Member of Parliament Tengku Razaleigh Hamzah, in his statement last week, challenged government ministers, promoters and supporters involved in the ongoing effort to acquire at least one Covid-19 vaccine for Malaysia, be vaccinated first before any members of the Malaysian public.
My parents and I step forward to pick up the gauntlet and volunteer ourselves to be among the first to receive the mRNA vaccines which are being acquired by the Malaysian government, especially if the MP is offering to help with the process. We trust in the science.
Being below 45 years of age, with no chronic diseases and not being a member of any of the public services serving at the forefront of this public health emergency, I am not likely to be in any of the priority groups slated for vaccination in the rollout for 2021. It will probably be 2022 that I will get my shot. My parents on the other hand, who are in their late 60s and in the identified risk categories should qualify.
Unfortunately, the parliamentarian’s statement contained many problematic points which are commonly found in the evolving Covid-19 information landscape. These can often be inaccurate, biased, and full of misinformation. Many arguments have been weaponised and even politicised to strike doubt and undermine the credibility of various developing treatments.
They cause unnecessary delays, or worse, raise levels of vaccine hesitancy among people. Anti-vaxxers may use them to discredit not just the Pfizer-BioNTech vaccine, but any vaccine developed through this international effort. These points need to be fact-checked.
Vaccine hesitancy will result in people being unprotected and left behind. Such misinformation and disinformation can cause serious harm beyond the current Covid-19 crisis.
A common concern raised is the allegation that Malaysians will end up being guinea pigs for untested and unproven vaccines. If anyone were made into guinea pigs or test subjects for the development of these vaccines, it would be the thousands of volunteers who agreed to participate in the clinical trials, particularly for Phase 3, receiving either the vaccine or a placebo.
The Pfizer-BioNTech vaccine had around 44,000 participants, the AstraZeneca-Oxford trials had 23,000 individuals, and hundreds of thousands of people were administered with the Sinopharm candidate before it has even completed late-stage trials.
I am confident that anything that passes the scrutiny of the National Pharmaceutical Regulatory Agency (NPRA), which is one of the best regulators in this region, as best as possible will be safe and minimises harm. However, it is impossible to escape the possibility of adverse events.
Some individuals respond differently to medication. Paracetamol, which pretty much everyone takes for a headache, can cause severe allergic reactions for some people. Muscle pain, chills, and headaches after being vaccinated? Sounds like reactions to almost every other vaccine. Some experience them, others do not.
Anyone who starts talking about taking a “holistic” approach when dealing with an infectious pathogen and suggests “improving immunity” via herbal or natural remedies and living healthier, simply has not been paying attention.
In addition to those who are elderly and with non-communicable diseases, the virus has also struck down marathon runners, vegetarians, athletes, and people in the prime of their lives.
There are at least three legitimate concerns involving Malaysia’s upcoming Covid-19 vaccination programme.
Firstly, the delivery timetable for the vaccines that have or will be ordered. As the issue of safety in the use of these vaccines is paramount, it is necessary for the NPRA to review and determine whether any vaccine can be safely used.
Though the US Food and Drug Administration, UK’s Medicines and Healthcare products Regulatory Agency, Health Canada, Bahrain’s National Health Regulatory Authority, Saudi Arabia’s Food and Drug Authority, and Singapore’s Health Sciences Authority have approved and authorised the use of the Pfizer-BioNTech vaccine, the NPRA will decide independently and must be allowed to do its work. It is essential that this process and status determination be cleared as soon as possible.
Delays will result in Malaysia slipping further down the list of countries which are wanting to receive delivery of the vaccine for its population.
Secondly, the logistical burden, specifically the cold chain involved in safeguarding the integrity of the vaccines, especially the Pfizer-BioNTech vaccine will need to be addressed. We do not know yet which vaccine will be acquired through the COVAX initiative and what logistical requirements will be needed.
We need an honest and open discussion regarding Malaysia’s current logistical capacity regarding vaccines. This is to inform not only the public, but also involve and reassure the health care professionals who will be mobilised in this undertaking.
Thirdly, the harsh reality is that if we had the Covid-19 vaccine today, we may not be able to mobilise and rollout the vaccination programme at the scale and level of community that are needed. This is on a scale and urgency that we have never experienced before in the history of not only this country, but any country in the world.
As we are still in the midst of mitigating and managing the outbreak, the people who might be needed to supervise and guide the deployment of the vaccine are currently preoccupied running the epidemic response. We need to plan now, and the results of that planning should be communicated and shared with the public to promote confidence and erase doubts.
If we solely depend on the public health system, we may not have enough manpower. We must also involve the private sector in a “whole of society” approach. The government should not and cannot do it alone.
Vaccines are not magic bullets which can work in isolation. In order for them to work properly, we need to ensure that the right populations get vaccinated and protected first, and in sufficient quantities. We need to ensure that people continue to follow existing SOPs and practices. We need people to not be complacent. It could take up to two to three years to ensure that 70% of the population is protected. We need to manage expectations.
Caution and informed decision-making are necessary and vital to ensuring that any vaccination effort is successful, and that people and communities are protected from Covid-19. We need to be rigorous and critical in the examination of the clinical data, evidence, and findings, especially when it relates to human vaccines. We should be guided by the data, the science, and the evidence, not misinformation.
Azrul Mohd Khalib is the head of Galen Centre for Health & Social Policy.