interim NITAG for COVID-19 Vaccine 5
Resolution No. 2
S. 2021
different stakeholders who do not belong to the initial priority list requesting for
immediate vaccination.
9. The Department of Health through the Health Promotion Bureau shall implement an
aggressive information drive on COVID-19 vaccination. These information
campaigns shall target stakeholders including vaccinators, allied healthcare workers,
vaccine recipients, and implementers. Campaigns shall include dissemination of
materials on the Emergency Use Authorization of vaccines, vaccine side effects,
adverse events, and other important information that shall be made clear to the public.
The difference between causality and coincidence must also be emphasized to allay
the fears of those who are hesitant to be vaccinated.
10. To ensure the overall alignment of the country’s vaccination program, regular updates
of policy directives shall be cascaded regularly to all implementing sites across the
country.
RESOLVED during the ___ Meetings of the Interim NITAG for COVID-19 Vaccine, as
reflected in the minutes of the meeting, held on February 8 and February 9, 2021 via video
conference
APPROVED BY:
[SGD] [SGD]
MAY MONTELLANO, MD EDDIE DOROTAN, MD, MPA
Interim National Immunization Technical Interim National Immunization Technical
Advisory Group Advisory Group
[SGD] [SGD]
NINA CASTILLO-CARANDANG, PhD SHELLEY DELA VEGA, MD, MSc
Interim National Immunization Technical Interim National Immunization Technical
Advisory Group Advisory Group
[SGD] [SGD]
MARIA CONSORCIA QUIZON, MD MARY ANN BUNYI, MD
Interim National Immunization Technical Interim National Immunization Technical
Advisory Group Advisory Group
Interim NITAG for COVID-19 Vaccine 6
Resolution No. 2
S. 2021
[SGD]
MINETTE ROSARIO, MD
Interim National Immunization Technical
Advisory Group
Interim NITAG for COVID-19 Vaccine 7
Resolution No. 2
S. 2021