Like most of you, I have been following the Covid-19 pandemic at close range.
I honestly hope it has been a journey based on good science and loads of cool, calming thoughts, common sense and compassion.
In the wake of the approval of the two vaccines for use in several countries, allow me to share some of my early thoughts namely with respect to its utilisation in our nation.
1. Transparency and accountability of the Covid-19 vaccine choices and advance payments is of pivotal urgency and importance.
2. Priority must be given to the WHO, GAVI and CEPI, COVAX Initiative. This is a global effort to make the vaccine available to all nations irrespective of GDP status. Their tag line is “No one is safe until everyone is safe”.
3. COVAX has 18 vaccine candidates in its portfolio. As 1 in 5 candidates are expected to falter in clinical trials, this is the best option to protect the world citizens’ and our rakyats’ interests.
4. COVAX also offers the best price at approximately USD$10 per dose (even more affordable for the Low and Middle Income Countries LMIC i.e tier pricing).
5. MOF Inc. should make direct dealings with COVAX and vaccine manufacturers, removing entirely the Middle-Man.
6. This will ensure Malaysia gets the best vaccine price per dose without the insane profits accrued by the Middle-Man.
7. For a 20 per cent population coverage (6.4 million people) and initial vaccine purchase of 12.8 million doses (2 doses per person required), the Middle-Men by hiking the price a mere RM10 will amass a profit of RM128 million overnight. This is not tenable when our national coffers are severely stressed by the pandemic.
8. Malaysia should be placing an initial 20 per cent order in the COVAX instead of the present 10 per cent.
9. And to avoid putting all our eggs in one COVAX basket, direct dealings with vaccine manufacturers is proactive planning but it must be transparent and in our national interest, not another rent-seeking ploy.
10. Several Chinese vaccine manufacturers have been courting interest with Malaysian companies to sign vaccine related MOUs with a view to sell vaccines or conduct vaccine research.
11. The MOH’s related agencies, namely the National Pharmaceutical Regulatory Agency, needs to step up its act and undertake several actions.
12. Many countries have undertaken Emergency Use Authorization (EUA) and licensed the use of the Pfizer-BioNTech and Moderna vaccines.
13. It is high time for the NPRA to act likewise. There is now sufficient published data in the scientific journals and to the FDA (US) and the MHRA (UK) for our local approval and licensing purposes.
14. China and Russia have approved for early and limited use of their vaccines. Their government approvals were initiated whilst the vaccines were still in Phase 2 trials. This makes the scientific community a bit wary and concerned as to their safety and efficacy.
15. The MOH must therefore be cautious of the influx of Chinese Covid-19 vaccine manufacturers in Malaysia and insist on their research data in scientific journals.
16. Peer review must be through scientific publications and not through press releases as has happened with the Covid-19 vaccines.
17. The government has announced that it will provide the vaccine free to the selected cohort of high-risk persons. I am of the opinion that the uptake should be voluntary ie not made mandatory.
18. The MOH needs to be proactive and kick start its awareness campaigns to inform the lay public of the various facets of the Covid-19 vaccine, the why, who, when, where, safety, efficacy, permissibility and address the issues of vaccine hesitancy and the deluge of anti-vaccine and fake news on social media.
19. Non-high risk and non-priority persons may wish to be vaccinated in the private sector. It is of national interest and utmost priority that the government cap the price of the vaccine so as to be affordable in the private sector.
20. It is of national interest because the nation needs to achieve a vaccine coverage in excess of 70 per cent to obtain herd immunity.
21. Much too often, the government through its agencies the National Security Council (NSC) and the MOH has been reactive instead of proactive in its efforts to address issues related to PPEs, PCR, RTK-Ag and masks etc.
22. Masks used to cost up to RM5-10 per piece until the belated NSC intervention to cap at 75 sen per piece. The vaccine price in private should be addressed promptly and made affordable as part of our national campaign to achieve community protection.
23. It must be emphasised to the rakyat, that the vaccine is only one of our multi-prong strategy to exit the pandemic. Masking, physical distancing, personal hygiene, the 3Ws and 3Cs and other SOPs needs to be followed whilst ensuring a sizeable proportion of our population has been immunised with the vaccine towards achieving herd protection.
24. We must all continue to remain vigilant with our SOPs to ride the current 3rd wave and prevent the resurgence of another.
25. Meanwhile, post marketing surveillance will closely track the vaccine through pharmacovigilance. Post licensure monitoring will give invaluable information about the vaccine’s long-term safety and effectiveness from real world experience.
26. Both vaccine manufacturers have indicated that they will be following up their vaccine trial recipients for up to at least 30 months, as part of the trial design.
27. We pray and hope that this breakthrough and unprecedented gift of Covid-19 vaccines will be optimally utilised and that the COVAX initiative to make it accessible to every country and everyone will be realized in out joint efforts to make this world a safer place from the coronavirus and prepare us better for any other pandemic threats.
By : Dr Musa Mohd Nordin – MALAY MAIL