PUTRAJAYA faces plenty of challenges to immunise at least 50-60% of the population by year-end as targeted under the national Covid-19 immunisation programme, said health experts.

Public health expert and epidemiologist Prof Dr Awang Bulgiba Awang Mahmud said the three main challenges are timely vaccine supply and delivery schedule, logistics and slow registrations.

Awang Bulgiba said Malaysia is “slightly behind” some countries in getting the vaccine, noting that supply issues have caused problems even to countries that can pay extra for an early supply.

“So, it will be an issue getting the vaccines supplied on time.

“But once off the blocks, the Science, Technology and Innovation Ministry has acted quite swiftly in getting the Pfizer-BioNTech and other vaccines.

“Vaccine diplomacy by the Foreign Ministry has helped with the Sinovac vaccine,” said Awang Bulgiba of Universiti Malaya.

Some rich countries have together bought half the world’s Covid-19 vaccines, which is more than enough to vaccinate their populations two or three times over.

Malaysia has secured more than enough Covid-19 vaccines for its population from five companies, at a total cost of more than RM2 billion.

The government kicked off a three-phase national immunisation plan on February 24. It aims to inoculate at least 80% of the population, or 26.5 million people, to achieve herd immunity in a year.

Besides timely supplies, Awang Bulgiba said logistics would be another challenge.

The current first phase of the national immunisation drive involves around 500,000 people, mostly healthcare workers.

There must be proper coordination to ensure all data are properly submitted when it’s time for the rest of population under phase 2 and 3, he said.

“For phase 2 and 3, the government is trying to increase the number of vaccination centres and trying to get enough people to run the vaccination centres to speed up the pace of vaccinations.

“General practitioners, some private hospitals and the Malaysian Pharmacists Society have all offered to help.

“The question will be how to coordinate all these and make sure that all the data is properly submitted to a central database.”

Vaccination registrations are also slow and he suggests that the government use staff from other agencies or even volunteers to help, as healthcare personnel are already stretched.

“Verbally asking people to register on their own accord is not going to speed up registration.

“I would suggest identifying people from all the databases that we have, like the Malaysian Health Data Warehouse (MyHDW), non-communicable disease registries, health centre records, Tele Primary Care-Oral Health Clinical Information System (TPC-OHCIS) database, and others.

“Invitations to register for vaccination should be sent to all those deemed to be at higher risk.

“I would also suggest sending letters to every registered address explaining in simple terms why they need to be vaccinated and how they can register.”

He also proposes using civil groups and local community leaders to canvass Malaysians and migrants to register for vaccination.

Finally, a massive communication campaign advised by behavioural scientists should be carried out for the best impact, he said.

Khairy Jamaluddin, the minister coordinating the vaccination programme, said the target is to vaccinate 150,000 people a day by June, when the third phase is rolled out across more than 600 vaccination centres nationwide.

As of Friday, 112,914 people have received the vaccine, up from 99,616 the day before.

Galen Centre for Health and Social Policy chief executive officer Azrul Mohd Khalib is sceptical that Malaysia can hit its vaccination targets. 

He predicts only 60% of the population will be vaccinated by the end quarter of 2022, whereas the government is aiming for 80% by February.

He cites vaccine hesitancy as a major factor in Malaysia not achieving the intended target.

There must be adequate education on the vaccine, even though immunisation is voluntary, he said.

“It is tougher to vaccinate the adult population, compared to newborns.

“We should not underestimate the level of hesitancy that exists among the population regarding Covid-19 vaccines. It must be addressed, not through laws and punitive measures, but through education, awareness and positive examples.”

A bigger challenge to address than “queue-cutting” by VIPs is preventing vaccine wastage, Azrul added. 

The sensitive storage conditions of the vaccines mean they will be wasted if people fail to keep their vaccination appointments.

Trained personnel

Malaysian Medical Association (MMA) president Dr Subramaniam Muniandy said vaccine hesitancy and manpower issues ware major challenges.

“To vaccinate around 150,000 people per day would require more than 5,000 vaccinators or trained people.

“It would make sense to use private hospitals and clinics to help,” he added.

Azrul said the government must learn from the issues in phase one in order to hit the target of vaccinating 70-80% of the population.

Awang Bulgiba proposes carrying out vaccinations 24 hours a day, seven days a week.

“I am not sure if we can even meet the February 2022 original target as we are already adding more tasks.

“If we really want to vaccinate 32 million or more people (including children below 16 if clinical trials are approved), as well as foreigners, by February 2022, we will need to step up our game.

“We will need to persuade more people to register for vaccination – Malaysians and non-Malaysians alike – recruit more people to help and provide more vaccination centres or have 24/7 vaccination centres.”

So far, just more than two million people have registered for vaccination, while Malaysia has a population of almost 32 million. – March 7, 2021.