Vaccines Alone Can’t Control Covid-19, WHO Tells Malaysia

By Kanmani Batumalai |

The World Health Organization (WHO) for the Western Pacific says more evidence is required to prove that vaccine efficacy decreases against severe illness before deciding on booster shots, due to limited global vaccine supply.

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KUALA LUMPUR, August 25 — The World Health Organization (WHO) today recommended that Malaysia properly study the risks before lifting any Covid-19 restrictions amid soaring infections.

Dr Takeshi Kasai, WHO regional director for the Western Pacific Region (WPR), said that vaccines alone will not put an end to the Covid-19 epidemic in Malaysia, and that the country should also implement effective intervention measures to control the outbreak.

“It’s actually up to countries to carefully assess and weigh the risk, the effectiveness of the intervention, and its social acceptance and its negative impacts. The very important point for the Covid-19 response is not to rely on just one measure, but to make it as a combination,” Dr Kasai mentioned today during WHO’s virtual press conference on Covid-19 in WPR.

“The vaccine is a good example. Vaccines alone cannot put Covid-19 under control, but together with public health and social measures, we can suppress Covid-19.”

Dr Kasai noted that strong Covid-19 intervention measures should be taken when a country’s ability to accommodate critical patients exceeds the actual capacity of intensive care units.

“When the number of critical cases exceed ICU capacity or expected to exceed ICU capacity, that’s the time we really have to take strong measures so that we can protect health care workers and health services.”

On August 23, the ICU bed occupancy rate reached more than 100 per cent in six states in Malaysia: Sabah (132 per cent), Kedah (132 per cent), Kelantan (109 per cent), Perak (106 per cent), Penang (103 per cent) and Johor (100 per cent), amid the unrelenting epidemic in these states.

Of these states, Kelantan, Penang, Sabah, Perak have already been placed in Phase Two under the National Recovery Plan, allowing fully vaccinated residents to travel across the districts, dine-in, and take part in some social activities, including religious activities. 

Kedah and Johor are still in Phase One, but then-Prime Minister Muhyiddin Yassin recently announced relaxation of movement restrictions for fully vaccinated residents in Phase One states, including dine-ins and reopening hair salons.

Dr Kasai agreed that movement restrictions or lockdowns alone won’t curb the growing Covid-19 outbreak in the regions.

“We know lockdown alone cannot really, really reduce transmission. It is very important to identify and know where the infection is occurring and suppress that and also use that information for risk-based measures so that you can effectively suppress the transmission.”

According to Dr Kasai, the increase in cases in the Western Pacific region was partially driven by the growing Delta outbreak.

“With the Delta variants which might have higher transmissibility, it may take a much longer time to see the effect of those interventions and it is very important to carefully lift those interventions that they put in place,” Dr Kasai added.

WHO also commented on the necessity of administering booster shots for Covid-19 in countries in the Western Pacific region.

Dr Socorro Escalante, coordinator of the WHO for the Western Pacific region, said that the focus now is to ensure that countries use limited vaccine supplies to fully vaccinate people with first and second doses, especially priority groups like health care workers and vulnerable communities.

Dr Escalante said more evidence is required to prove that vaccine efficacy declines against severe illness before deciding on booster vaccine programmes due to limited global vaccine supply. 

“There are initiatives or studies that are already being undertaken to determine the needs of booster doses, with several considerations, and one of which is to really look at whether or not there is waning protection of the current vaccines against severe disease, and whether or not the effectiveness of the vaccines is reduced against the variants of concern,” Dr Escalante mentioned in the virtual press conference. 

“However, at this point in time, we really do not have sufficient evidence to say that we need these booster doses now, and especially within the context of the very constrained global supply, our priority will be for countries to ensure that the vaccines that are available to them are used to cover the priority groups, including the health care workers, the elderly and the vulnerable.”

Dr Escalante pointed out that administration of Covid-19 booster shots should be supported with sufficient scientific evidence.

“But WHO will continue to work with scientists and experts around the world to continue with the studies. We are also really urging that the introduction of booster doses should be firmly evidence-driven and targeted to the population groups in greatest need.”

Amid growing doubts about Chinese Covid-19 vaccines in Southeast Asia, Thailand emerged as the earliest nation in the region that gave the green light to administer booster shots or a third dose with AstraZeneca-Oxford for its health care workers.

Similarly, Indonesia has also decided to administer the United States’ Moderna vaccine as third booster shots to 1.47 million health care personnel.

Japan, Malaysia, the Philippines and Vietnam are some of the countries in the Western Pacific region reporting a rising trend of new Covid-19 cases, according to Dr Tamano Matsui, WHO’s programme area manager for health emergency information and risk assessment.

Dr Matsui listed a few factors that contributed to the surge in cases in these countries, including widely circulating virus, especially the Delta variant, insufficient public health and social measures, non-compliance with existing public health and social measures, and difficulty in detecting asymptomatic or mild Covid-19 cases.  

However, Dr Matsui noted that high vaccine coverage, stringent implementation of public health measures, as well as a targeted approach when sustained community transmissions are detected, have helped countries like China, Singapore and Mongolia to suppress the Covid-19 outbreak in their respective countries.

“The combination of early implementation of public health, social measures in addition to vaccine uptake has been shown to be effective at reducing transmission. This is also true for transmission of the Delta variant,” Dr Matsui said at the virtual press conference.

The WHO for the Western Pacific noted that the region is continuously working to secure enough Covid-19 vaccines for health care workers and elderly people with comorbidities.

“We are making progress in securing vaccines, especially for priority groups — health care workers, the elderly and people with comorbidities. The region already has enough doses to protect all health care workers, around 26 million people. We are also closely monitoring progress with vaccine uptake in the region,” Dr Matsui added.

Dr Matsui emphasised that early detection of Covid-19 cases with high vaccine coverage combined with “stronger and longer” public health and social measures are the way to prevent Covid-19 transmission in the Western Pacific region.

“Considering higher transmissibility of Delta variant, early detection of community transmission and implementation of public health and social measures are key to suppressing transmission and minimising impact.

“Vaccination helps to prevent severe cases, so vaccination of high-risk population groups is important.”

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