In case you missed it, Minister of Science, Technology and Innovation, Khairy Jamaluddin has recently organised a panel discussion on Clubhouse to talk about COVID-19 vaccines. He is joined by Dr Helmy Haja Mydin (Pulmonologist & Head of the Lung Centre at Pantai Hospital), Dr Jemilah Mahmood (Public Health Special Advisor to the PM), Dr Kalaiarasu Peariasamy (Director of Institute of Clinical Research), Dr Giri Rajahram (Infectious Diseases Physician) and Dr Akhmal Yusof (CEO of Clinical Research Malaysia).
If you want to get up to speed, here are 11 key takeaways from the informative discussion.
When is Malaysia getting the vaccines?
The first batch of vaccines from Pfizer will be arriving today, 21st February and the vaccination programme will start on 26th February. Everyone in Malaysia can register to get the vaccine from 1st March 2021.
[ UPDATE 21/02/2021 12:00 ]: JKJAV has announced that the vaccination programme will begin earlier on 23rd February 2021. Prime Minister Muhyiddin Yassin and Health D-G Dr Noor Hisham Abdullah will be the first recipients to get the jab.
According to Khairy, Malaysia will receive a new batch every two weeks from Pfizer’s factory in Puurs, Belgium. By 29th of March, a total of 1,000,350 doses of Pfizer vaccines would have been delivered.
Other vaccines will be coming after it receives approval from the national Pharmaceutical Regulatory Agency (NPRA). However, the Sinovac vaccine will arrive in bulk on the 27th February and it will be “fill finish” by Pharmaniaga‘s facility.
Efficacy of Vaccines
At the moment, Malaysia currently has procured 5 different vaccines which include Pfizer, AstraZeneca, Sinovac, CanSinoBIO and Sputnik V. There are public concerns about the different efficacy levels of the vaccines.
So if the vaccine has an efficacy of 50%, does that mean if two people are vaccinated and only one will be protected? Dr Kalaiarasu Peariasamy said it isn’t meant to be interpret that way and it depends on the clinical trial design. He said there’s a difference between how you interpret efficacy and effectiveness.
A person with a vaccine with 50% efficacy will have a 50% reduction of the symptoms versus someone who didn’t receive the vaccine (placebo) in a trial. The effectiveness will reveal how it will perform in the real world.
Addressing concerns that Chinese vaccines are inferior due to its lower efficacy of 50%, Dr Kalai said the trial conditions for the China vaccines were very different as they were mostly conducted on healthcare workers who have the highest risk of getting infected. He stressed that all these vaccines have one thing in common, which is to prevent death and serious illnesses.
All the approved vaccines fulfill the minimum level of efficacy set by the WHO and US FDA which is at 50%. Instead of looking at efficacy, we should be looking at whether it does reduce serious illnesses and death, which is what the vaccines are meant to do.
Dr Kalai said whether the vaccines come from the China, Russia, India, the US or the UK, the narrative is the same, which is it will prevent death and severe illnesses due to COVID.
Khairy said Malaysians will not get to choose which vaccine to get and this is the case in other countries that have procured a portfolio of vaccines. If people get to choose, it will create confusion and possible points of bias and discrimination for certain vaccines. Another main reason why they can’t allow people to choose is because it would create a logistical nightmare if there’s a higher demand for a particular vaccine and the demand doesn’t jive with the delivery schedule.
Is Malaysia late in vaccination?
COVID-19 vaccinations have already begun in various countries including the US, the UK, Singapore and Indonesia, and some may think that Malaysia is late to the vaccine race.
Dr Jemilah Mahmood said that Malaysia is doing okay and in fact, South Korea is also going to start their vaccination on 26th February, which is on the same day as Malaysia. Considering how advanced South Korea is in its COVID response, to be on the same level in terms of vaccination, we are doing quite okay.
She added that the main concern is that we do need to have the mass population of the world vaccinated. At the moment, about 1% of the population has received the jab and we still have a long way to go. The good news is that Malaysia is getting the vaccines and we are starting our vaccination program this month.
Why do you need to be vaccinated?
Dr Giri Rajahram shared that COVID-19 isn’t just a respiratory illness alone. Predominantly people thought you would only get respiratory complications from COVID but it’s a multi system illness which can cause various complications post-COVID which include the heart, clot in the lungs and blood clot in the brain. As a result, some people can get very ill which require special care.
He added COVID-19 is still a relatively new virus and we don’t fully understand the full complications that it may cause and doctors are learning something new every day. Dr Giri said the vaccines come at the right time and it will be a game changer. However, he said that medical practitioners would caution that vaccines are just of piece of a big jigsaw puzzle.
Khairy admits there are some vaccine hesitancy especially from the antivaxxers. He said some people claim that because the mortality rate in Malaysia is so low (currently 0.4%), we don’t need to take the vaccine as most of us will be asymptomatic carriers anyway.
However, due to the long term complications after getting infected, Khairy stresses that you don’t want to get COVID-19 at all. Just because the mortality rate is low, doesn’t mean it’s ok to get COVID. Therefore, it is important to protect yourself and you can do so by getting vaccinated.
Dr Giri added that based on studies, people who are asymptomatic from COVID-19 do exhibit changes in their lungs via CT scans. He added that these are people who are young and healthy. He shared that even in some cases of people who come out from ICU, their lungs are damaged so extensively that they would probably end up with long term complications in the lung and heart. .
Deaths after vaccination not directly linked to vaccines
There have been reports of people fainting or have died after receiving vaccines especially in Norway. While these news sound scary, Khairy said we need to establish causality and there might be other causes of death.
In the case of Norway, he said it involved frail and old people that have received the vaccines and may have passed on for various reasons. It was reported that the deaths of the 23 elderly Norwegians were not proven to be directly caused by the Pfizer vaccines.
The Minister said that causality is very important. Eventually there might be cases of people having adverse reactions or adverse events but we need to established causality. He gave an example whereby someone could die due to various reasons including getting other illness or a car crash after receiving the vaccine, so it is important to let experts to look into the cases to determine the actual cause of death.
Malaysia will setup COVID-19 injury scheme
To reassure the public, the Cabinet has discussed that in a rare event there’s a serious adverse effect, the government will have to provide something for the affected person. He said some countries have introduced a vaccine injury scheme and the government has agreed to set up a similar COVID-19 injury scheme to protect people in Malaysia by providing an ex-gratia payment if there’s a clear link that they suffered injury from the vaccine.
Vaccines also prioritised for non-health essential workers
Apart from individuals in the health sector, the vaccines will also be prioritised for non-health sector frontliners. The agencies that have been shortlisted for now include the police, prisons department, immigration, fire and rescue services, RELA, armed forces and national welfare department under phase 1 which will cover 500,000 individuals.
Khairy said that he has received appeals from different groups to be included in the first phase of vaccination under essential workers. This include the Ministry of Education for teachers, places for worships for imams and priests and the transport sector for cabin crew, pilots and shipping.
The Minister said the challenge right now is supply. However, if NRPA approves other vaccines such as Sinovac and Sputnik V, we can start including more people in the list of essential services. Before a decision is made, there will be a risk assessment on these groups to see how at risk they are in discharging their duties.
Why are we vaccinating non-Malaysians?
Dr Jemilah Mahmood said we are not safe until everyone is safe. In Malaysia, we must acknowledge that we have a large migrant population and also refugees. These people have been infected by COVID-19 and are also at risk, and they have been working to serve the needs of the country.
The government has announced that all non-Malaysians will be vaccinated for free including undocumented migrants. She said there are concerns of apprehension and fear among undocumented people and refugees. However, the government has assured that they won’t be arrested if they come forward to vaccinate and they will find a way to get them documented.
Obviously undocumented migrants would fear authorities in uniform and to address the issue, the government will work closely with civil society organisations and agencies to engage with them. Dr Jemilah said it is important to convince them to get the vaccine because it is for everyone’s good.
Similarly, other countries have also vaccinated their migrant communities. This include Malaysians who are studying or working in Singapore and the United Kingdom.
Malaysia can complete vaccination by December 2021 if….
When asked when can all Malaysians get access to the vaccines, Khairy said vaccines don’t save lives, vaccinations do. He said buying the vaccines was the easy part but getting the vaccines into people’s arms is where the game is.
On the actual timeline, Khairy said the biggest challenge is supply which is something the government can’t control. However, if everything goes according to plan, which include expedited regulatory approvals without cutting corners, manufacturers fulfilling their deliveries according to the timeline signed in the contracts, Khairy thinks we could get everything done by December 2021. Giving it an extra buffer, it might take up to February 2022.
He shared that the plan started off with 18 months but the Prime Minister said it was unacceptable. After that they cut the timeline down to 12 months.
Assuming that the vaccine supply arrives uninterrupted according to plan and if we can reach a peak of 150-160K vaccinations per day, Malaysia can complete its vaccination plan by December or earlier. This would also depend on how we handle vaccinations on ground which include operating hours of each vaccination centres and how much resources are available.
Khairy also mentioned that the government is having discussions to include the private sector in the vaccination program. Ideally, they would also want to utilise private hospitals and private clinics, and over 3,000 general practitioners to be part of the immunisation programme. This would be dependent on logistics especially for vaccines with strict storage requirements such as the Pfizer vaccines.
User Generated Content a key driver to convince people to get the jab
Khairy shared that the government will be engaging with Key Opinion Leaders (KOL) to educate the public about the vaccination program. However, he said the negative often trumps the positive.
He gave an example where you can have Shalin Zulkifli and Lee Chong Wei telling you to get the vaccine because it is safe, but then you’ll have some random doctor or ustaz spreading misinformation that the vaccine is illuminati and it’s a microchip which will control your mind, which everyone is going to watch. That itself already puts the campaign at a disadvantage and it is a battle that they are facing right now.
He said the best way of educating is self generated content. The most convincing way is getting vaccinated people to share that it is safe to get the jab and you have faith in the science behind the vaccines. This will serve as a validation once more people take up the vaccines.
Avoiding wastage of COVID-19 vaccines
Khairy said a Just in Time (JIT) logistics system will be introduced with data analytics to look into actual demand, projected demand, registrations and it will match that with the delivery schedule. This will ensure that the vaccines are not stored for too long and it will be immediately deployed to the vaccine storage and immunisation centres.
It is expected that not everyone will turn up for their appointments. Out of 10, maybe only 8 or 9 will turn up at the vaccination centres. Once a vail is opened, you’ll have to use it in a short period of time.
To mitigate vaccine wastage, there are protocols in place to ensure that these doses are used. At immunisation centres, there will be volunteers on standby to receive the jab which may include police, RELA, military or medical volunteers. Another option is to put the word out on social media that immediate walk-in vaccinations are available at selected centres.
For more information on the National COVID-19 Immunisation Programme, visit vaksincovid.gov.my. If you want to listen to the full panel discussion, just hit “listen in browser” in the embedded clip below:
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