Dr Kelvin Yii: Vaccine not a silver bullet to Covid-19 pandemic

Picture from CNBC

By John Isaac

RECENT news on the approval of Pfeizer’s Covid-19 vaccine in the United Kingdom (UK) and plans to distribute it in their country as early as next week is exciting as Malaysia has also signed a preliminary purchase agreement with Pfizer to buy 12.8 million doses of its Covid-19 vaccine.

While this is indeed highly welcomed news, the government must be transparent on their plans in terms of logistics, distribution infrastructures, equity, and even proper education to prevent misinformation, confusion, and hesitancy.

Bandar Kuching MP, Kelvin Yee said, we must not be overly carried away by the announcement and let our guard down as a vaccine isn’t a silver bullet to the pandemic, especially since the announcement also states that doses will be spread throughout next year, with Pfizer only delivering one million doses (for 500,000 people) to Malaysia by the first quarter of 2021.

“In total, the deal involves 12.8 million doses of Pfizer’s mRNA vaccine, a two-dose regimen, will cover about 6.4 million Malaysians which is about 20 per cent of the population.

“On top of that, an additional 10 per cent of the population will be covered through the agreement Malaysia signed with the COVAX Facility, although they have yet to indicate whose vaccines in the Covax portfolio they will be purchasing,” he said.

This means, by the end of 2021, just under a third of Malaysia’s population may be vaccinated against Covid-19, which is still a long way to achieve herd immunity, which requires about 70 per cent of the population to acquire some form of antibodies.

So this raises the question on how the government intends to fill the gap to reach that 70 per cent target, how many other companies are they negotiating with and how much is it expected to cost.

“Also, what is the timeline that we are looking at so the public are aware and not develop a sense of false security when the vaccine is first distributed in the community,” he asked.

While based on the Ministers answers recently, as part of the deal Pfizer is to handle the shipment and delivery of their vaccine as it requires ultra-cold storage of -70 degrees’ Celsius.

“The Ministry must clarify does this include delivering it all the way to the targeted user, not just shipping it to one central location in Malaysia or even just the main cities.

“This of course poses problems in our tropical weather especially target groups in the rural areas of Sabah and Sarawak and even in West Malaysia where there may not be proper infrastructure, including ultra-cold freezers for such specialised distributions,”.

While there are ultra-low temperature freezers in universities and research institutes, are they sufficient to cater for a nationwide distribution especially in the rural areas?

Picture from MSN.com

Making sure no one left behind 

“How does the government intend to make sure no one is left behind when receiving such vaccines regardless of their demographics?,” asked Kelvin.

If there is a issue with improper storage, it could make the mRNA vaccine unusable, with analysts projecting that about five to 10 per cent of the Pfizer vaccine could be made ineffective “due to inadequate storage conditions”.

Some of this waste could go undetected too, leading to people getting ineffective shots and insufficient protection from the coronavirus.

On top of that, this Pfeizer Vaccine is a 2-dose regimen vaccine, taken about 2-3 weeks apart.

“How do we help those especially the elderly and those living in the rural in terms of logistics to make sure they return to take the second dosage?

“How will be the storage of the vaccine be done for the period in between especially in the rural areas?,” he asked.

We do not want them to take one dosage and not return for the second which may defeat the purpose of the vaccine itself as the user may not develop the required amount of antibody, added Kelvin.

Another question the Ministry may have to answer is who are the initial targets for the first batch of the vaccine?

“While it is generally understood that it should be reserved for front liners, but I believe different considerations should be taken into including our epidemiology data on most affected population including the elderly with pre-existing conditions or high-risk and vulnerable population group, since there is where most death occurs,”.

On top of that, while waiting for the required scientific data for the vaccine to be approved by the National Pharmaceutical Regulatory Agency (NPRA) under the Ministry of Health (MOH), the government should be starting proper communication now to educate the public on the importance of such a vaccine to prevent misinformation, confusion, and hesitancy.

Resources should be allocated to properly educate and fight misinformation and pseudoscience which may increase vaccine hesitancy which will affect its distributions.

“All these will require a whole of-society approach, that is why the  National Vaccine Roadmap that is being developed by the Ministry of Science, Technology & Innovation (Mosti) must include different research institutes, medical fraternities including the private practice.

“Elected representatives from across the political divide must also play their roles, so  there is a joint collaboration to exemplify and coordinate communication to ensure this vaccine reaches its intended target and no one gets left behind regardless of their status, demographics or background,” he added.