WIDESPREAD acceptance and understanding of vaccines is necessary to combat Covid-19 because the purpose of vaccination is not only to protect an individual, but rather a whole population for a long-term period.
Vaccination is the safest and most effective approach to contain viral infections while offering promising protection within a community, says Dr Leow Chiuan Yee, a senior lecturer specialising in vaccinology and immunology at Universiti Sains Malaysia (USM)’s School of Pharmaceutical Sciences.
“In light of this, mass vaccination is highly required to achieve herd immunity against Covid-19, ” he adds.
Unfortunately, Leow explains that fake news against the Covid-19 vaccine could reduce the confidence of certain people to stay away from vaccination, which can eventually magnify the outbreak and aggravate the situation.
Efforts to combat the spread of the pandemic have been somewhat hindered by the growing number of people across the world who reject immunisations, also known as anti-vaxxers. At the moment, there is no clear number of exactly how many anti-vaxxers there are in Malaysia, but even a minority can pose a danger to the individual themselves and wider population. Worrying still, the group has found room to grow relatively unrestricted on social media with some local celebrities even buying into the propaganda. Facebook announced in December that it will start removing false claims about the Covid-19 vaccine, but many wonder if the move has come too late.
Vaccine hesitancy – the reluctance or refusal to vaccinate despite the availability of vaccines – was listed by the World Health Organisation as one of the top ten global health threats in 2019.
Previously, smallpox and measles, once considered deadly and highly infectious, were successfully controlled or eradicated through community acceptance of vaccines.
However, there has been precedence where vaccine rejection has led to devastating consequences.
“We can look at the experiences of several developed countries after they allowed their immunisation levels to drop.
“The United Kingdom, Sweden and Japan cut back the use of pertussis (whooping cough) vaccine due to doubt about the vaccine.
“The effect was dramatic and immediate from 1974 to 1978 where infectious cases suddenly spiked and caused the deaths of hundreds, ” Leow explains.
Diphtheria, another disease that can potentially cause life-threatening complications, re-emerged in Kedah and Pahang in 2016 after a long absence. In 2014, Kedah was identified as the state with the highest number of vaccine rejection cases.
In a video message on the Covid-19 vaccine posted on the Facebook page of the Special Committee on Covid-19 Vaccine Supply Access (JKJAV) on Friday, the Prime Minister’s Special Advisor on Public Health Tan Sri Dr Jemilah Mahmood emphasised that the vaccines acquired by Malaysia are effective and safe.
“For the vaccine to be most effective, as many citizens as possible above the age of 18 that are able to receive the vaccine must be vaccinated. This is because the more people who receive the vaccine, the more difficult it will be for Covid-19 to spread, ” she said, adding that the vaccine will be free for all Malaysian citizens.
“Although the Covid-19 vaccine is not mandatory, I urge all those who are eligible to take it. Let us work together to break the chain of infection, ” she said.
Dr Jemilah added that the government will announce ways to register for the vaccine soon.Malaysia has secured vaccine orders from Pfizer-BioNTech, Oxford-AstraZeneca, Gamaleya and Sinovac, and is finalising agreements with CanSino, with the goal of immunising more than 80% of the population. According to healthcare and policy news portal Code Blue, Malaysia’s total Covid-19 vaccine supply can cover 98.75% of the population.
Malaysians will be able to use the Pfizer-BioNTech vaccine when it arrives next month, as it has received conditional approval by the National Pharmaceutical Regulatory Agency (NPRA). The other vaccines are awaiting approval by the government regulator.
The ones that are currently being rolled out in the United Kingdom are the Pfizer-BioNTech-BioNTech and Oxford-AstraZeneca vaccines. The Moderna vaccine, made by a United States company, was approved for use in the United Kingdom earlier this month.
A recent Health Ministry survey found that 67% of respondents (out of 221,006 Malaysians surveyed) accepted the Covid-19 vaccine with up to 95% of them expressing confidence that the vaccines are safe for use.
Despite this, on top of the successes of vaccines in the past, there remain some lingering questions among Malaysians when it comes to the Covid-19 vaccines. This can be due to the complexity and misconceptions on vaccine information, says Leow.
A 2018 article by the Health Ministry’s Institute for Health Behavioural Research analysed potential factors contributing to vaccine hesitancy among parents in Malaysia found that low awareness about the benefits of vaccination; availability, accessibility, and affordability of vaccines; misconceptions and concerns about side effects of vaccines; as well as preference for alternatives medicines were among the reasons associated with vaccine hesitancy.
Concerns have also been raised among the Muslim community on the halal status of the Covid-19 vaccine.
This was later clarified in a Dec 23 statement by Malaysia’s Islamic Authorities that taking the vaccine is not only permissible (harus), but is even mandatory (wajib) for some groups.
Minister in the Prime Minister’s Department in charge of Religious Affairs Datuk Seri Dr Zulkifli Mohamad Al-Bakri pointed out that global Islamic institutions including Egypt’s al-Azhar University; the United Arab Emirates’ Fatwa Council; and Majma ’Fuqaha’ al-Shari’ah in the United States have also issued fatwas (religious edits) on the permissibility of the use of vaccines. Across the Causeway, Singapore’s Mufti Nazirudin Mohd Nasir strongly urged Muslims in the island republic to take Covid-19 vaccines once it is available for safe use, regardless of their ingredients, as a basic necessity (daruriyyat) in order to save lives.
Doubts by some parents and guardians on the content and function of vaccines, and negative influence of friends or family members on the safety of vaccines can be alleviated by providing clear and understandable vaccine information, says Leow.
“Vaccine side-effects are rare and usually mild. Unsafe vaccine candidates have been terminated during the preclinical or early clinical trial. Sometimes the adverse effects of a vaccine were over-exaggerated by the media and this has made the public fear vaccines, ” says Leow.
Taking one case as an example, the Norway government clarified that there was no direct link between the Covid-19 vaccine to the deaths of some elderly patients above the age of 75 after they were vaccinated against the virus. Instead, the causes were attributed to underlying illnesses as all those who had died were already seriously ill before taking vaccination. Initially, reports of the deaths raised alarm when some parties wrongly associated the deaths to vaccination.
Like all other prescribed medicines and antibiotics, individuals with a known history of severe allergic reaction should seek doctors’ advice first before taking the vaccine, says Leow.
Various approaches on education and promotion of vaccination programs have been made publicly so far, says Leow, and they can be found on social media, televisions, newspapers, and on government websites and their respective social media pages.
Government bodies in the forefront of vaccine information dissemination include the Health Ministry (MOH), Science, Technology and Environment Ministry (Mosti), Education Ministry (MOE), Higher Education Ministry (Mohe) and the Communications and Multimedia Ministry.
Non-governmental organisations like Academy Science Malaysia (ASM), Malaysian Young Scientist Network (YSN), and the Institute of Strategic and International Studies Malaysia (Isis) are also doing their part to curb vaccine misinformation, says Leow.
Leow notes that the research community and governmental agencies need to be proactive with regard to continued vaccine education, guiding public perception with rigorous scientific research on vaccine safety, and emphasise the importance of vaccination in preventing unwanted and potentially lethal infectious diseases.
“Authorities and healthcare professionals need to ensure that the public have access to verified resources which can deliver simple and correct information about the vaccines, ” he says.
On the 31st Special Session of the United Nations General Assembly in response to Covid-19, held on Dec 4, Foreign Minister Datuk Seri Hishammuddin Hussein called for nations to work together to fight misinformation related to the Covid-19 vaccines and anti-vaccination propaganda.
“Misinformation costs lives, especially as we are preparing national vaccination plans for our people, ” said Hishammuddin, who added that public awareness on the need to vaccinate is crucial to prevent a climate of fear and division during the vaccine roll-out phase.
Even tech giant Google is taking measures by launching a US$3mil (RM12.1mil) fund a few weeks ago to fight vaccine misinformation. A month prior, the Google News Initiative pledged US$1.5mil (RM6mil) to support Covid-19 vaccine fact-checking research.
There have now been more than 100 million confirmed cases of Covid-19 and more than two million deaths from the virus worldwide, according to WHO estimates.