Thread by @drmusanordin

Like most of you, I have been following the COVID-19 pandemic at close range. I honestly hope it has been a journey based on good science and loads of cool, calming thoughts, common sense and compassion (1)

In the wake of the approval of the 2 vaccines for use in several countries, allow me to share some of my early thoughts namely with respect to its utilization in our nation (2)

Transparency and accountability of the COVID-19 vaccine choices and advance payments is of pivotal urgency and importance (3)

Priority must be given to the WHO, GAVI and CEPI, COVAX Initiative. This is a global effort to make the vaccine available to all nations irrespective of GDP status. Their tag line is “No one is safe until everyone is safe” (4)

COVAX has 18 vaccine candidates in its portfolio. As 1 in 5 candidates are expected to falter in clinical trials, this is the best option to protect the world citizens’ and our rakyats’ interests (5)

COVAX also offers the best price at approximately USD$10 per dose (even more affordable for the Low and Middle Income Countries LMIC ie tier pricing)
MOF Inc. should make direct dealings with COVAX and vaccine manufacturers, removing entirely the Middle-Man (6)

This will ensure Malaysia gets the best vaccine price per dose without the insane profits accrued by the Middle-Man (7)

For a 20% pop coverage (6.4M people) & initial vaccine purchase of 12.8M doses (2 doses per person), the Middle-Men by hiking the price a mere RM10 will amass a profit of RM128M overnight. This is not tenable when our national coffers are severely stressed by the pandemic (8)

Malaysia should be placing an initial 20% order in COVAX instead of the present 10%.
To avoid putting all eggs in one basket, direct dealings with vaccine manufacturers is proactive planning but it must be transparent & in our national interest, not another rent-seeking ploy(9)

Chinese vaccine manufacturers have been courting interest with M’sian co to sign vaccine related MOUs with a view to sell vaccines/conduct research.
MOH’s related agencies esp National Pharmaceutical Regulatory Agency NPRA needs to step up its act & undertake several actions (10)

Many countries have undertaken Emergency Use Authorization (EUA) & licensed use of Pfizer-BioNTech & Moderna vaccines.
High time for NPRA to act likewise. There is published data in scientific journals and FDA(US) and MHRA(UK) for our local approval and licensing purposes (11)

China and Russia have approved for early and limited use of their vaccines. Their government approvals were initiated whilst the vaccines were still in Phase 2 trials. This makes the scientific community a bit wary and concerned as to their safety and efficacy (12)

MOH must therefore be cautious of the influx of Chinese COVID-19 vaccine manufacturers in M’sia & insist on their research data in scientific journals.
Peer review must be through scientific publications & not through press releases as has happened with the COVID-19 vaccines (13)

The government has announced that it will provide the vaccine free to the selected cohort of high-risk persons. I am of the opinion that the uptake should be voluntary ie not made mandatory (14)

MOH needs to be proactive & kick start its awareness campaigns to inform the lay public of various facets of COVID-19 vaccine, the why, who/when/where/safety/efficacy/permissibility & address issues of vaccine hesitancy & the deluge of anti-vaccine & fake news on social media(15)

Non-high risk and non-priority persons may wish to be vaccinated in the private sector. It is of national interest and utmost priority that the government cap the price of the vaccine so as to be affordable in the private sector (16)

National interest cos the nation needs to achieve vaccine coverage >70% to obtain herd immunity.
The govt through its agencies-National Security Council (NSC) & MOH have to be proactive in its efforts to address cost issues related to PPEs, PCR, RTK-Ag & masks etc (17)

Masks used to cost up to RM5-10 per piece until the belated NSC intervention to cap at 75 sen per piece. The vaccine price in private should be addressed promptly and made affordable as part of our national campaign to achieve community protection (18)

The rakyat must know that the vaccine is only one of a multi-prong strategy to exit the pandemic. Masking, physical distancing, personal hygiene, 3Ws, 3Cs & SOPs needs to be followed until a sizeable % of our pop has been immunised towards achieving herd protection (19)

We must remain vigilant with SOPs to ride the current 3rd wave & prevent the resurgence of another. Post marketing surveillance will track vaccine through pharmacovigilance & give valuable info about the vaccine’s long-term safety and effectiveness from real world experience (20)

Both vaccine manufacturers have indicated that they will be following up their vaccine trial recipients for up to at least 30 months, as part of the trial design (21)

We pray that these unprecedented COVID-19 vaccines will be optimally utilized & the COVAX initiative to make it accessible to everyone will be realized in our joint efforts to make this world a safer place from CoV2 & prepare us better for any future pandemic threats (22)

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