Irresponsible skipping of vaccine appointment can affect herd immunity target, say experts


KUALA LUMPUR (Bernama): Malaysia aims to achieve herd immunity with at least 70% of its population vaccinated by the end of the year but so far, the percentage of those who have registered for the Covid-19 vaccine is very low.

At the same time, the rate of absenteeism for those who have been given an appointment is also quite high with various reasons given. In fact, many cancellations were made at the last minute or without any notification. So what is the impact of this on the country?

According to Associate Professor Dr Yahya Mat Arip, a virologist from Universiti Sains Malaysia (USM), if there are many who do not keep the appointment date then it will disrupt the National Covid-19 Immunisation Programme's target and delay the process of achieving herd immunity.

"Individuals who are not present at the vaccination appointment will indeed be given a new date but as far as possible (one should) keep the date given except for unavoidable factors. This will help those managing the vaccination process to run it smoothly.

"But if they do not show up without a reasonable reason or because they are influenced by (anti-vaccine) propaganda, this is an irresponsible attitude as many others are waiting for an appointment date and hope to get the vaccine immediately," he told Bernama when contacted.

He said failure to attend a vaccination appointment could also lead to wastage of vaccine doses as vaccines that had been removed from storage should be used up as they had a short shelf life.

Prof Yahya said a vaccine dose has to be removed first to reach room temperature before being administered to an individual. Repeating the process of storage temperature and room temperature was not good for the vaccine as it could degrade (leaving it useless).

"It depends on the type of vaccine, whether it is temperature-sensitive or not. For example, the Pfizer vaccine is temperature-sensitive and needs to be stored at a very low temperature of -70°C. So when removed from storage, it needs to be used within a certain period of time and cannot be restored at such low temperatures.

"Therefore, careful planning based on the number of appointments is important to avoid wastage and that is why it is important for one to keep the appointment date so that there is no wastage of vaccines," he said, adding that other brands of vaccines are more stable and do not require storage at low temperatures (-70 °C) but still require storage in a cool place of -20 °C or 4°C.

For the Pfizer vaccine, for example, it requires six people to each vial. So, Prof Yahya said that if there is one person short for that vial that day, it would be difficult for the five more individuals and also gives additional tasks to medical officers on hand to find a replacement in such a short time.

"This will waste the time and effort of the five people and cause frustration. If the same thing happens two or three times, it will definitely ‘demotivate’ individuals who were initially ready to receive the vaccine," he added.

Sharing a similar view is Malaysian Pharmacists Society president Amrahi Buang who said like medicines, vaccines also have an expiration date, which usually lasts for a year.

He said it was very important for every vial of vaccine received in the country to be injected immediately to recipients but if the number of individuals present at the appointment was insufficient, there would be wastage of the highly valuable vaccine.

"Sinovac needs only one person for each vial but Pfizer needs six people (to a vial) and AstraZeneca needs 10 people ... so you have to have enough (individuals) for each vaccine.

"Let's say the vial is for 10 people; usually they (vaccinators) have already removed 10 doses into the syringe, so if one person does not keep the appointment, it means we waste one dose because it cannot be put back and used the next day," he said.

He also believes that the issue of queue-jumping for vaccine jabs is a mere perception as what actually happens is that other people are called to receive jabs to replace those who failed to attend the appointment.

Meanwhile, Amrahi said the country was currently facing two situations, namely the Covid-19 infection and the fear and reluctance of some parties to be vaccinated as happened in Kelantan when many did not keep their appointments for various reasons.

"There are many challenges and impact on health and also on the country if they refuse to attend the vaccination appointment ... at the same time the relevant parties also need to work with speed to ensure the vaccine does not expire ... so both parties need to show responsibility," he added.

On May 16, Kelantan Health Department director Datuk Dr Zaini Hussin said 1,800 people did not attend the second phase of the immunisation programme, giving various reasons including doubting its halal certification and feeling that the vaccine is not beneficial for protection, apart from the fear of its side effects.

Meanwhile, Malaysian Association of Public Health Physicians president Datuk Dr Zainal Ariffin Omar said apart from messing up the vaccination schedule, those who did not attend their appointment were the losers because they have not been vaccinated and face the risk of serious infection.

"Those who are deliberately absent and not because of emergency issues have an irresponsible attitude and do not care about the hardships that others have to go through. A vaccine that is opened cannot be stored for a long time to avoid degradation and contamination," he added. - Bernama

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