around, moving with a sense of purpose among stacks of paper that were
piled high on tables, chairs, and every other surface.
For parents who believe their child died or fell ill because of Dengvaxia
at the hands of the government’s public immunization drive, Acosta’s advo-
cacy has earned their loyalty. She is the rare government official they trust,
their lonely crusading champion for justice.
As I waited in a small plastic chair, a security guard showed me a video
on his cell phone of a man being hacked to death, his way of explaining to
me the types of cases they get there. I told him I was there about Dengvaxia,
and he nodded. “Oh, many cases.”
Acosta was not available to see me, but I was allowed time with two
women attorneys (it was against their communications policy to give their
names, they said) who had both worked for the PAO for roughly a decade.
They had been leading the work on Dengvaxia cases, which at that point
encompassed 144 investigations and 44 criminal cases. (PAO had filed 91
criminal and civil cases through early November.)
The two attorneys repeated to me a dubious and controversial assertion
that their office had made in court filings—that it was Dengvaxia itself that
had killed the children directly rather than a severe dengue infection of the
kind that Sanofi had warned about.
They explained that PAO had autop-
sied all the bodies and in all cases found
the underlying cause of death had been
“viscero- and neurotropic-like disease”
caused by Dengvaxia. They did not believe
dengue, or vaccine-enhanced dengue, was
related to the deaths (though among the
deceased, one child’s death certificate had
listed dengue as the cause of death).
The attorneys dismissed criticism
of the PAO’s Dengvaxia work as “per-
sonal attacks” and defended the agency’s
methods and forensic findings, saying
they were confident they would prevail in court. They argue they have
seen evidence—the autopsied bodies—that PAO’s many critics have not
and rejected the idea that PAO was responsible for whipping up fear about
vaccines in the country. That, they said, was caused by the launch of a drug,
Dengvaxia, that hadn’t been fully tested.
The stated causes of death the PAO attorneys have cited—viscerotropism
and neurotropic-like disease—critics say, come not from credible autopsy
findings but rather from Sanofi’s boilerplate risk disclosures for Dengvaxia.
Many of the vaccines that protect us from terrible diseases present a
small risk of adverse events. On very rare occasions, the shot for rotavirus,
for example, causes a reversible tangling of the bowel called intussuscep-
tion. Likewise, there’s a one in 2.4 million chance one will contract polio
from the live polio vaccine. And yellow fever vaccine very, very infrequently
leads to viscerotropic disease, a deadly phenomenon involving organ failure.
Because Dengvaxia is constructed with the viral backbone of the yellow
fever vaccine, Sanofi listed viscerotropism and neurotropism as possible
risks for Dengvaxia, and studied the vaccine for this effect in trials. (None
was observed.)
Medical experts in the Philippines publicly decry PAO’s forensic investi-
gators as unqualified and their findings as utterly wrong.
“They’re not even pathologists. They’ve not had a single day of training,”
says Raymond Lo, an anatomical and clinical pathologist who is board certi-
fied in both the U.S. and the Philippines. “They were conducting autopsies in
public, in full vision of television cameras, exhibiting all these bloody organs.“it just snowballed
into this gigantic
thing,” says one
official. “I guess
initially everybody
just expected it to go
smoothly.”SMART
ROBOTS
ARE
NOT GOING
TO STEAL
OUR JOBS.
Y E T.
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