Stop the Queue Jumping for Vaccines

Stop immediately the queue jumping for COVID-19 vaccines!

1) There’ve been reports of queue jumping for the national vaccine rollout, and Pfizer vaccines – what do you make of this, and what might be causing it?

When we first launched the vaccine rollout in Feb 2021, there were many non-front-liners and non essential services personnel who were queue jumping. These were mainly VVIPs and families of VVIPS.

I hope we’ve seen the end of this

The case of the 20 year old queue jumping and received the Pfizer vaccine is I hope an isolated case.

This incident must be investigated and persons caught facilitating this immoral practice must be dealt with sternly to make it clear to all staff in the vaccine program that we are just, fair and equitable in our administration of the program.

The double standards that we still see in our treatment of politicians and VVIPs who flaunt the SOPs does not have any room in our health professional work culture and ethics.

2) What are the repercussions of queue jumping?

By queue jumping, you deny the high-risk groups in Phase 2 from getting the vaccine.

These are your parents and grandparents, your uncles and aunties who have co-morbidities e.g. diabetes, heart disease, those on dialysis etc, the elderly in the nursing homes and the OKUs – the physically and mentally challenged persons.

They are highest at risk of getting severe COVID-19, of being hospitalized for COVID-19, of being nursed in the ICU and of dying from COVID-19.

Let me give you some perspectives of the risks involved

I am afraid these are US data because the MOH has refused to share data with us since Sept. last year.

Your 70 year old grandfather is 400X at risk of being hospitalized with COVID-19 compared to the 20 year old young man

Your 70 year old grandfather is 600X more likely to die from COVID-19 than the 20 year old young man

I hope this helps to understand the sin of you jumping queue.

3) We’ve seen the government urging people who don’t have appointments to stay home, and yet there continue to be people who try their luck and wait outside the vaccination centres – what message would you have here? How can we address this mindset?

 

This is a logistical issue to be dealt with immediately and firmly by the MOH.

The MOH needs to make it unequivocally, plain and clear to the public that they will not entertain person who are not eligible crowding at the vaccine centres.

The Pfizer vaccine can now be stored in a fridge between 2 and 8 degree Celsius for one month.

So no Pfizer vaccines will be wasted once removed from the arctic temp of -80 degree Celsius.

And the nurse will only open the Pfizer vaccine vial when there are 6 people in line for the vaccine.

The Sinovac and AstraZeneca vaccines can be stored at this usual fridge temp.

4) Where are we on the vaccine rollout timeline? Are we achieving the targeted number of vaccinations per day?

We are now in Phase 2 of the vaccine rollout.

Whereby we serve the high-risk groups as abovementioned.

This will take us from April to August 2021.

The latest data on the immunization rate charts an average of 34,000 doses per day in the past 14 days.

If you remember, the Health Minister boasted that by the end of February 2021, 126,000 doses will be administered daily

The Vaccines Minister touted a figure of 75,000 daily doses.

We are only doing about 27% and 45% of the daily doses as claimed by the 2 ministers.

Malaysia has only immunized 3.6% of our population with 1 dose of the COVID-19 vaccines.

This is 9 times slower that our southern neighbor, Singapore at 32.5%

5) What steps would you like to see taken to ramp up the speed of vaccination nationally?

Since early this year, I have made a few suggestions to the MOH and JKJAV (Special Committee for COVID Vaccine Supply)

These included:

1. The conditional registration of more vaccines by the National Pharmaceutical Regulatory Authority (NPRA). Since the MOH is very compliant with the guidelines of the WHO, they should heed the recommendations of the WHO which has authorized under emergency use the Pfizer, AstraZeneca, Covershield, Johnson & Johnson, Moderna and most recently the Sinopharm vaccines. The Sinovac vaccine which is conditionally registered with the NPRA has yet to be recognized by the WHO.
2. The Association of Private Hospitals Malaysia (APHM), the private hospitals, the GPs and the states should be allowed to procure and administer vaccines. They have better and wider experience than the MOH in procuring and administering vaccines. Why we are seeing the mess we are in is because the MOH has no track record in adult vaccination compared to the private healthcare sector. When India first launched it’s COVID-19 vaccines in the MOH, they were only able to do 300,000 doses per day. When the private doctors and hospitals wereinvolved they ramped it to 7 times at 2 million doses per day.
3. The vaccines used will be up and above the vaccine stockpile of the MOH. With the movement of adults from the public to the private vaccine program, more space will be created and those in the bottom half of the vaccine hierarchy would advance faster and get an earlier date for their shots.
4. The fears of creating inequity of vaccine distribution is unfounded. If anything, the equity of the vaccine program would be better protected because young Muslim pilgrims planning to perform the Hajj, do not need to jump the queue and pushback 30,000 more deserving and high risk adults. They should rightfully pay for the COVID-19 vaccines at the private facilities.
5. Migrant workers and refugees who would bear the brunt of inequitable access to vaccines can now be afforded similar opportunities by their employers and by the state government to protect this potential epicenter of COVID-19 transmission to the wider community.
6. This program would also allow our clients to pick their vaccines of choice. Some would prefer the classical inactivated vaccines (Sinopharm, Sinovac) which is associated with relatively lesser Adverse Effects Following Immunizations (AEFI). Other well read clients may prefer the latest mRNA technology vaccines (Moderna, Pfizer) which has the widest research base in both clinical trials and real world experience. Others may just want to enjoy the single shot Johnson & Johnson and CanSinoBio vaccines.
7. If a segment of the population is able to pay for the vaccines, is this not something that the government should welcome to cushion the financial impact to the national economy?
8. With the restricted and unpredictable vaccine supply chain, I am hopeful that the MOH and JKJAV will consider delaying the second dose of the COVID vaccine, so that more first doses can be given to more people in order for us to faster achieve herd immunity and mitigate the risk of developing COVID variants of concern in the community.

6) And in terms of outreach for registration, what else can be done within communities?

I think if every MP and State Assembly perons organize campaigns in their constituencies to enhance registration for vaccines, them much can be achieved.

They should undertake this with the same vigor and enthusiasm that they do during elections

Not only that, for those who have registered they should organize transport for them to the vaccination centers like they do to the polling station

It’s a good prelude to the upcoming GE15

7) While we hear news reports of hesitancy among the older generation, we also anecdotally hear concerns and worries from senior citizens who have registered and are impatient to hear back with their appointment?

Our elders need to know that they are at high risk for getting severe COVID-19.

This is further increased by the fact that they also have other pre-existing illnesses

And they are therefore higher at risk of being hospitalized or succumbing to the disease

All the vaccines have been tested in the clinical trials and they have been vindicated and validated in the real world experience.

Without exception, all of the vaccines protect you from severe COVID-19 disease, from being hospitalized and from dying from COVID-19.

This is a remarkable achievement

More than 1 billion vaccine doses have been administered

So you are not guinea pigs!

My 92 year uncle has had the vaccine and he is alive and kicking

Do not listen to the nonsense, the fake news, the conspiracy theories that is plentiful in social media

If you have any doubt or concern, please discuss with your family doctor

Like me, he has had the vaccine and he will clear your doubts and anxieties

If you have registered you will soon get your notification

The MOH is doing another opt-in for the AstraZeneca vaccine, and I totally agree that senior citizens above 60 years old should be prioritized instead of the previous opt-in for those above18 years old.

If you do not have a vaccine appointment date yet,  do opt-in for the AstraZeneca vaccine. The UK, Germany, Spain, France, Italy, Australia and many other developed countries have recommended the AstraZeneca vaccines for persons above 50 years (the UK above 40 years old). The risk of blood clots is the least among these age group and the benefits are phenomenal

Dr Musa Mohd Nordin
20 May 2021

Taken from an interview with BFM: https://bfm.my/podcast/evening-edition/inside-story/rundown-of-the-vaccine-rollout?utm_source=twitter&utm_medium=tweet&utm_campaign=is-may20