The recent news of the approval of Pfizer’s Covid-19 vaccine in the United Kingdom (UK) and even plans to distribute it in their country as early as next week definitely comes as an exciting news, as Malaysia ourselves have also signed a preliminary purchasing agreement with Pfizer to buy 12.8 million doses of its Covid-19 vaccine.
While this is indeed news that is highly welcomed, but the government must indeed be transparent on their plans in terms of logistics, distribution infrastructure, equity, and even proper education to prevent misinformation, confusion, and hesitancy.
First and foremost, we must not be overly carried away by the prime minister’s announcement and let our guards down as a vaccine isn’t a silver bullet to the pandemic, especially since the announcement also states that the doses will be spread out throughout next year, with Pfizer only delivering one million doses (for 500,000 people) to Malaysia by the first quarter of 2021.
In total, the deal involves 12.8 million doses of Pfizer’s mRNA vaccine, a two-dose regimen, and will cover about 6.4 million Malaysians, which is about 20% of the population.
On top of that, an additional 10% of the population will be covered through the agreement Malaysia signed with the COVAX Facility, although they have yet to indicate whose vaccines in the Covax portfolio that they will be purchasing.
This means, by the end of 2021, just under a third of Malaysia’s population may be vaccinated against Covid-19, which is still a long way to achieve herd immunity, which requires about 70% of the population to acquire some form of antibodies.
So this raise the question on how the government intends to fill in the gap to reach that 70% target, how many other companies are they negotiating with, how much is it expected to cost, and what is the timeline that we are looking at so that the public are aware and not develop a false sense of security when the vaccine is first distributed in the community.
While based on the Science, Technology and Innovation Minister’s answers recently, as part of the deal, Pfizer is to handle the shipment and delivery of their vaccine as it requires ultra-cold storage of -17 degrees’ Celsius, but the Ministry must clarify — does this include delivering it all the way to the targeted user, not just shipping it to one central location in Malaysia or even just the main cities?
This, of course, poses problems in our tropical weather, especially target groups in the rural areas of Sabah and Sarawak and even in West Malaysia, where there may not be proper infrastructure, including ultra-cold freezers for such specialised distribution.
While there are ultra-low temperature freezers in universities and research institutes, are they sufficient to cater for nationwide distribution, especially in the rural areas?
If there is a issue with improper storage, it could make the mRNA vaccine unusable, with analysts projecting that about 5 to 10 per cent of the Pfizer vaccine could be made ineffective “due to inadequate storage conditions”.
Some of this waste could go undetected too, leading to people getting ineffective shots and insufficient protection from the coronavirus. So, how does the government intend to make sure that no one is left behind when receiving such vaccines, regardless of their demographics?
On top of that, this Pfizer vaccine is a two-dose regimen, taken about two to three weeks apart. How do we help those, especially the elderly and those living in rural areas, in terms of logistics to make sure they are compliant and return back to take the second dosage? How will be the storage of the vaccine be done for the period in between, especially in the rural areas?
We do not want them to take one dosage and not return for the second, which may defeat the purpose of the vaccine itself as the user may not develop the required amount of antibodies.
Another question the Ministry may have to answer is — who are the initial intended targets for the first batch of the vaccine? While it is generally understood that it should be reserved for frontliners, but I believe different considerations should be taken into account, including our epidemiology data on the most affected populations, including the elderly with pre-existing conditions or high-risk and vulnerable groups, since that is where most deaths occur.
On top of that, while waiting for the required scientific data for the vaccine to be approved by the National Pharmaceutical Regulatory Agency (NPRA) under the Ministry of Health (MOH), the government should be starting proper communications now to educate the public on the importance of such vaccines to prevent misinformation, confusion, and hesitancy.
Resources should be allocated to properly educate and fight misinformation and pseudoscience, which may increase vaccine hesitancy which will affect its distribution.
All these will require a whole of-society approach. That is why the National Vaccine Roadmap that is being developed by the Ministry of Science, Technology & Innovation (MOSTI) must include different research institutes, medical fraternities, including the private practice, and even elected representatives from across the political divide so that there is a joint collaboration to exemplify and coordinate communications to make sure this vaccine reaches its intended target and that no one get left behind regardless of their status, demographics, or background.
Dr Kelvin Yii is Member of Parliament for Bandar Kuching.
- This is the personal opinion of the writer or publication and does not necessarily represent the views of CodeBlue.