KUALA LUMPUR: With new and reportedly more contagious variants of Covid-19 emerging around the globe, at least 80 per cent of Malaysia's population will have to be vaccinated to achieve herd immunity against the virus.
Epidemiologist Professor Datuk Dr Awang Bulgiba Awang Mahmud said this when commenting on a Health Ministry survey, where 67 per cent of the respondents indicated their willingness to be inoculated.
This was more than the government's goal of immunising between 60 and 70 per cent (20 million to 23 million) of the population, which was said to be sufficient to minimise the spread of Covid-19 and protect even those who had not been vaccinated.
Awang Bulgiba said for herd immunity to happen, a 67 per cent coverage might not be enough, particularly with the presence of new variants, like the B.1.1.7 from the United Kingdom or the 501Y.V2 from South Africa.
Awang Bulgiba, who is the Science, Technology and Innovation Ministry's Independent Covid-19 Vaccination Advisory Committee head, said these variants had been reported to be spreading to other countries and causing a higher R value (reproduction number).
"The higher the R value, the higher the vaccination coverage that will be required to achieve herd immunity.
"I estimate that for herd immunity to happen in Malaysia, the proportion of the population that needs to be vaccinated may be as high as 80 per cent to 90 per cent, as the R value for some of the clusters in the third wave appears to be rather high.
"A 70 per cent coverage will not be adequate. We have computed direct protection rates based on 70 per cent and 95 per cent efficacy and concluded that a 70 per cent coverage is way too low," he told the New Sunday Times.
The Health Ministry's survey was conducted online between Dec 21 and 28, involving 212,006 respondents. Of the total, 17 per cent said they were unsure of the vaccines' efficacy, while the remaining 16 per cent said they would reject the vaccine.
Awang Bulgiba said the issue with the 80 per cent target was that children under 16 would need to be included, but none of the approved vaccines had been tested for children under 16.
"Assuming that 80 per cent is our target, we cannot afford to have large numbers of people refusing vaccination. So the problem that could arise is that the 16 per cent who reject the vaccine could influence fence-sitters or others to reject the vaccine.
"Then the number of those against the vaccine could increase and this will cause problems for the country to achieve herd immunity."
To address this, he said, the authorities needed a clear communication strategy to convince the public of the vaccine's efficacy through objective facts, backed by scientific data.
This, he said, needed to be a continuous effort as it was not an easy job to convince doubters or anti-vaxxers.
"However, efforts and measures to achieve this have to
be done as we do not have many options if we want to put this pandemic behind us and see a semblance of normalcy return.
"We are not worried about the 33 per cent who are unsure of the vaccine or unwilling to be vaccinated, but the bigger concern is the effect of unclear communication on the 67 per cent who have expressed their willingness to be vaccinated.
"If the 67 per cent drops, it will defeat the goal of achieving herd immunity and the return to normalcy will be delayed."
Prime Minister Tan Sri Muhyiddin Yassin had said the government would launch an advocacy campaign to fight vaccine misinformation as the country prepared to roll out its Covid-19 immunisation drive.
To help with the government's communication strategy, Awang Bulgiba said behavioural scientists and communication specialists could be roped in.
The messages need to be professionally crafted in clear language, he said, and delivered in a consistent manner to make sure people understand the rationale behind the vaccination.
"I am optimistic that people are generally reasonable. As such, we need to communicate the messages in a non-condescending manner to appeal to their common sense. People are usually convinced if they see genuine honesty and concern from the authorities for their health, safety and wellbeing.
"I believe that vaccination is one of the best weapons we have to win this seemingly never-ending pandemic war."
Awang Bulgiba said it could take almost two years to achieve a herd immunity of 80 per cent in Malaysia once the vaccination programme began.
"The first thing the government needs to do is identify people who are eligible to be vaccinated.
"There are several databases that can be used, although they are not necessarily comprehensive and may not contain updated addresses," he said, referring to Non-Communicable Diseases registries, Teleprimary Care — Oral Health Clinical Information System, Malaysian Health Data Warehouse and health centre records.
He said the government needed to reach out to the candidates and devise a system for them to register for vaccination, schedule appointments at locations closest to them, and pick dates and times most convenient to healthcare staff and vaccines.
"This can be done through mobile applications, postal appointments, TV and radio. It is a massive logistical exercise and tabletop and drills need to be carried out to simulate and prepare for all eventualities.
"By my team's estimate, we would require between 15 and 20 months of continuous efforts at 500 to 1,000 vaccination centres to vaccinate enough people to ensure some degree of herd immunity."
He added that consideration should be given to certain segments of professions and society.
"These include teachers, who are necessary to protect children, institutionalised populations, such as psychiatric hospital patients, drug rehabilitation centres, nursing homes and prison inmates, as well as migrants and the homeless."