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INTERACTIVE: Vaccination showing good results abroad but experts warn against complacency

The Star, Monday, 01 Mar 2021


PETALING JAYA: Countries that are on board with a vaccination programme since last year are now showing positive results in reducing Covid-19 cases and deaths, with promising views of a semblance of normalcy of life in the months to come.

For example, more than half of Israel's population of more than nine million people had received the first dose of the Pfizer-BioNTech vaccine while about three million of them have since been given the second dose.

Israel's health statistics saw the first group to take the vaccine - those 60 years and older - showing a 41% decrease in the number of new infections within six weeks of the vaccination programme, while Covid-19 hospitalisation dropped by 31% and those who became critically ill reduced by 24%.


Universiti Putra Malaysia medical epidemiologist Assoc Prof Dr Malina Osman said that such obvious significant reduction can be seen by four to six weeks after the commencement of the vaccine.

"For example, in the UK, it has been a reduction of 70%. A similar pattern is also observed in the US, India and other Europen countries," she said.

She said that none of the scientific reports documented any gross errors or mistakes in terms of protocol, procedures or complications.

However, Israel faces the threat of the highly infectious B.1.1.7 variant which accounts for up to 80% of samples tested. Coupled with lower compliance with the country's lockdown since Jan 8, its average daily cases are up again.

In efforts to address this, its government is making vaccines available to those 16 years and older, while proposing that cultural and religious gatherings are only limited to people who have been fully vaccinated, have recovered from Covid-19 or have recently tested negative for the virus.

In the United Arab Emirates, more than a quarter of its population have received at least one vaccine dose, with 60 doses administered per 100 people.

The country was able to ramp up its vaccination programme by establishing more than 100 vaccine centres in its most populated cities, Abu Dhabi and Dubai, where more than 70% of its population lives.

British territory Gibraltar is expecting to have a normal summer as they are close to achieving herd immunity with more than 70% of its people vaccinated.

As of Feb 26, 40% of its 33,701 people have fully vaccinated and over 60% have received at least one dose of vaccine.

Malaysian Medical Association president Datuk Dr Subramaniam Muniandy said the success in a country's vaccination programme depends on a reliable supply of vaccines, sufficient centres for vaccination and enough trained staff to administer the jabs.

He said that clear communication is important to relay to the people about the date and venue of the jabs and who they can contact for enquiries in each district.

Universiti Malaya epidemiologist Prof Datuk Dr Awang Bulgiba Awang Mahmud said vaccination is faster where there is tighter integration between public and private health care providers like in the United Kingdom.

"The UK has universal insurance coverage and a nationwide digital network integrated with its public health system.

"With clinical data available for every person, identifying high risk individuals and communicating with them is much easier, enabling the actual registration and vaccination to take place faster," he said.

Malaysia, he said, should accelerate plans to set up a National Healthcare Financing System to ensure a complete national healthcare database and a dichotomy of public-private health care providers to allow for a smooth vaccination programme.

Dr Awang Bulgiba said the effectiveness of the vaccine can be assessed by epidemiological and other studies.

"During the early stages of the vaccination exercise, this can be quickly done by comparing the disease rates in a group of vaccinated people versus a group of unvaccinated people," he said, however, cautioning that the study design will be more difficult after more people are vaccinated.

Dr Awang Bulgiba, who is head of the Independent Covid-19 Vaccination Advisory Committee, has recommended to the government to establish a voluntary Covid-19 Vaccination Registry.

He also warned that while evidence from countries such as the United Kingdom suggested that improvements in Covid-19 infections can be seen even before herd immunity is reached, the public needs to continue to adhere to the SOP.

He said that after vaccination, non-pharmaceutical interventions (NPIs) such as wearing masks, physical distancing, washing hands and others need to remain in place until infection levels are very low.

"If we continue with NPIs, then it is likely that a sustained decline in new infections will be seen when about 50% of the population has been vaccinated.

"This would be the effect of a low contact rate combined with increasing immunity," he said, adding however, that other factors need to be looked into as well.

Dr Awang Bulgiba said the country needs continuous engagement with the public via a communication exercise by communication specialists who are advised by behavioural scientists in order to encourage high participation in the vaccination programme.

"In this pandemic, the elderly and those who have co-morbidities are the ones who are the most likely to get a severe disease and to die from Covid-19 so they are the ones who are most likely to benefit directly from the vaccine.

"This is a point that needs to be communicated in an easily understood and non-condescending way to the public," he said.

UPM's Dr Malina also encouraged the elderly to take up the vaccination programme as early as they can to reduce complications arising from Covid-19 infections.

"Considering the benefits and risks of vaccine, data so far has indicated that the benefits are far beyond the risks.

"Of all one million vaccinated, only 11 had adverse effects compared to 3,500 death in one million infections," she said.

Dr Subramaniam added that many older people have been vaccinated without ill effects.

He, however, said that caution should be exercised in the very frail, bedridden patients.

Dr Subramaniam noted that studies show that even one dose of the Pfizer vaccine gives about 85% protection against hospitalisation and severe disease.

"However, it is still recommended to follow the SOP because there isn’t enough information yet on how effective it is at preventing transmission of disease.

He estimated that the earliest the country can achieve herd immunity of 70% to 80% of the population vaccinated is by end of the year, but the country will see decline in cases even before that.


Tarikh Input: 10/03/2021 | Kemaskini: 10/03/2021 | norashiqin


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