Article title:
As Malaysia grapples with record COVID-19 cases, authorities ramp up mass vaccination to stem the tide
1) What is your viewpoint on Malaysia’s vaccination progress, eg. faster than global average or slower?
Malaysia’s vaccine rollout campaign has been accelerated since early June. Previously the country could not administer many doses mostly due to the arrival of vaccines from abroad, delays in the order delivery. Now the vaccine coverage stands at 32.4% (first dose) and 15.1% (fully vaccinated) of the total population, as of 21 July. In fact, it is faster than the world's average (13.23% fully vaccinated) and Asia’s average (9.81%).
2) Would you say the vaccination effort in Malaysia counts as a “silver bullet” to the number of cases in Malaysia, due to the inefficiencies of the current lockdowns/National Recovery plan phases? Why so?
No. From the public health and life science point of view, current vaccines that we have are not ‘silver bullets’ - though they are expected to significantly reduce the number of cases and the need for hospitalisation, they cannot eliminate the disease transmission. The positive effect is yet to be observed due to a large proportion of the population still without any dose of vaccine yet, and those with 2 doses are still too small to attenuate the rising trend of local transmission in certain states/territories.
Though currently the government seems like running out of ideas, and looks like the vaccination effort is their only effective response to the current predicament. Many states will only achieve at least 50% fully vaccinated population by September. But from now to September we have more than a month to go, and 50% is also not a magic number to stop any disease spreading. Thus if measures responding to the situation stay unchanged, we should expect more cases to come, especially death cases.
3) What are some challenges or hiccups you’ve identified in the current vaccination drive?
Currently the vaccine rollout campaign is running quite well, with 446,052 doses administered yesterday (21 July) -- more than 1% of the total population received a dose in just one day. With this rate of vaccine rollout , hardly one would complain about the speed.
The most recent controversy is about the ‘empty jab’ phenomenon. Many wonder if they have received ‘empty jab’ given there are some incident reports and videos circulating around. This could be driven by real but unintentional events due to human mistake.
The other challenging narrative is the claim that the Sinovac vaccine is not as effective as it seems. This is not unique in Malaysia, a few recent studies have shown negative findings about Sinovac vaccine have dented the confidence of some quarters of the public. Sinovac vaccine also has some racial undertone, where some states in Malaysia, for example, Kelantan, has stopped administering Sinovac vaccine to new attendees, or risk a significant number of rejections or absentees. Perhaps it has to do with some rumours spreading among the Muslim community believes that the Sinovac vaccine is not halal.
4) Is vaccine inequity, whether in terms of delivery of doses to different states, or socio-economic and geographic disparity, a cause for concern in our national vaccination drive?
Looking at the current data by state, judging at the population who received at least one dose, there is some disparity among states in terms of percentage of coverage or number of total doses administered. For some states, the vaccine coordinating minister Khairy Jamaluddin did mention that the government will put priorities for the states/territories which currently facing worse pandemic (Labuan, KL and Selangor) and also for the state which is going to hold state election probably not long after the emergency period is expired.
Some states are also facing low numbers of registration. For example, Sabah, after 5 months of registration drive, currently only has about one-third of the adult population registered for vaccination. These would probably have negative consequences for the state health department and CITF teams to find arms for vaccination, surely this will not be as efficient and likely to have a longer timeline of completion of the vaccine rollout target. Kelantan is the second lowest, with less than 60% registered. Authorities might have concerns that there are many on the ground having vaccine hesitancy if not outright anti-vaxxer.
5) Just clarifying, would you be able to comment a bit on the anti-vaxxer segments in MAlaysian society?
Nowadays, due to even more aggravating COVID-19 situation throughout the nation, the sentiment for the antivaxxers actually has changed. Very likely that those fence-sitters, those respondents who were unsure (17%) according to the large-scale survey conducted by the MOH Dec last year, become more willing to go for vaccination, and we see the surge also in the registration rate and vaccine rollout speed, is a testament to reflect that.
However, there is another trend that most remaining antivaxxers are now taking.... they asked why not the government approve and let them take Ivermectin and some other unproven medicine as prophylatic , they see these are a substitute of vaccine. They do believe that these medicines can make wonder and would be equally good for early treatment, hence the grave consequences of disease can be averted without vaccine help.
This trend is growing, the call is louder by day for ivermectin when the pandemic looks spiraling out of control.
To me, it is a risky proposition, the medicine is not robustly proven it is really effective against COVID-19. Though i can understand that now there is none of the medicine has achieved that, when patients get desperate for treatment, no harm for them to try.
But for the antivaxxers, they believe that ivermectin is the antitode, and equally good to prevent the disease
thus i can say that currently ivermectin is a great distraction.
I often tell the proponents, please do not take it as a substitute for a vaccine.
6) So from the government's side, aside from the stick by threatening fines/jail using the Sedition or multimedia communication acts, other ways to persuade the populace to take the vaccine includes public vaccinations by themselves and social media campaigns like the photo booths?
Persuade the people with real facts and evidences, be clear about risk communication , focussing on what the vaccine can do and why they are beneficial for the people.
coersion won't work, though the authority has to quickly clarify and respond to false information circulating around in the social media.
Once they almost clear all the backlogs and queues for those who have registered, they should go into the community to offer on-the-spot vaccination drive, instead of passively waiting for people to register or walk in
7) Would you say vaccine hesitancy is primarily a geographic issue? eg. some states have higher proportions of anti-vaxxer/vaccine hesitancy residents than others? And which ones?
low registration rates for certain states could be for various reasons. The states with high religious piety, might have hesitancy towards some brands of vaccine or all vaccines.
Some others, for example, Sabah, is mostly due to technical barrier for registration.
For long I have observed about anti-vaxxers (even long before COVID-19), it cuts across different socioeconomic backgrounds, urban-rural divide and even education levels! So i do not think that vaccine hesitancy presents a clear baseline pattern of distribution, perhaps except slightly more obvious for some religious groups in certain northern peninsular and east coast states on the claim of 'halal-ness' of vaccine. (Kedah used to have the worst children immunisation records prior to COVID-19 pandemic)
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