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Thesis Statement Example – Importance Of A Good Thesis Statement

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Inhaltsverzeichnis

• 1 Definition
• 3 Writing a Thesis Statement
• 4 Examples for Research Papers
• 5 Thesis Statement Examples
• 6 In a Nutshell

A thesis statement is defined as a sentence or paragraph that expresses the key idea or central message of a research paper. A thesis statement is the foundation of an essay, research paper, or any other piece of academic writing. Thesis statement examples are samples that might help you to find your thesis statement. It comes after the background of information, at the end of the introduction of your research paper. Thesis statements should not be mistaken for research paper introductions. While an introduction is used as a gateway to your research paper to capture the reader’s attention, the thesis statement example is a highlight of the paper’s main idea.

Thesis statements are fundamental elements in academic writing, particularly research papers and essay writing. When writing a research paper, your argument reflects the article’s main idea or central message, which is referred to a thesis statement.

This article highlights everything that you should know about writing a thesis statement and gives you some thesis statement examples that might inspire you.

What is a thesis statement example?

A thesis statement refers to the sentence or set of sentences used in academic writing to offer a way to understand and interpret the thesis topic . It gives a summary of points regarding what will be addressed throughout the research paper or essay. The thesis statement example is a sample for you which can help and inspire you to find your thesis statement.

Can a thesis statement be a question?

The answer is no. A thesis statement cannot be a question. This is because a thesis statement points out a claim or idea that will be supported by the rest of the paper. A question does not give the direction the research paper takes, which is what a thesis statement is about. What you may be thinking about is the research question . The research question forms the basis of your thesis statement.

What are the two types of thesis statements?

There are two types of thesis statements , including argumentative and analytical thesis statements. An analytical thesis statement provides an analysis of the different parts of the main idea of a research paper through a broken-down discussion. The parts are then evaluated and presented in the order of the analysis. An argumentative thesis statement, on the other hand, is the format where the author makes a claim about the topic of discussion then presents their opinion in support of their claim.

How many sentences should a thesis statement have?

The thesis statement should be 1-2 sentences. It presents the thesis topic to the reader as well as the author’s stance on this topic and the tone of the paper. In rare cases, the thesis statement can be longer if you’re writing a very long and detailed paper, however, it’s best to always check with your supervisor or professor.

Tip: For optimal thesis formatting, the thesis statement should always be placed towards the end of the introduction- regardless of the length of the thesis statement.

What is a bad example of a thesis statement?

Bad: Despite an increase in the consumption of dieting products, obesity is on the rise.

Good: Despite an increase in the consumption of dieting products, obesity is on the rise as many dieting products lack proper scientific research regarding the nutritional effects that they have on the body.

The first thesis statement example is vague and unclear. If there are more people on diets, why is obesity still rising? The second thesis statement example is better as it provides evidence to support the claim that is made. You can find more thesis examples at our blog post ‘How to Write a Thesis Statement’ . These thesis statements were created to serve as examples and as such, no research was conducted on the above topics.

Writing a Thesis Statement

Whether you are writing a dissertation or a simple essay, formulating a thesis statement example can be challenging. Here is a step by step guide on how to write a good thesis statement example.

Make Your Thesis an Answer to Your Research Question

Your thesis statement example must respond to questions arising from any opinion, suggestion, or claim to be made throughout the research paper. This does not mean formulating your thesis statement into a question. It means supporting your paper’s main idea by answering questions that the reader may have. You might want to do some research on the topic of discussion before drafting your thesis statement example.

Identify the Right Type of Thesis Statement Example

Some research papers are meant to persuade, while others educate or shed light on specific issues. This is why you need to identify whether your thesis statement example should be analytical, argumentative, or even expository. When choosing the type of thesis statement to use, you might want to have the end in mind by considering the goal of the research paper or essay.

Make a Claim

You should take a firm stance on the topic and address it in detail. This is to ensure that every point made in the thesis statement example is well supported in the body of your essay or research paper. Ensure that your points are clearly addressed. Do not mince your words on your stance.

Your Thesis Statement Must Be Supported with Proof

It is said that a thesis statement example is the punchline of any research. It is in the thesis statement that the paper’s body holds together. You must, therefore, ensure that everything said can be backed up with some evidence.

Watch the Length of Your Thesis Statement Example

A thesis statement example should be concise and direct to the point. This is to enable the reader to easily identify and grasp the topic and the direction of your research paper. You might want to limit the length of your thesis statement to about one to two sentences.

Position Your Thesis Statement Appropriately

Due to the significant role that a thesis statement plays, it is essential to find the right place to position it in your research paper. Thesis statements are ideally positioned towards the end of the article’s introduction or at the end of the first paragraph. This is where you give the reader a glimpse of what to expect from your research work.

Examples for Research Papers

A thesis statement is an essential component of every piece of academic writing, including a research paper. Depending on the type of academic paper you are writing, a thesis statement example may differ in application. However, that does not exclude your academic work from the guiding principles of writing a thesis statement example. If you are wondering why it is necessary to formulate a thesis statement, here are some reasons why you must consider having one:

• Argument Development

You want your research work to be persuasive and convincing. You must, therefore, have your ideas organized and developed in a comprehensible and academic framework. This is where a thesis statement comes in handy. It enables you to give the reader a glimpse of your claim or stance before engaging the entire research work.

• A Guide to Your Research Work

Most readers want to know what to expect before they can read an article, essay, dissertation, or research paper. This is why you should formulate a thesis statement example. The statement acts as a guide to the argument captured in the rest of the article.

Thesis Statement Examples

Here are some examples of thesis statements:

In a Nutshell

• A thesis statement example is a fundamental element in the drafting of any academic work, including essays and research papers.
• A thesis statement is a sentence or paragraph that expresses the key idea or main message of a research paper.
• There are two types of thesis statements, including argumentative and analytical thesis statements.
• Since it points out a claim or idea that will be supported by the rest of the paper, a thesis statement example cannot be used as a question.
• A thesis statement example is significant in research paper writing as it is used to develop the author’s argument and offer a guide to the entire research work.

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Home > Schools & Departments > HE > School of Social Sciences > Political Science Dept. > Student Theses

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Wherever I am, the world comes after me. It offers me its busyness. It does not believe  that I do not want it. Now I understand  why the old poets of China went so far and high  into the mountains, then crept into the pale mist. "The Old Poets of China" by Mary Oliver

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Theses and Dissertations: A List

Abstracts and other related info may be viewed via the tuklas portal . just type the author's name and click accordingly. to inquire if and how you can access the dissertations, please email this email address is being protected from spambots. you need javascript enabled to view it. document.getelementbyid('cloaka6298c6ad1ad4badd6f62216b1c482d8').innerhtml = ''; var prefix = 'ma' + 'il' + 'to'; var path = 'hr' + 'ef' + '='; var addya6298c6ad1ad4badd6f62216b1c482d8 = 'aclib.upd' + '@'; addya6298c6ad1ad4badd6f62216b1c482d8 = addya6298c6ad1ad4badd6f62216b1c482d8 + 'up' + '.' + 'edu' + '.' + 'ph'; var addy_texta6298c6ad1ad4badd6f62216b1c482d8 = 'aclib.upd' + '@' + 'up' + '.' + 'edu' + '.' + 'ph';document.getelementbyid('cloaka6298c6ad1ad4badd6f62216b1c482d8').innerhtml += ' '+addy_texta6298c6ad1ad4badd6f62216b1c482d8+' '; or call 8 981 8500 local 3579. the library may/does not have access to electronic files of the theses and dissertations, nor can they be accessed since the university is closed due to quarantine. you can send your request to us, and we can forward it to the author (s) if feasible under university policies , including this 2015 memorandum . , view list of theses and dissertations from 1963 to the present . all theses and dissertations are for room-use only., please click on the year to view the dissertations., abelgas, franz jude solana, "not quite diasporic: diasporicity of southeast asian migrants' children in the macau special administrative region" (ma), abuan, romina eloisa manabat, "interrogating sense of belonging and citizenship among filipinos in diaspora in taiwan" (ma), agonos, mariam jayne macafe, "building a city: the environmental and social challenges and impacts of the development of indonesia's new capital" (ma), alvarez, bea roselle mance, "disaster memories of ivatan women: narratives before, during and after a typhoon" (ma), argonza, gladys mae zabala, "state and the peasantry: social and historical contestations over land use in rural vietnam" (ma), ariate, maria ima carmela laugo, “ibaloy notions of homeland from memories of place: an oral history of laokan, baguio city” (ph.d.), bahni, rosella camte, "revolution in exile: transnational mobilizations of filipinos in the united states and china, 1971-1986" (ma), briones, jervy cariño, "mei nu: examining chinese women's deployment of beauty in four biographical texts" (ma), carreon, latasha quiles, "exploring china's cultural soft power: cinderella chef as a case study" (ma), cruz, melodina sy, “komentaryo ni kalabaw: the carabao in jess abrera's a. lipin cartoon strips (1985-2018) as an image of the filipino's resistance identity and the philippines' cultural species" (ph.d.), del rosario, peter jerome bayot, "the covid-19 pandemic in binmaley: changes in space, experience of religion, and faith expressions" (ma), diaz, rizelle ablaza, “pagpapakahulugan sa mga naratibong nakapaloob sa mga banal na ukit ng mga sangley at mestiso, 1590-1898” (ph.d.), galang, romeo bala, "the human rights defenders in post-edsa philippines" (ma), gultia, christian baloran, “the shaping of a scientific built evironment (likhang kaligiran): the university of the philippines los banos, 1965-1986” (ph.d.), hufana, mary cita m., “the filipino ballet: examining process of indigenization and its identification in/of nation” (ph.d.), jacinto, joelle florence patrice banzon, “kabilin ug bahandi: traditional games as an educational tools in the preservation of heritage and culture among universities in cebu city” (ph.d.), macasil, ma. alena novillo, “diyandi: kultural na perfomans bilang kabilin at kasaysayan ng dakbayan sa iligan” (ph.d.), magdadaro, marjorie joy almario, "japanese sociocultural influence on migrant entrepreneurship: exploring the entrepreneurial activities of former filipina entertainers in the philippines" (ma), marcaliñas, jandell villena, “the symphony orchestra in the philippines: a cultural outline (1896-1986)” (ph.d.), martinez, edna marcil morato, “danas at dagok ng tokhang: state terror, gender, and the war on drugs” (ph.d.), mijares, aileen may paguntalan, “assessing the ethnolinguistic vitality of pahanan towards developing an instrument for measurement” (ph.d.), peña, andrew rey sosa, "seeking admission: mobility of indian medical students in the philippines (2014-2022)" (ma), ploteña, irene bel rosquillo, "oto valentin: stories of leadership, resistance, and compromise in the mountains of 20th century maasin, iloilo" (ma), ravena, kyle philip manzano, “pagsinaryo kag pangabuhian: implications of changes in the concept of land ownership among the ati of nagpana in barotac viejo, iloilo” (ph.d.), sabio, rodolfo cajilo, “the cooperative model in the philippine social economy: contributions and challenges of three local cooperatives” (ph.d.), salonga, norby roque, "land readjustment and disaster resilience in japan: exploring possible applications in the philippines" (ma), santiago, arlene de regla, "arab perceptions towards overseas filipino workers (ofws) in qatar: an exploratory study" (ma), suelto, emmeviene ann poson, "teaching and learning activism as experienced in two senior high schools: a grounded theory approach" (ma), tadle, frauline cainglet, "ang ating ha(pagpag)-kainan: analyzing the food (in)security situation and philippine food 'culture' through pagpag narratives" (ma), ugaddan, bryan gabriel ibañez, “the filipino contemporary commercial music singer: mimicry or phenomenon” (ph.d.), valdellon-molina, katherine frances romero, "sakay, salakay, salaysay: navigating (im) mobility and everyday commuting in a metro manila transport route" (ma), vargas, jericho lester magbilang, “saysay-laum: kritikal na pag-arok sa panlipunang balor ng mga kwentong-bayang daluyan ng kabayanihan at paghihimagsik ni agustin sumuroy ng hilagang samar” (ph.d.), verano, jay neil garciso , filipina migrant domestic worker's identity and narrative practices: from self to nation (ma), bancoro, sharon vergara, kendo as soft power and its role in japan's cultural diplomacy with the philippines (ma), bautista, roehl niño andrada, rethinking bakla: a keyword in philippine conceptual, sexual, and social history (ma), caliguia, gregorio iii recto, institutionalizing policies for persons with disabilities: a policy review and implementation verification of marikina city (ma), catura, severo severo, memories of the cultural revolution: analyzing selected written memoirs in english in the construction of conflict, survival, and escape (ma), lim, roberto jr. pangilinan, imperial temporalities, insurgent futures: comparisons of 20th century political thinkers in indonesia and the philippines (ma), magaling, christian lemuel magtaka, pasyon show: kwentong buhay ng mga camarerong bakla (ma), porciuncula, angelo palencia, loob at kapwa in action: analysis of "wanted sa radyo" in socio-cultural context (ma), ramos, chenny villaruz, political opportunity structure during the administration of pres. benigno aquino iii: a case study of a social movement of informal settler families in the philippines (ma), raymundo, alicia san pedro, contents tourism and local community revitalization – the case of hida-furukawa as an anime sacred site for “your name", reyes, maria corazon corre (ma), the testimonial narratives of the tausug survivors during the militarization of sulu and the 1974 battle of jolo: counterhistory, identities, and collective memories (ma), salomon, elgin glenn regencia, walls within walls: the architecture of intramuros by the end of the spanish colonial regime (ma), arcilla, john paul, firm-level knowledge and technology transfer in chinese engineering, procurement and construction projects in the philippines, diokno, harold andamo, mga lente sa likod ng lente: ang ningning at liwanag sa ilang piling retrato ng manila carnival (1908-1917) (phd), camba, moreal n., kababaihan, potograpiya, at kasaysayan: isang pagsusuri sa imahen ng kababaihan sa potograpiyang kolonyal sa harap ng imperyalismong amerikano (phd), jose, mary dorothy d.l, moro heroes in philippine history textbooks: the marginalization of the historical narratives of muslim filipino heroes in social studies education (ma), mejorada, alvin, governing climate change adaptation towards disaster resilience in selected coastal communities in the philippines (2006-2020) (phd), paje, philip michael i., serepungan: ang “katutubo” sa hugpungan ng mga diskurso (isang pag-aaral sa mga erumanen ne menuvu at teduray-lambangian) (phd), rodriguez, mary jane b., culture as transformative innovation: paglingap in the practice of family medicine in the philippines (phd), romabiles, maria socorro l., becoming to being filipino: a social history of music in manila 1860-1940 through journalistic print (phd), silvestre, maria patricia b..

  Censorship, Obscenity and Power: Regulation of Erotic Films from the Marcos to Estrada Administration, 1972-2001 (MA)

UBALDO, Abel

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ASEAN Intra Regional Humanitarian Assistance and Disaster Relief (HADR) 2012-2016: The Philippine Case (MA)

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Social Media, Filipino Youth, and Political Participation: An Exploration of University Students’ Political Actions during the 2016 Philippine Election (MA)

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Perceiving Patriotism: China’s Patriotic Education Campaign and Insights for Philippine Education (MA)

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Andres, brenson, darna and the intermediality of the filipino superhero genre (phd), brillon, cherish, the bagani spirit through the moral imagination of philippine army officers: strengthening military leadership based on the agyu epic (phd), ebrada, sandra, facility-based delivery: implikasyon sa paghulma sa pang-inang kalusugan (phd), encinares-enaje, ivy, ganting-loob at pamuling-pamudod: dalumat at realidad sa lipunang tagalog ng caciquismong espanyol, 1571–1896 (phd), enriquez, edelyndon, viewing mistresses: filipina audiences constructing meanings of gender and sexuality in media and everyday life (ma), erbite, kristina, the concept of 'ilmu' pagkausug in the jawi materials from sulu (phd), hairulla, munap, assessing the impact of thailand's government policies and programs in local context: the case study of karen's baan huai lad nai (ma), macalib-og, ariane, de(familial)izing the family: anak ng ofws' emergent narratives on parent-child communication, religious socialization, 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in the transition to a “disciplined democracy” (ma), alicias, maria dolores, indian textiles in the philippines: contexts of encounter and traces of practice (phd), canta, marilyn, forging peace in south thailand: a case study of the building peace by teaching peace program in pattani province (ma), ferrer, jasmine, the role of indonesia and malaysia in the peace process in southern philippines: a comparative assessment (ma), maamor, asnawi, communicating the popular and the quotidian in japan: when filipino wives engage in image production through facebook (ma), sioson, erica, demystifying the dorimu boi: understanding the representation of japanese pop idol masculinity through visual and discourse analysis of various media productions (ma), alegre, herlyn, the acculturation of korean students in the philippines and its implications on koreanness: the case of koreans in an urban private school (ma), blanca, ringo, philippines-china relations: the linkage of economic and security interests (ma), de guzman, charles, the globalization of hangugeo: exploring the spread of korean language in the philippines and its prospects for promoting philippine national interests (ma), domingo, sarah, culture in governance: marikina’s ka-angkan festival, meaning-making and urban policy process, southeast asia and china: south-south development cooperation on new hegemony (ma), garcia, shayne, kalinangang pinanday sa ginto: a cultural history of gold in philippine society (phd), gatbonton, esperanza, baybayin: makabayang hibik sa tinig ng sinaunang titik 1882–2012 (phd), lapiz, eduardo, muslim-christian intermarriage: complications and compromises (ma), magat, edel, nihon no imeji (japan’s images) through anime: perceptions of filipino students in selected universities (ma), obispo, joanna, the influence of the 1986 people power revolution on the basic education curriculum: a case study of two private secondary schools in metro manila (phd), panganiban, evangeline, diverging narratives: lives and identities of japanese-filipino children in the philippines (ma), ubalde, marrianne, identity and representation: the life and work of five philippine chinese neo-realist visual artists, 1954–1975 (phd), young, stewart.

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Home > ETD > DEP_ACC > ETDB_ACC

Accountancy Bachelor's Thesis

Theses/dissertations from 2023 2023.

An assessment of e-wallet adoption among the finance employees of selected Philippine government agencies , Janina Mae E. Aborot, Ryan Joshua M. Dela Rosa, Donna Mae A. Galang, and Patricia Marie G. Pabello

The determinants of profitability of all publicly listed construction companies in the ASEAN-5 from the years 2019-2021 , Elian Justin Acierto, Mark Christian Lim, Ron Miguel Rivera, and Palm Eric Rosario

Building a sustainable future through taxation: Examining the effect of taxation on the achievement of sustainable development goals (SDGs) in developed and developing countries in Asia and Europe , Danielle D. Aguirre, Ma. Josenie Kate U. Dellova, Alyssa Rose M. Pascua, and Kurt Zyvyl M. So

Exploring the susceptibility of fraudulent financial reporting among government-owned and/or controlled corporations in the Philippines using fraud risk factors with the moderating effect of corporate governance , Lorian Aliana Polintan Alcaraz, Abbygail Cuevas Condenuevo, Alexandra Nicole Manaig Perez, and Xyrelle Joyce Torreliza Tejoso

Self-perceived licensure examination preparedness of DLSU graduating accountancy students under non-traditional learning: An explanatory sequential design , Erin Angela Pang Alfonso, Herald John Bernardino Castro, Regina Bernadeth De Guzman Dela Cruz, and Regina Leigh Cruz Lacson

The effect of sustainability reporting on the financial performance and firm value among publicly listed firms in the Philippines in 2019 and 2020 , Martin Jiro S. Alix, Kyle Sidney C. Co, Carl David M. Hernandez, and Arwenna Mae T. Sarmiento

Career readiness of graduating BSA students of De La Salle University - Manila in industry 4.0 , Micah Ela A. Aman, Justine Keith D. Dela Cerna, Camille Patrice L. Orpilla, and Carl Abhram P. Pascua

The effects of case-based pedagogy on the academic performance of DLSU BSA students as mediated by student engagement and satisfaction , Joyce Anne Amoroso, Danica Marie Carpizo De Guzman, Jay-ar Carias Guyena, and Feliza Rasine Melad Teñoso

The use of generalized audit software by Filipino external auditors: Impact of GAS features and actual usage , Cyrus John B. Andin, Gregorio Rafael D. Herrera, Enrico T. Nitura, and Chad Andrei M. Salazar

Corporate governance, firm size, and tax avoidance: How does corporate governance influence tax avoidance across small and large Philippine firms? , Christine E. Ang, Shawn Luther S. Chan, Sean Ellison G. Sow, and Siegwald K. Yap

Taking up space: An intersectional approach on the corporate experience of accounting professionals in the Philippines , John Paul T. Aquino, Reghis Fel H. Atienza, Samantha Nicole L. Leonardia, and Cristine Loraine M. Magsipoc

Firm-specific characteristics as a mediator in the effect of corporate governance on dividend policy before and during the COVID-19 pandemic among publicly listed Philippine companies , Marcus Gabriel A. Aquino, Giancarlo C. Itaralde, Alyssa Frances C. Jopson, and Michaela Louisse P. Zamora

Understanding undergraduate accounting students' future intention to engage in sustainability accounting: The case of De La Salle University — Manila , Frances Yzabel B. Aranas, Vivian Gayle Sweetcyl C. Haw, Manuel Thomas S. Granada, and Rheanne Angelica J. Mendoza

Effectiveness of DLSU pure online integrating courses in the CPA board exam performance during the pandemic period , Stephanie Ann M. Asuncion, Patricia D. Mojica, Ynna Louise O. Rabaya, and Gillian Nina E. Salazar

The impact of corporate governance on the performance of Philippine government-owned and/or controlled corporations for the period 2018-2021 , Alessandra Romana J. Aurello, Claire Madison C. Chua, and Dana Abigail L. Ong

An analysis on the effect of accounting practices and accounting controls on the business performance among micro-, small-, and medium-scale enterprises (MSMEs) in Quezon City, Philippines , Cara Julia Ching Baldovino, Caira Andrea Peran Husmillo, Jose Dominick Favis Lim, and Patrick Joseph Villegas Maglanque

Effects of learning and teaching dimensions on experiences during DLSU’s online learning modality: Opportunities for curriculum change , Joanna Marie S. Bello, Rance Trevor K. Tan, Fritz Michael C. Viclar, and Ethan Duane P. Yeban

Accounting standards and frameworks consolidation for reporting net-zero in energy companies of ASEAN-5 , Rakel Mari F. Bermejo, Paul Ishmael P. Molato, Guia Louise A. Morales, and Micah Benilde T. Tan

Preconception vs. cognizance: The perception of DLSU BSA undergraduates towards the accounting profession before and during college education , Gennise Bernadette T. Betita, Raven I. Dela Cruz, Elyzza Anne B. Romanes, and Kim Barbara S. Tolosa

Optimizing the transitionary breakthrough for a sustainable future of accountancy education: The influence of blended learning experience to the Industry 4.0 readiness of graduating accountancy students , Ericka C. Bilango, Kyle Justin H. Gan, Gillian Ira C. Lim, and Grainne T. Ong

Portfolio performance analysis in the ASEAN-5: Assessing bitcoin as a safe-haven investment and its effect on the performance of a diversified portfolio during the start of the COVID-19 pandemic , Roy Alberto Valenzuela Bonitez, Jessica Rose Sy Cheng, Sacha Angela Gabriel De Ocampo, and Katrina Jerica Carmelo Lui

The effect of budgeting and costing practices on the financial performance of small and medium restaurants in San Fernando City, Pampanga , Missy Tayao Borja, Christine Anne Liu Españo, Kirsten Grace Daquial Orda, and Lorraine Angeline Roy Touzo

The mediating effect of internship satisfaction on the relationship between OJT factors and career intention among DLSU BSA students and graduates , Ava Janelle Mercado Briones, Gabrielle Ann Reambillo, Kazandra Erika Franz Apao Vargas, and Nikki Ysabel Niu Yeung

Evaluating the balanced scorecard perspectives: A study of selected Philippine flour milling companies , Angeleen Buban, Caryl Kate Leang Sy, Stephanie Dy Poon, and Al Carney Eleazar Lim Chua

A comparative study on conceptual-based and experiential-based learning of accounting information systems as evaluated by different measures of effectivity , Jasmin Alaine R. Cai, Azel Randall P. Chua, Jeraldine Nicole C. Chua, and Aleeza Jnaica U. Liu

The mediating effect of financial restatement on corporate governance and investor confidence of publicly listed firms in the Philippine Stock Exchange index , Sherrina Cano, André Jefferson G. Lim, Chyna C. Tomas, and Mary June B. Valenzuela

The moderating effect of audit quality on the relationship between environmental, social, and governance scores and corporate financial performance of listed companies in the ASEAN-5 , Michaela Nicole U. Cheng, Aimee Joyce Y. Gepte, Sheena Nicole U. Jabile, and Daniel Patrick T. Manabat

From professional to pupil: Demystifying tax education in De La Salle University’s BS Accountancy Program through students’ perceived professional skills and practitioners’ experience , Dominique Letisha Yu Chua, Erika Isabel Virginia Santos Martirez, Mikaela Joan De Guzman Tangco, and Alaina Carlize Centeno Tria

Accountancy as a career choice: The effect of influences on the intention to pursue professional accounting qualifications among current junior and senior BSA students in DLSU as mediated by interest in accounting , Jill Geraldyn L. Chua, Kate Hannah G. Enriquez, and Gerardine A. Garcia

Impact of business strategies on tax avoidance of publicly listed companies (PLCs) in the Philippines: The moderating role of corporate governance , Tyron Jasper Li Chua, Margarita Christalyn Maulion Cortez, and Hans Mackenzie Dy Uy

Perception of DLSU-M accounting students on SMEs in the food and beverage service industry in the city of Manila that adopts sustainability accounting practices before and during the COVID-19 pandemic , Cleo Claire B. Cobankiat, Janella Bianca T. Siruno, and Jeryl S. Sy

A comparative study on the effectiveness of purely online and hybrid learning modes on the academic performance and learning experience of accountancy students in taxation courses of De La Salle University – Manila: A cross-sectional study , Julliana Grace Cua, Cherry Catherine Ng, Vanessa Bernadette Patricio, and Chance Aiseah Ramos

A study on the impacts of expectations, motives, and preparedness on the academic performance of DLSU freshman accountancy students , Janna Kaye Citron Cuenca, Rogenelle Anne Argao Delos Reyes, and Evangeline Kizza Marie Tankiang Manotok

Assessing the impact of greenhouse gas emissions on corporate performance of oil and gas companies worldwide from 2019 to 2021 , Luis Raphael S. De Guzman, Francis Philip D. De Leon, Jose Ricardo M. Fajanilag, and Bryan Miguel D. Tiamsim

The accountancy faculty shortage: Exploring an intervention to influence accountancy students' intention to pursue an academe career , Veronica Anna S. Dela Cruz, Jasmine Elizabeth K. Lin, Dominic N. Narag, and Julius Raphael I. Tenorio

The effect of the corporate governance of Philippine GOCCs on the issued annual audit opinion , Shannen Mari C. dela Pasion, Jhanca Mariz B. Baldovi, Jackie Riole J. Untalan, and Anne Margareth G. Limsico

The nexus among intrinsic motivation, extrinsic motivation, ASEAN Economic Community readiness, and International Education Standards competencies using a moderated-mediated model: A test of self-determination theory by Deci And Ryan (1985) , Trisha Anne B. Dimailig, Honey Pearl P. Fernandez, Janica Ryaine T. Marquez, and Samantha Glo C. Revita

The moderating effect of firm visibility on the impact of corporate social responsibility on firm financial performance in Asia-Pacific publicly listed companies: A comparison between sensitive vs. non-sensitive industries , Kathrina S. Duyan, Audrey Lei T. Tan, Chennylle P. Verzosa, and Christine Mel C. Viernes

The impact of green initiative announcements on the stock prices of selected publicly listed companies in the food and beverage industry in ASEAN-5 , Samantha Nicole Fernandez Eguia, Angela Mikaella Baltazar Ferrer, Chikara Jane Sancho Grijaldo, and Nathaniel Adrian Ng Yanos

A study on the adoption of quick response (QR) code payments among micro and small enterprises in the City of Manila as mediated by the behavioral intention to adopt and moderated by age and income level , Jan Marie S. Espinosa, Ma. Maien B. Quiambao, and Vhianne Robie Mae V. Ramos

The application of accounting prudence on upper tone management (UTM) of publicly listed service companies in the Philippines through the interpretation of financial profitability and management discussion & analysis (MD&A) , Seth Rafael V. Feliciano, Clarissa Jae P. Lapan, Samantha Therese S. Piñgol, and Danielle Anne S. Potenciano

Beyond four walls: The effects of non-Curricular Activities Involvement on the Academic Performance of the De La Salle University Bachelor of Science in Accountancy Students , Erin Maxine C. Gallardo, Marc Zacchary C. Ram, Christian Jansen A. Supera, and Frances Anne G. Toong

The demographic, educational, economic, and social factors affecting the farm record-keeping activity of smallholder rice farmers in Pampanga, Philippines , Sharlynne Michelle C. Go, Chawne Hannah G. Gosyco, Claire Danielle C. Ng, and Kyllah Nicollaine M. Tumang

The effect of different community development activities as corporate social responsibility (CSR) programs to company profitability in the property industry of the Philippines for the period of 2019-2022 , Kristina Melisa E. Hamoy, Ma. Bianca N. Lazo, and Cezar Jerome O. Pana

The impact of aircraft capacity utilization on bankruptcy probability before and during Covid-19: Evidence from publicly-listed airlines in Asia, Europe, and the Americas from 2002 to 2021 , Trisha T. Huang, Leane A. Lin, and Joseph Regalado A. Siscar

The effect of internship dimensions on the experience of De La Salle University Bachelor of science in accountancy students , Bernard Adrian Y. Lu, Gamaliel Loim L. Niño, Carlos Miguel M. Raflores, and Andrew Wynford A. Sua

The impact of perceived factors on the intention of accounting professionals to use robotic process automation for accounting functions in the Philippines , Riam Levi A. Magalonga, Clarisse Antoinette M. Quodala, Allyana Jorge P. Rivamonte, and Jason Chong V. Sou

Sector level analysis: Impact of environmental, social, and governance performance on financial performance, stock performance, and firm value in Asia pre-and during the pandemic , Clarissa M. Piamonte, Ferdinand C. Panganiban Jr., Immah Jeanina L. Pesigan, and Jazehl Joy G. Valdez

The effects of bootstrapping potential, attitude, self-efficacy on the relationship between risk aversion and entrepreneurial intention among De La Salle University Accountancy students using moderated mediated analysis: A test of theory of planned behavior , Alexa Nicole L. Rosauro, Katrina B. Chioson, Sofia F. Gaspar, and Reizza Mae R. Necesito

The moderating role of board gender diversity on financial reporting transparency and stock returns: A study on publicly-listed firms in the Philippines before and during the COVID-19 pandemic , Michelle Andrea Santos, Marianne Ivy B. Estanislao, and Daniella Marie Espiritu Leonida

Lifestyle habits and study habits predict academic performance in hybrid modality of 4th-year Bachelor of Science in Accountancy students at De La Salle University - Manila , Shannen Virginia Antonio Silvino, Roel Vincent Burca Boreta, Mari Felicity Abril Lopez, and Geoffrey Ivan Laxama Roaring

Theses/Dissertations from 2022 2022

The effects of eco-efficiency on the profitability of ASEAN-5 companies from 2017-2019 , Angelica Sarah E. Abad, Alexandra Uniss Q. Geniebla, Sabina Allen C. Ma, and Allen Joshua F. Olaño

The impact of ESG ratings on the firm performance of listed companies in the ASEAN-5 , Arvin Marion Barroga Abaniel, Sophia-anne Marie Lavarez Domingo, Mike Alvinjay Ramos Jarin, and Josef Marcelus Igle Villanueva

ASEAN stock market reaction on the issuance of green bonds , Margaret L. Agarao, Gabriel Kean T. Ebeo, Richard Allen A. Jimenea Jr., and Victoria Elizabeth P. Yason

An empirical study on the effect of tax aggressiveness on financial performance and firm value with moderating role of corporate governance: Evidence from the Philippines , Jose Gabriel Delgado Aggabao, Jean Shairah Pia Horario Lectura, and Wesley Charles Sy Sam Tan

Before the next normal: How voluntary ESG reporting affects stock performance and trading among publicly-listed companies in the Philippines — An event study , Loren Andrea P. Alcaraz, Michel Ann A. Calapatia, Alia Isabella M. Joaquin, and Doris Wu

A comparative study on the effectiveness of De La Salle University-Manila's old and newly revised accountancy modular programs using selected factors of effectiveness , Marc Christopher Gache Alelis, Grace Anne Ericka Gadia Lui, Roniel Jiggy Kalaw Malañgen, and Charlene Grace Keh Tiong

The effect of corporate social responsibility, dividend policy and capital structure on firm value among selected Asian banking institutions during the scope of the COVID-19 pandemic , Ryann Kristoffer Soy Ang, Sharrie Mae Co Lao, and Anne Margarette Ventura Ong

Factors affecting the reporting of audit supervisors upon discovery of false sign-off among small and medium accounting firms in Metro Manila, Philippines , Irish Stacey Alano Arugay, Justine Alannah Gonzales Cruz, and Rodante Antonio Simbe Jr.

The impact of online distance learning on the work readiness of De La Salle University (Manila) bachelor of science in accountancy students , Raphael Joseph Camilo Atmosfera and Cheziel Lyn Gallon Cabacungan

The influence of fraud pentagon model on academic dishonesty of accountancy students in an online setup from the perspective of accounting educators as differed by the educators' gender , Tricia Nathalia J. Avila, Alyssa Amor B. Manigbas, Jose Raphael R. Miranda, and Joan Setias

The art of accounting: Business students’ perspectives on the ethicality of the creative accounting practice , Vincent Raven B. Baldomero, Monica Joyce S. Chua, and Shermaine Kayle C. Chua

Academic self-efficacy among graduating accountancy students during the COVID-19 pandemic: A convergent-parallel mixed methods study , Nell Charisse Ameera M. Bejasa, Rayhanah N. Decampong, Nikka Allyson D. Gue, and Pauline Sharry S. Tiu

An analysis on the bidirectional causal relationship between ESG performance and corporate financial performance of publicly-listed companies under sensitive industries in the ASEAN-4 emerging countries , Sophia Marie Regencia Beltrano, Sophia Rose Samonte Follosco, Ronnie Angelic Oliva Saraza, and Jewel Almodiel Vinson

The moderating impact of regulatory policy formation, corporate governance, and economic development on the relationship between the accounting environment and control of corruption in ASEAN countries , Vishal Bhagia, Colleen Monica K. Chiu, Jean Nicole L. Ng, and Bianca Alanis Ysabel C. Redulla

Assessing the self-efficacy of accounting professors from universities and colleges within the city of Manila in relation to the transition to online distance learning due to COVID-19 pandemic , Kashmir Jansen Oba Burgos, Mikaelle Angelica Banares Perez, Janne Emile Robellon, and Ma. Samantha San Juan Valero

A qualitative assessment of the business continuity practices of selected ASEAN banks in response to the COVID-19 pandemic , Hillary Anne V. Carbonel, Danica R. Manabat, Batrix Marie B. Perocho, and Alyssa Vienesse C. Tan

The effect of attitude, subjective norms, perceived behavioral control, and personality on the career decisions of accounting professionals in the Philippines as mediated by behavioral intention: A test of theory of planned behavior by Ajzen , Cheri Mae H. Claveria and Rochelle O. Nabos

The effect of corporate governance characteristics on selected financial ratios and firm value before and during the COVID-19 pandemic among publicly listed companies in the Philippines , Joebert L. Co and Danielz Rafael B. Javilinar

The impact of key audit matters and firm performance on investor reaction: An empirical study on the Philippine stock exchange index from 2016 to 2019 , Bianca Mae S. De Castro, Carmella Grace R. De Leon, Leiana Aika L. Go, and Erin Chelsea Y. Llobrera

Meeting expectations: A phenomenological study on the gap between the ICT competencies of BS Accountancy ID 117 graduates from De La Salle University and ICT competencies prescribed by the International Accounting Education Standards Board , Kurt Lewis O. Dela Cruz, Lance Mikhail Jason A. Go, and Laureen Macy C. Ong

An analysis of the factors influencing the audit opinion of cities in the Philippines during the COVID-19 pandemic , Pamela Grace Villavicencio Dela Cruz, Elyza Sophia Ramos Ladines, Frances Harriet Lituanas Lim, and Irish Giorgia Cuento Valera

An alignment study of the Bachelor of Science in Accountancy program in the Philippines, the International Education Standards, and the Certified Public Accountant Licensure Examination: Basis for curriculum reforms , Pauline C. Dela Peña, Caitlin Gail O. Rodil, Carl Fredrick P. Sayson, and Richmond Lloyd S. Young

A content analysis on the comment letters to IFRS IC: Accounting for cryptocurrencies , Jan Josef D. Domingo, Ronin J. Galido, Gabriel Angelo J. Jon, and Mark G. Rizada

The moderating effect of corporate social responsibility on the impact of COVID-19 on stock prices of selected Philippine publicly listed firms , Maraiah L. Fernandez, Alexander G. Gallamos, Jasteen Maer Panganiban, and Jaela Marie M. Talisic

Assessing the implementation of excise tax on sweetened beverages on manufacturing companies in the Philippines: Basis for tax reforms , Francesca Glen Esteban Gacal, Francesca Beatriz Agamata Reyes, Mireah Kyra Molina Wong, and Dominique Bianca Uy Yap

An analysis of the effect of board characteristics and the pandemic on sustainability performance among emerging markets , Ma. Beatrice Emmanuelle Z. Garcia, Ryen Keith Nibungco, and Ana Ysabelle T. Valenova

An event study on the effect of the COVID-19 pandemic on stock price of publicly listed companies in the ASEAN-5 , Jasper Salvio Jesswani, Lance Nitzcel Padilla Kho, Nica Franze Tan Lino, and Julian Franco Balcita Mejos

The effect of audit committee charateristics on audit fees and audit opinion with moderating effect of audit committee gender , James Adrian T. Lai, Denise Allyson D. Ng, Jillian Mitziko C. Limqueco, and Park Jinyeong

A multiple-group analysis on the moderating effects of remote auditing on the internal audit effectiveness of government-owned and or controlled corporations in the Philippines and its determinants , Christine Paola D. Lorenzo, Peter Ernest C. Mallari, Romeo Neil N. Manlangit, and Kelly Junine C. Yu

Effect of service sub-sector vulnerability due to the COVID-19 pandemic enhanced community quarantine on the cumulative abnormal returns of service firms listed in the Philippine Stock Exchange with disclosure tone as a moderating variable , Micah Jaye R. Maristela and Benelli Policarpio Tuazon

Future-proofing the accounting information systems profession: Prospects of a double degree bachelor of science in accountancy and bachelor of science in accounting information systems programs aligned with model curricula in De La Salle University-Manila , Carla Sofia T. Padilla, Katrina Louise C. Reyes, Henrico Gustav Mikhail P. Sanchez, and Monique Ellenor L. Sy

Accounting information vs. financial market information in explaining stock returns: Evidence from publicly listed non-financial firms in the ASEAN-5 stock markets from 2010 to 2020 , Roseanne N. Roque, Marielle Lissette U. Sarmiento, Yanesah Ann L. Tumambing, and Mary Gabrielle Eligius A. Yap

Theses/Dissertations from 2021 2021

The effect of environmental costs and factors affecting environmental accounting on firm profitability of publicly-listed industrial companies in the Philippines , Kaycee Nicole E. Acis, Rea Marie B. Diaz, and Abigail Faith B. Javier

The effect of COVID-19 pandemic government response to top global airline stocks’ performance and risk profile as controlled by market returns , Alysson Ace B. Agustin, Marcellin Enrico M. Cruz VII, Ysabelle Mikayla S. Orlino, and Sean Patrick T. Uy

The effects of capital structure on the financial performance of publicly listed commercial banks: Evidence from the ASEAN-5 countries , Ricardo Raphael Alday Atienza, Jasmine Alliah Kiu Bactat, Jamie Angela Lee Chua, and Kristen Kyla Lim Tan

The moderating effect of ownership structure between the relationship of corporate social responsibility and firm performance in the ASEAN-5 , Mari Luis Augustin T. Avila, Katherine Ann J. Fernandez, Louise Kyle V. Ngo, and Dave Johann Y. Tan

The effect of information system capabilities on medium and large enterprises’ firm performance: A moderated mediation analysis , Chanelle Z. Batin, Johncary Angelo N. Laysico, Quennie G. Robiso, and Francesca Margaret Red M. Santos

A‌ ‌comparative‌ ‌analysis‌ ‌of‌ ‌key‌ ‌financial‌ ‌ratios‌ ‌of‌ ‌Philippine‌ ‌publicly‌ listed‌ companies‌ ‌before‌ ‌and‌ ‌during‌ ‌COVID-19‌ , Alec Johnson C. Billan, Jemaiah Lorraine M. Delima, Ram Steven Martin S. Naval, and Magick Dovelyn S. Wee

The impact of adjustment, agency, and political costs on cost stickiness of publicly listed companies in the Philippines from 2009-2019 , Angela Bianca N. Catalig, Charles Justin M. Decena, Maria Denise A. Franco, and Ma. Colleen L. Ventura

The effect of value added intellectual coefficient, firm size, and leverage on business performance in the ASEAN-5 service industry , Jessica Maris H. Chen, Sophia Kelly G. Chua, and Alyana Ysabel A. Tan

Cross-country and regional Analyses on the effect of environmental accounting on financial profitability, liquidity, marketability, leverage, and firm value of environmentally sensitive industries across the ASEAN-5 , Venz Luis D.M. Delos Reyes, Jovelle Anne T. Laggui, Matthew O. Lagonera, and Rhazelle Teemee S. Lapuz

Analyzing the effect of accountability, government characteristics, and citizen participation on the financial performance of Philippine cities , Lou Brad N. De Nobili, Chelsie Marie D. Gumba, Alexander E. Rodriguez Jr., and James Vincent E. Rodriguez

An event study on the market's reaction on information technology Investment announcements of selected publicly listed companies in the Philippines , Elysia Kallysta R. Falco, Jose Eduardo A. Guillermo, Rafael Angelo A. Laya, and Kyra Isabelle G. Monje

Religiosity and its effects on financial reporting quality of publicly listed companies from 3 ASEAN countries with COVID-19 as a moderator: A PLS-SEM model study , Javier Francisco B. Laurena, Nicole Elise O. Torres, Jansen C. Kang, and John Andrew C. Andrada

Theses/Dissertations from 2016 2016

A study on the impact of environmental management practices on firm growth of publicly listed companies under the Philippine industrial sector from 2011 to 2015 , Ed Norvile John B. Aba, Gean Margaret S. Manalastas, Jenn Mae Clarisse C. San Pedro, and Janneth S. Tee

The effects of ownership concentration on the financial performance of publicly-listed companies in the ASEAN region , Kristina Pauline B. Abesamis, Jiro Nigel Cadungon, Hans Cedric O. Lee, and Ida Frances T. Santiago

Factors affecting audit fees of Philippine listed non-financial firms , Miguel Marciano M. Advincula, Rafael Q. Ocampo, Joshua T. Pamaran, and Pramela D. Menghrajani

Propensity in intangible investments: Firm heterogeneity among publicly listed ASEAN consumer discretionary and consumer staples firms , James Paulo G. Agnes, Aaron Cade D. Cariño, Michael Eugene C. Santiago, and Allen Ivan P. Sta. Maria

Recalibration and improvement of the Altman, Zmijewski, and Prophecy model: Earnings management as a predictor of bankruptcy of Philippine manufacturing firm , Eugene C. Aguirre, Noel Christian C. Marcojos, Leomar T. Santiago, and Alyssa Gale D. Valeriano

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• v.17(6); 2021

Vaccination in the Philippines: experiences from history and lessons for the future

Ma. sophia graciela l. reyes.

a Duke-NUS Graduate Medical School, Singapore, Singapore

Edward Christopher Dee

b Harvard Medical School, Boston, MA, USA

Beverly Lorraine Ho

c Department of Health, Health Promotion and Communication Service, Philippines

In anticipation of a potential vaccine for COVID-19, vaccine uptake may be critical in overcoming the pandemic, especially in countries like the Philippines, which has among the highest rates of infection in the region. Looking at the progress of vaccination in the country – its promises, pitfalls, and challenges – may provide insight for public health professionals and the public. The history of vaccination in the Philippines is marked by strong achievements, such as the establishment and growth of a national programme for immunization, and importantly, the eradication of poliomyelitis and maternal and neonatal tetanus. It is also marred by critical challenges which provide a springboard for improvement across all sectors – vaccine stock-outs,

strong opposition from certain advocacy groups, and the widely publicized Dengvaxia controversy. Moving forward, with recent surveys having shown that vaccine confidence has begun to improve, these experiences may inform the approaches taken to address vaccine uptake. These lessons from the past highlight the importance of a strong partnership between health leaders and the local community, bearing in mind cultural appropriateness and humility; the engagement of multidisciplinary stakeholders; and the importance of foresight in preparing public health infrastructure for the arrival of a COVID-19 vaccine.

Introduction

Much hope for life after the COVID-19 pandemic lies in the potential success of vaccines. Multiple vaccines are in various stages of development, 1 and preliminary results from various trials are promising. 2–4 However, the success of a vaccine is incumbent upon uptake in the general population. 5

The Philippines has among the highest Covid-19 infection rates in the region, interlaced amidst economic and political ramifications. 6 In countries like the Philippines, population adherence to vaccines may be critical to overcoming the pandemic. 7 Adherence, however, is dependent on the population’s willingness to receive the vaccine. 8 Analysis of the history of vaccine uptake in the Philippines may highlight pitfalls and challenges that may impact efforts to disseminate a future Covid-19 vaccine. Importantly, an eye toward history may provide insight – and foresight – as public health authorities and healthcare professionals plan the steps forward.

Overview history of vaccination in the Philippines: promises and pitfalls

In 1976, the Expanded Programme on Immunization (EPI) was established in the Philippines through Presidential Decree No. 996, with the assistance of the World Health Organization (WHO) and the United Nations Children’s Fund (UNICEF) in order to combat the top infectious diseases causing child mortality through increased accessibility to preventive care. This programme made basic immunization compulsory for children under the age of 8, and covered six vaccine-preventable diseases at the time: tuberculosis, poliomyelitis, diphtheria, tetanus, pertussis, and measles. A National Immunization Committee (NIC) was formed in 1986 to take charge of coordinating the EPI. 9 The EPI was revised and expanded in 2010 to cover mumps, rubella, Hepatitis B, and H. influenza type B, through Republic Act No. 10152 – the “Mandatory Infants and Children Health Immunization Act of 2011”. This covered responsibilities of health care workers (i.e., to educate pregnant mothers on the importance of vaccination) as well as continuing education programs for health care personnel. Importantly, the Act mandated basic immunization to be freely given at any government health facility to infants and children up to 5 years of age. 10

Recently, newer vaccines have been introduced, such as the pneumococcal conjugate vaccine (PCV), rotavirus vaccine, and the human papillomavirus (HPV) vaccine. Beginning in 2013, school-based immunization was the strategy of choice to target school-aged children for more age-appropriate vaccines and missed doses for basic vaccines, and was administered by the Department of Health (DOH) in coordination with the Department of Education (DepEd) and the Department of Interior and Local Government (DILG). Vaccination of senior citizens with PCV and influenza vaccines was also mandated in the program through Republic Act No. 9994 – the “Expanded Senior Citizens Act of 2010”. 11

Despite having eradicated poliomyelitis in 2000, and having adopted various strategies to improve immunization coverage, 1 vaccine coverage declined significantly from 2010 to 2015. Figure 1 shows the estimates of immunization coverage in the Philippines for BCG, DTP1, DTP3, HepB3, MCV1, and Pol3. 2 In particular, DTP1 declined from a 98% coverage rate in 2013 to 69% in 2015, and further declined after a spike in 2016, completely missing the Global Vaccine Action Plan 2011–2020 (GVAP) goal of reaching 90% national coverage and 80% coverage in every district for DPT-containing vaccines. 12 , 13 MCV coverage saw a steady decline in the aftermath of a measles outbreak in 2014; post-Dengvaxia®, MCV coverage declined even further, with another outbreak occurring in early 2019. 14 Because of this decline, many sites of resurgence of measles around the world have been traced back to the Philippines. 12 , 15 Notably, three rubella outbreaks also occurred in the recent past – once in 2001, then in 2011, and finally in 2017. 14 Fluctuating coverage over the years was also reported in the Philippine National Demographic and Health Survey 2017 (NDHS), with the percentage of children aged 12 to 23 months who received all basic vaccinations 3 increasing from 72% in 1993 to 80% in 2008, and declining steadily after that from 77% in 2013 to 70% in 2017. 16

WHO-UNICEF estimates of immunization coverage. Philippines (PHL) 2019 revision. Retrieved from https://apps.who.int/immunization_monitoring/globalsummary/estimates?c=PHL. 12

Several key events may underlie the most significant dips in the graph above. In 1995, despite anti-tetanus vaccinations having been administered since 1983, a campaign was launched by pro-life groups and anti-abortion advocates to stop the administration of the tetanus toxoid vaccine. These groups alleged that the vaccine contained a small amount of human chorionic gonadotropin (HCG) in order to induce abortion or produce infertility; this claim may also have been augmented by reports of adverse events following immunization (AEFI), particularly inflammation at the injection site. 17 , 18 Efforts to understand the public’s perception of vaccines, and catering educational information toward tackling potentially false claims about vaccine safety, may have contributed toward allaying fears regarding AEFI. Indeed, in spite of this challenge, maternal and neonatal tetanus was eliminated in the country in 2017 due to continued efforts to promote vaccine adherence. The significant and sharp decline in immunization coverage for DPT and Hepatitis B from 2014 to 2015, and continuing on to 2016, may be attributed to vaccine stock-outs. 19

In 2016, the Philippines incorporated the newly-licensed dengue vaccine (Dengvaxia®) into its national immunization programme, despite the mechanism of action being equivocal. It was rolled out in an expedited manner in response to an exceedingly high burden of disease in the country. 7 , 20–22 The occurrence of adverse reactions in children that some have attributed to Dengvaxia®, along with inadequate social preparation and risk communication, inadvertently led to a widespread controversy amidst media hype and political discord. This media hype was possibly fueled even further by a divided stance and a diversity in opinion among the members of the medical community in the Philippines. 21

In the aftermath of this controversy, confidence in vaccines and/or the national immunization programme in the country plummeted. 21 Shortly thereafter, in early 2019, measles outbreaks were declared in several regions across the Philippines. 23 There were more than 33,000 cases, overrunning the capacity of many hospitals. A measles vaccination campaign was launched in response; however, challenges in administering the vaccine were met, such as the tendency for mothers to give false reports of their children’s vaccination status out of fear of being scolded by their physicians, 24 possibly suggesting a lack of confidence in vaccination. This may bias the next NDHS report disproportionately given an already-existing recall bias, as information on vaccination coverage is obtained not only from written vaccination records, but also from verbal reports, the latter especially in cases where official documents would not be available. 16

The response to vaccines other than DENV in light of public fears about DENV sheds light on the value of learning from the past. Understanding the public response – and its magnitude – to unforeseen AEFI should inform the care with which vaccination programs are implemented in the future. The Dengvaxia experience highlights the need to engage multidisciplinary stakeholders in the approach to increasing vaccine adherence. Importantly, cooperation among healthcare experts, media, and policymakers may have improved the communication between the vaccine’s manufacturer and providers on the ground and may have mitigated the backlash against vaccines in general, in light of adverse effects potentially associated with DENV.

Notably, a PulseAsia survey conducted in the Philippines in December 2018 reported that 78% of respondents believed that vaccines are safe for themselves, their children, or their family members. 25 These findings suggest the positive effects of education campaigns and widespread confidence in the safety of vaccines, despite the DENV controversy. It is possible, therefore, that education efforts moving forward should focus on demonstrating the utility of vaccines for a population that deems vaccines safe. These successes should also inform the approaches taken to optimize public reception of a potential COVID-19 vaccine.

Lessons and considerations for Covid-19

The successes and shortcomings highlighted in the recent history of vaccination in the Philippines shed light on lessons that can inform measures to improve vaccine uptake if and when a successful vaccine for COVID-19 becomes available. The past has shown the importance of a partnership between health leaders and the local community; the engagement of multidisciplinary stakeholders; and the importance of foresight in preparing vaccine infrastructure.

Firstly, cultural humility and appropriateness are important in promoting vaccine uptake, especially when there is a large gap in knowledge between the healthcare provider and the recipient of care, particularly for novel therapies (such as DENV when it was newly released). There may be a knowledge monopoly biased toward the physician, where patients tend to place their trust in the former to make decisions. Community engagement and education are therefore important in ensuring individuals make informed decisions about their healthcare. 7

Efforts to engage barangay and other local leaders may prove critical in engendering trust in the population. 7 Much in the same way that providers are encouraged to engage in a patient-provider partnership to grant autonomy to patients while simultaneously encouraging treatment adherence, it is critical to engage in a partnership with local leaders to create trust and encourage vaccine adherence. For example, those implementing programs may engage barangay tanods (local community custodians) and trusted community individuals and leaders; community health workers could be trained and equipped to administer the vaccine and contextualize medical jargon into the vernacular; and finally, for health care practitioners to speak eye-to-eye and lessen the knowledge gap when asking individuals to vaccinate.

Secondly, multidisciplinary collaboration is necessary. Previous crises such as the Dengvaxia controversy and now the eruption of the pandemic in the country have pulled the medical and academic community apart, when it is necessary for us to be united most. Efforts to align and build coalition among healthcare providers, data scientists, policymakers, private sector and media are merited. Healthcare workers may provide insight into attitudes toward the vaccine and the pandemic at the patient level; PulseAsia reported healthcare workers as the second-largest influence on individuals’ decision-making for vaccination next to the Department of Health, with family as the third most influential force. 25 Data scientists may help define patterns of success and failure among various interventions. 26 Policymakers, particularly at the local level, may influence local actions and decisions among citizens in their jurisdictions. 5 , 27 The private sector – mavericks in supply chain and logistics management – may understand the macroscopic supply and demand factors at play, and could aid policymakers in program implementation. Both traditional and social media may inform what patients learn about vaccines. The ability to shape the narrative and public opinion makes the media a critical player in risk communication and community engagement. 28–30 Although the Philippines has some of the highest rates of social media use, traditional media is a key channel in advocating for vaccine adherence; several recent surveys during the COVID-19 pandemic showed that Filipinos’ primary source of information continues to be traditional media (i.e., television and/or radio), followed by social media. 30–32 Multidisciplinary cooperation well in advance of a future vaccine may help prime the population for adequate vaccine uptake.

Lastly, there is no shortcut to building a reliable vaccine infrastructure, especially for the 23 rd most densely populated country in the world. Whether the Philippines would decide to manufacture its own vaccines or participate in advanced market commitments, one thing remains clear: the infrastructure for vaccine delivery needs to be built fast, and in a manner that is sustainable, as this would be the highway for future vaccines. Medical infrastructure is not something that will be built from scratch; years of investment in the expanded programme on immunization exist as its foundation, but its completion needs to be accelerated. Efforts must be made to modernize supply chains, taking into account the challenging archipelagic geography as well as multiple geographically isolated and disadvantaged areas (GIDAs). For example, routes for cold chains should be planned and prepared beforehand, in anticipation of an eventual vaccine. The Build! Build! Build! (BBB) Program of the national government promises to connect far flung areas through new roads, expressways, bridges, and railways, among others. 33 Continuous innovation is necessary to supplement these developments, which may include the development of sea ambulances, in order to make GIDAs more accessible.

Furthermore, we must engage all members of the community in a way that fosters trust. In addition to simply training health workers to educate their communities, ensuring that enough health workers are present and that all are adequately compensated and protected while in the line of duty would prepare the human infrastructure as a substrate ready to accept a COVID-19 vaccine when one becomes available. Training health workers to vaccinate is as important as training them for risk communication and managing refusals. Lastly, improving vaccine and science literacy among all members of the community is a key step in building a patient infrastructure equipped to make informed decisions in immunization.

These lessons have in common the need for foresight, so we are not caught blindsided when the vaccine arrives. In gaining a better understanding of the pitfalls and promises of the history of vaccination in the Philippines, lessons from the past must be used to guide the future.

Funding Statement

No funding was received for this work.

1. The Department of Health of the Philippines had adopted a “Reaching Every Barangay” strategy from the “Reaching Every District” strategy of the WHO-UNICEF in 2004, which included data analysis, outreach services, and strengthening links between the community and service providers.

2. BCG – % infants who received one dose of the Bacillus Calmette Guerin vaccine at birth; DTP1/DTP3 – % infants who received the 3 rd dose of either oral or inactivated polio-containing vaccine; HepB3 – % infants who received the 3 rd dose of Hepatitis B-containing vaccine following the birth dose; MCV1 – % infants who received the 1 st dose of measles-containing vaccine; Pol3.

3. Basic vaccinations include one dose of BCG vaccine, three doses of DPT-containing vaccine, three doses of polio vaccine (IPV or OPV), and one dose of measles-containing vaccine (measles or MMR).

Disclosure of potential conflicts of interest

No potential conflicts of interest were disclosed.

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Philippians Thesis, main chapters and bibliography

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