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Vaccine benefits outweigh the risks
Published on: Tuesday, June 01, 2021
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Probably nation’s oldest vaccine recipients: 101-year old Chung.
Our Covid-19 situation is getting worse day by day – a combination of issues have led us to this point, and our only hope to return to manageable numbers and some sense of normalcy, is a well-executed and accelerated vaccine programme.

That is a challenge as we are only receiving our supplies in smallish but progressively we will receive larger supplies soon, that will allow a rapid scale up. Vaccine hesitancy is a real issue in Malaysia, but it is a global phenomenon.

When our numbers were low anti-vaxxers were loud. In the West, when they had to deal with peak numbers earlier than us and vaccines were available, mass vaccination programs started earlier have clearly brought the numbers of cases and admissions down rapidly.

Sadly, social media, WhatsApp and other mobile messaging tools are (more dangerous as it is so easy to share info without evidence or verification) has really confused our public and it is the intellectual community that is more hesitant in the end. 

Did you know that only one dozen people are responsible for spreading misinformation globally??

You can read it here : https://www.npr.org/2021/05/13/996570855/disinformation-dozen-test-faceb...

Vaccines have been around for ages. Mothers in the United Kingdom used to hide their children up their chimneys when health workers were vaccinating for smallpox in 1796 but persistence has led to the horrible disease being eradicated in 1980. No one questions the safety of flu vaccines, meningococcal vaccines that pilgrims for hajj and umrah take, do they?

Did you know their efficacy is MUCH lower than the Covid vaccines we have in the market today? Yes, the Covid vaccines are new, but the platforms are neither new nor unknown, and this pandemic has brought people of science working together in a way never seen before.

To have any vaccine achieving more than 50 per cent efficacy meets WHO criteria and all of the vaccines we have now exceed that criteria. We consider three things when approving vaccines and believe me, for Malaysia’s NPRA probably one of the world’s strictest agencies – safety, quality and efficacy criteria must be met.

Covid is a nasty disease. As a health practitioner, I have not seen anything like this in my career and my friends working in infectious diseases say the same as we all learn a little more each day about the disease.

It rips through patients and evokes an overdrive of their immune systems leading to clots, tissue damage and literally takes their breaths away. The saddest part is it affects the old and frail and co morbid much more, but it is now also killing younger people.

In Malaysia, most of the positive and often asymptomatic patients are young, between 20-40 years.

They are more mobile, and they bring the disease home to the ones more vulnerable. It is a cruel disease - those affected are not only gasping for breath, but end up dying alone, buried without loved ones either. Any risks one might consider of the vaccine are FAR less than the risks contracting Covid.

Wearing my Obstetrician and Gynaecologist hat, let me also provide a perspective for women, especially those trying to get pregnant or already are, and lactating. 

Firstly, pregnancy is a state where women’s immune systems are less robust compared with non-pregnant states, so if a woman falls ill with Covid-19 during pregnancy, the effects could be devastating to her and her unborn baby.

This is especially so among those with underlying co-morbidities from diabetes, hypertension, obesity and others. To make things worse, many women are healthcare workers and care givers making them even more vulnerable and exposed.

When the vaccines were first rolled out in USA, many healthcare workers given the Pfizer vaccine did not know they were pregnant, but some did and were at high risk as health care workers.

Researchers have followed thousands of these women through their pregnancies and there have been no reported adversities.

Similarly, with AstraZeneca, the Royal College of Obstetricians and Gynaecologists, where I also graduated from, have given clear advisories that its administration is important when the benefits outweigh risks.

The vaccine does not affect fertility, has not been shown to harm the unborn child and is also safe in breastfeeding and notably, decent quantities of antibodies have been found in breastmilk, which is great! In Malaysia, we have also endorsed use of Pfizer in pregnancy to be given ideally between 18-33 weeks of pregnancy.

This will be the vaccine preferred and reserved for pregnant mums. For lactating women, both Pfizer and AstraZeneca can be used. There is more research on Pfizer since it was rolled out earlier, but UK, Australia and Canada have also endorsed AstraZeneca for breastfeeding mums.

Here are some useful references

https://www.rcog.org.uk/en/guidelines-research-services/coronavirus-covi...

https://www.cdc.gov/coronavirus/2019-ncov/vaccines/recommendations/pregn...

https://www.acog.org/clinical/clinical-guidance/practice-advisory/articl...

https://www.sogc.org/common/Uploadedfiles/Latest News/SOGC_Statement_COVID-19_Vaccination_in_Pregnancy.pdf

Finally, as a Muslim, we have a duty to uphold the basic tenets of Maqasid Syariah – Protecting Faith, Protecting Progeny, Protecting Life and Humanity. In a raging pandemic where each person has a critical role to protect each other and humanity, we must make every endeavour to comply with public health safety measures.

Vaccination is one of them. It is now our duty to be vaccinated. Many Muslims do not realise this and deny the right of other human beings. We must vaccinate 70-80 per cent of our population to achieve herd immunity and that means almost all adults over 18 years of age.

We are facing a health crisis and we have the tools to help us overcome this. Let’s all play our part – comply with public health measures and ensure we encourage our own circles of influence, and get that vaccine into as many of our arms as soon as possible.

Tan Sri Jemilah Mahmood

(Special advisor on Public Health to the Prime Minister)





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