What you need to know about the COVID-19 vaccine

To say that year 2020 has been a rocky year is an understatement. A year ago, the rise of the novel SARS-CoV-2 virus in Wuhan, China alerted scientists and public heart experts. During the early time, the rest of the world, including Malaysia, dismissed it as ‘just a flu’ and were still going about the usual daily business. In the meantime, the novel coronavirus silently held grip to almost every country on the earth and paved the way to the worst pandemic of the century.

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By the time of this writing, COVID-19, the disease caused by SARS-CoV-2, has infected over 77 million people worldwide, with over a million people have tragically died from the disease. Recently, a more contagious and mutated version of the virus appeared in the United Kingdom, sparking waves of worrisome and fear among the global population.

Things are not better at home either. At the time of writing, there are approximately 17,000 active COVID-19 cases in Malaysia. 

Okay, we get it, year 2020 is terrible. COVID-19 has destroyed lives, families, jobs, economy and people’s well-being. Fortunately, it’s time that we deserve some good news: COVID-19 vaccine is here! Finally, a light at the end of the tunnel. 

The current state of COVID-19 vaccine

Since the start of the pandemic, scientists all around the work have been working relentlessly to develop an effective COVID-19 vaccine. Their hard work has finally come to fruition. As of the third week of December 2020, more than 1.6 million people worldwide have been vaccinated against COVID-19. 

The development and production of vaccines is a costly process (by costly we mean spending-billions-of-dollars kind of costly), so it is an endeavour that can only be taken up by big pharmaceutical corporations. Some of the major pharmaceutical companies who develop and produce COVID-19 vaccines for the world are Pfizer (collaboration with BioNTech), Moderna and AstraZeneca (collaboration with Oxford University). Besides companies in the Western countries, companies in Russia and China are also in the race, despite concerns about safety and transparency.

COVID-19 vaccine: Malaysia

Tentatively, Malaysia shall receive the first batch of COVID-19 vaccine (1.7 million doses) from Pfizer in February 2021, and its supply will be continued until the end of year 2021 (total: 12.8 million doses from Pfizer).

Believe it or not, Malaysia is actually among the fastest countries in Asia Pacific to receive the vaccine. The reason that we cannot start vaccinating Malaysians by this month or next year’s January is because the National Pharmaceutical Regulatory Agency (NPRA) has to review each vaccine candidate before Malaysians receive the jab. The entire reviewing process would take between 3- 4 months before approval can be granted to each vaccine candidate. 

Pfizer is not the only company that will supply COVID-19 vaccines to Malaysia. We have also made deals with the Chinese government, AstraZeneca, and Covax facility from the World Health Organization (WHO) to procure vaccines for the people. Collectively, these deals should help Malaysia to vaccinate 60 - 70% Malaysians against COVID-19.

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However, not everyone can get the vaccines straightaway. The COVID-19 vaccines are to be given by priority basis: the first batch to receive the vaccine will be the frontliners (Ministry of Health staff, police, army, staff at Immigration Department etc.), followed by high-risk groups (those with long-term illness and elderly), then the adult population. The reason behind this priority-based distribution is to protect the most vulnerable individuals and to prevent the lack of manpower should Malaysia experience a sudden surge in COVID-19 cases again. Similar distribution strategy is also used in other countries such as the US and UK. 

Types of COVID-19 vaccines

The general idea you should know is that COVID-19 vaccines help our bodies develop immunity to the virus that causes COVID-19 without us having to get the illness. Vaccine is an amazing medical innovation that has saved millions of lives, and if you are eligible to receive it, you should always do so to protect yourself and the people around you. 

None of these vaccines can give you COVID-19. They are:

• mRNA vaccines, which contain material from the virus that causes COVID-19 that gives our cells instructions for how to make a harmless protein that is unique to the virus. After our cells make copies of the protein, they destroy the genetic material from the vaccine (so you don’t have to worry about COVID-19 growing in your body). Those copies of proteins ‘trick’ out the body's immune system to start churning out an army of white blood cells that specifically fight the virus if we are infected in the future. The COVID-19 vaccines produced by Pfizer-BioNTech and Moderna are examples of mRNA vaccines.

• Protein subunit vaccines, which include harmless pieces (proteins) of the virus that cause COVID-19 instead of the entire germ. It’s similar to mRNA vaccines except in the case of mRNA vaccines, your body produces the viral protein; while in protein subunit vaccines, the viral protein is directly introduced into your body.

• Vector vaccines, which contain a weakened version of a live virus—a different virus than the one that causes COVID-19—that has genetic material from the SARS-CoV-2 virus inserted in it (this is called a viral vector). Once the viral vector is inside our cells, the genetic material gives cells instructions to make a protein that is unique to the virus that causes COVID-19. The rest of the story is similar to mRNA vaccines and protein subunit vaccines.

• Inactivated vaccine, which contains killed SARS-CoV-2 viruses. This is a more traditional form of vaccination. It has been used to vaccinate against other types of infectious diseases such as rabies, flu and polio. CoronaVac, a vaccine candidate from China, is an example of inactivated vaccine.

These vaccine candidates differ in terms of their effectiveness, storage conditions and costs. 

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Is the COVID-19 vaccine safe?

Before the COVID-19 pandemic, a vaccine can take more than 10 years to fully develop and costs up to $500 million. This is because it is a process with a high failure rate -- often 93% of vaccine candidates failed at the beginning of the process. 

Well, desperate time calls for desperate measures -- with millions of lives and the global economy in jeopardy, the status quo is no longer tolerable. In less than a year, we now have multiple viable COVID-19 vaccine candidates. It is stunning that an endeavor that usually takes decades can be accelerated to less than a year, without compromising its safety and efficacy. 

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While many people want an injection as soon as possible, others are worried about putting something unknown into their bodies -- especially if it is developed over a short duration of time. However, rest assured that any vaccine -- no matter how soon they will be introduced to the market -- has to go through rigorous and stringent clinical trials. In the case of COVID-19 vaccine, none of the necessary tests were skipped but rather compressed within a shorter timeframe.

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In addition to the rigorous review done by the United States Food and Drug Agency (FDA), the COVID-19 vaccine will undergo a five-stages scrutiny by our own National Pharmaceutical Regulatory Agency (NPRA) before it can be approved for use in Malaysia. 

To further ease your scepticism, prominent political figures such as the U.S president-elect Joe Biden and our very own Prime Minister Tan Sri Muhyiddin Yassin have already or will be receiving COVID-19 vaccines.

While COVID-19 vaccine is generally safe in the adult population, its safety and efficacy are still unclear in children and pregnant and lactating women, as of the time of writing. We should get more clarity next year as more trials are going to be conducted in these populations.

Will the COVID-19 vaccine be effective against mutated COVID-19 strains?

Virus mutates all the time, and in a global pandemic like the present, mutation is almost expected to happen. The SARS-CoV-2 virus has already mutated a handful of times. Besides the UK's COVID-19 mutant that was discovered recently, new COVID-19 mutation was also detected in the Benteng Lahad Datu cluster in Sabah, Malaysia this month. While its infectivity rate is still unclear, many people are worried if our existing COVID-19 vaccines can protect the people against future mutations. Regarding that, infectious-disease experts are optimistic the vaccines will be able to protect people against the new COVID-19 strains. They pointed out that even if the virus were to mutate further, the vaccines could be rapidly reprogrammed to remain effective against new mutations. This is what we do with flu shot, actually. High-risk individuals get vaccination against the infleunza/flu annually because the virus mutate so quickly that the vaccine from last year may be less effective in protecting the individual against the latest flu virus. 

COVID-19 vaccine: the halal issue

One of the Malaysia’s latest challenge from the pandemic is the concern among local Muslims about vaccine shots which could contain substances forbidden by Islam. Among them, one of the substances is pork-derived gelatin. Pork-derived gelatin has been widely used as a stabilizer to ensure vaccines remain safe and effective during storage and transport. Although companies in Malaysia as well as worldwide have strive to develop pork-free vaccines, concerns of  demand, existing supply chains, cost and the shorter shelf life of vaccines have made the effort harder, and pork gelatin is likely to remain as the ingredient in most of the vaccines.

According to Health director-general Dr Noor Hisham Abdullah, the COVID-19 vaccine need not be halal in order to be administered in Malaysia, as non-halal medications were registered in Malaysia too. 

Religious leaders from various states have since called for a study to be carried out to ensure the Covid-19 vaccine is shariah-compliant. Science, Technology and Innovation Minister Khairy Jamaluddin has since assured that the vaccines would be vetted and approved by the Malaysian Islamic Development Department (Jakim).

How much will it cost to be vaccinated?

What do Malaysian like the most? Free stuff! 

If you are a Malaysian, then you are in luck. Prime Minister Tan Sri Muhyiddin Yassin has announced that the COVID-19 vaccine will be given free to Malaysians but foreigners will have to pay a charge determined by the Ministry of Health. 

Currently, the government has no plan to make the COVID-19 vaccination compulsory, and the vaccine will be administered only to those who agree to take it voluntarily, particularly people at risk and prone to disease.

But hey, if you are eligible to receive it, you should always do so to protect yourself and the people around you.

Let’s hope for a better 2021

Almost everyone struggles through the year 2020: whether it's risking your lives serving at the frontline, losing your job, learning how to use Zoom, managing your children’s school curriculum or maintaining your mental health -- you are a real hero for coming this far.

While COVID-19 vaccine is on the horizon, there are many things that we do not know yet. For instance, we are not sure whether COVID-19 vaccine can reduce transmission of the virus from one person to another. So let’s not give up the obvious things just yet: follow SOP, wash your hands, wear your mask, practise social distancing and only go out when necessary. The frontliners are staying at work for us, so let’s stay at home for them.

If you want to educate yourself more on vaccines and COVID-19, here are some credible resources:

1. World Health Organization - COVID-19 vaccines

2. World Health Organization - COVID-19

3. Ministry of Health - COVID-19 Malaysia 

4. Immunise4Life

If you have any enquiries related to COVID-19, you can consult our COVID-19 Task Force, which consists of professional doctors and healthcare professionals, for FREE! (Just keep the free stuff coming!) 

You can access to free COVID-19 virtual health advisory by downloading the Doc2Us® app on http://onelink.to/doc2us or use our web chat https://web.doc2us.com/

Happy new year! Stay safe and healthy. We’ll see you on the other side.

Disclaimer: COVID-19 is a novel disease. The information and scientific evidence of its development and vaccines are changing as we speak. Some content of this article may be outdated in the future. We encourage you to always speak with a healthcare professional you trust for the latest updates on COVID-19 and its vaccines.
 

Written by

Ms Joyce Toh