COLD feet over potential side effects, logistical issues and even religious concerns could be reasons why more than 52,000 people have given their Covid-19 vaccination appointments a miss, said medical experts.

According to reports, Kedah has the highest number of missed appointments, with 10,827. This was followed by Pahang (10,000), Kelantan (10,000), Perak (9,009), Negeri Sembilan (6,323), Malacca (3,612) and Perlis (3,000).

State health authorities said most of them who did not turn up gave various reasons, such as that they were out of town, unfit to travel, not ready for it, or undergoing quarantine.

The Galen Centre for Health and Social Policy head Azrul Mohd Khalib said vaccine hesitancy remains a serious concern.

“Despite the sights, sounds and enthusiasm from the videos of people sharing their experience participating in the AstraZeneca opt-in vaccination stream, the fact is, vaccine hesitancy remains a serious issue of concern,” Azrul told The Malaysian Insight.

A survey conducted by the Ministry of Health in December 2020 found that 33% of more than 200,000 respondents were uncertain or did not agree to taking a Covid-19 vaccine. Most were concerned about side effects, vaccine ingredients, and the safety of existing vaccines,” he added.

He said there was still work to be done to build confidence towards vaccines and to ensure that the right messages are properly communicated.

Logistical challenges

Azrul, however, said the logistical challenges cited are also real and it is important to ensure that people are able to get to the vaccination centres (PPV).

“Older people need added assistance, especially in the notification and confirmation of those appointments. People should be able to get to these vaccination sites and return home safely,” he said.

The state and district government departments, not just health, should be able to facilitate such logistical assistance,” he added.

Malaysian Public Health Physicians’ Association president Dr Zainal Ariffin Omar said based on information from the ground, vaccine hesitancy, overlooking appointments given via the MySejahtera application, and transportation are some possible reasons.

He also added that some people may not have taken vaccination seriously.

“These reasons are not acceptable. They (health authorities) should then give the jabs to others and not wait for those who don’t turn up,” he said.

“Some think that the vaccine may have haram ingredients and there are others who assume that the jab may cause serious side effects,” Zainal said.

The myth about the vaccine being haram was earlier today dismissed by Minister in the Prime Minister’s Department Mustapa Mohamed in urging the Kelantanese to take the vaccination, saying Muslims should take the Covid-19 vaccine as advised by the national fatwa council.

Mustapa reminded Muslims that the fatwa council, after studying the matter, had made the shots “wajib”, or compulsory for high-risk groups and “harus”, or encouraged for the rest.

Virologist Dr Chee Hui Yee from the Faculty of Medicine and Health Sciences at Universiti Putra Malaysia said concerns over the side effects could be a reason.

She, however, said the problem is not unique to the Malay community as people of all races are concerned over the safety of the jabs.

“Since the Malays are the major population in Malaysia, it may give us the impression that the Malay community has issues with the vaccination.

“The reasons they gave are valid and (it) could be they are elderly (people) who do not know how to check text messages or the MySejahtera app. I saw many Malays wanting to register for AstraZeneca but could not get through,” Chee said.

Azrul, meanwhile, said developments within the Malay community are worrying.

“I don’t speak for the Malay community. However, there are several developments in the Malay community that are worrying.

“Many older people have followed the government’s advice to get registered for the vaccine and have received their appointments.

“However, their sons or daughters, who may be vaccine-hesitant or even anti-vaccine, persuade their parents, through fear mongering and sharing of misinformation, not to show up for the vaccination appointments,” Azrul said.

He added the volume of misinformation regarding vaccines on social media and messaging platforms have increased multiple-fold.

Official and credible communication from health authorities have gotten lost in the sheer volume of false information, Azrul said, while adding that it is an uphill battle to combat misinformation.

Universiti Putra Malaysia medical epidemiologist Associate Prof Dr Malina Osman, however, disagreed that vaccine hesitancy could be a reason.

“I don’t think so, perhaps there are social factors that inevitably lead them to defer the appointment,” she said.

“I have been on the ground before. We need to identify the underlying causes before concluding anything.”

Dr Malina suggested that a study be conducted by health authorities to determine the underlying causes, so that the issue can be rectified based on the findings.

Vaccine wastage

Azrul and Chee said there is certainly a risk of vaccine wastage if people do not turn up for their appointments.

“This is especially if there are insufficient numbers of people to finish the vaccine vials that have already been opened,” said Azrul.

“People who are deliberately excluding themselves from vaccination without legitimate medical reasons, are harming themselves, their families and communities.”

Chee said the government may need to come up with a back-up plan to prevent vaccine wastage.

One option is to carry out the vaccination drive on an opt-in basis like the parallel programme for AstraZeneca, which drew positive response. – May 28, 2021.