THE Sarawak government should continue with other public health measures to contain rising Covid-19 cases in the state instead of giving booster shots, said health experts.

They said a detailed study is required before deciding whether the additional shot should be administered.

Universiti Putra Malaysia medical epidemiologist Associate Prof Dr Malina Osman said this is probably not the time for booster shots to be administered in Sarawak.

“Detailed analysis should be carried out before any consideration of booster dose is to be made.

“The priority is to make sure all those high risk groups receive at least one dose before we can think of a booster,” she told The Malaysian Insight.

Malaysian Public Health Physicians’ Association president Dr Zainal Ariffin Omar said more information was needed on whether the rise was caused by waning immunity.

“We don’t know the percentage of people that have completed their vaccination and how long after that they were infected. So, we are not sure whether the booster shots are needed at this time,” he said.

Meanwhile, citing the World Health Organization, virologist Dr Chee Hui Yee from the Faculty of Medicine and Health Sciences at Universiti Putra Malaysia said booster shots are not needed at this time because the initial shots of the Covid-19 vaccine still has the potential to prevent severe hospitalisation and death.

“Vaccine will not prevent one from getting the virus, but it prevents severe symptoms,” she said, adding that the circulation of variants of concern (VOC) as highlighted by Universiti Malaysia Sarawak is one of the possible reasons for the spike in state cases, despite a high vaccination coverage.

Unimas’ Institute of Health and Community Medicine (IHCM) director Prof Dr David Perera reportedly said that as of August 17, at least 179 additional cases of VOC and variants of interest (VOI) were detected.

Perera said the institute had conducted genome sequencing for 220 samples.

Of this, 178 were of the Delta variant and one was the recently described VOI first found in Indonesia.

Meanwhile, Chee said public health measures were the way to go for now.

“Public health and social measures can help like mask wearing, frequent hand washing and social distancing and avoid gathering,” she said.

Malina agreed with Chee’s observation. She said, in addition to the circulation of the Delta variant, poor compliance with standard operating procedure could be also one of the reasons for the spike.

“With current Delta variants widely circulated in the community, particularly in Sarawak, we have no choice except to continue our adherence to the SOP, despite being vaccinated,” she said.

Last week, Health Minister Khairy Jamaluddin said the waning efficacy of the Covid-19 vaccines administered could be one of the possible reasons for the surge in cases in Sarawak.

“I have also asked the technical working group that advises on vaccines selection to quickly provide the special committee on Covid-19 vaccine supply with recommendations on booster shots because we are not sure what is driving the transmission in Sarawak,” he told a press conference.

“One possibility is the waning effectiveness of the vaccines over time (which) we have seen in other countries.

“Other countries have started administering booster shots to the elderly, the immunocompromised, and healthcare workers. We are certainly not ruling that out,” he added.

The report on booster shots is to be presented when the committee meets next, and the matter will then be discussed with the Sarawak government to determine the strategy forward.

According to government portal Covidnow, 77.4% of the vaccinated population received the Sinovac vaccine, while 20.2% received Pfizer and 2.4% received the AstraZeneca shots.

A recent article published in the Lancet, Considerations in Boosting Covid-19 Vaccine Immune Responses, said careful and public scrutiny of the evolving data would be needed to assure that decisions about boosting are informed by reliable science more than by politics.

“Even if boosting were eventually shown to decrease the medium-term risk of serious disease, current vaccine supplies could save more lives if used in previously unvaccinated populations than if used as boosters in vaccinated populations,” the article said.

“Boosting could be appropriate for some individuals in whom the primary vaccination, defined here as the original one-dose or two-dose series of each vaccine, might not have induced adequate protection, eg, recipients of vaccines with low efficacy or those who are immunocompromised (although people who did not respond robustly to the primary vaccination might also not respond well to a booster),” it added.

However, the article said it is not known whether such immunocompromised individuals would receive more benefit from an additional dose of the same vaccine or of a different vaccine that might complement the primary immune response.

The article was penned by 18 medical and science experts including WHO’s Soumya Swaminathan, Ana-Maria Henao-Restrepo and Mike Ryan.

Also on the list of authors were US Food and Drug Administration office of vaccines research and review director Marion Gruber and deputy director Phil Krause. – September 16, 2021.