MALAYSIA needs to administer around 360,000 Covid-19 vaccine booster jabs per day to cover 80 per cent of the population by the end of February to ensure optimal protection against the disease.
Experts said this would also allow vaccine recipients, particularly the elderly and those initially administered with the Sinovac vaccine, to keep their "fully vaccinated" status.
They also raised concern about prevalent vaccine hesitancy in the country, which remains a challenge across the population amid the threat of the Omicron variant which could see stringent restrictions being re-imposed.
They called on the Health Ministry, Immigration Department and travel agencies handling umrah and haj pilgrimages to explain how unvaccinated individuals were allowed to travel to Saudi Arabia, contributing to a growing number of imported Omicron infections.
Epidemiologist Professor Datuk Dr Awang Bulgiba Awang Mahmud of Universiti Malaya said the government had to increase its daily vaccine administration capacity to ramp up booster coverage.
Malaysia, he said, needed to administer 26 million booster jabs, and only seven million booster jabs had been administered so far.
"Therefore, there are 19 million boosters jabs to go. At the current rate of around 250,000 jabs per day, the country will require 76 vaccination days, taking us almost to the end of March 2022.
"The newer Covid-19 vaccination centres (and the reopening of mega centres in the Klang Valley) can help meet the target, but an additional capacity of 100,000 booster jabs per day needs to be added to the current 250,000," he told the New Straits Times.
Dr Awang Bulgiba, who is the Science, Technology and Innovation Ministry's Covid-19 Epidemiological Analysis and Strategies Task Force chairman, cited a few reasons behind booster hesitancy.
He said people could have had adverse effects from the primary jabs and did not want to go through a similar experience.
With daily cases and deaths having declined significantly since last year's peak, he said people might not feel the urgent need for booster jabs.
He said individuals who received Sinovac or AstraZeneca as primary jabs might also have cold feet over
the possibility of getting a heterologous ("mix and match") vaccine using Pfizer-BioNTech's Comirnaty instead of a homologous booster, which added to their uncertainty and hesitancy.
"There is also the wait-and-see attitude, as many people are probably just waiting for the Health Ministry to give out appointments via MySejahtera.
"The elderly, especially retirees, have probably less to lose through revocation of their fully vaccinated status, compared with younger working vaccinees, who may depend on their fully vaccinated status to remain in employment or to enter premises. So, the motivation among the elderly to get booster jabs is probably lower compared with younger people," he said.
Health Minister Khairy Jamaluddin on Thursday said more than half of senior citizens in five states, namely Pahang, Terengganu, Perlis, Kelantan and Sabah, had yet to receive Covid-19 booster shots.
On Dec 16, Khairy said everybody aged 60 and above, and Sinovac recipients must get their booster doses by February to keep their "fully vaccinated" status.
Dr Awang Bulgiba said boosters were probably the best and most practical preventive action in the fight against Covid-19,
particularly in mitigating a potential Omicron-fuelled wave.
He said the government should improve its crisis communications and roll out the booster vaccination campaign with the help of medical experts, behavioural scientists and communication specialists, to allay public fears.
"Everyone who has been vaccinated (Sinovac or AstraZeneca vaccines) but are now being offered Pfizer boosters have overcome whatever initial fear they may have had about the Covid-19 vaccine.
"Their current uncertainty is about the heterologous approach, not about whether they should be vaccinated.
"Younger vaccinees are probably convinced through social media, but the older vaccinees need to be reached via other means — perhaps through religious sermons, TV, print media and their local health clinics."
On a related matter, he said since Saudi Arabia only allowed the fully immunised to enter, umrah agencies and the Immigration Department must explain how unvaccinated pilgrims were allowed to fly out.
Malaysian Mental Health Association president Datuk Dr Andrew Mohanraj said other reasons for booster hesitancy could be side effects from a previous vaccination, bad experience while getting the vaccination and misinformation on booster doses on social media.
The consultant psychiatrist shared an incident involving a 75-year-old retired lawyer who was shocked to find large crowds at a vaccine centre, but did not appear to cater to the needs of an elderly person like her.
"She drove around the centre and went back home, refusing to take her booster dose and decided to leave it to fate," he said.
Many elderly are also overwhelmed by updates on the vaccine guidelines, the potency of ever-evolving strains of the virus and other logistical challenges, leading them to decide to leave things as they are and making them less enthusiastic to get booster shots.
This category of people might be unfazed with the possibility of losing their vaccination status, he said
Dr Mohanraj said the strategy to win over the elderly should include impressing on their contribution to the community in reducing the risk of infection.
"It must be done through local community, religious leaders and family physicians or medical staff at Klinik Kesihatan. Public health communications must be tailored for this group.
"Additionally, logistical barriers can demoralise and incapacitate the elderly, making them feel undervalued, resulting in them being dismissive of the
system and to be resigned to their fate.
"The core of the vaccination issue lies on building trust, raising awareness as well as putting
forward an argument that vaccination is the surest route to
the eventual return to a life for every generation."
Molecular virologist Dr Vinod Balasubramaniam of the Jeffrey Cheah School of Medicine and Health Sciences at Monash University Malaysia said "vaccine fatigue" especially among the elderly could contribute to the low booster rates.
Many elderly people, he said, might think that primary doses were sufficient to give protection and, therefore, were less concerned with the subsequent dose, even if it meant losing their vaccinated status.
"Many are refusing to go through the ordeal of getting the vaccine again, from standing in long queues to having severe side effects, which can be daunting for people in their age group. At the end of the day, it begs the question — is it worth it?"
Vinod was also puzzled how unvaccinated individuals managed to go for the umrah.
"This shows that despite the SOP and rules, we clearly lack enforcement. Something is fundamentally wrong somewhere. How did they get the clearance at the border and from airlines?
"Omicron is already here, and missteps like this are a recipe for disaster."
Public health expert and epidemiologist Datuk Dr Zainal Ariffin Omar urged the Health Ministry to investigate the matter and share the findings with the public.