IT’S a rather trying time for all of us, and many are the aspects of the pandemic in Malaysia that remain unanswered despite frequent questions from the public. Today, we will focus on 10 Covid-19 vaccination vexations.
There are more, but the 10 main ones will do for now.
1. Why were we late to vaccinate people?
The official reply is that vaccine supply was short, but that does not explain why many countries, some of them less wealthy than us, were still able to source supplies. There needs to be a better explanation – this is important because if it is due to bureaucracy, underhanded stuff or incompetence, we need to get rid of it for better Covid-19 handling in the future.
2. What will be the total cost of vaccination?
There is no proper answer to this. Vaccination drive coordinating minister Khairy Jamaluddin said RM2 billion was added to make for a RM5 billion allocation to the National Covid-19 Immunisation Programme. This was after various factors were considered, including increased costs to procure vaccines and the costs of administering the programme.
3. Is there a breakdown?
None for the individual costs of the various vaccines. The minister said the RM5 billion includes RM3.5 billion for vaccines (no breakdown), RM333 million (rental and utilities), RM260 million (disposable equipment and vaccination implementation) and RM100 million (sanitisation and cleaning).
The allocation also includes gifts worth RM200 million for non-health volunteers, data integration costs and the appointment system (RM70 million), community outreach and vaccination advocacy programme (RM55 million), gifts for health volunteers (RM147 million), post-immunisation surveillance and system upgrade (RM15 million), outsourced private medical practitioners (RM210 million) and unexpected contingencies (RM110 million). We could not find a proper breakdown for each of these, which the government should give.
4. Are middlemen involved, and who are they?
This is somewhat hazy. Government-linked company Pharmaniaga Bhd has a bottling arrangement for Sinovac, but that has faced bottlenecks, with calls to secure supply directly from China. In the past, statements were made to the effect that vaccine purchases must go through the agents of providers, implying there are middlemen. It is hard to see vaccine providers insisting on governments using the former’s agents in this environment. This adds to speculation that the government may not have direct deals, increasing costs and causing bottlenecks.
The presence of middlemen is also suggested by Putrajaya’s snub of the PETRA Group’s offer to donate 200,000 vaccines to the government vaccination system. All that was needed was the government nod for the purchase.
5. Are mega vaccination centres necessary, how much do they cost, and are they sources of infection?
Let’s deal with the costs first. Going by what Khairy said, there are costs for rental and utilities amounting to some RM333 million (in Point 3 above), but there are no breakdowns. Still, it seems a rather large number. But, such vaccination centres are easier to administer, and if properly managed, can lower logistics costs. As it turns out, they are also major sources of infection, as thousands of people are brought together daily. Sufficient thought has not been given to this, and alternative plans are rather slow to materialise – even now. Who administers these centres? Good question, but we don’t have an answer.
6. Are there alternative distribution channels, and why were they not used?
An easy alternative would be to mobilise some 7,000 general clinics and 1,000 specialist ones throughout the country, making use of existing infrastructure instead of setting them up and paying expensive rentals. Logistical concerns can be settled by setting up regional centres for vaccine distribution. If one clinic, operating in full swing, can vaccinate 100 people on average a day, we can potentially vaccinate 800,000 people daily, nearly double the existing record rate.
So, this is a terribly overlooked channel for vaccination that is potentially cheaper and faster. Speculation as to why this was not done is unfavourable, and centres around a lack of patronage business if it were done. Tsk, tsk!
7. Are migrant workers being vaccinated?
Only if they are employed legally. Then, they can be registered even on the MySejahtera app and queue for the vaccine like the rest of us. And, there are also programmes for vaccinators to go to premises and vaccinate them for a small charge, which can still vary according to situations and circumstances. Officially, that covers some two million workers, addressing only about a third of the “problem” as we shall see.
8. What about undocumented workers?
Ah, we now come to one of the serious problems in vaccination. There are up to four million of these workers, according to some estimates, and by some accounts, most of them are not vaccinated, and therefore, may freely infect others. If you wonder why the daily Covid-19 infection rate has gone up despite lockdowns, this is a partial answer. Some of the more “responsible” employers try and get their workers vaccinated, but those who depend on contract labour provided by third parties turn a deaf ear and a blind eye, and continue operating, making sure they are far from the area of operations. These may be the ones who cry “don’t close down our factories” while socially distancing from them.
The unfortunate workers, a product of government bungling over the years – no, decades – and the naked greed of employers, may also be responsible for “community spread” when they return to their homes, which could be anywhere. This problem must be solved for a comprehensive cure to the Covid-19 issue by firmly including these people in the vaccination process. We really need to see some progress here.
9. Is there a black market for vaccines?
I heard it through the grapevine that this is how many well-to-do people and their help got vaccinated long before their turns came on MySejahtera or the shameful lottery that people rushed into to get AstraZeneca. It is well known that MySejahtera can be tweaked (how else can you prioritise some people?), and in Malaysia, we all know how this process can be modified for the right price and right influence. The next question further elucidates this point. It would appear that there is not only a black market for vaccines, but for government vaccines, too.
10. Why are people getting blank jabs?
The allegations of getting blank jabs are too many to be mere chance, and video evidence of this indicates it’s quite deliberate. Why would any person do this dastardly act deliberately if not for pecuniary gain? Some of those in the know cited a price of RM50 a vial on, yes, the black market. However, strict adherence to the standard operating procedures will get rid of this in a jiffy. With all the publicity around it, one has to be a real dunce to try a stunt like this again. The consequences are likely dire.
Well, that about sums it up, and if you are going to get vaccinated, take a look at that vial – before and after – if only for your own peace of mind. Me, I don’t doubt it happens, but it’s likely overblown, like the risk of side effects from vaccination. Don’t let that deter you from vaccination, by the way – it’s the only shot we have left in our limited arsenal, if you will pardon a bad pun. Let’s keep that powder dry. – The Vibes, July 22, 2021
P. Gunasegaram is chief executive of advocacy and research group Sekhar Institute and editorial consultant of The Vibes