KUALA LUMPUR: Mandatory vaccination is the way forward to manage Covid-19 as Malaysia enters the endemic phase, experts said.
They deemed it a crucial and appropriate approach to curb the spread of the coronavirus, adding that unvaccinated groups would only hamper the country's return to normal.
They also said the private sector could play a major role by insisting that only those vaccinated be allowed entry.
Malaysian Public Health Physicians Association president Datuk Dr Zainal Ariffin Omar said the government's current approach of according greater leeway to the vaccinated had created an unnecessary "discrimination perception".
It had fuelled uneasiness and hatred between the anti- and pro-vaxxers, he said.
"Tightening restrictions on the unvaccinated and relaxing restrictions on the vaccinated risks widening the much-debated 'privilege gap' of the Covid-19 vaccine rollout in the future.
"This, however, should not be viewed as privileges for the vaccinated, but it is a matter of fundamental rights.
"A vaccine mandate also means that the government is confident in the vaccination and assumes total responsibility for any negative consequences to individuals and the population at large.
"Moving forward, mandatory Covid-19 vaccination (for all eligible population) could be imposed instead of leaving it as voluntary," he told the New Straits Times.
Dr Zainal noted that there was a strong case for mandating Covid-19 vaccination with one of the key points being that the virus posed a grave threat to public health locally and globally.
Besides, he said, Covid-19 vaccines had been proven to be safe and effective, and mandatory vaccination also had a superior cost-and-benefit profile compared with other alternatives.
Additionally, he said, Malaysia had provided enough education, coercion and universal access to all eligible population.
"Making Covid-19 vaccination compulsory is quite controversial and complicated. The government has to decide whether to continue with voluntary or opt for mandatory.
"What is the government's final objective of herd immunity? Is it to achieve a higher percentage of vaccination coverage or total protection of the population?
"If it's total protection to reduce the country's social and financial burden of Covid-19 patients and prevent further epidemics, we should opt for a vaccine mandate. And the rakyat is ready for that."
Molecular virologist Dr Vinod Balasubramaniam, from the Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, said Covid-19 vaccine mandates should be part of Malaysia's weapons' arsenal in fighting the pandemic and "infodemic" from anti-vaxxers.
"This is the 'pandemic of the unvaccinated'. For each person refusing vaccination, the chance of him becoming a 'reservoir' for the virus to replicate and mutate is higher and this will give rise to newer variants.
"Malaysia's biggest threat going forward is the anti-vaxxers constantly spreading misinformation and lies on vaccines.
"While vaccination rates in Malaysia have been resounding, we are not there yet and we cannot let our guard down.
"The road to compulsory vaccination is a long and winding one in legal terms, and an immense challenge.
"But the private sector doesn't have those shackles. Concert organisers, business owners, restaurants, hotels and amusement parks, for instance, may insist that only those vaccinated be allowed entry or have the vaccination pass."
Dr Vinod said the dispute of whether the government could discriminate against the unvaccinated was an integral part of the anti-vaccination movement, which was getting fiercer.
"For the vaccinated, it's a matter of basic rights, not privileges. As of the moment, when everyone has access to a vaccination shot, the government can impose measures on those who refuse to be vaccinated in line with the requirements of society.
"Of course, in doing so, we must grant exceptions to minors who cannot (yet) be vaccinated and those who can't due to medical exemption."
Dr Vinod said those who denounced vaccination as arbitrary seem to forget and ignore the seriousness of the pandemic — the overburdened hospitals, the collapse of healthcare structures, the detrimental effects on the younger generation, which some were already calling the "lost generation", and the challenging social and economic upheavals.
"The factors make the case for ethical mandatory vaccination. Politicians occasionally distinguish between this ethical requirement and a legal requirement to vaccinate, or to allow others to make that distinction.
"If vaccinated people are granted more freedom in their social activities, it will be possible to justify this on ethical grounds."
He also said immunity conferred from natural infection and vaccines, patterns of social contact and virus transmissibility would play a role in what Covid-19 would look like as it continued to circulate in the months and years ahead.
"The expectation that Covid-19 will be endemic essentially means that the pandemic will not end with the virus disappearing.
"Instead, the optimistic view is that enough people will gain immune protection from vaccination and from natural infection, such that there will be less transmission and fewer cases of hospitalisation and death, even as the virus continues to circulate."
Covid-19 vaccine mandates have been implemented in several countries, including the United States' "no jab, no job" policy. It is also prevalent in many economic sectors in Europe, while Australia has made vaccination mandatory for healthcare and aged care workers and employees of quarantine hotels.
In Canada, unvaccinated federal public servants are put on indefinite unpaid leave, while in Indonesia, where the jabs are mandatory, fines of up to five million rupiah will be imposed for refusal to be vaccinated and social aid will not be provided.