The long war of vaccines vs variants


PETALING JAYA: More infectious Covid-19 variants, such as the Delta variant, have made the ramping up of the vaccination drive all the more crucial, say health experts.Universiti Putra Malaysia medical epidemiologist Assoc Prof Dr Malina Osman said a global report by the World Health Organisation (WHO) confirmed that the Delta variant, also known as B.1.617.2, has become the dominant strain in most countries now.

The United Kingdom is seeing a rising trend of infections in recent weeks due to a partial easing of restrictions together with the growth of the Delta variant, which is now believed to account for 99% of new Covid-19 cases there.

“In Malaysia, based on the sampling report done by the Health Ministry, 21 out of 183 samples detected the Delta variant,” she said.

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According to the ministry, three Variants of Concern (VOCs) have been identified in Malaysia as at June 19: the Beta variant (B.1.351) in 137 cases, Delta in 21 cases, and Alpha (B.1.1.7) in nine.

Dr Malina said the actual prevalence of variants in the country was unknown due to limited data being released on the methodology and actual samples being sent for detection.

She said current vaccines were effective in deterring severe complications of Covid-19 but ultimately, prevention via public health measures such as adhering to the standard operating procedure was crucial.

She suggested that those who are allowed to be at workplaces be vaccinated as soon as possible, adding that their families should also be immunised for faster coverage.

To detect the prevalence of different variants in the community, Universiti Malaya epidemiologist Prof Datuk Dr Awang Bulgiba Awang Mahmud said it was vital to increase random sampling of viruses from cases in the community.“If we follow the logic elsewhere, for example in the United Kingdom, the Delta variant, once established in the community, will rapidly displace the other variants.

“However, our genome sequencing is dismally low at the moment,” he added.

He said besides a total lockdown, the only effective way to avoid the spread of any variant was to achieve herd immunity through vaccination.

“This is assuming that the vaccines remain effective against the variant and that a sufficient number of people are vaccinated,” he said, adding that from recent studies, the Pfizer-BioNTech and AstraZeneca vaccines have shown to be effective against the Delta variant.

Two doses of the Pfizer-BioNTech jab prevent 96% of hospitalisations due to the Delta variant, while the AstraZeneca-Oxford vaccine prevents 92%, according to a study involving 14,000 people published by the Public Health England agency last Monday.

Dr Awang Bulgiba also warned that there were some issues with the pandemic that might cause it to be protracted.

“Firstly, it is a true pandemic in that almost every country is affected, making global control impossible unless all countries can vaccinate their populations to a sufficient degree,” he said.

He added that even if a country was able to deal with a particular variant, the emergence of new variants which spread quickly across borders makes control “transient and uncertain”.

A third factor, he said, involved the differences in the effectiveness of various vaccines, which would make it hard to ensure real herd immunity even with sufficient coverage.

“Thus, the battle between vaccines and variants will continue until we resolve all the above issues,” he said.

To ensure the country achieved optimal protection from the Delta variant, Dr Awang Bulgiba suggested vaccinations be increased to between 300,000 and 500,000 doses per day, and that the interval between the AstraZeneca doses be shortened from 12 weeks to three or four weeks.

Malaysian Medical Association president Datuk Dr Subramaniam Muniandy said Malaysia should implement effective “test, trace and isolate” methods to control the spread of new variants in the country.

“If supply suffices, we can vaccinate a quarter million patients a day.

“Rationally, we should continue to vaccinate high-risk groups first, but if the vaccine supply is adequate, we should also start vaccinating factory, construction and retail workers,” he added.

Medical Practitioners Coalition Association of Malaysia president Dr Raj Kumar Maharajah said although the Delta variant was not as pervasive here as in other countries where it had become dominant, existing cases needed to be quickly detected and isolated to prevent its spread.

He said with multiple variants and their increased transmissibility, vaccinations must be sped up so that more people were protected, including the vulnerable.

He suggested that general practitioners across the country be mobilised to support the national vaccination drive, as well as the deployment of more mobile vaccination units to reach the disabled, bedridden and the poor.

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