Booster shot aimed at keeping protection level up

Dr Helmy Hazmi

KUCHING: A third dose of the Covid-19 vaccine does not imply that immunisation has been unsuccessful, says Dr Helmy Hazmi.

The Associate Professor attached to the Faculty of Medicine and Health Sciences in Universiti Malaysia Sarawak stated that generally waning immunity affected both the mRNA and inactivated vaccines used in Sarawak’s vaccination programmes.

“When we talk about booster injections, we are talking about the third shot given to someone who has built up enough immunity after receiving the first two doses of vaccine but because the amount of protection has waned with time thus a booster shot is administered to keep the level of protection high.

“In addition to that, the third dosage is an extra dose given to individuals who have not built up adequate resistance to the Covid-19 infection or do not have any protection against it. This was observed in immunocompromised, elderly people and possibly people with multiple underlying medical conditions.

“The latter group of people demonstrates a wide range of immunological responses after completing their vaccination, but the most concerning of which are those who lack it.”

Dr Helmy pointed out that slowly rising immune responses in immunocompromised and elderly people as well as declining immunity over time were cause for concern and this could lead to an increase in hospitalisation, serious disease and even death.

“This declining immunity effect had been observed in real-world data from the United Kingdom and Israel. When the third additional dose was given to the elderly and immunocompromised in Israel, the rate of severe form of disease and mortality was reversed in those who received it compared to those who did not.

“Although we have yet to witness the same pattern in Sarawak as in Israel, we should not wait for serious cases and deaths to increase before deciding to deploy the third additional dose.”

He mentioned that it was still preferable to be vaccinated than not to be immunised at all as the case fatality rate had actually decreased due to the high vaccination coverage among adults and nearly all new cases are mild.

“Having said that, we recognise the importance of maintaining vaccine equity when neighbouring regions have low immunisation rates. However, we are currently working in both directions namely reaching out to the unvaccinated and now considering the third dosage.

“Thus, the elderly, persons with several underlying conditions and the immunocompromised should be given the additional dose.”

When asked should the booster shot be made mandatory, Dr Helmy reminded that vaccination was a totally consented and voluntary procedure.

“Therefore, there must be respect in the decision made by individuals even if it is not in the best interests of the community as a whole.

“The two most important questions to ask about the third shot are, ‘is it safe?’ and ‘is it effective?’. To address this, we must rely on science and it will not be acceptable to refuse the third dose if there is solid evidence that it is both safe and effective.

“Lockdowns are already a no-no, so why aren’t we taking a third shot if we despite them? We simply need some social restructuring to encourage people who are on the fence to take action.

“One example is the reassignment of unvaccinated teachers and the other is some benefits granted to the vaccinated can be taken away from those who have not been vaccinated.”

Dr Helmy also urged the public to always obtain accurate information from reputable and trustworthy sources.