MAC Disputes Malaysia’s Exclusion Of HIV Patients From Covid-19 Vaccination

By Ashswita Ravindran and Boo Su-Lyn |

According to UNAIDS and US CDC guidance, people living with HIV should get vaccinated against Covid-19; none of the approved vaccines or those under development are live vaccines.

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KUALA LUMPUR, Feb 22 — The government should prioritise people living with HIV for Covid-19 vaccination, the Malaysian AIDS Council (MAC) said today, disputing the Ministry of Health’s (MOH) guidance that contradicted international advice.

MOH’s MyHealth portal earlier today tweeted, on its MyHEALTHKKM Twitter page, a video of Health Minister Dr Adham Baba saying: “Individuals that have a poor immune system like those infected with HIV cannot take the Covid-19 vaccine.” 

Although MyHealth later deleted its tweet, MOH’s official guidance on its Covid-19 website listed a few groups it deemed are not suitable to receive Pfizer-BioNTech’s vaccine, including those with HIV with CD4 counts less than 200; women who are pregnant or planning to get pregnant; and cancer patients who are undergoing treatment like chemotherapy, radiotherapy, and immunotherapy, among others. 

The Pfizer-BioNTech vaccine the government has procured for 50 per cent of the population is an mRNA vaccine, not a live attenuated vaccine, that simply gives instructions to the cells to produce the coronavirus’ signature spike protein, so that the body eventually recognises it and builds antibodies against it. 

“As the Covid-19 vaccine is being rolled out in Malaysia under the National Covid-19 Immunization Program, the Malaysian AIDS Council stands by the current national and international exemptions made by medical experts that; People Living with HIV (PLHIV) can safely get the Covid-19 vaccinations,” MAC said in a statement

MAC said that until further evidence shows otherwise, there should not be any discouragement for PLHIV to be vaccinated against Covid-19, as data has shown that people with underlying disease, including HIV, tend to develop severe Covid-19 once infected. 

“It is recommended that all persons with HIV be vaccinated irrespective of CD4 count (protein found on immune cells) in line with international guidelines. The vaccines are safe in persons with HIV as they are not live vaccines,” the HIV group added. 

MAC president Dr Christopher Lee emphasised that the immunisation programme is to ensure that herd immunity is built in the community to break the chain of Covid-19 transmission. 

“I sincerely hope MOH (Ministry of Health) can clarify its position on the provision of Covid-19 vaccines for persons living with HIV (PLHIV),” Dr Lee tweeted separately. 

“Based on international recommendations including from UNAIDS, PLHIV must be part of any national vaccination programs.”

International AIDS Society (IAS) president Dr Adeeba Kamarulzaman said that MOH’s guidance excluding people living with HIV from getting vaccinated against Covid-19 was contradictory to international guidelines.

“None of the vaccines that have been approved are live vaccines — which could be a relative contraindication for PLHIV,” Dr Adeeba told CodeBlue.

“Furthermore recent studies have shown that PLHIV with Covid-19 may have a worse outcome. So, in fact, they should be given the vaccine to prevent the development of severe disease.”

Dr Adham explained to CodeBlue that stable HIV patients, such as those undergoing ARB treatment for more than six months and with CD4 counts more than 200, can be vaccinated against Covid-19. 

“Need to ask health experts at the HIV division for an explanation,” Dr Adham told CodeBlue earlier today, adding that compliance issues with HIV patients must also be addressed.

However, the health minister acknowledged that many societies are giving their opinion with regards to this issue. 

The Joint United Nations Programme on HIV/AIDS (UNAIDS) has recommended that PLHIV take the Covid-19 vaccine, saying it is safe for them as none of the vaccines approved by regulators or under development are live vaccines.

Besides UNAIDS, the United States’ Centers for Disease Control and Prevention (CDC) said that people with HIV can choose to be vaccinated if they have not had any history of allergic reactions to any of the vaccine ingredients. 

US infectious disease expert Dr Anthony Fauci previously explained that the Covid-19 vaccines produced are inactivated vaccines, hence are not contraindicated in those with poor immune systems. Only live attenuated vaccines are contraindicated (a situation where one shouldn’t take the vaccine) in those with poor immunity. 

The Covid-19 vaccines approved by Western regulators include mRNA vaccines like Pfizer-BioNTech and Moderna, as well AstraZeneca-Oxford University’s vector-based vaccine.

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