Poser over Pfizer vaccine, MP raises questions on distribution, storage and patient-compliance

Dr Kelvin Yii

KUCHING, Dec 3: Following the approved (UK) Pfizer’s Covid-19 vaccine which the Malaysian government has signed a preliminary purchase agreement, a Sarawakian MP is raising questions on its availability, delivery, storage and administration especially to rural folks of Sarawak and Sabah.

As Malaysian government has signed to buy 12.8 million doses of the vaccine, Bandar Kuching MP Dr Kelvin Yii asked for the government’s transparency on its plans in terms of logistics, distribution infrastructures, equity, and even proper education to prevent misinformation, confusion, and hesitancy.

“First and foremost, we must not be overly carried away by the announcement and let our guards down as a vaccine isn’t a silver bullet to the pandemic, especially since the announcement also states that the doses will be spread out throughout next year, with Pfizer only delivering one million doses (for 500,000 people) to Malaysia by the first quarter of 2021.

“In total, the deal involves 12.8 million doses of Pfizer’s mRNA vaccine, a two-dose regimen, will cover about 6.4 million Malaysians which is about 20 per cent of the population,” he said.

On top of that, he said an additional 10 per cent of the population will be covered through the agreement Malaysia signed with the COVAX Facility, although they have yet to indicate whose vaccines in the Covax portfolio that they will be purchasing.

“This means, by the end of 2021, just under a third of Malaysia’s population may be vaccinated against Covid-19, which is still a long way to achieve herd immunity, which requires about 70 per cent of the population to acquire some form of antibodies.

“So this raises the question on how the government intends to fill in the gap to reach that 70 per cent target, how many other companies are they negotiating with, how much is it expected to cost and what is the timeline that we are looking at so that the public are aware and not develop as sense of false security when the vaccine is first distributed in the community,” said Dr Yii.

He said based on the Ministers answers recently, as part of the deal, Pfizer is to handle the shipment and delivery of their vaccine as it requires ultra-cold storage of -70 degrees Celsius. His query however is, does this include delivering it all the way to the targeted user, not just shipping it to one central location in Malaysia or even just the main cities?

This to him, poses problems in Malaysia’s tropical weather especially target groups in the rural areas of Sabah and Sarawak and even in West Malaysia where there may not be proper infrastructures including ultra-cold freezers for such specialised distributions

“While there are ultra-low temperature freezers in universities and research institutes, are they sufficient to cater for a nationwide distribution especially in the rural areas?

“How does the government intend to make sure that no one is left behind when receiving such vaccines regardless of their demographics?” Dr Yii questioned.

He said if there is an issue with improper storage, it could make the vaccine unusable, with analysts projecting that about 5 to 10 per cent of the Pfizer vaccine could be made ineffective “due to inadequate storage conditions”. Some of this waste could go undetected too, leading to people getting ineffective shots and insufficient protection from the coronavirus.

“On top of that, this Pfizer Vaccine is a 2-dose regimen vaccine, taken about2-3 weeks apart. How do we help those especially the elderly and those living in the rural in terms of logistics to make sure they are compliant and return to take the second dosage? How will be the storage of the vaccine be done for the period in between especially in the rural areas?

“We do not want them to take one dosage and not return for the second which may defeat the purpose of the vaccine itself as the user may not develop the required amount of antibody,” said Dr Yii.

Another question, he pointed out was who are the initial intended target for the first batch of the vaccine.

“While it is generally understood that it should be reserved for front liners, but I believe different considerations should be taken into including our epidemiology data on the most affected population including the elderly with pre-existing conditions or high-risk and vulnerable population group since there is where most death occurs,” said Dr Yii. – DayakDaily