Too many Americans still mistrust the Covid-19 vaccines. Here's why

‘According to a December survey undertaken by the Pew Research Center, nearly 40% of Americans say they will definitely not or probably not get the COVID-19 vaccine when it becomes available to them. Gallup polls put the number at 37%. That’s bad news not just for the vaccine refusers themselves but for the public as a whole. Experts including Dr. Anthony Fauci, head of the National Institute for Allergy and Infectious Diseases, had previously concluded that achieving herd immunity—the point at which a population is sufficiently vaccinated that a spreading virus can’t find enough new hosts—would require anywhere from 60% to 70% of Americans to take the vaccines. But lately, he and others have been inching that number upward, now estimating that herd immunity could require as much as 85% vaccine coverage...

‘But most people in the COVID-19 vaccine hesitancy camp are more rational, more measured—informed enough not to believe the crazy talk, but worried enough not to want to be at the head of the line for a new vaccine. “For first responders and for older people with underlying conditions it’s a godsend,” says Padgett. “But I do believe this was rushed. I’m reasonably healthy. Six months to a year just to get more data on it is what I’d need to be vaccinated.”

Read here (Time, Jan 5, 2021)

Covid-19 is dangerous, not vaccines — 20 scientists, doctors, and concerned individuals

‘Statements propagating fear-mongering and pseudoscience that attack Covid-19 vaccines’ mRNA (messenger RNA) technologies – which have now been approved by the US’ Food and Drug Administration, the UK’s Medicines and Healthcare Products Regulatory Agency, the European Medicines Agency, and the regulatory bodies of at least seven other countries – risk turning Malaysians off all Covid-19 vaccines entirely, as some may not differentiate between one type of Covid-19 vaccine with another. mRNA and vector-based therapies have actually been used for nearly a decade to treat people with cancer, inherited immunodeficiencies, and metabolic, eye, and neuro-muscular diseases.’

Read here (Code Blue, Jan 4, 2021)

The economic case for global vaccinations: An epidemiological model with international production networks

‘We show that the global GDP loss of not inoculating all the countries, relative to a counterfactual of global vaccinations, is higher than the cost of manufacturing and distributing vaccines globally. 

‘Our estimates suggest that up to 49 percent of the global economic costs of the pandemic in 2021 are borne by the advanced economies even if they achieve universal vaccination in their own countries.’

Download PDF here (NBER.org, January, 2021) 

China vaccinates a million (interim target: 15 million by mid-February) but some take a jab back

‘Workers kept in the dark about the vaccine injected and are warned not to take any photos of the process...

‘At least a million priority or at-risk Chinese have had their first shots of indigenous Covid-19 vaccines after guidelines kicked in on December 15. Several populous provinces and gateway cities from Guangdong to Shandong and Henan to Shanghai are included as Beijing triages vaccine distribution to regions more exposed to Covid flare-ups and “backflows.” The interim goal, cited by the National Health Commission (NHC) and Xinhua, is to immunize at least 15 million police officers and medical and customs personnel by the Chinese New Year in mid-February...

‘Yet initial feedback from those chosen for the pilot scheme appears to be less than ideal. As seen on forums and WeChat groups popular among medical workers and immigration officers and through Asia Times’ interviews of airport workers in Shanghai, major complaints center around the elusive manner in which these drugs are produced and administered.’

Read here (Asia Times, Dec 30, 2020) 

Covid-19 vaccines for Malaysia: A call for transparency in registration & purchasing

By Citizens’ Health Initiative (citizenhealthinitiative@gmail.com)

With the exception of the People’s Republic of China and a few other countries like New Zealand, Vietnam, Cuba, Senegal, and Kerala state in India, which seem to have largely brought Covid-19 under control without the help of vaccines, most countries are struggling with succeeding waves of the pandemic and a likely global spread of a more contagious mutant of SARS-CoV-2.  

The collateral damage to economic and social well-being worldwide has been unprecedented, and it underscores the urgently felt need for vaccines and a return to some semblance of normalcy.

Despite a major lapse with a 16,000 plus person religious gathering which erupted into several clusters locally and in the region (March 2020), Malaysia had performed creditably earlier.

Sources of current outbreaks

Unfortunately, since October 2020, a resurgence of clusters emerged from non-compliant returnees from abroad, and porous Sabah state border controls, exacerbated by lax enforcement of SOPs during the September 2020 Sabah state elections. 

Immigration and health authorities were not sufficiently pro-active to prevent its further spread in the peninsula, resulting in numerous outbreaks, especially among workers in congested accommodations and workplaces, and in prisons and detention centres.

Unlike Singapore’s experience with outbreaks in migrant dormitory complexes, we in Malaysia are additionally reaping the consequences of decades of corrupt mismanagement of labor migration, viz. a persistently large pool of undocumented migrant workers (currently estimated at 1.2-1.5 million) who have strong incentives to avoid contact with government agencies.   

Senior Minister Ismail Sabri’s disastrous U-turn in going after undocumented migrants (after initially promising them sanctuary and no arrests and deportation during the pandemic) greatly complicated pandemic control efforts, in particular the crucially important contact tracing.

As generally younger daily-paid workers, more likely to ride out the milder symptoms of Covid-19 infection, they are now even less inclined to cooperate in testing and isolation, given the risks of arrest, detention and deportation.

\We thus face the prospect of protracted and repeated seeding of the general population by the asymptomatic or mildly symptomatic, especially undocumented workers reluctant to seek treatment unless severely ill. (We should also note that active avoidance of contact tracing and testing involves others disinclined to divulge network contacts or contact history, e.g. underworld elements, drug and sexual encounters, etc).

As in many other countries, many Malaysians support efforts to secure vaccines to enhance pandemic control efforts.

Procuring vaccines for Malaysia

The minister for Science, Technology, and Innovation Khairy Jamaluddin has announced commitments to purchase a basket of Covid-19 vaccines, and options for further orders .

Khairy Jamaluddin needs to be transparent about the technical rationales, criteria, and pricing for his ministry’s purchasing decisions.  In particular, he needs to respond to very pertinent points raised by the Covid Research Centre (KL) , chest specialist Dr Jeyakumar Devaraj , and others, which include the following:

• there is currently little information on long-term safety beyond 2 months or on durability of protection, for all candidate or approved vaccines (any late-manifesting adverse effects will only be detected by conscientious follow-up surveillance, monitoring, and reporting systems).  This is especially pertinent for novel mRNA vaccines, in comparison with the more familiar inactivated whole-virus vaccines with which we have decades of experience
• the decision by the UK’s Medicines and Healthcare Products Regulatory Agency (MHRA) to grant immunity to Pfizer from legal liability for late-manifesting adverse effects, and the Pfizer CEO declining to be among the early vaccinees (claiming selflessness in prioritising those more vulnerable, in contrast to some vaccine researchers who vaccinated themselves even before phase 1 human trials) perhaps reflects the true risk perception or assessment of the pharmaceutical corporations (whose profitable research and development work has been highly subsidised by governments for ‘vaccine nationalist’ reasons)
• stringent logistic requirements (deep-freeze or ultra-low temperature facilities) for the mass deployment of mRNA vaccines to under-served remote areas
• one additional advantage of the inactivated whole-virus vaccine is that the host immune response is mounted against a spectrum of antigens from the whole virus, rather than against a much more limited array of antigenic sub-components of say, the spike protein.  This could provide some insurance against mutations, say in the coding sequences for the spike protein, which might render vaccines directed solely against the spike protein wholly or partially ineffective.

Beyond the immediate urgency of securing access to adequate quantities of safe, efficacious and affordable vaccines, the larger question of our continuing dependency on foreign vaccine developers, producers and suppliers remains unaddressed.

National capabilities in production of medicines and vaccines

Consider Cuba, a nation of 12 million citizens hamstrung by a 60-year economic blockade by the US, which has invested in human and material resources to become a biotech power-house:  recombinant hepatitis B vaccines, synthetic polysaccharide vaccine against Haemophilus influenzae type B , CIMAvax vaccine against lung cancer , and innovative treatment of diabetic foot ulcers.

Cuba’s repeated offers of scientific collaboration in R&D, and joint ventures to position Malaysia as a regional production and distribution platform for Southeast Asia , have elicited only a lukewarm response.  Tan Sri Dr Abu Bakar Suleiman, the retired Director General of Health, has shown greater foresight and entrepreneurial verve as chairman of Bioven , which is shepherding CIMAvax through US-FDA and UK phase 3 clinical trials .

It is not too late to make the necessary strategic decisions for a promising growth area (pharmaceuticals and vaccines) in the national and regional economies of the newly launched RCEP.

For more information/clarifications, please contact:

• Chan Chee Khoon     cheekhoon50@gmail.com 
• Chee Heng Leng        cheehengleng@gmail.com 

Endorsers

• Aliran
• Citizens’ Health Initiative
• Freedom
• Kuala Lumpur & Selangor Chinese Assembly Hall (KLSCAH) 
• Malaysian Physicians for Social Responsibility (MPSR)
• North South Initiative
• Pengguna Pahang
• Parti Sosialis Malaysia (PSM)
• Pergerakan Tenaga Akademik Malaysia (GERAK)
• Suara Rakyat Malaysia (SUARAM)
•  Childline Foundation

Fauci says herd immunity could require ‘between 70% and 90%’ to get COVID-19 vaccine

‘Herd immunity against the novel coronavirus could require vaccination rates "between 70 per cent and 90 per cent", Dr Anthony Fauci, the most prominent US infectious disease expert, said in an interview published on Thursday (Dec 24). More than 1 million Americans have received a first dose of a vaccine since Dec 14, according to the US Centers for Disease Control, or only about 0.3 per cent of the population.

‘Fauci, who is advising both President Donald Trump and President-elect Joe Biden on the pandemic, acknowledged that he had incrementally increased his estimates from earlier in the year, when he tended to say only 60 per cent to 70 per cent would need to be inoculated for herd immunity to be reached.’

Read here (Channel News Asia, Dec 25, 2020)

Covid-19 vaccine: Hold your horses, let us play safe! Jeyakumar Devaraj

• Malaysia should rely on old tech vaccines comprise of viral proteins. Let us not experiment on our population with the “sophisticated” vaccines that use RNA and DNA technology.
• Offer the old tech COVID-19 vaccines to the high risk groups initially, and then later to the entire population. But do not make it mandatory for any particular group. Let people make an informed choice.
• Provide clear information to the public. We should be honest with our people. The authorities should also tell the people that at present we do not have data regarding long term safety of the RNA and DNA vaccines.
• Provide the old tech COVID-19 vaccine free to the population.
• Conduct post COVID-19 vaccination surveillance to obtain an accurate estimate of side effects arising from the vaccines.
• It is high time for civil society groups and concerned individuals to voice up and urge for a cautious and measured approach to the mass vaccination of the Malaysian public.

Read here (Focus Malaysia, Dec 24, 2020)

The vaccine news is great, but Big Pharma is still fooling us

‘Heroic work went into the development of the coronavirus vaccines. But that does not mean this industry deserves your affection...

‘I recall feeling, at the start of this pandemic, both horror at the unfolding calamity, and also a small sense of hope that as in other times of hardship, people would find ways to change the world for the better. There was talk of community support, mutual aid and the rediscovery of the positive powers of the state to protect its citizens. Much of that has dimmed now, and it often seems that we simply want relief - to go back to the way the world was before, and as soon as possible.

‘We have to get back to that place. Yet this may be the best chance in our lifetimes to break the hold of an industry that, until recently, was rightly vilified. The public is following these developments closely, and the state support that underwrites pharmaceutical profits couldn't be more obvious: Operation Warp Speed alone has dispensed over US$10 billion to the industry.

‘Pay it to make the vaccine, sure. That's a service. But we shouldn't be afraid to demand more: Public support should mean a public vaccine, one that reaches people as quickly as possible - profitable or not. The pharmaceutical industry wouldn't be able to rake in its profits and restore its reputation without funding that comes from our tax dollars. We shouldn't let Big Pharma forget it.’

Read here (Straits Times, Dec 22, 2020)

Hang on for 3 more months

‘Some simple advice for anyone contemplating a holiday gathering: Wait until March...The fight against the coronavirus has been called a “national marshmallow test” [for the United States] that we’re failing. In a famous study, children were left alone with a marshmallow for 15 minutes, and promised a second if they didn’t eat the first. Kids who were better at delaying gratification were found to be more successful later in life. At first, this correlation was explained as demonstrating the importance of willpower and executive function.

‘Later, a team of researchers set out to replicate this study and uncovered something profound. Once they adjusted for factors such as household income, mother’s education, and home environment at age 3, the effect disappeared...

‘If we failed our national marshmallow test this summer and fall, perhaps that says something about how little reason the public was given for optimism. Hope can’t just be a slogan or a pep talk; it must be justified by facts, experiences, and trustworthy promises. And in fairness, until last month, it was less clear when and how this would all end... But hope is justified today.’

Read here (The Atlantic, Dec 17, 2020)

PM Muhyiddin: Govt to order more Covid-19 vaccine to cover 60-70pc of Malaysians

‘The government has plans to increase its purchase of the Covid-19 vaccine to cover the immunisation needs of about 60-70 per cent of Malaysians compared to 30 per cent currently. Prime Minister Tan Sri Muhyiddin Yassin said this was because some nations had purchased doses exceeding their population.

“As for Malaysia, we have already got 30 per cent. I have instructed Health Minister Datuk Seri Dr Adham Baba along with Khairy Jamaluddin Abu Bakar (Minister of Science, Technology and Innovation) to negotiate and increase it from 30 per cent to 60 or 70 per cent.’

Read here (Malay Mail, Dec 13, 2020)

What an FDA committee weighed in voting for the Pfizer Covid vaccine

‘An all-day hearing of the Food and Drug Administration’s vaccine advisory committee closed, on Thursday evening, with a vote to recommend an Emergency Use Authorization of the Pfizer-BioNTech covid-19 vaccine for people sixteen and older. 

‘The proceedings involved a great deal of data and technical talk, but might be quickly summarized this way: there are things we still do not know about the vaccine, but nothing that we do know looks bad. Indeed, the vaccine looks very, very good. And its known goodness applies to a diverse range of populations, including Black and Latinx and older people. An F.D.A. analysis of the raw data, released earlier this week, confirmed previous reports that the vaccine’s efficacy in preventing disease in trial participants was close to ninety-five per cent. That number held up under questioning from committee members, who represented a range of specialties, from pediatrics to virology, throughout the eight hours of the hearing. 

‘Amid a pandemic—on a day when more than three thousand people in this country were reported to have died from covid-19—that result is far more than it would have been reasonable to hope for even a couple of months ago. As Dr. Doran Fink, of the F.D.A., said in one of the day’s presentations, there is no “adequate, approved, and available alternative.” It was a long day, but a reassuring and even energizing one.’

Read here (The New Yorker, Dec 11, 2020)

Not without India: World's pharmacy gears up for vaccine race

‘India, the world’s biggest vaccine maker, is getting set for the massive global blitz to contain the coronavirus pandemic with its pharmaceutical industry and partners freeing up capacity and accelerating investments even without firm purchase orders. India manufactures more than 60% of all vaccines sold across the globe, and while its $40 billion pharmaceutical sector is not yet involved in the production of the expensive Pfizer Inc and Moderna shots, the nation will play a pivotal role in immunizing much of the world. Indian companies are set to produce eight, more affordable vaccines designed to fight COVID-19, including AstraZeneca's Covishield, called the "vaccine for the world here" by its developers.’

Read here (Reuters, Dec 10, 2020)

Man named William Shakespeare, one of the first to get Pfizer vaccine, sets off pun cascade

‘To be or not to be vaccinated, that is the question. After an 81-year-old named William Shakespeare became the second person in the West to receive the Pfizer-BioNTech coronavirus vaccine in Britain outside clinical trials Tuesday, social media erupted with joy, puns and many quotes from the great British playwright. “They really are prioritising the elderly: this guy is 456,” wrote one user, while the term “Two Gentlemen of Corona,” a play on “The Two Gentlemen of Verona,” swiftly became a top trend in Britain. Others quipped that the first batch of inoculations, part of the first mass coronavirus immunization campaign in the West, marked the “Taming of the Flu.”

Read here (Washington Post, Dec 9, 2020)

The Covid-19 vaccines are here: What comes next?

‘The outstanding progress made by the scientific community has brought the vaccine closer to our doorstep. The baton now passes from the scientific community to a new collaborative effort, led by government and policy makers, healthcare professionals, the private sector, and other community groups. The COVID-19 vaccine rollout will be unlike any other prior vaccine delivery effort. Governments and their partners will be expected to rapidly accelerate their efforts to ensure they are able to address community expectations.

‘Multiple factors will make the rollout of a COVID-19 vaccine more complex than any other previous vaccine effort.

‘Accelerated pace and giant scale of delivery: Countries face a four-by-four challenge: a vaccine arriving at four times the pace and requiring delivery at four times the scale.

‘Four times the pace. The coronavirus vaccine has been developed four times faster than the mumps vaccine, which was the previous record for a vaccine developed for use in a widespread community setting. The consequence of this pace of clinical development is that governments and policy makers have had far less time than previously to prepare for a robust vaccination program.

‘Four times the scale. The COVID-19 vaccine rollout is expected to be four times larger than any previous effort because the aspiration is for broad adoption at significantly higher rates than typically achieved with seasonal adult vaccines, such as the flu. Compared with the flu, for which roughly half the adult population across the OECD is covered each year with a single dose, the COVID-19 situation may require vaccinating more than half the adult population with two doses. Globally, that means billions of people could seek the vaccine.’

Read here (McKinsey & Co, Dec 9, 2020)