Multiple COVID-19 vaccines ensure quicker herd immunity for Malaysia, say public health experts

Public health experts reassure Malaysians that the government’s decision to obtain credible and well-researched COVID-19 vaccines from various sources is the right one if the country is to achieve herd immunity in good time.

For respiratory specialist Dr Helmy Haja Mydin, the multiple sources of procurement mean everyone will receive their jabs within a reasonable time frame, which in turn ensures the overall goal of herd protection is reached.

“We can’t afford to obtain vaccines from a single source — no company has the ability to provide enough doses for everyone within an appropriate time frame. In fact, waiting will further impair our ability to reach herd immunity,” he said.

“The approved vaccines with strong evidence-based trial results have been shown to significantly reduce the rate of COVID-19. The end game is the same — to reduce the spread of the virus,” he added.

Protect yourself and others

Concerns about differences between the COVID-19 vaccines procured by the government aside, Malaysians should pay heed to being vaccinated first, said Malaysian Medical Association President Prof Datuk Dr Subramaniam Muniandy.

“The important thing is to vaccinate. Initially, the decision on which vaccine to get would have been difficult to make due to lack of trial data — it would have been a gamble to put everything on one candidate. 

“Later, as trials were completed, no one company could supply enough for the whole country in a short time frame; thus, the decision to go with several suppliers.

“It won’t affect herd immunity — each vaccine will elicit an antibody response. Side effects are not very different across the different vaccines. Certainly, the diagnosis will not be affected,” he said. 

Prime Minister Tan Sri Muhyiddin Yassin launched the National COVID-19 Immunisation Programme (NPI) handbook and website yesterday, detailing the country’s long-awaited COVID-19 national vaccination plans for the year and beyond.

Among the details revealed under the plan is that Malaysia has procured vaccines from five different firms: the United States’ Pfizer, the United Kingdom’s AstraZeneca, China-based Sinovac and CanSinoBIO, as well as Russia’s Sputnik V.

All five have varying levels of effectiveness, ranging from 62 to 95 per cent, with the first batch of vaccines from Pfizer scheduled to roll out on February 26 for 500,000 frontline personnel.

Two doses, one source

Dr Helmy also cautioned the public to ensure that both COVID-19 vaccine doses received come from the same source, and that said vaccine must be approved by the National Pharmaceutical Regulatory Agency (NPRA).

“It does not matter if different vaccines are given to different individuals, as long as those vaccines have been approved by the NPRA, and as long as a single individual receives the same vaccine from the same source (for example, if my first dose is a Pfizer vaccine, then my second dose should also be from Pfizer and not another company),” he said.

Health policy specialist Dr Khor Swee Kheng concurred with Dr Helmy, stating that it is the norm for major nations to procure vaccines from multiple sources to ensure adequate supply for their population.

“There are many reasons for a portfolio approach, but mainly due to supply considerations as no single manufacturer can supply vaccines for the entire world. Herd immunity depends more on vaccine efficacy rates and population coverage, and less on the type or number of vaccines,” he said.

“It is also dangerous to depend on one company only. For example, a shortage of raw ingredients might disrupt their supply chain, a hurricane might damage their factories, or the company may raise prices as they have a monopoly and leverage or the vaccine isn’t approved by the NPRA.”

Another crucial issue highlighted by Dr Khoo is that as COVID-19 mutates over time, this could mitigate the impact of one vaccine source if it is deemed ineffective against the mutation.

Decent response to dynamic situation

The NPI handbook, which is available through the COVID-19 Vaccine Supply Access Guarantee Committee’s (JKJAV) official website, provided an overview of the entire vaccination process, from registration to post-inoculation observation.

The handbook also contains the ways one can register for the vaccination: through the MySejahtera app, the Vaksin Covid website, a hotline, outreach programmes, and at both private or government medical facilities. 

While the 26-page document divulges the overall vaccination plan, it does not furnish exact dates or answer technical questions that Malaysians might have.

Touching briefly on the handbook, Dr Helmy pointed out that it is an attempt to share knowledge with the public and not meant to contain too many technical details.

Dr Helmy stated the handbook encompasses four key components:

1.         Vaccine supply

2.         Vaccination policy and phases (strategy and target groups)

3.         Vaccination centres and programme implementation

4.         Resources (manpower) required for implementation

“We must also remember that the situation is very dynamic and there must be flexibility in addressing logistical issues. 

“Public doubt and concern will need to continue being addressed by the comms plan that is being run by JKJAV,” he said.

Dr Subramaniam also said the handbook is a good introduction to the government’s national vaccination plan.

“There should also be websites in all the major languages with FAQ as well as regular publications in all major newspapers and on social media. The information has to be repeated again and again to ensure it reaches all levels of society,” he said.

Vaccinations will be conducted at 605 vaccination centres appointed by the Ministry of Health. Temporary vaccination centres such as stadiums, convention centres, public halls, universities and suitable facilities will also be opened as needed. 

Locations will be updated from time to time, according to the handbook. 

The National COVID-19 Immunisation Programme will roll out in three phases, from the end of this month, targeting 80 per cent of the population, or 26.5 million recipients, who will be inoculated for free.

The public can register for COVID-19 vaccination starting from March 1, Health director-general Tan Sri Dr Noor Hisham Abdullah announced last night. 

The vaccination is also wholly voluntary. ― Malay Mail

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