To jab or not to jab

BY KHIRTINI K KUMARAN

With the National Covid-19 Immunisation Programme (NIP) well underway, some Malaysians are still wondering if they should take the vaccine.

The hesitance to receive the vaccine is mostly due to the doubts and fear of the vaccine’s safety, efficacy and other issues.

To address this hesitance, the Medical Fellowship SIBKL organised a ‘To Jab or Not to Jab’ medical forum on Feb 27, 2021, with speaker Dr Benedict Sim, Consultant of Infectious Diseases at Sungai Buloh Hospital.

Dr Sim explained that those who received this vaccine were very well-protected.

“In fact, it is important for people with comorbidities to receive the vaccines as they are at risk of severe Covid-19 along with its complications if contracted with the virus.”

He noted, however, that there were two situations where the vaccine can either be ineffective or dangerous.

“For patients with active cancer, who had an organ transplant, or are on some particular medications that modulate or suppress one’s immune system, they need to discuss with their doctors individually whether they will benefit from the vaccine.

“It’s not that the vaccine is dangerous for them. It is just that they cannot mount any antibodies after receiving the vaccine, which is wasteful. Instead, they should take the vaccine after they have recovered from the illness.”

Factors to consider

Meanwhile, there are two groups of people for whom the vaccine is potentially dangerous.

“The vaccine might be dangerous to those who can get severe allergic reactions or anaphylaxis from it, which is a small group of people.

“For those who had anaphylaxis reaction to the vaccine, one-third of them had anaphylaxis to other substances before, whether it’s foods, insect bites, injections or medications,” he said, referring to the Pfizer clinical trial data,

“Another group is the extremely frail elderly whose health is not good and is not capable of handling the side effects of the vaccine.

“Apart from these situations and these groups of people, the rest will benefit from getting this vaccine. And based on all the understanding of how this vaccine works, we find that the benefits of getting the vaccine far outweigh the risk of getting the vaccine because the risk is thought to be extremely small.

“Every once in a while, there is a novel germ that our immune system has not encountered before it emerges. The immune system then goes haywire, and most visibly damaging the body systems, especially the lungs.

“And so, vaccines are meant to introduce a weaker form or part of the germ to the body and let the immune system recognise it. This allows the body to have a head start to effectively kill off the actual germ once infected.

“There are many different types of vaccines, and I think there are over 100 candidates of vaccines for Covid-19. The ones that we tend to take seriously are those that have completed a certain phase of their clinical trials,” added Dr Sim.

Understanding the efficacy rate

In Malaysia, the vaccine that has received approval is the Pfizer-BioNTech Covid-19 (Pfizer) vaccine. Several other more vaccines are in the line to get permission from the National Pharmaceutical Regulatory Agency (NPRA).

Both the Pfizer and Moderna vaccines are mRNA vaccine, and according to Dr Sim, it is a relatively new technology.

“Before the pandemic, none had heard of it. Contrary to popular belief, mRNA technology has been around. In fact, you can find scientific papers that talk about RNA technology in vaccines.

“It has been used to make successful vaccines for Ebola. It is also used to deliver medications for some cancer.

“Thankfully, Ebola didn’t spread around the world. And so, the mRNA technology never reached a point where it was made for fast public usage and was not widely marketed.”

He explained that the mRNA vaccine introduced the germ’s precursors into the human body and instructs the cells into making a bacterial or viral protein. The immune system then responds to these proteins and develops the tools to react to future infections.

Sim noted that Pfizer and BioNTech had announced their vaccine had a 95 per cent efficacy rate. But it did not mean if 100 people get vaccinated, 95 won’t get the virus, and five people will.

“It means that you are 20 times less likely to get the disease if you are vaccinated.

“The clinical trial data also showed those who have received the vaccine were actually less likely to contract coronavirus. And thus, less likely to either get the symptoms, hospitalised or die from Covid-19. This is how effective the vaccine is,” he continued.

The forum, which was held via Zoom
and YouTube live, was co-moderated by Dr Khay Wee Toh, Consultant Anaesthesiologist from Subang Jaya Medical Centre and Dr Ong Chin Tuan, Consultant Ophthalmologist at Beacon Hospital. — The Health