A DELAYED start to phase 3 of the national vaccination drive could derail Malaysia’s target of achieving herd immunity against Covid-19 by the first quarter of next year, said health experts.

The aim is to have 80% of the population inoculated by next February. 

To achieve herd immunity, at least 60% of the population, or 20 million people, must be immunised. It is hoped this could be achieved by the end of the year.

Coordinating minister for the national Covid-19 immunisation programme Khairy Jamaluddin said on Wednesday phase 3 of the plan might not take off this month as planned due to limited supply of the vaccine.

About 13.7 million people aged 18 and older are due to get their shots in this phase.

Khairy said the shortage of vaccines was due to the pharmaceutical companies prioritising richer nations for supply.

Former deputy health minister Dr Lee Boon Chye said it would be impossible to achieve herd immunity within the targeted timeline if vaccine supply did not arrive on time.

“Vaccination helps and minimal vaccination coverage is 80% of population if we are aiming for herd immunity. Even at 80% vaccination, there is no guarantee that herd immunity will be achieved. We need more data on herd immunity,” he told The Malaysian Insight.

It was crucial that public health measures be continued, regardless of the vaccination programme, to contain  the pandemic in Malaysia, he added.

Malaysian Public Health Physicians’ Association (PPPKAM) president Dr Zainal Ariffin Omar said late rollout of phase 3 would delay protection for the population.

He urged the government to look for new sources of vaccine supply.

Azrul Mohd Khalib, head of the Galen Centre for Health and Social Policy, said that it was doubtful Malaysia would reach the minimum 60% coverage by March given the current situation.

He said for Malaysia to achieve its goal, there needed to be a steady supply of vaccines and enough people willing to take them.

“The main problem faced by most countries at the moment is the reliability, predictability and consistency of the vaccine supply. 

“The vaccines have been ordered but not necessarily received. The pace of the vaccination effort is dictated by the availability of supply,” he said.

However, Azrul said it was not all bad news as the government had recently approved emergency use of the Sinovac vaccine, which was produced under a fill-finish arrangement with Pharmaniaga, while several hundred thousand doses of the AstraZeneca vaccine were fully claimed by Malaysians within hours of their becoming available.

Virologist Chee Hui Yee of the Medicine and Health Sciences Faculty in Universiti Putra Malaysia said herd immunity could be achieved with 60% of the population inoculated if the infectivity rate (r0) was controlled.

She was also optimistic that if the standard operating procedures (SOPs) for health were observed, community infections would drop.

“If we can control the r0 through good public health measures and the public follow the SOPs, 60-70% herd immunity is enough while we wait for more vaccines to arrive.

“As long as we can reduce the r0, even if we achieve only 50% herd immunity, that is good enough.

“When we reach 50-60% herd immunity, we will at least be able to reduce a lot of community transmissions,” she said.

Chee added that the second wave of Covid-19 infections in India had contributed to the shortage of vaccines. The country is one of the world’s biggest producers of vaccines but it has been crippled by a surge of infections and a lack of raw materials and manpower to manufacture the vaccines.

“This is a challenge to vaccine production, which will lead to rich countries hoarding vaccines. This is a fact.

“Hopefully with Malaysia also involved in vaccine testing and clinical trials, more pharmaceutical companies will come up with new vaccines and it will be approved for emergency use.

“Then we will reduce the dependency on these few vaccines that are currently available.”

Universiti Putra Malaysia medical epidemiologist Associate Prof Dr Malina Osman is optimistic that the vaccination programme will go on as per schedule despite the delays.

She added that unlike the shots for pertussis (whooping cough), tetanus, hepatitis B, rubella and tuberculosis, which were readily available, Covid-19 vaccines would only arrive in phases.

On that note, she said those who signed up for vaccination should honour their appointments and be present according to schedule.

Former deputy health minister Lee said when it came to prioritising vaccine recipients in the current and next phase, those with chronic illnesses and those whose jobs expose them to a lot of people,  such as teachers, journalists and food and beverage workers, should be given priority.

PPPKAM’s Zainal concurred with Lee that after frontliners, priority should be given to vulnerable groups, including for the AstraZeneca vaccine which the government has made an opt-in vaccine. – May 8, 2021.