TWO years ago on Jan 12, 2020, Chinese scientists shared the genomic sequence of the virus that was causing a large outbreak of severe pneumonia in Wuhan. This enabled the development of diagnostic PCR (polymerase chain reaction) kits and a race to develop a vaccine against the disease.
On the back of decades of research in mRNA vaccine technology (M[essenger] RNA vaccines teach our cells how to make a protein that will trigger an immune response inside our bodies), two vaccines, (Pfizer-BioNTech and Moderna), were successfully developed, underwent large clinical trials and received emergency use authorisation by the United State Federal Drug Administration by December 2020.
Since then, several more vaccines have been developed. To date 9.37 billion doses of vaccine have been administered globally. Just under four billion people or half of the world’s population have been vaccinated since December 2020.
In Malaysia, 59.8 million doses have been given, covering 78.6% of the total population. Almost 98% of the adult population have received two doses of Covid-19 vaccines.
With a concerted effort currently being made to achieve an equally high coverage of the booster dose to protect us from a potential Omicron surge, 35.4% of adults have received a third dose since October 2021.
Malaysia currently ranks among the top 20 countries in the world for vaccine coverage, including the booster dose. We should thank the Malaysian government, specifically the National Covid-19 Immunisation Programme (PICK) and the Health Ministry (MOH), and recognise this extraordinary achievement.
Over the last 12 months since the global vaccine rollout, through intense scientific research and the most comprehensive vaccine safety monitoring in history, several important facts have been learned about the effectiveness and safety of Covid-19 vaccines.
FACT 1: The vaccines save lives. Local studies show that an unvaccinated person has a 40 times greater chance of dying compared to a vaccinated person who has had two doses, and 62 times greater chance of dying compared to someone who has received a booster dose. A recent European study estimated that the lives of 470,000 of those aged 65 years and older have been saved since the rollout of the vaccine programme in Europe.
FACT 2: The primary effect of the vaccine is to prevent severe disease, hospitalisation and death. Analysis of local data during the period of the Delta surge in Malaysia between July and October 2021 shows that a reduction in the number of admissions to ICU and reduction in the number of new daily cases were achieved once the vaccine coverage reached 55% and 60% of the population respectively. This enabled loosening of restrictions and cessation of the movement control orders over the ensuing months across the nation and Malaysia entering Phase One of the National Recovery Plan.
FACT 3: Covid-19 vaccines reduce the risk of transmitting the Delta variant. People who receive two vaccines and later contract the Delta variant are less likely to infect their close contacts than are unvaccinated people with Delta. The Omicron variant, however, is estimated to be three to six times more infectious than previous variants and spreads more rapidly. Although the Omicron variant has demonstrated some evasiveness against double-dose vaccines, all vaccines still seem to provide a significant degree of protection against serious illness from Omicron, which is the most crucial goal. With two vaccine doses, protection against severe disease drops to approximately 70% after three months and 50% after six months. Three months following a booster dose, protection against hospitalisation among those aged 65 and over remains at about 90%.
FACT 4: The Omicron variant is associated with breakthrough infections despite vaccinations. Breakthrough infections after vaccines occur because no vaccine is 100% effective. Even the measles, mumps and rubella (MMR) vaccine – one of the most powerful disease prevention tools we have – is only 96% effective against measles after two doses while the seasonal flu vaccine is only 45% effective. Despite this, the flu vaccine is estimated to prevent 130,000 flu deaths in the US alone each year.
FACT 5: More evidence is emerging that the Omicron coronavirus variant affects the upper respiratory tract, causing milder symptoms than previous variants and resulting in lower death rates being reported even in countries with very large number of cases. Although Omicron may be associated with a milder form of disease, because it is highly contagious, the number of cases can grow exponentially and overwhelm the health system.
FACT 6: Myocarditis following the mRNA vaccines are rare and estimated at one in 10 cases per one million vaccinated persons in multiple studies. In comparison, myocarditis due to Covid-19 has been reported to occur in approximately 40 per one million cases. In other words, myocarditis due to Covid-19 infection is approximately 40 times more than following an mRNA vaccination. Evidence-based risk/benefit assessment shows that getting vaccinated is safer that running the risk of exposure to Covid-19 acquired myocarditis.
Covid-19 vaccines are being monitored for safety with the most comprehensive and intense vaccine safety monitoring programme in history.
FACT 7: For children aged five to 11 years, the Pfizer-BioNTech vaccine is over 90% effective at preventing Covid-19. Unvaccinated young children are at risk for prolonged post-Covid-19 conditions, hospitalisation, multi-system inflammatory syndrome (MIS-C), or death. The risk of vaccine-induced myocarditis is rare. Eleven verified reports have been received after administration of approximately eight million vaccine doses among children aged five to 11 years in the US. Two deaths after Pfizer-BioNTech Covid-19 vaccination were reported for children with multiple chronic medical conditions. On initial review, no data were found that would suggest a causal association between death and vaccination.
Vaccinating children aged five years and older can protect the entire family, keep them in school and help slow the spread of Covid-19 in the community.
In conclusion, the scientific community, pharmaceutical and biotech companies supported by governments and philanthropists have delivered a modern scientific miracle – not one but multiple vaccines against Covid-19 in record time that have helped save millions of lives and returned the global and local economy to some semblance of normality.
However, the history of the pandemic and in particular the vaccines will also be remembered for the widespread misinformation and disinformation that are contributing to significant levels of vaccine hesitancy all around the world.
Sadly, in Malaysia some of the biggest perpetrators of this misinformation and disinformation, using pseudo-scientific analysis, are a few members of the medical fraternity. We urge the public to continue to seek information on Covid-19 vaccines and treatment from reputable sites and organisations and not to fall for misinformation from unreliable sources.
PROFESSOR ADEEBA KAMARULZAMAN, Universiti Malaya and TAN SRI JEMILAH MAHMOOD, Sunway University