KUALA LUMPUR: Malaysia may not be able to achieve the target of vaccinating 80 per cent of the population by next February if registration for the National Covid-19 Immunisation Programme (NIP) continues to move at a snail's pace.
Medical experts urged the government to devise strategies to meet the vaccination goal, failing which the country may not be able to achieve herd immunity on time.
This would result in the prolonging of the pandemic, which would take a huge toll on the people's health and wellbeing, as well as the country's economy.
Epidemiologist Professor Datuk Dr Awang Bulgiba Awang Mahmud said the people's lack of trust in the authorities was one of the main reasons for the slow registration rate.
He said this was due to past instances where messages were not communicated consistently, as well as claims of double standards leading to public cynicism.
"The public is not convinced that vaccination is necessary because new infections are supposedly declining and death rates are low. The message about vaccination has not been convincing enough for them to register for it," he told the New Straits Times.
Dr Awang Bulgiba, who is the Science, Technology and Innovation Ministry's Independent Covid-19 Vaccination Advisory Committee head, said two issues needed to be addressed to improve the registration rate — willingness of the public to be vaccinated and willingness of the government to change methods in disseminating information.
On improving the public's willingness to be vaccinated, he said the government could make vaccination compulsory through direct or indirect ways, such as by mandating vaccine passports or certificates for entry into certain premises in services or travel.
However, he said, this would likely result in the hardening of attitudes among anti-vaxxers and there would be a backlash.
Secondly, he said, the government could change the way vaccination was being discussed.
"The government needs to convince people through clear, objective explanations backed by credible scientific experts. I don't think we've done enough in this respect.
"I would seek the advice of the best behavioural scientists and communication specialists in the country to make this happen. The messages need to be professionally crafted, in clear language and be delivered continuously to make sure people understand the rationale behind vaccination."
As for the government's willingness to change its methods in disseminating information, he said the Independent Covid-19 Vaccination Advisory Committee had reiterated that Malaysia could not depend on passive methods and needed to actively reach out to people to get them to register for vaccination.
"Sarawak has made a good start by using district offices to send invitation letters to people to register via their village heads. This should be emulated in other parts of the country where MySejahtera registrations have been slow.
"Non-governmental organisations, influencers and community leaders can canvass Malaysians and migrants to register for vaccination. Continuous engagement with the public needs to be done to convince people who show vaccine hesitancy to agree to register.
"A continuous communication strategy needs to be in place until the end of the vaccination programme."
Dr Awang Bulgiba said the government should identify people who were considered high risk, like people with comorbidities, and suggesting sending invitations to registered individuals.
He said Independent Covid-19 Vaccination Advisory Committee had suggested that some groups that merit special consideration be moved up to Phase Two of the vaccination programme.
"They include teachers (as we are not vaccinating children), psychiatric and nursing institution populations, prison wardens, prison inmates, drug rehab centre inmates and the socially vulnerable, like the homeless."
He said in terms of per capita engagement, the United Kingdom and the United States stood out as countries with large populations that had done well, with Singapore leading in Southeast Asia.
Manipal University College Malaysia's Professor of Community and Occupational Medicine Dr G. Jayakumar said it was a growing concern that the vaccination uptake did not achieve the expected rates.
"We need to embark on far-reaching messaging campaigns in various languages.
"The government needs to empower various health organisations, community-based NGOs and religious bodies in providing the right messages."
He said recommendations from trusted authorities were essential in an environment rife with misinformation.
"Studies have shown that the confidence of physicians, medical students and public health officials can also be instrumental in allaying people's fear.
"People firmly opposed to the Covid-19 vaccine may be relatively few, but they wield huge influence, particularly on social media and especially over fence sitters."
He said medical students and allied health students who were in constant contact with patients and others parties like police officers, teachers, security guards and garbage collectors, should also be included in the second phase due to the nature of their work.
He said to boost registration figures, places of worship, villagers and malls could be roped in.
He urged the government to dispel vaccine misinformation by differentiating between the under-vaccinated, anti-vaxxers and vaccine-hesitant groups.
Universiti Putra Malaysia epidemiologist and biostatistician Associate Professor Dr Malina Osman said the government's decision to include economic frontliners and other groups under the second phase would put the country back on track to achieve its target.
"Despite the low registration rate, the available vaccines need to be used within the given period (before their expiration date). We will be able to use the available vaccines and avoid wastage when we anticipate the new groups.
"The suggestion to involve state governments, with the participation of all industries, organisations and departments, to facilitate the vaccination programme in their respective settings is welcome news as this will enhance involvement and allow the process to be more coordinated."
The NIP aims to inoculate 9.4 million people from next month to August. This phase includes remaining healthcare workers, those in essential services, defence and security personnel, senior citizens and high-risk groups.
Coordinating Minister for the NIP Khairy Jamaluddin had on Thursday said registration for the second phase did not achieve the target yet.
Dr Malina urged the public and private sectors to commit to the NIP by forming committees to expedite the registration of their employees and family members.
She said this should extend to the education sector, like universities, educational institutes and non-governmental agencies.
She said "social" frontliners, including those who work in business settings like markets and supermarkets, media personnel, journalists, photographers, public transportation employees, school support staff, religious leaders and NGOs actively involved in community work, should be included in Phase Two of the NIP.