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Malaysia’s recent vote of no confidence in the Jab is the choice to exclude AstraZeneca from its main inoculation drive Covid-19, complicating the already lenient roll out of the vaccines across Asia.

China beat the United States on Thursday (29 April) in terms of total doses, but Thailand, the Philippines and India are scrambling for the doses available, while Hong Kong has had a lackluster vaccination program open for all over 16 years.On Wednesday, Malaysia’s coordinating minister for vaccines, Khairy Jamaluddin, told the UK-Swedish vaccine received last week that the 268,000 doses would only be provided in a separate opt-in, given public hesitancy about the perceived risk of blood clots – a side effect on a small percentage of vaccine users.

“We do not want to waste this vaccine which is effective and safe, but at the same time, we understand that in this period, perhaps science and facts cannot overcome people’s fears and fake news that have gone viral,” said Khairy.

Malaysia Major Inoculation
Image Source: The Straits Times

Although Malaysian people are still able to choose a jab at a selected vaccination center in the State of Selangor in the state capital Kuala Lumpur, the government’s only vaccinations will be Chinese Sinovack Biotech vaccine and Pfizer BioNTech shot.

Malina Osman, a Universiti Putra Malaysia epidemiologist, has believed that officials have taken a “intelligent step” to alleviate public concerns and encourage vaccine reception.
“There are many individuals who are now eagerly waiting for the Covid vaccine but need to wait due to the scheduling process of the programme,” Malina said.

“Hopefully with the up-to-date information on the safety and effectiveness of the vaccine, more people will be empowered to decide best for their health quality and come forward voluntarily to get the vaccine.”

Azrul Mohd Khalib, CEO of the Centre, Health and Social Policy, said that it was “like what could happen if a private option were offered” that it would have the potential to speed up the vaccination uptake.Free vaccinations are currently eligible to Malaysians over 18 years of age. In cases where its infection figure reached almost 400,000, only approximately 4% of the 32 million population has received at least one dosage as the country faces a spike.

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Yanzhong Huang, a senior global health fellow of the Foreign Relations Council, however, expressed his concern about the widespread harm to vaccine confidence caused by the decision by Kuala Lumpur.
“The government decision might be responding to public concerns about safety only, but if the decision is not based on the assessment of actual risks, the decision risks vindicating the fear and worries over the vaccine, further discouraging its use in Malaysia and other Asian countries,” Huang said.

“This, in turn, could undermine the global vaccination efforts, at a time when access to vaccines remains a major concern in the lower- and middle-income countries.”

Under the Covax facility (the global initiative for fair access to the vaccines), Malaysia has secured a total of 12.8 million doses from AstraZeneca. Khairy, the Minister of Science, said the first 600,000 doses of vaccines were to be received by June in March. The supply of vaccine in poorer parts of the region is still a major concern, with countries including the Philippines and India likely looking to share excess AstraZeneca doses in other countries, such as the USA.

South-east Asia, including Indonesia, the Philippines and Thailand, is a major part of the vaccine drive of Sinovac. Its effectiveness has become poorer than other countries and Chinese vaccines have not been used by any developed country, although the World Health Organization is considering approval of these vaccines, along with the Sinopharm jab.

Malaysian Minister of Health Dr Adham Baba said on Thurday that the authorities are going to use and do not send them to any other country all the AstraZeneca dosages.
“We know that there is a vaccine hesitancy due to the negative reports about it and these hesitancies exist because of the thrombocytopenia and low platelet cases, but these reports are very rare,” he said.

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Adham also said the country planned to roll out 3.5 million doses of China’s single-dose CanSino vaccine, which has a reported 68.83 per cent efficacy, once approval has been granted by the National Pharmaceutical Regulatory Agency.

“We have agreed on our binding terms with CanSino and we have begun making our orders,” he said.

Malaysia Major Inoculation
Image Source: South China Morning Post

Fuelling vaccine hesitancy

The Malaysian decision follows Hong Kong’s move to cancel the order for 7.5 million AstraZeneca doses at an earlier date this month and the introduction of European and Asia Pacific countries, including Australia, South Korea and the Philippines, of age-linked advisories or restrictions on young people. Some countries like Japan still have to accept the jab.

Last week US health officials lifted an 11-day break from vaccine Johnson & Johnson following similar reports of extremely unusual blood coagulation.Some experts have complained that the authorities have reacted with hypercaution and said it could delay the inoculation and inadvertently delay the hesitation of the vaccine.

AstraZeneca and J&J jabs are cheaper and easier to distribute, more important to vaccinate developing worlds, than their MRNA-based Pfizer/BioNTech opponents and form the bulk of the Covax supply.According to polling reports, public trust in vaccines for AstraZeneca and J&J has fallen sharply in Europe and the US in recent weeks, although it is not clear how much government policy is driving the decrease relative to the reported side effects themselves.

The average seven day intake for all vaccines in the US has fallen by more than 20%, not only for J&J, since the pause of April 13.

According to data from the British Medicines and Healthcare Products Regulatory Agency (AMA), the reported risk of blood coagulation after taking British-Swedish jab is about four in one million and the risk of death is about one in one million.Recent European Medicines Agency analyzes have increased the risk of blood clot to around 10 million in 1 million, albeit extremely small.

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Malaysia Major Inoculation
Image Source: South China Morning Post

In comparison, according to the United States Centers for Disease Control and Prevention, the chance of lightning is about one in 500,000 in a particular year. Massayuki Miyasaka (Emeritus Professor of Immunology at the University of Osaka, Japan) compared the risk of AstraZeneca with the probability of an air accident, even when he said that the authorities may be justified “to provide it for elderly people selectively, particularly in a country such as Japan where there is not a high incidence of SARS-CoV-2”

The director general, Jerome Kim, of the Seoul International Vaccine Institute, said countries had to consider carefully balancing vaccine risk minutes against the much larger pandemic threat.

“I hope that Malaysia, which now has 84 infections per million population versus the UK with 35 infections per million, is looking at that kind of risk-benefit assessment?”

In spite of the efforts of Beijing for the promotion of its soft power through vaccine diplomacy, Chong Ja Ian, associate professor of international relations at Singapore’s State University, said there were no winners from AstraZeneca’s image problems.

“It is one less source of vaccine that can be used to protect the wider population. Should suspicion grow around the safety of vaccines due to the withdrawal of the AstraZeneca vaccine, they will add to existing concerns about the low efficacy rates of PRC-produced vaccines and compound vaccine hesitancy,” said Chong.

“The end result will be less people taking vaccines at a rate that can control the pandemic more quickly. More people could lose their livelihoods and even die.”

Source: South China Morning Post

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