Two agreements inked by the government will ensure that millions of Malaysians are vaccinated against the Covid-19 virus.
The agreement with pharmaceutical giant Pfizer, whose vaccine is awaiting the nod from the US authorities on Dec 10, is expected to cover 6.4 million Malaysians, or 20% of the population.
Prime Minister Muhyiddin Yassin, who recently made this announcement, said the vaccine would be administered in two shots, three weeks apart.
Another vaccine, under the Covax global collaboration to fight Covid-19, aims to inoculate 3.2 million Malaysians, or 10% of the population.
Combined, the two vaccines, to arrive on Malaysian shores early next year, will cover 9.6 million Malaysians.
Pfizer’s vaccine has generated more interest. The company has reported about 95% effectiveness when administered in a two-dose regimen.
Once the nod comes from US drug regulator the Food and Drug Administration, or FDA, some 6.4 million doses of the vaccine will be dispatched across America.
It is now clear that America, the country worst affected by Covid-19 with 13 million cases and over 265,000 deaths, is leading the race to find the cure for Covid-19.
As such, how the vaccine is distributed and implemented in America will be keenly watched by other countries, and there will be lessons for Malaysia.
A local public health group recently warned of a major concern about Pfizer’s vaccine.
It would require ultra-cold storage of -70 degrees Celsius, which means the logistical part of distributing the vaccine could be as central and critical as injecting it into the veins of millions of people.
“We expect the most challenging part of the process will be the delivery of the vaccine to rural areas. Due to limitations and pragmatic concerns, will urban areas end up being prioritised over rural areas?” asked Azrul Mohd Khalib, who heads the Galen Centre for Health and Social Policy.
The logistical nightmare was anticipated as early as May by the Trump administration which launched Operation Warp Speed, a public–private initiative to accelerate the manufacturing and distribution of Covid-19 vaccines.
“We expect the most challenging part of the process will be the delivery of the vaccine to rural areas.”
In the US, the plan is to distribute Pfizer vaccines in special containers packed with dry ice, or thermal shippers which can hold up to 5,000 doses.
But the ice must be replenished, and to preserve the integrity of the vaccine, the container cannot be opened more than twice.
Azrul also asked whether the health ministry would acquire such storage containers.
“Are we going to acquire Pfizer’s special ice boxes? Have we allocated for the record-keeping system that will be needed?”
Once out of the shipments, the vaccine can only be stored for five days in a regular fridge.
Those tasked with administering the vaccine will also need special training on how to handle it.
For example, the Pfizer vaccine must be diluted with saline, unlike other common vaccines.
“This isn’t something where you can watch the video and then you are ready to go,” Claire Hannan of the Association of Immunisation Managers, a vaccine interest group in the US, told The Economist recently.
For now, the US is undergoing “dry runs” on how to administer vaccines effectively once they arrive.
Questions are being asked on the anticipated problems and issues surrounding what is perhaps the most keenly awaited vaccine in the world in recent times.
“This isn’t something where you can watch the video and then you are ready to go.”
There is also the question of whether a two-time jab will be enough, or if the Covid-19 vaccine is similar to the flu vaccine which is usually taken annually.
But even more challenging perhaps are the suspicions that the public may have about the potential side effects, especially if the vaccine is seen as a “rush job” in a global race to stop the spread of the virus that has claimed over a million lives and torn apart economies worldwide.
In August, a poll found that one in three Americans, or 35%, did not want to be vaccinated even if the vaccine is free and has the FDA’s approval.
There are also concerns that medical frontliners will not be trained to answer questions from the public that could put to rest their misgivings.
The US is having a hard time battling this, and experts predict close to US$10 billion in campaigns and efforts for vaccination preparation.
Malaysian authorities will need to ask the same questions in the days and weeks to come.
As thousands of health workers prepare to be at the front line of vaccine recipients, authorities may have to roll out similar dry runs and think of solutions for managing the vaccination programme.