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‘We need detailed vaccination plan now’

A doctor collects a swab sample from a man to be tested for the coronavirus disease (COVID-19) outside Clinic Ajwa in Shah Alam, Malaysia December 10, 2020. REUTERS/Lim Huey Teng TPX IMAGES OF THE DAY

KUALA LUMPUR: The Health Ministry has to devise a comprehensive plan on the National Covid-19 Immunisation Programme soon to ensure an orderly and chaos-free vaccination process takes place.

Epidemiologist Datuk Dr Awang Bulgiba Awang Mahmud said that without planning, the government would not be able to implement the massive inoculation exercise properly, such as in ensuring effective logistics delivery.

“There are many things that need to be done and it should have started now, but I do not see much by the way of announcements from the Health Ministry on how this is supposed to be carried out.

“There has been some general announcement and bits of information here and there, but none about a comprehensive vaccination plan, which the public can understand and act on,” he told the New Straits Times.

The Science, Technology and Innovation Ministry’s head of the Independent Covid-19 Vaccination Advisory Committee (ICVAC) said there needed to be a detailed vaccination plan and Gantt chart with clear aims and goals.

A Gantt chart is a type of bar chart that illustrates a project schedule.

“The logistics are the most daunting and have to be sorted out. They need to be planned down to the last detail, including registration, appointments, human resource, administration, transport and cold chain requirements.

“Where the vaccination centres should be (located), when they will be opened, their target populations, how to contact potential vaccinees, and follow-up — all these need to be sorted out.

“The timelines for all these processes and the process flow all need to be made clear now. There is no time to lose.”

He said scenario planning needed to be carried out with contingency plans laid out for all eventualities.

Dr Awang Bulgiba said ICVAC had made recommendations to the government, which included the need for a risk assessment tool to determine priority needs so that the correct persons were given inoculation earlier.

These high-risk potential vaccinees, he said, should have been contacted by now and engaged.

Besides that, a dedicated call centre, website and registration database system should also be in place and registering people (via mobile apps, post and phone calls) and scheduling appointments for the next one year, he said.

He said special consideration for some groups (incarcerated populations, long-stay hospital patients, care-home populations, schoolteachers, migrants and the homeless) needed to be drawn up and the reasons made clear.

“A voluntary vaccine registry of 50,000 vaccinees (for active surveillance) and Phase 4 passive surveillance for all other vaccinees need to be carried out continuously for at least two years to monitor adverse events and check for vaccine effectiveness.

“The active surveillance needs to be detailed and university labs need to be roped in for this as it involves monitoring for more than just antibody levels.

“The government should also get university experts to model the impact of vaccination on the economy and health indicators, and monitor to see if the intended effects are taking place.

“At the same time, non-pharmaceutical interventions, such as physical distancing and mask-wearing, need to remain in place until infections are reduced to very low levels.”

He stressed the importance of engaging experts from various fields as done by the ministry in establishing ICVAC.

“The Health Ministry, as the implementing body, needs to listen to the committee’s recommendations as ICVAC has expertise in many fields — epidemiology, immunology, vaccinology, virology, occupational health, infectious diseases, health economics, pharmaco-economics, applied ethics — and has studied issues related to vaccinations extensively.”

Additionally, he said, engagement with the public via a massive communication exercise by communication specialists who were advised by behavioural scientists needed to be carried out.

“The vaccination plan needs to be transparent, easily understood and communicated in a non-condescending way to the public.

“Credible experts should be engaged to speak on this issue.

“This exercise needs to be done continuously for the duration of the vaccination rollout.”

The immunisation programme is set to roll out at the end of the month where 80 per cent (or 26.5 million people) of the population will be inoculated for free in three stages.

The first phase would involve 500,000 health and non-health frontliners, which is scheduled to take place in April.

The second phase will be from April to August and cater to those who are at risk of contracting the virus, such as senior citizens, the disabled and people with underlying health conditions. The third phase, from May to February next year, will see those aged 18 and above receiving their doses.

Dr Awang Bulgiba added: “By right, the next phase should start immediately after the first phase ends, but this depends on the supply of vaccines, such as whether they have been scheduled to arrive before the next phase begins.”

Source: New Straits Times

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