Vaccine strategies need tighter supervision

Emeritus Professor Tan Sri Dato' Dzulkifli Abdul Razak
Opinion - New Straits Times
August 31, 2021 

THE appointment of the "new" health minister has eliminated the dicey portfolio of a minister coordinator in charge of a vaccination programme straddled over several ministries, including his own at the Science, Technology and Innovation Ministry.

The new arrangement can better iron out many of the emerging issues that are plaguing vaccination strategies, especially the outbreak of the Delta variant worldwide, the insistence of an additional dose which may not be the last, and the more acute need to vaccinate children.

By implication, it means the vaccine(s) is not as effective as claimed.

It is also perhaps not as safe when in comes to children.

In addition, it serves to distract from the cry that most of the developing world has yet to receive the first dose for adults, while their developed counterparts are already counting on a third one!

This hypocrisy must be dealt with once and for all if the pandemic is to be reined in as soon as possible.

Otherwise, the notion of herd immunity that has been touted as a reason for the "emergency use" approval on vaccines will fall flat on its face.

And, there is still no shortage of problems.

One is in relation to the "falsified" vaccine according the World Health Organisation (WHO).

Last week, WHO Medical Product Alert highlighted a falsified Covishield (a brand of the Astra-Zeneca vaccine) identified in the Southeast Asian and African regions.

The manufacturer of the genuine product, the Serum Institute of India, has reportedly confirmed the issue.

False vaccines pose a serious risk to global public health and place additional burden on vulnerable populations and health systems worldwide.

It also clearly illustrates how desperate marginalised people are for the vaccine, and how they can be duped by the greedy and unscrupulous.

As though this is not tragic enough, Reuters news agency more recently reported a suspension of the use of 1.63 million doses of the United States' Moderna Covid-19 vaccine after a Japanese domestic distributor received reports of "contaminants" in some of the vials.

The move prompted several Japanese companies to cancel planned vaccinations for workers.

Meanwhile, Moderna confirmed the matter, which has led to an investigation into the issue.

A European manufacturer which bottled the vaccines for supply to Japan has been implicated as the source of the contamination.

Such cases inhibit the global supply of vaccines, which is already plagued by production delays in recent months.

The incident comes at an awkward time when the world is struggling against waves of infections due to the Delta variant.

Malaysia can learn from this episode when receiving "donations" from suppliers worldwide.

How safe are these, to cite the Japanese case, given its technological sophistication and meticulous adherence to safety principles in all matters?

The above developments maybe just the tip of the iceberg if we are not careful in regulating and monitoring the use of the vaccine products in the rush to secure supply.

Past vaccine disasters should not be overlooked, warned vaccines experts.

In particular, emergency use authorisation (EUA) remains a matter of contention, where approval is given before late stage clinical trials are complete if the data showed "strong enough" evidence that it would "protect" people.

An EUA is not the same as full approval, as it is much quicker despite the assurance that nothing had been compromised.

Evidently, when rushed, there have been bad outcomes.

The Cutter incident of 1955 is a historic case in point involving the first vaccine protecting kids against polio.

Thousands of doses of the vaccine, made by Cutter Labs, accidentally contained live polio virus.

This resulted in an outbreak when more than 200,000 children received the vaccine, and within days, the programme was abandoned.

Additionally, from 1955 to 1963, some 10 to 30 per cent of polio vaccines were contaminated with simian virus 40.

Increased oversight, in this case, even failed to discover the problem with the polio vaccine.

Hence, the need for tighter strategies, closer surveillance and open communication with the public in a transparent way is vital in order to build genuine trust in support of vaccination.

The writer, an NST columnist for more than 20 years, is International Islamic University Malaysia rector