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KUALA LUMPUR: With the results of the human trials of at least one of the Covid-19 vaccine applicants to be released this month, public health experts recommend caution and adherence to current precautionary measures for the foreseeable future.
Results of human trials conducted by Pfizer are expected this month, while many other vaccine manufacturers are waiting to know if their product works by the end of the year.
According to the World Health Organization (WHO), there are more than 150 vaccines in various stages of development.
However, the WHO representative in Malaysia, Singapore and Brunei, Dr. Jacqueline Lo Ying-Ru, reminded the public that they should not expect a vaccine until mid-2021 at the earliest.
“We hope that sometime next year, we will have a Covid-19 vaccine available, a safe and effective vaccine.
“That said, the vaccine alone will not be the solution. The vaccine has to be available in the quantities we need, ”he told Bernama.
He said that any vaccine approved by the WHO under the Covax facility, an initiative by 172 countries to acquire and provide an effective vaccine to at least 20% of the member population, must go through other steps before it can reach the masses.
Long road ahead
Eleven vaccines, three of them included in the Covax facility, are undergoing phase three trials, in which thousands are vaccinated in many countries while some receive a placebo.
Malaysia announced on September 19 that it would join Covax, and Science, Technology and Innovation Minister Khairy Jamaluddin said the country would negotiate bilaterally with other countries to procure vaccines.
However, experts warn that the road from Phase Three to widespread vaccination is long.
For one thing, only time can guarantee the safety and efficacy of the vaccine. Subjects in trials have to spend months to see if they can become infected with the coronavirus and, if so, how they respond to it.
Researchers also monitor subjects for adverse side effects. Then they compare the results with those who received a placebo to see if there are any statistically significant differences in the data.
According to the US Centers for Disease Control, once a vaccine is deemed effective and safe by experts, it moves on to the manufacturing and quality control phases.
The entire process usually takes between 10-15 years, but for Covid-19, this has been compressed to about two years. Approval, however, does not mean availability.
“It is important that the vaccine is implemented in every country in the world, not just some countries,” Lo said.
He said that even with the acceleration of the vaccine, there were certain steps that should not be eliminated, adding that the approval bodies of the respective countries will have to test and approve it, in addition to producing enough doses.
To be truly effective, the Covid-19 vaccine must have a 50% success rate, either preventing infection or reducing the severity of the disease. It should also have a coverage of 60% to 70% among the population.
The WHO has said that the first groups to be vaccinated should be healthcare workers and high-risk groups such as the elderly and people with health problems. Others will have to wait.
All this talk of caution and delays in distribution has not dampened the Malaysian public’s appetite for a Covid-19 vaccine.
In an IPSOS survey for the World Economic Forum, 85% of Malaysians surveyed said they would take a Covid-19 vaccine if one was available. About half think a vaccine will be available by the end of the year.
Of the 15% who refused to get vaccinated, nearly half cited fear of side effects as a reason.
Lessons from Dengvaxia
Public health experts say the 15% fears may be valid. With the production and approval process speeding up, there are concerns that no amount of safety testing will be enough and any adverse effects would only embolden the small but noisy movement against vaccination in Malaysia.
“We have to try to be cautious and at the same time, we don’t give these anti-vaccines a bullet,” said the president of the Malaysian Public Health Physicians Association, Dr. Zainal Ariffin Omar.
He said no one wanted a repeat of the Dengvaxia incident, where it was discovered that the dengue vaccine in the Philippines in 2017 possibly caused the deaths of hundreds of school children.
Its manufacturer, Sanofi Pasteur, discovered that the vaccine could exacerbate the effects of a dengue infection in people who had never had the disease, but only after the Philippine government had vaccinated millions of school children.
Dengvaxia has been blamed for losing confidence in vaccines in the Philippines, which later contributed to a measles outbreak last year.
The vaccine, which had been in the works for more than 20 years before being approved for use, is now recommended only for people who have had dengue before.
However, the former president of the Malaysian Medical Association, Dr. N Ganabaskaran, believes the trend would go the other way, saying that Covid-19 has increased support for vaccines.
“The people we are talking to know that the vaccine is very important,” he said.
Old is new again
So what should people do when a vaccine is available but cannot or will not receive it? Rely on old proven methods to prevent disease, such as physical distancing, hand washing and restriction of movement, say public health experts.
Zainal said the vaccine should not be considered a panacea, but rather a complementary way to fight the disease.
“Keep doing what we’ve been doing until we’re sure about the vaccine,” he said.
He agreed. “We’ve seen what works,” he said, adding that self-discipline also works against other diseases.
“Always is good. It prevents many things. Transmission not only of Covid-19, but also of influenza and other infections that are transmitted through respiratory droplets, ”he said.
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