MEDICAL experts have warned the government could make the second booster shot – the fourth vaccination – mandatory if a spike in Covid-19 cases reached alarming levels.

They expressed concern that the efficacy of the Covid-19 vaccines is waning.

Universiti Malaya Department of Social and Preventive Medicine Prof Moy Foong Ming said she will not rule out the possibility of a second booster shot.

She told The Malaysian Insight that she believes the Health Ministry is monitoring cases closely for possible spikes, particularly in hospital admissions and Covid-19 related deaths before making a decision.

“If there is a spike, I believe a mandatory fourth vaccination for the population will not be ruled out,” Moy said.

On April 14, Health Minister Khairy Jamaluddin announced that the fourth vaccination shot could be administered to those in the high-risk groups – people over the age of 60 with comorbidities and to young people over the age of 12 with moderate or severe immune deficiency.

Health authorities in neighbouring Singapore have warned that there could be a new wave of the pandemic next month or in August.

Virologist Dr Chee Hui Yee of Universiti Putra Malaysia’s Faculty of Medicine and Health Sciences told The Malaysian Insight that fears over the waning efficacy of the Covid-19 vaccines after six or nine months is a global concern.

“Malaysians should be concerned. The response of Malaysians to the third vaccination – the first booster dose – has not been overwhelming.

“The data show that the administration of the third dose did not even reach 50% in several states,” Chee said.

According to data from the CovidNow website, as of Tuesday only 68.5% of adults in the country had taken the third dose.

“On the other hand, there are people who have already received their third dose, but based on scientific findings, different people have a different immune response to the vaccine.

“So (even though they have had their third dose) but are in a high-risk group, they should talk to their doctor about whether they need to take the fourth dose.

Chee said healthy people, those who do not suffer from any chronic diseases, need not have the second booster but must maintain good personal hygiene and observe basic standard operating procedure to cope with the virus in any new wave of the pandemic.

“It simply means that although the government has relaxed the requirement on wearing of the mask outdoors in general, some outdoor places, particularly where there are many people and have poor ventilation like the night market, it is advisable to mask up.”

Chee said fears that the possible spike could see cases reach the levels seen early in the year is dependent on how an individual who had had the virus develops a response.

“Since February this year, our confirmed cases have repeatedly exceeded 10,000 cases. Many of these people have produced antibodies.”

“Even then, the vaccine of the mandatory second dose will start to slowly diminish, necessitating the taking of the first booster shot.

“It is estimated that after about six to nine months, the confirmed cases may show signs of increasing.”

Moy agreed with Chee’s assessment that the spike could be in the second half of the year.

“The antibodies in the vaccine are to prevent you from getting seriously ill even if you have contracted the virus.

“Even if the antibodies are weakened and the positive person is only mildly ill, I think everything will still be under control.”

However, Moy does not believe the government will mandate a fourth dose.

Yet, she said the government must be concerned that when the efficacy of the vaccine is weakened, there is no need to force the elderly and those with co-morbidities to get the fourth dose.

“It would cost the government a lot of money to force people to get vaccinated again.”

Dr Lim Chee Han, an infection biologist, said as long as there are no new variants that are more infectious than the Omicron or Delta variants, Malaysians need not worry too much.

“If it’s an Omicron subvariant, there’s not even much to worry about because it’s a virus similar to Omicron.

“If the vaccine efficacy is declining but our immune system is able to recognise it, I don’t think it’s going to be a big concern,” Lim said.

The Omicron sub variants, BA.4 and BA.5, are now predominant worldwide.

“However, the combined data from the United States and the United Kingdom, where the impact is greatest, show that the two Omicron subvariants, while causing an upward trend in cases, have not led to record high cases as they did before with the emergence of new variants of the virus.

Lim said the European Centre for Disease Control and Prevention had nothing to show that the BA.4 and BA.5 variants increase the risk of post-infection.

However, he said it could lead to a significant increase in cases in European countries in the coming months.

On June 9, confirmed cases of Omicron subvariant BA.5 and BA.2.12.1 were detected in Malaysia.

BA.2.12.1 is now the dominant strain in the US, accounting for 58% of confirmed cases there and spreading faster than Omicron.

Khairy said a total of three cases of the Omicron subvariant have been detected in the country, although its risk factors remain the same. – June 17, 2022.