AS I am writing this, the reported daily number of Covid deaths in Malaysia is 360, another new high. With more anecdotes of deaths surfacing on social media, I can’t help but notice that many of them involved vaccinated people.

As I look through the data from the Ministry of Health, it appears that between August 1 and August 7, around 20% of daily recorded new cases came from those with a history of vaccination.

That averages to 3,742 cases daily, with a total of 646 cases needing some form of hospitalisation (category 3 and above).

Let me be unequivocal here, lest this article is read in the wrong way. Vaccines work.

At this point, they are both a personal and social necessity to get us out of the pandemic, and the severe health and socioeconomic consequences it has wrecked.

All research points to vaccines being able to drastically reduce the transmissibility of the virus and the risk of hospitalisation for anyone infected.

In other words, you are significantly less likely to catch or get sick from the virus due to your own and other people’s vaccination.

Also, to put the numbers above into perspective, by August 2021 around 450,000 doses of vaccine are given daily in Malaysia, which means that post-vaccination positives is only around 0.8% of those vaccinated – a fairly minuscule number.

Research from the United Kingdom has shown a 0.5% positive rate for those inoculated with one dose and 0.1% for two doses.

Reading intriguing data

Putting aside that the UK study and data I used are based on different sampling methods (the UK study draws on a sample of close to 300,000 vaccinated individuals; while mine is from the daily breakdown of recorded new Covid cases), there is still cause for concern.

For example, in the Malaysian case, those who tested positive with a vaccination history are much more likely to exhibit symptoms, meaning that most of them are Category 2 and above, with Category 2 (mild symptoms) being the largest group.

In fact, for the period I look at, Category 2 post-vaccination positives consistently outnumber Category 1 (asymptomatic) positives, with the former often more than doubling the latter.

This differs significantly from the non-vaccinated positives, where the largest group is the asymptomatic positives. It also differs from the UK study I cited above, whereby only 37.3% of those tested positive post-vaccination exhibit symptoms.

It goes without saying we should be concerned because every life lost is a life, not a number.

The fact that there are 175 cases of ICU-admissions for patients with a vaccination history in the seven-day period I recorded means if there’s a hole we can plug, many lives can be potentially saved.

With the limited data, there is also no way to tell if those with a vaccination history who tested positive with mild symptoms will see their condition worsen or not.

Moreover, if people look at the numbers and think that there might be some currency to the idea that going for vaccination actually increases their risk of infection, they might be discouraged to go.

I can certainly understand those fears, especially for someone weighing the risk for the elderly. It doesn’t help that outbreaks have happened in our mega-vaccination centres and that some of us were told tales of people having to spend hours in these centres (and tested positive days later).

Such fear and scepticism are not helpful as they may stand in the way of us reaching herd immunity. Eventually our current vaccination progress will slow (as is the case with other countries).

Covering that last mile would require us to assuage people of their fears and concerns.

Thus, it’s best we tackle the question head-on now: are we seeing a case of people catching the virus during vaccination?

Let’s first acknowledge that that’s not the only explanation available.

Firstly, vaccines do not offer absolute protection, and scientists are still working to establish vaccine efficiency against the delta variant (although early results have been positive).

Secondly, the infection could have happened before vaccination, or after it, given that it takes about 14 days for the vaccine’s effects to kick in.

A recent study in the United Kingdom has also shown that the risk of post-vaccination Covid positivity peaks within 21-days after vaccination before it drops drastically, although the report does not offer a concrete explanation as to why.

Possible reasons include pre-vaccination exposure, exposure during vaccination, or behavioural change after vaccination, which may result in a greater risk of exposure for the individual.

Similarly, in our case, without having more granular data, it’s difficult to say what is the cause for our post-vaccination positivity. There’s simply too much we don’t know.

For example, what’s the average post-vaccination day count for those who tested positive? Are they one or two-dose recipients? Is there a particular geographical or age profile for this group?

That being said, I would argue that our case of having more individuals tested positive with a vaccination history and having symptoms as compared to those without symptoms is a puzzle worth taking seriously.

Does it support the ‘exposure during vaccination’ theory, though? Again, the data lacks detail to offer any conclusive proof. But it does not discount it either.

It is certainly a possibility that vaccines, due to how it triggers an immune response by mimicking an infection, could increase the likelihood of someone who’s infected during vaccination to develop symptoms.

Plus, unlike the UK where lockdown has eased considerably, and mask-wearing is far less common when compared to Malaysia, the fact that Malaysia is still under lockdown means the likelihood of exposure during vaccination increases relative to other sources of infection as it is one of the very few crowded indoor places one visits.

As I said, the conditions at our mega-vaccination centres are not exactly convincing.

Sensible working theories direly needed

Again, I am not discounting that exposure could come from other sources. The data just isn’t detailed enough to tell. The whole point of me writing this is to invite the government (and experts) to develop a working theory for this phenomenon and test it. Or release more data for more people to work on it.

I strongly believe that if we can do anything to reduce infections and deaths, we have a moral obligation to do so. If we can nip any grounds for vaccine scepticism – whether justified or not – in the bud, we should.

If our mega vaccination centres are indeed risk factors, we should rethink our embrace of them and substitute spectacle for more nimble operations.

However, if my worry as a non-expert is overblown, an informative communique from the government would help stem it. Yet so far, there is none.

This frustrating lack of working theories (or hypotheses) is seen in another Covid-related debate in Malaysia: the whole debate as to whether factory clusters are responsible for Malaysia’s Covid spike.

International Trade and Industry Minister Azmin Ali said they are not, but analysts have disputed this.

In my view, we can’t get over this highly consequential debate (it is because it determines the policy we take) because the authorities announced no working theories as to how a country in lockdown could see cases keep on spiking if it’s not the clusters?

Without a working theory, we can neither prove an argument conclusively nor counter sceptics convincingly.

Releasing figures that show sporadic cases outnumbered the cluster cases without giving a sensible explanation as to why it is so won’t help regain the public’s confidence.

This is because there is still a case to be made that those non-cluster cases are actually cases that can be traced to clusters but have escaped test-and-trace; a highly plausible scenario, given that our skyrocketing numbers mean the logistics of keeping up with test-and-trace is almost impossible.

Contrary to popular belief, science does not work on data alone. Without a working theory, data means nothing. In fact, we can’t even know what kind of data we need.

By not coming up with any sensible working theories (though the government isn’t immune to coming up with bizarre excuses), it’s almost impossible for a government to convince the people they are doing all they can to keep the pandemic in check. – August 12, 2021.

* A Forensic Science-Asian Studies hybrid, Nicholas Chan is interested in how authority is shaped, exercised, and more importantly, resisted in Southeast Asia.