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Published by lopezleslie871, 2022-06-03 21:24:56

Farmakeío Exélixi (8)

Farmakeío Exélixi (8)

JUNE 2022








APOTHECARY. Referred to both the person who
manufactured and dispensed medicines, and the
shop in which those medicines were sold. The
appearance of the first apothecary in history was in
Baghdad in 754 AD. Apothecaries were at their most
popular throughout the 1700s but by the turn of the
century, they were starting to be outnumbered by
Victorian chemists. However in the modern age, for
a few remaining establishments, the apothecary as it
was once known is all but extinct.

TABLE OF 0 Olden Days of Pharmacy
by Marie Angeli Durban
0 Diseases in the Olden Times
by Marie Angeli Durban

0 Medicinal Plants Back Then
by Alyssa Reese Lantaca

0 The People Behind Drugs
by Alyssa Reese Lantaca

0 International Legislations
by Leslie Gwen Empuerto

0 Centerfold: Timeline
0 Philippine Pharmacy Laws

by Leslie Gwen Empuerto

0 Modern Diseases
by Marielle Faith Panes

0 Vaccines for Flu, Polio, etc.
by Marielle Faith Panes

0 Pandemic & E-Prescriptions
by Cyrel Supera

0 Immunizing Pharmacists
by Cyrel Supera

0 Editorial

The Greek god of healing with
his daughter, the Greek
goddess of health. The Rod of
Asclepius, one snake around a
rod as the symbol of doctors,
and the Bowl of Hygieia, a snake
drinking from a cup as the
symbol of pharmacists. The
two divinities are accompanied
by a snake, the symbol of
wisdom and healing power.

AVICENNA. The Persian Galen.

As they say, there are times when we have to look Saint Cosmas and Damian were third century Arabian-born
back to see how far we have come and realise twin brothers who embraced Christianity and practiced
that we made progress after all. Certainly, medicine and surgery without a fee. Due to this, it led them to
the practice of Pharmacy has evolved and be known as the holy unmercenaries, the Anargyroi. They
developed throughout the centuries. That reputedly cured blindness, fever, paralysis and reportedly
said, let us take a walk down memory expelled a breast serpent. Aside from this, they were credited
lane, to revisit the rich history of the profession, back to for being the first to attempt a limb transplant on a human
where it all started and how it came to be. Here, we will be being. Hundreds of healing miracles are attributed to the twin
featuring some of the renowned personalities that created saints. They are most famous for the miracle of the black leg.
history through their remarkable contributions. All that the It is said that the saints appeared in the man’s dream carrying
practice of Pharmacy is known for today, and what it will be an ointment and an instrument. In his dream, the saints
known for or become in the next generations, we owe it all to decided to remove his diseased leg surgically and grafted a
these people who became our beacon of light, that continues healthy leg from a recently-deceased Ethiopian who was
to inspire, guide, and give hope to pharmacists all around the buried in another church. When the man awoke, he reached
world. for his leg and felt no pain and observed that he now had two
Hippocrates of Kos was a Greek physician who lived from healthy legs although one was not his.
about 460 B.C. to 375 B.C. At a time when most people Avicenna “The Persian Galen” also known as Ibn Sina was a
attributed sickness to superstition and the wrath of the gods, true polymath with his contributions ranging from medicine,
he taught that all forms of illness had a natural cause. He psychology and pharmacology to geology, physics, astronomy,
established the first intellectual school devoted chemistry, and philosophy. His most important contribution
to teaching the practice of medicine. For to medical science was his famous book, "The Canon of
this, he is widely known as the "Father of Medicine." A larger portion of the first book discusses the
Medicine." The school of medicine focused causes of health and disease and emphasizes the importance of
on treating the causes of disease rather considering both physical and psychological factors when
than just its symptoms. Moreover, these devising medical treatment plans for patients. Furthermore,
early medical practitioners promoted the he also emphasized on preventative care through balancing
systematic study of clinical medicine. the six essential lifestyle factors, including diet, nutrition, and
Meaning to say, they studied diseases by exercise, etc. Aside from this, he was also credited with some
directly examining the living person. Through of the early stirrings of important public health and safety
his efforts, medical practice pointed in a new measures still in practice today, such as quarantine. In his
direction, one that would move toward a observations throughout The Canon, he identifies
more rational and scientific view of medicine. Tuberculosis as a contagious disease whose victims should be

olden days of

of Kos

Saint Cosmas


“The Persian Galen”

A Greek physician who lived from also known as Ibn Sina was a true polymath Saint Cosmas and Damian
about 460 B.C. to 375 B.C. At a time with his contributions ranging from were third century Arabian-
when most people attributed medicine, psychology and pharmacology
sickness to superstition and the and the like. His most important born twin brothers who
wrath of the gods, he taught that all contribution to medical science was his embraced Christianity and
forms of illness had a natural cause. famous book, "The Canon of Medicine." A
He established the first intellectual larger portion of the first book discusses practiced medicine and
school devoted to teaching the the causes of health and disease and surgery without a fee. Due to
practice of medicine. For this, he is emphasizes the importance of considering this, it led them to be known
widely known as the "Father of both physical and psychological factors
Medicine." The school of medicine when devising medical treatment plans for as the holy unmercenaries,
focused on treating the causes of patients. Furthermore, he also emphasized the Anargyroi. They
disease rather than just its on preventative care through balancing the
symptoms. Moreover, these early six essential lifestyle factors, including diet, reputedly cured blindness,
medical practitioners promoted the nutrition, and exercise, etc. Aside from fever, paralysis and
systematic study of clinical this, he was also credited with some of the
medicine. Meaning to say, they early stirrings of important public health reportedly expelled a breast
studied diseases by directly and safety measures still in practice today, serpent. Aside from this,
examining the living person. such as quarantine. In his observations
Through his efforts, medical throughout The Canon, he identifies they were credited for being
practice pointed in a new direction, Tuberculosis as a contagious disease whose the first to attempt a limb
one that would move toward a more victims should be subject to quarantine, or transplant on a human
rational and scientific view of isolation, so as to avoid further spread of being. Hundreds of healing
medicine. the illness. miracles are attributed to
the twin saints.

As they say, there are times when we have to look back to see how far we have come and realise that we made progress after all. Certainly, the practice of
Pharmacy has evolved and developed throughout the centuries. That said, let us take a walk down memory lane, to revisit the rich history of the profession, back
to where it all started and how it came to be. Here, we will be featuring some of the renowned personalities that created history through their remarkable
contributions. All that the practice of Pharmacy is known for today, and what it will be known for or become in the next generations, we owe it all to these
people who became our beacon of light, that continues to inspire, guide, and give hope to pharmacists all around the world.

alexander friedrich
flemming serturner

and damian

They are most famous for A Scottish pharmacist, pharmacologist, A German pharmacist, who
the miracle of the black leg. and biologist, who was famous for the discovered morphine, a drug that
It is said that the saints discovery which has saved millions of belongs to a class of drugs known as
appeared in the man’s dream lives – the world's first antibiotic opioid analgesics. His discovery of
carrying an ointment and an penicillin. A staphylococcus culture was morphine is most important to the
instrument. In his dream, full of mold, but Fleming, instead of well-being of the general public in
the saints decided to remove discarding it, wanted to observe it under their management of pain, and this
his diseased leg surgically his microscope. Surprisingly, the mold story also served as an inspiration
and grafted a healthy leg had eliminated all bacteria in its path. for further scientific developments.
from a recently-deceased After a more thorough investigation, it He was the first to isolate the active
Ethiopian who was buried in allowed him to find the substance he
another church. When the called penicillin. This powerful element ingredient associated with a
man awoke, he reached for would become one of the first antibiotics medicinal plant and the first to
his leg and felt no pain and effective against diseases that at that time isolate an alkaloid from any plant,
observed that he now had could be deadly, such as scarlet fever,
two healthy legs although pneumonia, meningitis and gonorrhea. thus disproving the prevailing
one was not his. He devoted himself to highlight in notion that all plant substances were
multiple speeches and lectures that the
antibiotic should not be consumed unless acidic in nature and launching the
it is really necessary, and that if it is done, new science of alkaloid chemistry.
the dose should not be very light, nor
should it be taken in a too short period. This initiative of his stimulated
This incorrect use of the drug only allows other chemists to isolate other
the bacteria that cause the disease to important alkaloids, such as codeine,
become stronger, worsening the patients' quinine, strychnine, and caffeine.
condition and making it difficult to Although his discovery was made in
recover. Even up until today, this is still 1805, it wasn’t until after 1815 that
one of the lessons that practitioners morphine became widely available
ensure to emphasize to the patients and for use. Due to his discovery and
the public in general. extensive research into the effects of
morphine, we are able to harness its

pain relief qualities today.


in the olden times

For centuries, explanations for disease were not based on science rather, religion, superstition, and myth.
The Hippocratic Corpus was an early attempt to think about diseases, not as punishment from the gods,
but as an imbalance of man with the environment. By considering the possibility that disease was associated
with environmental factors or imbalances in diet or personal behaviors, the Corpus also opened up the
possibility of intervening to prevent disease or treat it. Despite the contributions of the Corpus, medical
and scientific progress in Europe was arrested for several centuries. The population grew, and cities became
densely populated, but there was little attention to waste disposal and sanitation. These factors set the stage
for endemic disease and periodic epidemics.

Scarlet fever, also known as scarlatina, was SCAR LET FEVER
common and occurred as epidemics in the 1800s
with a death rate as high as 150/100,000. It is
caused by an organism, Streptococcus and is seen
rarely in developed countries like the United
Kingdom these days. It commonly affects
children ages 5 to 12, and shares many symptoms
with strep, such as fever, sore throat, headache,
nausea, along with a red, sandpapery rash that
appears on the chest and neck and may spread
across the body.



Leprosy was initially thought to be a curse or a
punishment from God. In fact, leprosy sufferers were

stigmatized, forced to wear special clothing or ring
bells to warn others when they were approaching.
However, it is an infection caused by the slow growing

bacteria, Mycobacterium leprae having a long
incubation period of two to five years and symptoms

usually start as a numbness or loss of feeling in a
defined area of skin - reflecting the affinity of the
bacterium for nerve cells. Symptoms vary from person
to person, and tend to progress with time; ranging from
mild, indeterminate hypopigmented skin lesions to
blindness, deformity and severe facial disfigurement.

Before the advent of mass production

of medication by drug companies in the

D I D mid 20th century, each Medication was
custom-made from raw ingredients to

Y O U suit an individual patient’s needs.
Pharmacists used the mortar and

pestle for centuries to make custom

medications, which is why it is now

KNOW? theindustrysymbol
of today’s




PLANTS back then

Healing with medicinal According to data from the The great age of herbalism is plants were also discovered
plants is as old as mankind Bible and the holy Jewish said to have occurred from the such as tannins, saponosides,
itself. In view of the fact that book “The Talmud”, during 15th to the 17th century. etheric oils, vitamins,
at the time there was not various rituals accompanying a Herbal books were becoming hormones, etc.
sufficient information either treatment, aromatic plants available in English, having
concerning the reasons for the were utilized such as myrtle been translated from Latin Human kind’s quest for
illnesses or concerning which and incense. and Greek. One of the first solutions to relieve pain and
plant and how it could be In Homer's epics The Iliad herbal books to be published alleviate illnesses continues.
utilized as a cure, everything and The Odysseys, created in English was "Grete Herball" Every successive generation
was based on experience for circa 800 BCE, some plants in 1526. This was preceded by learns from & builds on the
our ancestors. were given the names after "Banckes’s Herbal," which is knowledge of the previous.
mythological characters from considered the first English The knowledge of the
The history of medicinal these epics. For instance, the book on herbalism, printed in development of ideas related
plants dates back to 60,000 plants from the genus 1525. to the usage of medicinal
BCE when researchers have Artemisia, which were plants as well as the evolution
found evidence of yarrow, believed to restore strength In 18th century, in his work of awareness has increased the
chamomile, and poplar on the and protect health, their name Species Plantarium (1753), ability of pharmacists and
tooth plaque of Neanderthals. was derived from the Greek Linnaeus (1707-1788) provided physicians to respond to the
We see continued use of plants word Artemis, meaning a brief description and challenges that have emerged
through the ages when the “healthy.” classification of the species with the spreading of
oldest written evidence of Theophrastus (371-287 BCE), described until then. professional services in
medicinal plants’ usage for known as the Father of facilitation of man's life.
preparation of drugs was Botany, founded botanical Early 19th century was a
found on a Sumerian clay slab science with his books “De turning point in the “All that a man
from Nagpur, approximately Causis Plantarium” and “De knowledge and use of needs for health
5000 BCE, which comprised of Historia Plantarium”. In the medicinal plants. The and healing has
12 recipes for drug preparation books, he generated a discovery, substantiation, and been provided by
referring to over 250 various classification of more than 500 isolation of alkaloids - from God in nature.”
plants. medicinal plants known at the poppy (1806), ipecacuanha
time. (1817), strychnos (1817),
Shortly after, the Chinese In ancient history, the most quinine (1820), pomegranate
book on roots and grasses prominent writer on plant (1878), and other plants, then
“Pen T’Sao,” written by drugs was Dioscorides, the the isolation of glycosides -
Emperor Shen Nung circa Father of Pharmacognosy, marked the beginning of
2500 BCE, treats 365 drugs who wrote the work “De scientific pharmacy. With the
(dried parts of medicinal Materia Medica,” which offer upgrading of the chemical
plants), many of which are plenty of data on the methods, other active
used even now. substances from medicinal

The Indian holy book medicinal plants constituting
“Vedas” mentioned treatment the basic materia medica until
with plants, which are the late middle ages and the
abundant in that country. Renaissance. Of the total of
Numerous spice plants used 944 drugs described, 657 are of
even today originate from plant origin.
India, such as nutmeg, pepper, The most distinguished
and clove. Roman physician
(concurrently a pharmacist),
Around 1500 BCE, the Galen (131 CE–200), compiled
Egyptians created the “Ebers the first list of drugs with
papyrus”, a compilation of similar or identical action
medical texts that contains (parallel drugs), which are
over 700 formulas and interchangeable.
remedies meant to cure Ebers Papyrus. The largest and only complete extant medical
afflictions using plants. scroll originated in Ancient Egypt, 16th century BC.

Panax ginseng
Papaver somniferum Mandragora officinarum Cannabis sativa
Cultivation of the plant A plant that can kill and The medicinal uses of The originating area of
dates back to the earliest cure - it is used as an cannabis was listed in ginseng is known to be in
years of human aphrodisiac, narcotic, Emperor Shen Nung's China during the Han
civilization in Sumer sedative, and anesthetic. (Father of Chinese dynasty era. Its major
around 5000 BCE. It is One of the oldest Medicine) pharmacopoeia. active ingredients are
known for millennia to references to mandrake is It possesses analgesic, ginsenosides, which
relieve pain and its use from the Bible and anti-inflammatory, exhibits a variety of
for surgical analgesia. probably dates to 4,000 anxiolytic, and anticancer therapeutic effects,
“Morphine”, a highly B.C. for its supposed properties, among others. including antioxidation,
potent opiate analgesic fertility power. anti-inflammatory,
psychoactive drug, is antiallergic, antidiabetic,
derived from this plant. and anticancer.

Aloe vera Curcuma longa
The first record of human Ginkgo biloba Ocimum tenuiflorum
use of Aloe vera is in The medicinal use of Ginkgo is one of the Holy basil is native to the
Sumerian hieroglyphics turmeric dates back nearly world’s oldest living tree Indian subcontinent and is
engraved on clay tablets 4000 years to the Vedic species, thus referred to commonly used in the
during the Mesopotamia culture in India, where it as a “living fossil”. It traditional Indian medicine
civilization circa 2200 BC, was used as a culinary supposedly has been system, Ayurveda. It has been
in which it is described as a spice and had some around since the time of found to counter metabolic
laxative. 2000 years ago, the religious significance. It the dinosaurs, and one stress and psychological stress
Greek scientists regarded it possesses anti- tree in China is about - through its anxiolytic and
as the universal panacea. inflammatory, antioxidant, 3,500 years old. anti-depressant properties. It
The Egyptians called it “the anticancer, antimutagenic, Mechanisms of action is also known to help skin,
plant of immortality.” Its antimicrobial, antiobesity, may include antioxidant, respiratory, gastrointestinal,
pharmacological activities hypolipidemic, neurotransmitter/recept and joint conditions.
include promotion of cardioprotective, and or modulatory, and
wound healing, antifungal neuroprotective effects. antiplatelet activating
activity, anti-inflammatory, factor properties.
anticancer, anti-aging, and


By: Leslie Gwen L. Empuerto

A statesman of Roman
descent, Marcus Tullius Cicero,
once said, “The safety of the
people shall be the highest
law”, to which I believe, must
be ingrained in the minds of In light of the exponential growth
every citizen, and be lived as of pharmaceutical medications
across several civilizations,
long as we walk this earth.

Time and experience have opened movements have been created
the minds of the masses about the throughout centuries which are
importance of laws in the context anchored on their proper use and
of medicine, pharmacy, and in regulation. Thus, legislations have
every other field, as a matter of been formulated to ensure the
fact. See, after the creation of safety of the preparations and to
essential pharmaceutical drugs (as ensure the accountability of
previously discussed in the druggists over the course of this
previous section), it is important rapid development of medicines.

to ensure the proper regulation
and moderation of their use and
distribution. Why? It is simply The American Pharmacists
because everything must be done Association, has responded to a
in regulation, otherwise, what certain movement in the late
should’ve been used to save 1860s with regard to the
people’s lives just might be the “increased public protection and
reason a life would come to an occupational security”, by making
end. law amendments which paved the
way for a pharmacy act to be
modeled. Throughout the globe, a
pharmacy act provides the
consolidated provisions and ideas
to be implemented within the
scope of pharmacy (Government
Gazette, 2020). It may have
different variations from country
to country, but the gist remains to
put high priority on the safety of
the people through the
medications and pharmaceutical
preparations dispensed and
provided by pharmacists.

However, as we know, there will The 1870s, 1880s, 1890s and
always be split ideas and results onwards were the decades
from the conduct of certain bills, wherein there was a great boost in
acts, or laws provided. Amongst the funding and association In pharmaceutical legislation,
the prominent issues with regard among pharmacists, traders, and modification was necessary and
to that act was the fact that some those who were supportive was reflected in the vast changes
pharmacists took it negatively in sponsors in the advancement of in therapeutics and practice. Laws
such a way that they find some the field. It was a great time for of the land, especially those of
restrictions in the pharmacy act pharmaceutical development and federal nature, were more strict in
drawn up by other professionals professionalism, as there was a the regulation and production of
who were concerned with the safe disintegration of hindrances and pharmaceutical drugs, especially
usage of poison, quite unfair in communication-gaps between following the war that took place.
terms of delegation of authority pharmacy practitioners and other The practice of pharmacy saw a
when it comes to compounding, healthcare professionals. wave of modernization as 1938,
administering, and even Institutional certification and the 1951, and 1962 amendments in
dispensing medications. Thus, to identification of pharmacists as a already established laws were
compensate for this, they have collective group of highly skilled passed (Remington’s: The Science
decided to have an empowered and competent health care and Practice of Pharmacy, 2021).
committee to draw up their own providers have paved the way for Medicines had tougher standards
model law which would protect the flourishment of the field and to pass and each one
the best interests of the masses and
of the practice of Pharmacy practice of Pharmacy.
(Remington’s: The Science and
Practice of Pharmacy, 2021).

Throughout the years, as with any Still, despite a seemingly steady
law created, amendments and growth, dramatic changes
resolutions are still occasionally happened in the 19th and 20th
added to address probable mishaps centuries, among which would
or overlooked provisions in include the scourges of humanity
already established ones. which would require more
modifications to be done in order
to accommodate the rapid rate of
change in the needs of the citizens
and the healthcare community in

was meticulously judged for safety
and efficacy. The distribution of
pharmaceutical drugs and
products were highly regulated in
the market to ensure that no
counterfeits or substandard ones
are distributed. Moreover, laws
with regard to the production and
usage of drugs prone to abuse and
addiction were updated through
the ...

Drug Abuse Act, which was enforced through
agencies which monitor and control the
aforementioned preparations.

did you know?

The first Pharmacy Act was passed in Great Britain
on the 31st day of July in the year 1868. This was
marked as a huge milestone in the history of the
field and practice of Pharmacy, as it set up a

register of people who were qualified to restrict or
permit the sale of poisons to only qualified people.

This paved the way for the promotion of safe
medicines and it jumpstarted the introduction of
formal qualifications for pharmacists who were the
ones responsible for thorough examination of the
pharmaceutical products they were distributing to

the public.

did you know?

in the year 1962, Important
amendments of the international
Federal Food and Drug Act were
made. furthermore, in the year
1973, there was the approval of
the united states Supreme Court
decision which states that
licensed pharmacists can have
ownership control of pharmacies.

Evidently, the 18th, 19th, and 20th centuries were integral milestones International
for the uphill growth of the field and practice of Pharmacy, which is Pharmacy
why it is essential to have a thorough understanding of the legislations
that became pillars for the laws we now have today. Thanks to the Legislations
pioneering heads and members of Pharmacy Organization and
Associations around the globe, we continually have an empowered Penned By: Leslie Gwen L. Empuerto
mindset which further showcases our competence, talent, intellect,
and skill in the conduct of our work, all for the glory of the one above
and in the service of our fellowmen.

Pharmacy Laws

Penned By: Leslie Gwen L. Empuerto

Since time immemorial, laws that govern The previous article titled: “International Pharmacy
the land will always have a huge bearing in Legislations” has introduced the mothership of the laws
the conduct of any field, and this includes that govern the practice of Pharmacy from centuries
the utmost importance of healthcare- ago. The Pharmacy Act established in Great Britain in
related laws that would go hand-in-hand the year 1868 was the foundation of all other Pharmacy
with the movement of the Medical Field Acts from all across the globe. Here in the Philippines,
which in turn, also touches the vast field we also have our own variation of the said act. In fact,
and practice of Pharmacy. amendments were created from the prior version, which
gave birth to the current Republic Act 10918 “Philippine
Pharmacy Act”.

Fortunately, lawmakers in the Philippines have come to terms with the importance
of the pharmaceutical preparations that pharmacists deliver to their patients,
which is why there are several laws which supplement the Philippine Pharmacy Act
and provide a wide scope of health care service to accommodate everyone’s needs.
Amongst the other laws approved and spearheaded by the Professional Regulatory
Board of Pharmacy and with the approval of the Professional Regulation
Commission (PRC) that would further improve the services offered to the citizens
of the Philippines would include the (1) Philippine Pharmacy Act, (2) Food Drug
and Cosmetic Act, (3) The Generics Act of 1988, (4) The Comprehensive
Dangerous Drug Act of 2002, (5) Special Law on Counterfeit Drugs, (6) Food and
Drug Administration Act of 2009, and (7) Expanded Senior Citizens Act of 2010.

Philippine Pharmacy Laws

Penned By: Leslie Gwen L. Empuerto

RA 10918

This Act provides for and shall govern the:

(a) Standardization and regulation of pharmacy education;
(b) Administration of licensure examination, registration, and licensing of
(c) Supervision, control, and regulation of the practice of pharmacy in the
(d) Development and enhancement of professional competence of
pharmacists through continuing professional development, research, and
other related activities; and
(e) Integration of the pharmacy profession.
Amongst the importance of Republic Act 10918 to the pharmacists here in
the Philippines is that it allows the expansion of the scope of the tasks and services
which pharmacists are able to do. This includes being able to administer adult
vaccines by licensed and trained pharmacists provided in Section 40 of Article IV:
Regulation of the Practice of Pharmacy. Moreover, as previously mentioned, this
current Philippine Pharmacy Act contains the new provisions and amendments,
which thus repeals the ones that needed to be changed from the previous version,
as further emphasized by Section 52 of Article VIII: Final Provisions.

This particular act is an RA 3720
essential guide not only for (FOOD, DRUG, AND COSMETIC ACT)

pharmacists but also for

professionals who work in Section 2. It is hereby declared the policy of the
regulatory agencies. It is always State to insure safe and good quality supply of
important to ensure the safety food, drug and cosmetic, and to regulate the
of the production of drugs, production, sale, and traffic of the same to protect
the health of the people.
especially those of Section 3. In the implementation of the foregoing
pharmaceutical nature, that policy, the Government shall in accordance with
the provisions of this Act:
are released to the public.
Cases of mass poisoning would (a) Establish standards and quality measures
be reduced when the drugs are for food, drug, and cosmetic.
not defective, which is why it is (b) Adopt measures to insure pure and safe
supply of food, drug, and cosmetic in the
essential to mandate the country.
meticulous inspection of any
pharmaceutical preparation.

Philippine Pharmacy Laws

Penned By: Leslie Gwen L. Empuerto

R.A 6675 (GENERICS ACT OF 1988)

Section 2. Statement of Policy – It is hereby declared the policy of the State:
§ To promote, encourage and require the use of generic terminology in the
importation, manufacture, distribution, marketing, advertising and promotion,
prescription and dispensing of drugs;
§ To ensure the adequate supply of drugs with generic names at the lowest possible cost
and endeavor to make them available for free to indigent patients;
§ To encourage the extensive use of drugs with generic names through a rational
system of procurement and distribution;
§ To emphasize the scientific basis for the use of drugs, in order that health
professionals may become more aware and cognizant of their therapeutic effectiveness;
§ To promote drug safety by minimizing duplication in medications and/or use of
drugs with potentially adverse drug interactions.

This particular act is an R.A 9165
essential guide not only (THE COMPREHENSIVE DANGEROUS DRUG
for pharmacists but also
ACT of 2002)
for professionals who Section 2. Second Paragraph.
work in regulatory
Toward this end, the government shall pursue an
agencies. It is always intensive and unrelenting campaign against the
important to ensure the trafficking and use of dangerous drugs and other
safety of the production similar substances through an integrated system of
of drugs, especially those planning, implementation and enforcement of anti-
of pharmaceutical nature, drug abuse policies, programs, and projects. The
that are released to the government shall however aim to achieve a balance
in the national drug control program so that people
public. Cases of mass with legitimate medical needs are not prevented
poisoning would be from being treated with adequate amounts of
appropriate medications, which include the use of
reduced when the drugs dangerous drugs.
are not defective, which is

why it is essential to
mandate the meticulous

inspection of any

R.A 8203 (SPECIAL LAW ON Counterfeit drugs, as provided by
COUNTERFEIT DRUGS) definition, “refers to medicinal
products with the correct
Section 8. Penalties. ingredients but not in the
(f) should a counterfeit drug be amounts as provided hereunder,
the proximate cause of death of a wrong ingredients, without active
victim, who unknowingly ingredients, with insufficient
purchased and took a counterfeit quantity of active ingredient,
drug, the penalty of life which results in the reduction of
imprisonment and a fine of Five the drug’s safety, efficacy, quality,
hundred thousand pesos strength or purity.” Thus, it is
(P500,000) to Five million pesos essential for pharmacists to always
(P5,000,000) shall be imposed. ensure the authenticity of the
drug, as counterfeits could harm
the lives of patients.



SEC. 4. This Act has the following In line with the R.A. 3720 Food, Drug,
objectives: and Cosmetic Act this act specifically
focuses on the government agency
(a) To enhance and strengthen the which is in-charge of the overall
administrative and technical regulation and monitoring of the
capacity of the FDA in the production of food, drugs, and
regulation of establishments and cosmetics for the people to utilize. This
products under its jurisdiction; emphasizes the role which
(b) To ensure the FDA’s monitoring manufacturers have, their
and regulatory coverage over responsibilities, the scope to which
establishments and products under them and their business production
its jurisdiction; and would be penalized in accordance with
(c) To provide coherence in the the law.
FDA’s regulatory system for
establishments and products under
its jurisdiction.

R.A 9444

Rule IV. Privileges for the Senior Citizens

Article 7. Twenty Percent (20%) Discount and VAT
Exemption - The senior citizens shall be entitled to the grant
of twenty percent (20%) discount and to an exemption from
the value-added tax (VAT), IF APPLICABLE, on the sale of
the goods and services covered by Section 1 to 6 of this
Article, from all establishments for the exclusive use and
enjoyment or availment of senior citizens.

Finally, this law is one
of the beneficial ones
created for the benefit
of the senior citizens of
our country.
Pharmacies should
always honor this as
well, since under the
law, it is stated that
any person or company
who refuses to honor
the 20% discount
granted to senior
citizens may be
imprisoned from two
to six years, and shall
be fined not less that
PHP 50,000 but not
exceeding PHP

A statesman of Roman
descent, Marcus Tullius
Cicero, once said, “The safety
of the people shall be the
highest law”, to which I
believe, must be ingrained in
the minds of every citizen,
and be lived as long as we
walk this earth.


By: Marielle Faith S. Panes

Good health contributes Undoubtedly, the time, it allows alleviations
and treatment through
prosperity to any aspect of avoidance of pathogenic hospital systems and
patient care including
one’s progress without microorganisms that those that offer medical
feeling any hindrance within generate disorders
The following are
the human body. However, seemed not enough to some known conditions
that caused a great
it has been typical that prevent acquiring such effect on the economic,
social, and physical
every life reaches its fate; diseases. Their causes facets of the people
during the 21st century,
connoting that physical and are yet to be identified and some points on how
they were treated:
social well-being might and the deaths of the

degenerate. As human victims were continuously

beings, experiencing reported.

In health care, diseases

diseases and illnesses are the main concerns

have been recognized as a that need to be

misfortune phenomenon addressed. At the same

for mankind. For the past

years, some people and

certain places around the

world suffer from ailments

and even from those that

cause global epidemics.

Anthrax (2001)

Anthrax is an infectious and serious disease that causes skin, lung, and bowel
disease (Davis, 2020). It is caused by Bacillus anthracis and affects domestic
and wild animals such as sheep, goats, camels, cattle, and antelopes.
However, people can acquire anthrax when in contact with infected animals.
The first diagnosed case was identified in October 2011, causing a total of 22
cases and five deaths (Moran-Perez, 2020).

Three (3) Forms of Anthrax

Cutaneous Anthrax
Affects the skin and tissue
around the site of infection.
Cutaneous anthrax
symptoms include itchy small
blisters or bumps, swelling,
and skin soreness.

Inhalation Anthrax
Affects the lungs and is often
fatal. Symptoms of inhalation
of anthrax include fever,
malaise, and cough or chest

Gastrointestinal Anthrax
Acquired when a person eats

undercooked meat from an

animal infected with anthrax,

thus, affecting the

gastrointestinal tract.

Gastrointestinal anthrax

symptoms include fever and

chills, sore throat, nausea,

bloody vomiting, and painful


This disease (all types) can be treated with antitoxins and antibiotics, including
intravenous antibiotics. Accordingly, antitoxins target anthrax toxins that have been
released into the body (CDC, n. d.). Antibiotics, on the other, prevent the growth of

anthrax or destroy it.



Severe Acute Respiratory Syndrome (SARS) is a viral respiratory disease
formed due to the SARS-associated coronavirus. This disease was first
discovered during an outbreak that occurred in China in February 2003, and
eventually, spread to four other countries (World Health Organization, n. d.).
SARS is said to be the first severe and readily transmissible disease to
appear in the 21st century which had a clear capability to spread along the
routes of international air travel. Accordingly, it is an airborne virus and can
transmit through droplets of saliva in a similar way to colds and influenza.

This illness includes symptoms such as high fever having a temperature of
38 degrees celsius, sometimes associated with chills. Aside from those, it
may include headaches, non-productive cough, shortness of breath, malaise,
and muscle pain symptoms. For people to avoid acquiring SARS, preventive
measures such as hand washing using soap and alcohol-based disinfectants,
and using masks must be frequently performed. People who are infected
must isolate and quarantined for certain days.

H1N1 Virus (Swine Flu)


This flu is a type of influenza A virus and is primarily
caused by the H1N1 strain of the influenza virus. Its signs
and symptoms can include chills, cough, difficulty in
breathing, headache, seizures, muscle pain, diarrhea,
and others (MayoClinic, n. d.). The swine flu outbreak
happened in 2009, and health workers have traced the
virus to a pig farm in a southeastern Mexican state
(DerSarkissian, 2021). Recommended treatments for this
illness include antiviral drugs such as peramivir and
zanamivir—such drugs could help patients get well

Ebola Virus Disease
(EVD) (2014)

EVD is a rare yet severe and Moreover, two monoclonal

fatal illness in humans. The virus antibodies such as Inmazeb and

can be transmitted from wild Ebanga were approved by US

animals to humans which might Food and Drug Administration for

eventually spread through the treatment of ebolavirus

person-to-person transmission. infection in adults and children in

In March 2014, WHO reported late 2020 (World Health

cases of EVD which soon Organization, 2021).

spread in the rural region of Breastfeeding and pregnant

southeastern Guinea. People women with this disease should

with this disease may suffer be offered early medical and

from fever, aches, fatigue, sore supportive care. Furthermore,

throat, gastrointestinal outbreaks can be controlled by

symptoms, and more. applying a series of interventions

Fortunately, vaccines were including case management,

developed to protect against infection prevention, contact

Ebola and have been used to tracing, good laboratory service,

prevent its spread and social mobilization, and dignified

outbreaks burials.


Coronavirus disease (COVID- Infected people might
19) is caused by the SARS- experience the most common
CoV-2 virus. Similar to SARS- symptoms of COVID-19
CoV, COVID-19 is also an including fever, cough, and loss
infectious disease that of taste or smell, and less
causes respiratory illness. common symptoms include
The virus can transfer through sore throat, headache,
droplets of small liquid diarrhea, and aches. Some
particles from an infected might also experience difficulty
person when they cough, in breathing, loss of mobility,
sneeze, speak or breathe. and chest pain. Fortunately,
This disease is easily vaccines were developed to
transmitted resulting in a protect against acquiring the
surge of cases and eventually virus. To further prevent,
causing a global pandemic preventional measures such as
and lockdown. Some people wearing a proper mask,
with this disease can recover physical distancing, and
without special treatment; frequently washing hands with
however, some will become soap, water, and alcohol. For
severely ill that will require people who are infected,
medical attention, especially staying home and self-isolation
older people and those with are recommended until
other conditions. recovered.

A lot of unexpected incidents have emerged in the past years.
Indeed, the occurrence of various diseases is something that is
not new in human nature; yet, the effects they give on those
affected are injuriously unpredictable. Patients suffering from
certain diseases carry both physical discomfort and emotional
feelings of heaviness; even the idea of encountering ailments and
disorders itself is already terrifying. However, there are remedies
that helped alleviate from experiencing diseases. Such remedies
involve the health care system which consists of medical
organizations, people, and activities that aim to promote, maintain,
prioritize, and restore health. It allows access to obtain medical
care along with disease prevention and medications. With some
aforementioned known diseases and outbreaks that occurred in
the 21st century having the corresponding responses and attention
ascertain that health should be significantly valued.

Did you Smallpox is a condition
know? that first occurred 3,000
years ago but currently,
A contagious, blemished, and deadly there are no cases of this
disease that induced a downcast surge disease, and is totally
affecting humans for thousands of eradicated!
years. Smallpox is reportedly caused
by infection with the variola virus, and it
has the ability to be transmitted from
person to person. This condition is a
terrible disease. People who acquired
this suffer from unfortunate physical
appearance which shows small red
bumpy rashes that are gradually filled
with a milky fluid (Skin Sight, n. d.). Such
characteristics follow the symptoms
like fever, achiness, headache,
vomiting, and overall discomfort.
Moreover, smallpox is life-threatening
and often causes death. According to
Cleveland Clinic, 30% of millions of
people who got smallpox every year
died. Accordingly, it was due to
systemic shock (body-wide infection)
and toxins in the blood. People who
survived may have long-term problems
such as severe scars and blindness.

The smallpox-like rashes findings on
Egyptian mummies suggest that
smallpox existed for thousands of
years. The first description of this
disease appeared during the 4th
century CE in China. In India and Asia
Minor, there were also written
descriptions that emerged during the
7th and 10th centuries, respectively.
Fortunately, due to the success of
vaccination, the last outbreak of
smallpox in 1949 occurred in the United
States. The World Health Assembly
finally declared that smallpox had been
completely eliminated in 1980, and no
cases of smallpox have happened
since (Centers for Disease Control and


By: Marielle Faith S. Panes


By: Marielle Faith S. Panes

Germs, viruses, and other counters pathogens.

bacteria have been However, these scenarios

acknowledged as natural should not be overlooked

causes of health and life as those who experience

threats. These pathogenic this might be susceptible to

microorganisms are present diseases. Some may cause

both in the surroundings and mild symptoms and for

bodies that when certain reasons, they might

encountered, will generate lead to severe and life- a “memory” that allows the
body to remember a certain
diseases and worse, death. threatening diseases. virus or bacterium to protect
itself against them and the
Nonetheless, the human body Fortunately, there are disease it causes. The
Centers for Disease Control
has various ways of protecting antidotes that help alleviate and Prevention (2018) further
added that vaccines imitate
itself from these disease- and treat such diseases infection to develop immunity.
Below are some known
causing organisms. To prevent including vaccines. diseases that are prevented
by vaccines.
pathogens from going into the According to World Health

body, organs, structures, and Organization (2021),

certain organelles including vaccines work with the

the skin, mucus, and cilia body’s natural defenses for

primarily act as barriers. When protection; thus, reducing

pathogens enter the body, the the risks of acquiring a

immune system will act as a disease. They contain

defense and helps destroy inactive parts of a particular

them through the antibodies organism that initiate an

that are produced. immune response.

Accordingly, these According to European

phenomena are the natural Vaccination Information

responses when the body en- Portal, vaccines help create

Flu (Influenza)


Influenza, commonly known headache, persistent cough,
as flu, is a viral infection that chills, shortness of breath,
attacks the respiratory and others. Flu can be
system. It can be spread resolved over time; however,
from person to person and its complications can be fatal
can be acquired through the and deadly, especially for
air while the infected person young children under the age
is coughing or sneezing, or of 5, older people over the
via contact with infected age of 65, and people with
surfaces. Symptoms include chronic illness and weakened
colds, fever, aching muscles, immune systems.

Vaccines such as flu

shots and nasal spray

vaccines are

recommended by the

Centers for Disease

Control and Prevention

(2019) to reduce the

risk. Flu shots are given

to children aged 6

months and older. Nasal

spray vaccines can be

given to patients aged 2

through 49 years.

However, there are

restrictions applied to

certain people with

underlying medical

conditions. Furthermore,

some types of influenza

vaccines include

inactivated influenza

vaccines (IIV) and live

attenuated influenza

vaccines (LAIV). Both are

produced to protect

against distinct seasonal

influenza viruses.

COVID-19 Vaccines

SARS-CoV-2, known as coronavirus, is a virus that causes respiratory
illness that emerged in 2019 causing the disease called COVID-19. It can
be acquired through breathing in the air or close contact with an infected
person and by touching the eyes, nose, or mouth with hands that have the
virus. This virus has caused the pandemic and millions of health problems
and death around the world as it easily transmits in different ways. The
arrival of COVID-19 in every region calls for a high demand for solutions to
such diseases. Fortunately, researchers and pharmaceutical
manufacturers have developed vaccines that aim to protect one from the
virus and limit its spread.

The availability of vaccines exists in different brands. In the Philippines, the
available COVID-19 vaccines are Sinovac Biotech, AstraZeneca, Pfizer-
BioNTech, Moderna, Johnson & Johnson, and Sputnik V. These are
categorized by the ways that obtain key vaccine ingredients into the body.
Pfizer and Moderna fall under the type of messenger RNA vaccines that
carry a blueprint of the partial genetic information from the virus,
instructing the body to make key immune-fighting cells. Viral vector
vaccines such as AstraZeneca and Johnson & Johnson use adenovirus, a
harmless virus that carries the instructions, that serves as a carrier to
acquire immunity-boosting instructions to the cell. Lastly, the inactivated
vaccines use an inactivated form of the virus that would help the human
body recognize the virus and fight it off when exposed to it.

These vaccines require two doses delivered between fourteen (14) to
twenty-eight (28) days apart, except for the Johnson & Johnson vaccine
which requires only one dose. Generally, the efficacy range of these
vaccines is as follows:

1.AstraZeneca - 70%
2.Johnson & Johnson - 57%-72%
3.Moderna - 94%
4.Pfizer - 95%
5.Sinovac (50%-91%)
6.Sputnik (91%)

Polio Vaccines

Polio, or poliomyelitis, is caused by poliovirus that induces disabling and life-
threatening conditions. According to the Centers for Disease Control and Prevention
(CDC, n.d.), the virus spreads from person to person and can affect the human spinal
cord, causing immobility or paralysis. Fortunately, it can be prevented with the help of a
vaccine. The Polio vaccine is administered through certain methods, depending on its
type: IPV and OPV. The inactivated polio vaccine (IPV) is given by a shot in the arm or leg,
considering the patient’s age. Meanwhile, the oral polio vaccine (OPV) is administered
orally. CDC (n. d.) suggests that children should get one dose at ages 2 months, 4
months, 6 through 18 months, and 4 through 6 years old, a total of four doses of polio


It is a contagious condition caused by the VZV or varicella-zoster virus. Reportedly, two
doses of the vaccine given subcutaneously (separated by at least three months) are
about 90% effective to prevent chickenpox. Some vaccinated people could still get
chickenpox, however, it is usually milder with fewer blisters and little or no fever.

Hepatitis Vaccines

Hepatitis is most often caused by a viral infection that results in an inflammation of the
liver. There are three types of hepatitis namely hepatitis A, hepatitis B, and hepatitis C.
The vaccines developed for preventing this disease are for hepatitis A and hepatitis B
only; thus, there is no vaccine created for hepatitis C. The vaccine for hepatitis A is
administered as a series of two shots while for hepatitis B, it is given in three shots.
Essentially, taking shots according to the schedule would help get long-term protection
from these viruses.




By: Cyrel Supera

As discussed in the With this COVID-19 battle, about COVID-19

previous article, modern there is indeed a need for therapies, and

disease, COVID-19 is a shields and soldiers for the conducting COVID-19

global pandemic that has people to rely on. Such are triages and screenings.

infected millions of people the healthcare system and Moreover, due to the

globally, killed over a our respective healthcare increasing number of

million people, and is professionals, which COVID-19 patients

readily transmitted, largely undoubtedly include before, community

by respiratory secretions pharmacists. COVID-19 has pharmacists have

or droplets but also not caused pharmacists to reduced the burden on

through contact with quit working; in fact, they the healthcare system

contaminated surfaces, have stepped up to take on by diverting the influx of

has prompted health more responsibilities. One patients away from

services to adapt how they of which is the community hospitals through

provide health care. pharmacists, they have educating patients on

Hence, both health played various roles in telehealth services.

professionals and patients, helping the healthcare

particularly those who are system during COVID-19.

older or have co- This include giving drugs to

morbidities, are at risk of patients, assessing

infection. patients for chronic

" THE THREAT medication renewal,
NOT THE PEOPLE " providing minor ailment

consultations, debunking

common misunderstanding

Prior to the pandemic era,

most physicians print out a

patient's prescription in the

surgery using a feature in

their computerized

medical records. Patients

then take it to a drugstore

to get the prescription

According to Imlach et al. facilitated. The filled. This written

(2021), similar to other government's decision to prescription must be kept

countries, services that put the country on at the pharmacy for two

previously delivered all or 'lockdown' in response to years.

most of their care in- the COVID-19 pandemic

person shifted to remote led to a swift move to

ways of working, such as telehealth and e-

telephone and video prescribing.

consultations (telehealth).

To reduce communication Electronic prescribing,

between health commonly known as “e-

professionals, prescribing/prescription”, However, due to the onset

pharmacists, and patients, is a prescription that is of COVID-19 pandemic,

electronic prescribing made electronically physicians can utilize their

procedures (e-prescribing) (Penm, 2020). Health care medical software program

were developed or providers enter to compose and transmit

prescription information the prescription as a

into a computer device – "token" to the patient's

such as a tablet, laptop, phone via e-prescribing.

or desktop computer – This may be sent as a text

and securely transmit the message or an email with

prescription to pharmacies a QR code. Patients may

using a special software then pick which pharmacy

program and connectivity they want to use to get

to a transmission network. their “token” dispensed.

They can either have their or immuno-compromised mistakes, pharmacists

phone scanned or have illnesses who require should intervene during

the SMS or email sent to prescription medicines or prescription screening and

the pharmacist. The maintenance maintain regular

pharmacy enters the code pharmaceuticals based on communication with

into its dispensing an electronic prescription prescribers, particularly

software, unlocks the supplied by a licensed when it comes to

prescription, verifies it, physician and dispensed medication regimens.

and then administers the by a registered pharmacist Future prescribing-

drug. Nevertheless, if the (Domingo, 2020). problem-reduction

email or SMS is deleted

by accident, patients must

contact their doctor to

have their token cancelled

and reissued. In line with

this, the Food and Drug

Administration released

FDA Circular No. 2020-

007, "Guidelines on the

Implementation of the Use

of Electronic Means of Although e-prescription attempts should focus on

Prescription for Drugs for has been touted as a way the medication categories

the Benefit of Individuals to ease the inpatient and specialty wards that
Vulnerable to COVID-19," medicine ordering and are most commonly
on March 17, 2020. The dispensing process, there connected with e-
said guidelines were is still a possibility of prescription interventions

developed to allow prescription inaccuracies, (Lean et al., 2021).

medication dispensation which necessitates Therefore, the

to Senior Citizens, pharmacist involvement, significance of

Persons with Disabilities albeit at a lower rate than pharmacists in each ward

(PWD), and patients with manual prescribing. To for identifying prescription-

chronic disease reduce prescription related issues should not

be underestimated, and

prescribers should be

aware of their importance

in optimizing

pharmaceutical treatment.

Therefore, Improved e-

prescribing system quality

and multidisciplinary

collaboration, particularly

between prescribers and

pharmacists, will enhance

medication rationalization

and improve safety and

clinical outcomes.

Ultimately, the need to

protect individuals, reduce

transmission of the virus

and maintain a functioning

health system are always

at the heart of changes to

health service delivery. Did you know?

Calvin Michael Burton in drive-thrus were

1951 invented the instrumental in keeping

pharmacy drive-thru, the pharmacy businesses

trend wasn’t popularized open and helping them

until 1991. However, provide an effective

pharmacy-drive thrus pandemic response. With

became a boon during the a continued desire for

peak of COVID-19 limited-contact services,

pandemic. Amid drive-thrus can continue

quarantines and state- to be a value-add for

wide restrictions, pharmacies long-term.

By : Cyrel Supera

A Immunizingfter declaring the new With this, pharmacists
coronavirus disease were given a legal Republic Act (R.A.) No.

(COVID-19) as a pandemic framework and national 10918, commonly known as

on March 11, 2020, World regulations that would the "Pharmacy Law",

Health Organization (WHO) authorize pharmacists to administration of adult

sought a collaboration operate specific vaccines, as authorized by

among different nations guidelines, and the FDA, constitutes

and healthcare personnel procedures for every practice of the profession

even though the global activity that is related to of pharmacy. Said

medical system faced vaccination in community administration, however,

multiple challenging novel pharmacies. should be supported by

responsibilities. During the

pandemic last year,

pharmacists were active in

public health throughout

the world by providing

point-of-care testing and

assuring drug advice,

access, and optimization.

Several governments

throughout the world have One of such is the proper training for its safe

given them more authority aforementioned law administration and adverse

to help overloaded written in the Philippine events following

hospitals. Law article which is the immunization.

Pharmacist specifics are needed for a administered without an
Pharmacists, under the said better understanding of the appointment. This might

law, should likewise hold a expanding role of make it easier to get

certificate of training issued community pharmacists in vaccines that have been

by an institution accredited terms of administering recommended by

by the Professional vaccines. doctors. Human

Regulation Commission skepticism and fear

(PRC), to administer adult As such, community about this unique health

vaccines. Such training must pharmacists have been intervention deters

not only include learning involved in pandemic vaccination programs,

epidemiology, immunology, vaccination campaigns, thus pharmacists should

and proper vaccination which pave the way to the dispute misinformation,

distribution, but as well as following advantages. explain clearly, and

practicing the right use of Community pharmacies are assess patient

protective equipment, already equipped for comprehension,

vaccine storage and vaccination logistics with minimizing vaccine

handling, and ongoing several injection/vaccine apprehension via

monitoring of the eligible supply chain management continual education.

population, as part of their systems; they may be able

community pharmacist to give immunization at a

training. However, further low and convenient cost.

policy and educational They are commonly

reforms considering available, and vaccination

national-based priorities and treatments are regularly

Conclusively, vaccination training should be integrated into pharmacy education
because it could enhance professional opportunities and could increase the
recognition of community pharmacists as reliable and trustworthy healthcare
professionals. Because in today’s world, infectious diseases are spreading rapidly,
extensive planning programs and medical staff readiness might help pharmacists to
be more psychologically resilient. As a result, extending pharmacists' position as
frontline medical experts who are highly sensitive to patient requirements may pave
a way to combat the COVID-19 pandemic. Ultimately, the participation of
pharmacists in vaccination programs has shown to be a significant method for
disease prevention and improving immunization rates.


Since 1996, when the American pharmacies since it is more convenient.
Pharmacists Association established a The widespread presence of
nationally recognized vaccination pharmacists in both urban and rural
delivery program, pharmacists have areas enables for rapid and simple
been trained in the administration and access to health care professionals
teaching of vaccines (APhA). who are not just medication experts but
Pharmacists may now administer also vaccination experts. Because
vaccines in all 50 states and can provide pharmacists are accessible and
the majority of immunizations. In reality, available, patients may get vaccines
most people choose to be vaccinated at when it is most convenient for them.

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