The Malaysian Insight

THERE is no strong evidence to support the need for a second booster shot, leading to hesitancy among the public, health experts said.

They added that it could also be the reason why the Ministry of Health has not gone out of its way to encourage the public to take the shot, instead limiting it to a select group.

While its effectiveness may not be significantly greater than the first booster, health experts and former deputy health minister Dr Lee Boon Chye said those who are elderly or have comorbidities should take the second shot nonetheless.

“In terms of the need for a second booster, there is evidence of its effectiveness, but it is not as strong as the vaccine and first booster,” Lee told The Malaysian Insight.

“For the second booster, it is better to have it if you are above 60-years-old or have illnesses.”

Earlier this month, Health Minister Khairy Jamaluddin urged those above 60 and those with serious medical conditions to take the second booster shot in light of the Omicron BA.5 sub-variants spread in the community.

He also announced in Parliament that the government is now allowing second booster shots for those aged 50-59 years without any comorbidities.

He also encouraged the 31.1% of the adult population who have not received the first booster shot to do so.

To date, 99.2% of the adult population have received one dose of the vaccine, while 98% are fully vaccinated.

Some 68.8% have received their first booster shots, while only 1.3% of the adult population has received a second booster dose. Of this, 3.8% account for those above 60.

Clinical studies in Israel, one of the first countries to administer a fourth dose, showed that the vaccine restores antibodies to levels observed after the third dose but provides only a modest boost in protection against infection.

In the United States, the Centers for Disease Control and Prevention (CDC) have recommended a fourth dose for people who are above 50 and who are immunocompromised.

While BA.5 is said to be vaccine resistant, Lee said vaccines have been shown to reduce severe illness and hospitalisation.

“The second booster helps. On principle, I would still encourage it, but it is not mandatory,” Lee said.

First booster shot more important

“While pushing the second booster dose, those missing the first booster should be prioritised,” Public health expert Dr Moy Foong Ming said.

“Based on the results of a study published in the British Medical Journal, the protection against severe outcome for two doses was 52%, compared to 77-80% for three doses of and 78-86% for four doses.

“This reinforces the point that it is more important to have the third dose.”

Some experts also suggested that we should consider three doses as the standard for fully vaccinated, instead of two, Moy said.

Increase outreach effort

Meanwhile, epidemiologist Dr Malina Othman said there needs to be more awareness among the public to convince them to take the vaccine.

“Agencies should aggressively promote the second booster to ensure that those in the targeted age groups are prevented from severe infection,” Malina said.

Meanwhile, Moy called for outreach programmes in the community, especially “for the elderly in the community, nursing or old folk homes”. – July 28, 2022.