THE Philippine Health Insurance Corporation (PhilHealth) yesterday announced a benefit package for vaccinees who will experience serious adverse effects following immunization.
Considered by PhilHealth as serious adverse effects are anaphylaxis, generalized convulsion, acute respiratory distress syndrome, acute cardiovascular injury, coagulation disorder, acute kidney injury, acute liver injury, acute pancreatitis, acute aseptic arthritis, aseptic meningitis, encephalitis/encephalomyelitis, and idiopathic peripheral facial nerve palsy, among others.
Dr. Shirley Ocampo, PhilHealth vice president for corporate affairs, said indemnification package also covers those who will suffer permanent disability, or death.
Under the benefit package, PhilHealth will shoulder a maximum of P100,000
for hospitalization due to serious adverse effects.
“The claim corresponds to remaining charges on top of PhilHealth benefits and other health benefits provided by private health insurances (PHIs) and health management organizations (HMOs),” she said.
As for permanent disability or death, Domingo said the vaccinees will receive a lump sum of P100,000.
Aside from the person vaccinated, considered eligible to claim the benefits as primary beneficiaries are the legal spouse until he/she remarries, or children who are legitimate, legitimated or acknowledged illegitimate, while secondary beneficiaries are the legitimate parents.
Eligible for the benefits are those who received inoculation at least once through the national COVID-19 vaccination program, with the use of a vaccine that has not been granted a certificate of product registration (CPR) by the Food and Drug Administration.
All vaccines now in use in the country are covered by emergency use authorization (EUA) and not one has been granted a CPR which will allow the commercial sale of the vaccine.
Domingo said a causality assessment showing “vaccine product-related reaction” or “vaccine quality defect-related reaction” may also be necessary.
“If we need further clarifications, we will get an expert’s advise. That will be the causality assessment,” said Domingo.
Not covered by the benefit package are those who received vaccines that have been granted a CPR, and those who have received or plans to receive compensation through the COVAX No Fault Compensation Program (COVAX-NFCP).
PhilHealth said valid claims are those vaccinations done from March 3, 2021 to March 2, 2026, or until completion of the COVID-19 Vaccination Program “whichever comes earlier.”
The national vaccination program was launched on March 1.
The benefit package is anchored on Republic Act No. 11525 or the COVID-19 Vaccination Program Act of 2021, which provides for the creation of an indemnity fund for coverage for serious adverse effects following immunization.
Other AEFI considered by PhilHealth are thrombocytopenia, acute disseminated encephalomyelitis, Guillain Barré Syndrome, multisystem inflammatory syndrome, anosmia, ageusia, Chilblain-like lesions, erythema multiforme, single organ cutaneous vasculitis, rhabdomyolysis, and sub-acute thyroiditis.
