Prioritising Scientific Data In Covid-19 Vaccine Policy — Ahmad Mahfuz Gazali

Public health policy mandating Covid-19 booster shots in those who received Sinovac vaccine and the elderly is supported by considerable evidence from scientific data.

The CovidNow website has indicated that only 47.1 per cent of eligible adults aged 18 years and above have taken their booster shots, as of March 18, 2022.

Although it is not compulsory to take the booster shot, the Ministry of Health (MOH) has recommended taking it three months after completing the first two doses of the vaccine.

Booster shots have been shown to increase vaccine effectiveness, reduce breakthrough infection and severe disease, and most importantly, reduce death.

Health minister Khairy Jamaluddin has announced on February 7 that Sinovac vaccine recipients 18 years old and above and elderly people aged 60 years old and above must take their booster shots before March 1, 2022.

Their MySejahtera statuses will indicate incomplete vaccination if they fail to do so.

The policy has been discussed among MOH’s top management, and will be implemented despite the deadline being postponed to April 1, 2022.

The question is why was the decision taken and made as policy, especially for Sinovac vaccine recipients and the elderly?

Public health policy is based on scientific data to reduce the incidence of disease, particularly Covid-19.

Some of the data used to support this policy is based on a study conducted by a research group from Yale University on a patient cohort in the Dominican Republic.

The lead researcher, Prof Dr Akiko Iwasaki, and her team members demonstrated no detectable neutralising antibody against the infectious Omicron variant in Sinovac vaccine recipients.

However, after receiving the mRNA Pfizer booster shot, the subjects demonstrated detectable levels of neutralising antibodies against Omicron. 

In addition, a real-world study in Chile demonstrated that Sinovac vaccine recipients who received booster shots showed increased vaccine effectiveness, regardless of any booster shot received.

Pfizer booster shots have been proven to increase vaccine effectiveness to 93 per cent, followed by AstraZeneca (91 per cent), and Sinovac (71 per cent), compared to 50 per cent vaccine effectiveness 14 days after receiving a second dose of the Sinovac vaccine. 

Furthermore, scientific data from Italy has demonstrated clear benefits of older people getting booster shots, compared to those who did not.

The subjects who received booster shots (1.5 million) had a 75 per cent lower risk of SARS-CoV-2 infection, 82 to 83 per cent lower risk of hospitalisation and ICU admission, and 81 per cent lower risk of death, compared to those who have completed just two doses of the vaccine (2.3 million).

Therefore, the public health policy mandating booster shots for those who received the Sinovac vaccine, and the elderly, is supported by considerable scientific evidence.

Additionally, sound public health policies supported by solid scientific data have been adopted by many countries such as the United States, the United Kingdom, Singapore, and others, which are offering booster shots to increase protection. 

Despite the importance of having solid and robust scientific data, not all scientific data will be translated into public policy.

A seminal study led by researchers from Australia showed that neutralising antibody levels are highly predictive of immune protection from symptomatic SARS-CoV-2 infection.

This study demonstrated that the Moderna vaccine showed the highest concentration of neutralising antibodies towards SARS-CoV-2, and the concentration of neutralising antibodies correlates with vaccine effectiveness.

Another study from the US concluded that the Moderna vaccine is the most effective vaccine, compared to Pfizer and Johnson and Johnson, as shown by its high vaccine effectiveness.

Despite being shown as one of the most effective vaccines, the Moderna vaccine is not being used in the National Covid-19 Immunisation Programme (PICK), and its PICK Remaja and PICKids offshoots.

The special advisor to the health minister, Dimishtra Steven Sittampalam, revealed one of the reasons why the Moderna vaccine was not included in PICK or PICKids.

He said that the cost of the Moderna vaccine was far more expensive compared to the Pfizer vaccine, despite the fact that both companies use mRNA technology to produce their vaccines.

Prime Minister Ismail Sabri Yaakob announced on March 8, 2022, that Malaysia will transition to the endemic phase on April 1.  

After considering various factors, risk assessments, opinions from MOH, and suggestions from multiple ministries, the prime minister has decided to implement the policy.  

Hence, the transition from the pandemic to the endemic phase will be implemented after considering scientific data (high vaccination coverage and the low number of severe cases) and other factors.

One of the most critical consequences of transitioning to the endemic phase is that the country’s borders will be opened to foreign tourists.

Therefore, it is hoped that the announcement will help rejuvenate the tourism industry by encouraging more tourists to visit Malaysia.

Although various factors were considered in the transition to the endemic phase, it is clear that scientific data was given priority in formulating this public policy.  

Prioritising scientific data in formulating public policy is essential, and must be consistently practised to help Malaysia keep Covid-19 in check.

Ahmad Mahfuz Gazali is a senior lecturer at the Faculty of Industrial Sciences and Technology, Universiti Malaysia Pahang.

  • This is the personal opinion of the writer or publication and does not necessarily represent the views of CodeBlue.

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