Covid-19 Boosters For High-Risk Pfizer Recipients Pending Mix-And-Match Study

The elderly aged 60 and above, health care staff, and frontline workers who were vaccinated with Pfizer will be offered Pfizer boosters, pending an MOH study on heterologous vaccination starting November in Sarawak.

KUALA LUMPUR, Oct 13 — The government today rolled out boosters of Pfizer-BioNTech’s Covid-19 vaccine for the elderly, health care staff, and frontline workers who were double vaccinated with the mRNA shot.

Health Minister Khairy Jamaluddin said the boosters — which are meant to curb waning immunity — would be offered to eligible recipients at least six months after their second jab via the MySejahtera app, or SMSes or phone calls by vaccination centres (PPVs) to those who do not have the app.

Private general practitioner (GP) clinics under ProtectHealth Corporation’s coordination will manage the booster programme for senior citizens aged 60 and above, as well as frontline workers.

Public health care facilities will offer boosters to their respective health care workers. Private health care staff can obtain booster jabs from their respective facilities, depending on approval from the state health department under the Ministry of Health (MOH).

Malaysian Armed Forces (ATM) health facilities will administer the Covid-19 booster vaccination programme for ATM frontline workers.

“MOH also plans to do a study on heterologous vaccination with booster doses. This study will be conducted in Sarawak in November 2021 and will be expanded to other states upon approval by the Medical Research Ethics Committee (MREC),” Khairy said in a statement today.

Last October 8, the National Pharmaceutical Regulatory Agency (NPRA) issued conditional registration approval for Pfizer to be used as a booster shot, but the typically conservative agency did not explicitly authorise mix-and-match vaccines. Malaysia uses a predominant mix of Pfizer, AstraZeneca-Oxford, and Sinovac vaccines, as well as a little CanSino.

The United States’ Food and Drug Administration (FDA) last month authorised Pfizer boosters for certain populations who were previously vaccinated with Pfizer, based on real-world data from the US’ Centers for Disease Control and Prevention (CDC), the United Kingdom, and Israel, besides data from certain participants in the original clinical trial of the Pfizer vaccine who had received boosters.

The US’ CDC does not yet permit Pfizer boosters to be offered to people who had received Moderna or Johnson & Johnson in their primary vaccine series, pending efficacy and safety data of Moderna and Johnson & Johnson boosters.

NPRA’s decision not to authorise mix-and-match vaccines, pending data, was made even as Sinovac comprises the majority of breakthrough infections in Malaysia among fully vaccinated people since September 1, according to raw data published on MOH’s GitHub database.

Between 4,000 and 8,000 breakthrough infections in fully vaccinated people were reported every day in Malaysia from September 1 to October 11. Sinovac comprised between 55 per cent and 69 per cent of daily breakthrough coronavirus cases in that period.

As of yesterday, about 47 per cent of fully vaccinated individuals in Malaysia had received Pfizer, while 42 per cent received Sinovac, 8 per cent AstraZeneca, and 0.5 per cent CanSino.

Khairy also announced today that third doses would be offered to people with weak immune systems, as part of their primary vaccine series, at least 28 days after completing vaccination.

Cancer patients, organ recipients, kidney disease patients undergoing dialysis are among those identified in the immunocompromised group who will be offered additional shots as they may not have mounted an adequate immune response from initial vaccination.

Treating physicians have the autonomy to decide on whether to provide homologous or heterologous vaccination with third doses to immunocompromised individuals. These third doses will be offered at selected health clinics under physicians’ monitoring.

“MOH again guarantees that vaccine supply in Malaysia is sufficient for the administration of additional doses and booster doses of the Covid-19 vaccine,” Khairy said, adding that boosters are offered voluntarily for free under the National Covid-19 Immunisation Programme.

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