The Malaysian Health Coalition (MHC) cautiously welcomes the in-principle decision to provide booster doses for selected high-risk groups in Malaysia beginning early October 2021, and we welcome the decision to provide COVID-19 Care Packages (PPC) to the B40 group.

We hope that these two decisions will help transition Malaysia to an endemic COVID-19. We urge the following:

1. A targeted booster strategy guided by transparency and published data

Globally, we are still developing the long-term vaccination strategies for an endemic COVID-19.

While there is some real-world data that shows booster efficacy in those aged ≥60 years and the US FDA has approved boosters in targeted groups (Sept 17), a commentary in The Lancet (Sept 13) advocates for caution and the World Health Organization (Aug 10) stated that “evidence remains limited and inconclusive on any widespread need for booster doses”.

We call on the Ministry of Health (MOH) to release Malaysian data to show increasingly poor outcomes for high-risk groups that will receive boosters, such as increased cases, hospitalizations or deaths, to justify boosters in these groups.

This data can be stratified by age, type of vaccine and time since completed vaccinations, and can guide our targeted booster strategy.

2. Focus equally on vaccinations in states with low vaccination rates

Several states have low vaccination rates, and we must focus equally on these states. For example, as of Sept 20, only 54% of Sabahan adults are fully vaccinated while 107% of adults in Klang Valley are fully vaccinated. This is a large discrepancy.

MOH data shows that those who are unvaccinated or partially vaccinated have higher ICU admission rates. Therefore, we must increase our efforts to increase vaccinations in states with low vaccination rates, and prioritize a vaccination rate of 90% for all states in the primary vaccination series.

Focusing on less vaccinated states is important for equity, and no state should be left behind.

3. Publish transparent data on vaccine supplies

We call on the MOH and JKJAV to release granular data on current vaccine supplies and projected delivery schedules. This information will prove that Malaysia has enough supplies for boosters beyond mere verbal reassurances.

In the scenario of inadequate vaccine supplies, we propose an equal emphasis on completing primary vaccination series nationally, including for those aged 12-17 years old and non-citizens.

Boosters are likely to be inevitable in an endemic COVID-19. This is why we cautiously welcome the decision to provide boosters.

We urge the government to provide the data to justify boosters, equally prioritize primary vaccination series in less vaccinated states, and publish data on vaccine supplies.

Malaysian Health Coalition