Overcoming vaccine hesitancy

PETALING JAYA: As the divide between the vaccinated and the unvaccinated deepens following a number of restrictions imposed on those without the Covid-19 jabs, health experts are suggesting different methods to coax them.

They go as far as to suggest making vaccinations mandatory.

Prof Dr Moy Foong Ming from Universiti Malaya’s Department of Social and Preventive Medicine said public education campaigns had successfully convinced over 95% of the country’s adult population to get at least one dose of the vaccine.

“But the remaining 5% may need more individualised methods. For those refusing the vaccine due to religious and cultural reasons, the messages must be tailored to those aspects, and community leaders or religious officers must be roped in to assist,” she said.

Dr Zainal: Making vaccination mandatory is more appropriate.Dr Zainal: Making vaccination mandatory is more appropriate.

According to the Special Committee on Covid-19 Vaccine Supply Access Guarantee, as at Oct 16, 95.1% of the adult population had received at least one dose, leaving less than 5% – roughly a million adults – yet to be inoculated.

The three states with the lowest rates are Sabah (67.5%), Kelantan (75.1%) and Kedah (81.3%).

The high transmissibility of the Covid-19 virus, especially the Delta variant, means that a high proportion of the country needs to be immunised for herd protection.

Prof Moy said for states like Kelantan and Kedah, religion and being less informed might be the main reasons for the low vaccination rate.

“For these groups, besides providing information at the layman level, understanding their religious concerns is of utmost importance so that appropriate answers can be given to counter their doubts.

Dr Moy: The remaining 5% may need more individualised methods.Dr Moy: The remaining 5% may need more individualised methods.“It may be better to have their community leaders or religious officers convince them,” she said.

Prof Moy said that as the low vaccination rate in Sabah might be due to the remoteness of the areas, the state healthcare team might need to make more effort to reach them.

“Those staying in remote areas and the interior may also be less well-informed of the risks and benefits of vaccines and underestimate the serious consequences of Covid-19 infection due to the inaccessibility of the Internet and television,” she said.

However, for those refusing the vaccine without reason, Prof Moy said the carrot-and-stick policy by the Health Ministry might work.

“When there is more freedom for those vaccinated, the unvaccinated will feel more of the inconvenience affecting them and this may ‘force’ them to come forward.

“Yes, it is the people’s right to decide to vaccinate or not. But if that right infringes on public health, then it becomes their social obligation to contribute to public health.

“The government, with the help of NGOs, should approach these individuals who are anti-vaccine, find out their reasons and try to get their community leaders to convince them.

“If that doesn’t work, then more stringent rules may be needed. For example, if they happen to be public servants, disciplinary action could be taken against them, which is currently being implemented,” added Prof Moy.

She said a National Testing Strategy – which will see those unvaccinated subjected to regular screening as suggested by the Health Ministry – was not 100% foolproof and would incur unnecessary costs.

Testing must be tailored to specific situations such as for events where standard operating procedures could not be avoided, she said.

Malaysian Public Health Physicians’ Association president Datuk Dr Zainal Ariffin Omar said the government had to relook and decide to either continue with voluntary vaccination or make it mandatory.

“I think making it mandatory is more appropriate and forward than the current approach, which is voluntary but that life will be made difficult for those unvaccinated,” he said.

“There is a strong case for making Covid-19 vaccination mandatory based on justifications such as the virus being a grave threat to public health, that the vaccines are safe and effective, and that enough education, coercion and universal access to all eligible populations have been provided.

“The current approach where privileges are given to the vaccinated and withheld from the unvaccinated, without doubt, creates an unnecessary discriminating perception, uneasiness and hatred between the two factions.

“If the government chooses to go for ‘total protection’ to reduce the country’s social and financial burdens of Covid-19 patients and prevent further outbreaks, we should opt for mandatory. The rakyat is ready for that,” he said, adding that any National Testing Strategy should be complementary to vaccination while remaining optional and for special purposes.

Malaysian Association for Occupational Safety and Health president Dr Shawaludin Husin said as there was no specific Act to require employees to be vaccinated, employers were recommended to conduct a risk assessment of the workplace and the nature of work.

Dr Shawaludin said while there was no such law, it was the employers’ responsibility to ensure that client-facing employees be compelled to get the vaccine.

“The employer can make it mandatory that if the employee works with someone else, there is a need for a vaccine.

“Otherwise, they have essentially breached a contractual agreement with the employer, under which they can be justified as individuals who are unable to perform their duties as prescribed,” he said.

However, he said if the risk assessment was low because the job did not require face-to-face meetings, such as telemarketing, then employers could not force their workers.

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