Opinion

Letter – 10 questions for Khairy Jamaluddin – Ong Kian Ming, Kelvin Yii

Problems in Phase 1 of Putrajaya’s inoculation drive need to be ironed out to avoid country’s health sector being overwhelmed

Updated 3 years ago · Published on 16 Apr 2021 8:07AM

Letter – 10 questions for Khairy Jamaluddin – Ong Kian Ming, Kelvin Yii
Phase 1 of the the National Covid-19 Immunisation Programme averaged less than 40,000 jabs daily, and at that rate it begs if the 160,000 daily target for Phase 2 is achievable.– The Vibes fie pic, April 16, 2021

IN the leadup to the start of Phase 2 of the National Covid-19 Vaccination Programme, there are many questions which need to be asked and hopefully answered. We commend the job which the programme’s coordinating minister, Khairy Jamaluddin, has carried out thus far under challenging circumstances. 

We hope that he can respond to the following 10 questions as Phase 2 of the inoculation drive starts on Monday.

1) What is the geographical distribution of those above 60 who have yet to register for the Covid-19 vaccine?

The minister has stated previously that due to the lower than expected vaccine registration rates among over 60s and above, Phase 3 registrants will be vaccinated together with those who are scheduled for vaccination under Phase 2. He was also reported as saying on March 29, that only two million senior citizens have registered for Phase 2 of the vaccination program representing only 22% of the target. This means there are approximately 7 million senior citizens who have yet to register for the vaccine.

At the time of writing, we do not know which states/districts they may possibly be located in.

This would be useful information for us to know so that more targeted efforts can be used in order to get more senior citizens to be registered for the vaccine.

2) What steps have been taken to work with state governments in order to increase the registration rate?

State governments have access to some data for those who are aged 60 and above. For example, in Selangor, over 60s are eligible to be registered under the Skim Mesra Usia Emas (SMUE). In Penang, there is the senior citizen’s acknowledgement programme, in which all above 60 are eligible. As far as we know, there has not been any concerted effort to work with state governments such as Selangor and Penang to mobilize their machinery, elected representatives and NGOs to register these senior citizens based on existing databases.

Of course, state governments can mobilize on their own without any initiation on the part of the federal government, but given that federal authorities are taking the lead on this programme, it would be very helpful and perhaps even necessary for the federal government to take the initiative, give the endorsement for and cooperate with the respective state governments to take the necessary actions to register as many senior citizens as possible for the Covid-19 vaccine.

3) Will the 2-week notice for vaccine takers which was initially promised by the minister be followed? What other measures can be used to reach out to those who have not confirmed their appointments via their MySejahtera app?

The minister promised on March 29 that those who have their vaccination appointments during Phase 2 will be given a 2-week notification via the MySejahtera app, phone calls and SMS. Anecdotal evidence thus far seems to indicate that many people have not received any notification yet via one or more of the channels indicated by the minister. Many people are feeling anxious and are checking their MySejahtera app regularly either for themselves or for their dependents/parents – Ong registered his mother as his dependent but has yet to receive any notification of the date of vaccination. Ong helped his father register via his own MySejahtera app and according to the Covid-19 Vaccine Supply Access Guarantee Committee’s website, his appointment is still pending. At the other end of the scale are those senior citizens who are not tech-savvy and probably had someone else register them for the vaccine and who have yet to respond to their MySejahtera and/or SMS notification. The minister indicated as much when it was reported on April 12 that more than half of those initially notified have not responded to confirm their appointment dates. 

We need to understand the reasons for the low rate of response if we are to increase the positive response rate. Other than not being tech-savvy, the issue of some senior citizens not being able to read and understand BM could also be another reason. Solutions such as voice messages, in more than one language, could be used moving forward.

4) Has the list of vaccination centers been confirmed? Will they be published soon?

At the time of writing, the full list of vaccination locations by state for Phase 2 has not been publicly announced yet.

Although each person will be given the clinic/exact location of where they will receive their vaccination, it would be useful if the full list of vaccination locations are published so that those who have their doubts about the location can refer to a verified list. This should include private clinics and hospitals which have signed up to be part of the vaccination programme.

5) Will there be translations for senior citizens who may not be very well-versed in BM? Will other assistance also be provided for those who are illiterate?

The process of vaccination will be challenging for those senior citizens who are illiterate, hard of hearing, have bad eyesight and/or are not so well-versed in BM. There are many forms to be completed, apps to be scanned and also one briefing to listen to. It would not be surprising to us if some senior citizens find the entire process too stressful and this may affect their physical health before, during and after taking the vaccine. Hopefully, at each of the vaccination locations, such issues would have already been considered and sufficient steps undertaken to minimize the stress for the senior citizens.

6) Do we have sufficient manpower to increase the number of vaccinations per day fourfold from 40,000 per day to 160,000 per day?

During Phase 1, the average number of daily vaccinations was less than 40,000. The target for Phase 2 is 160,000 per day. Do we have the capacity in terms of nurses and doctors to ramp up to this number? Even with the inclusion of private GPs and hospitals in the vaccination process?

7) Are there any contingency plans in place to have “volunteers” vaccinated in case those with confirmed registrations do not show up?

One would expect there to be some absenteeism among those who have confirmed their appointments based on the experience of other countries. The strategy in many of these countries is to have a queuing system or database where people can be informed if there are leftover vaccines which must be used before they expire in case there are people who do not show up for their appointments.

As far as we know, there is no such system in place in Malaysia. But we feel that this is a necessary step in the vaccination process so that vaccine wastage can be minimized.

8) How will the supply of Covid-19 vaccines be affected by continued uncertainties? 

The minister has said that we have sufficient supplies of Covid-19 vaccines to cover more than 80% of the population (including foreign workers), which is the percentage needed to achieve herd immunity.  But there remain outstanding concerns with regards to the authorisation of Russia’s Sputnik V vaccine by the National Pharmaceutical Regulatory Agency (NPRA) – very few countries seemed to have authorized its usage – while ongoing concerns on the small risk of developing blood clots via the AstraZeneca vaccine have made some countries like Denmark to temporarily stop its usage.

What contingency plans does the minister have in order to address some of these issues with regards to the supply of some of these vaccines? Will there be any further delays in the supply of some of these doses because of vaccine nationalism on the part of the EU and India?

9) Can vaccination be made compulsory? Is this constitutional? What other methods can be used e.g. vaccine passport and allowance for activities?

The minister was reported to have said on April 9, that vaccine registration could be made compulsory if the number of registrations remains low. Is this legal and constitutional? We take note that even taking the BCG vaccine jabs are not compulsory for kids who go to school. Can vaccine registration and later vaccine inoculation be made compulsory?

Surely other incentives such as allowing those who have been vaccinated to do certain activities e.g. vaccine passports should be considered before a move for compulsory vaccination be made.

10) How effective and efficient is the Covid-19 call center? Does it require more resources in terms of more callers who can speak different languages to call up those whose appointments are upcoming? Can we utilize technology such as chatbots and Artificial Intelligence to respond to queries on Phase 2 and Phase 3 appointments?

There is supposed to be a Covid-19 vaccination call center but we are not sure as to how well it is functioning. At the time of writing, we do not know how many people are manning this call center, whether this number of people is sufficient, which ministries they are from – or if this function has been outsourced to a private company – what training this group of people have received and so on. We would definitely be interested to visit this call center so that we can better understand how well it is functioning. And if we feel that there needs to be more resources allocated to this call center, we would definitely support the coordinating minister’s appeal for more funding and other useful resources. – The Vibes, April 16, 2021

Ong Kian Ming and Dr Kelvin Yii are DAP MPs for Bangi and Bandar Kuching respectively

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