Dealing with anti-vax campaigns

EVERY afternoon, we are faced with a distressing new set of Covid-19 case numbers – this past week alone a surge of 5, 000 to 7, 000 new infections have been reported daily. Dedicated intensive care units across the country meanwhile are operating beyond full capacity. The need to vaccinate as many people in the shortest time as possible has never been more vital.

While the National Covid Immunisation Programme is ramping up the administration of vaccines, it faces a huge challenge: naysayers who are spreading unsubstantiated, false and misleading information about the Covid-19 vaccines. Their aim: To discourage people from getting vaccinated.

The threat of these individuals has pushed the government to mull taking legal action against those who are found to have incited public opinion against the Immunisation Programme.

It is first important to note the distinction between those who are against vaccination (or anti-vaxxers as they are dubbed) and those who are vaccine hesitant. Vaccine hesitant individuals are those who may have doubts about vaccines or refuse to take them, but do not necessarily reject vaccines in general outright. This hesitancy is influenced by a range of factors which includes complacency, convenience and confidence. The anti-vaxxers are strongly opposed to vaccination.

It is also crucial for us to recognise that not all of those who are reluctant to take the Covid-19 vaccine are actively spreading unsubstantiated misinformation to discourage others from taking vaccines.

Still, ultimately, they will endanger lives as their refusal of the vaccine poses a barrier to Malaysia’s goal of achieving herd immunity to the virus.

Estimating numbers

Two years ago in April 2019, former Deputy Health Minister Dr Lee Boon Chye told the Dewan Rakyat that the local movement against vaccination comprised only around 1% of the population. However, this number may have increased as vaccination misinformation mushroomed exponentially after the Covid-19 outbreak.

According to Deputy Science, Technology and Innovation Minister Ahmad Amzad Mohamed @Hashim, the government is closely monitoring groups who disseminate anti-vaxx propaganda on social media.

The Institute of Strategic and International Studies’ November 2020 policy brief on countering Covid-19 anti-vaccination propaganda by Harris Zainul explains that we do not have the exact number of vaccine deniers in Malaysia. This makes it hard to strategise ways to counter the misinformation.

It is therefore important to build trust in the country’s immunisation programme and push for the wider dissemination of credible and accessible information on vaccines to counter anti-vaccination propaganda and remove hesitancy.

Earlier this month, Prime Minister Tan Sri Muhyiddin Yassin announ-ced that the Covid-19 Vaccine Supply Access Guarantee Special Committee (JKJAV) will be studying the possibility of making vaccination compulsory for all if the number of those registered in the national Covid-19 immunisation programme lags behind the total needed to achieve herd immunity.

To dispel vaccine concerns on religious grounds, the Fatwa Committee of the National Council for Islamic Religious Affairs carried out a muzakarah (discussion) in December and came to the resolution that the use of the Covid-19 vaccine is not only permissible (harus) in Islam, but also obligatory (wajib) for groups which have been identified by the government. The Kelantan Islamic Religious and Malay Customs Council recently said that it will take action against any preacher who gives lectures discouraging Covid-19 vaccination.

Malaysia is not the only country grappling with this problem – across the world and particularly in the West, anti-vaxx groups have gained influence. In November, the BBC reported that the United Kingdom’s opposition Labour Party called for new laws to be introduced to combat anti-vaccination content online and proposed criminal penalties for social media organisations that don’t remove anti-vaccination misinformation from their platforms.

A critical stage

Malaysian Lawyer Lim Wei Jiet is supportive of taking action against those who spread anti-vaxxer messages, and is of the view that they should be hauled into court and charged.

“A major benefit of punishing those who spread anti-vaccine messages is that it would curtail the spread of anti-vax conspiracies which are harmful to public health, ” says Lim, who is also secretary-general of the National Human Rights society (Hakam).

“One minor drawback is that some may view this as an erosion of free speech and the better way to address anti-vax theories is for government awareness instead of penal sanctions. But we have reached a stage where the pandemic is so bad, that I think it justifies the law stepping in, ” he explains.

However, Lim shares his concerns on the manner in which the government intends to prosecute anti-vaxxers.

“(Minister in the Prime Minister’s Department in charge of Parliament and law) Datuk Seri Takiyuddin Hassan is suggesting the use of the Sedition Act 1948 – which I vehemently disagree with because that is a misuse of the Sedition Act and we should not legitimise the use of this archaic law, ” says Lim, who argues that there are other laws such as regulations that can be enacted under the Prevention and Control of Infectious Diseases Act 1998 to deal with anti-vaxx misinformation.

Under normal circumstances, Dr Sharifa Ezat Wan Puteh, a public health professor with Universiti Kebangsaan Malaysia’s Health Economics and Public Health department, is reluctant to support punishment of those who spread fake news as she believes in an individual’s right to free speech.

However, she also recognises how misinformation spread by anti vaxxers and vaccine hesitant groups can influence others and have substantial adverse impacts on public health, particularly when Malaysia is struggling with peak infection rates.

To date, the country has recorded more than 652, 000 infections and 3, 800 coronavirus-related deaths.

“People may be taken in by vaccine misinformation, believe the misconceptions, and resist vaccinations. As a consequence, the country may not be able to achieve herd immunity by the end of the year, ” she says.

Dr Sharifa suggests that some leeway may be given to first time offenders who spread vaccine misinformation, but repeat offenders should be given a heavier punishment, such as a fine or imprisonment.

“This is disheartening as it puts so many lives in jeopardy. It must be stopped, ” says Dr Sharifa, who adds that the act of spreading vaccine misinformation also causes loss of human capital in terms of early deaths and also economic losses suffered by the country.

She points out that there have been many instances in Malaysia where lapses in vaccination caused some members of the population, especially children, to forgo immunisation which led to the spread of vaccine-preventable diseases such as polio and diphtheria.

Malaysia’s immunisation programme aims to vaccinate 80% of the population by the end of this year and has administered up to 150, 000 doses a day this month. Efforts are currently underway to raise the rate to 400, 000 doses a day in the coming months, dependent on vaccines arriving on schedule.

The national vaccine rollout has faced some challenges and teething problems ranging from faulty data integration systems to complaints about the efficiency of the MySejahtera app. Nevertheless, sharply improving vaccination rates give confidence that Malaysia is on the right track in its immunisation programme.