Seniors' Wildgoose Chase for Sinovac Booster

December 2021

One of the recent announcements from the MOH (Ministry of Health) is that all seniors aged 60+ who have received two doses of Sinovac earlier will have their fully vaccinated status withdrawn in February 2022 if they do not get their booster shots by then. It is not mentioned though if the booster must be Pfizer which is provided free. Given such urgency as reflected by the stern warning, does the authority wonder why many seniors are still dithering?       

When 40% of the seniors did not show up for their booster shot appointments in November last year, for whatever reasons, the authority responded quickly with various announcements. It was from the horses’ mouths, through their tweets or media statements, we learnt that Sinovac boosters would be approved soon by the MOH and made available at PPVs (Pusat Perkhidmatan Vaksinasi) nationwide, in STAGES. Seniors, especially those who cannot take Pfizer boosters because of medical issues, can now request for Sinovac at the PPVs they are assigned to. However, up until end of December last year, when these seniors received their booster shot appointments – some for the 5^th time!!! -- they found that Sinovac booster is still either unavailable at the PPVs, or they have to PAY for it! Some irate seniors quipped that announcements by the various authorities in November last year were like smoke screens, ambiguous and lack clarity, leading to confusion and false expectations. Perhaps it was a case of the media reporters misquoted or misinterpreted the tweets and announcements? We hope the authority will quickly clarify this matter by stating explicitly if it is MOH or Cabinet decision that seniors must either take the free Pfizer boosters or PAY for Sinovac boosters.

Given that worldwide, vaccine booster is a highly politicized issue, with experts and various studies offering conflicting opinions and conclusions, it is important that rakyat are not forced to accept the mandate “take the Pfizer booster for free, or PAY for Sinovac booster if you need it”.

One can understand the need to speed up the booster program before the huge stockpile of costly vaccines expires. But the MOH must get its priorities right and be more systematic in the booster roll-out operations. It is really not a Herculean task to find out the reasons behind the 40% no-show for booster appointments, and follow up with appropriate actions. One just needs to look into the database, identify those who need Sinovac boosters because of medical issues or fear of heterologous boosters, and let them get their desired boosters soonest possible. As it is, until quite recently, boosters have been offered to walk-ins of all ages rather randomly. A friend who accompanied her mother for her booster appointment at a PPV found the venue so crowded that they had to stand and wait in the hot sun for hours. It is no surprise that the duo decided to just return home to wait for another appointment!

Over the past two month or so, there was sporadic news of free Sinovac boosters being given in PPVs in the Northern states of Kedah and Penang, Triang in Pahang, and even in Senawang Convention Center in Seremban. There were reportedly long lines of walk-ins, including some anxious seniors who started to queue from as early as seven in the morning to ensure getting the Sinovac boosters. Surely the authority should feel some compassion for them, especially if they are the ones who cannot take the Pfizer booster because of some medical issues? Why subject these seniors to such hardship and unnecessary risk? This aside, why is there still no clear plan or schedule of where the ‘promised’ Sinovac vaccines are being sent to nationwide? Why such a haphazard way of distribution? Can ProtectHealth website do more than just listing the PPVs? Perhaps they can include contact information and also state clearly what vaccines are available for FREE at which PPVs and when? This will save a lot of frustrations having to find the contact information of PPVs and then call them – often to no avail-- to find out what vaccines are available.

Sometime last month, Selangor started offering about 15,700 free Sinovac boosters, supposedly to complement the effort of the Federal Government. However, it seems to be for walk-ins too with no priorities for seniors. It is not clear where the state government has acquired or purchased the Sinovac boosters. Whatever, this program presents a glimmer of hope for many seniors in the Klang Valley who had been frustrated with their wildgoose chase for the elusive free Sinovac boosters ‘promised’ since November last year.  After turning down two or three appointments, many just gave up the wait for more appointments from MySJ. They either paid for the Sinovac boosters or just tried their luck with Selangor Government’s offer through Selvax/Selangkah. For the latter ‘lottery’, some had to wait till end of January and even February for the booster appointments.

There is also this urgent question about the two million doses of Sinovac donated by China recently. Together with the one million or so doses donated earlier last year, there are now perhaps a total of 3 million donated doses in the stockpile? Surely we must try to use them up quickly before the need to extend expiry date once again? Interestingly, some photos of China-made Sinovac vials have been circulated on social media, allegedly taken in PPVs and private clinics where payment is required. Could this be malicious fake news? We hope so because all rational right thinking people know that it is unethical and morally wrong to make the rakyat pay for donated vaccine boosters. What more when vaccination is a national public health service that should be FREE for all rakyat? To quash such ‘rumors’, it is time the MOH starts making the distribution of these donated Sinovac boosters more systematic and transparent. The rakyat and tax payers have the right to know where exactly these three million doses will be sent to and when, who will get them for free and who will have to pay. If not, lack of transparency will only fuel more speculations and undermine the MOH’s effort in speeding up the nation’s vaccination program.

Booster Shot Concerns

(An abridged version with a different title was published in The Sun/ The Star 15 Nov 2021)

News that the Ministry of Health will be giving booster jabs to all frontliners and seniors is welcome by most quarters. Unfortunately, the recent announcement by the Minister of Health that Pfizer booster jabs will be given to seniors who already received two doses of Sinovac has created a lot of anxiety and uneasiness. This is especially so for those who are well read. They have strong apprehension about the safety of such heterologous booster shots. To add to their alarm is the press statement by the minister that this heterologous administration will be part of the government study, done in an off-label manner, meaning this booster jab is used in a way other than officially approved for. So, can we blame the seniors for the perception that they are being used as guinea pigs?!

Even though it was barely a few days ago that MySejahtera  has started notifying these seniors about their booster jab appointments, the ministry should have got the drift by now. Many seniors either did not confirm their appointments, or they    confirmed but did not show up for the vaccination. MySejahtera only asks recipients of booster jab offers to click a button to confirm, no other options are available. (Sounds like hard selling snake oil, take it or leave it, as one senior quipped!)  Those who found the date and time of jab appointment unsuitable tried calling helpline, but like before, to no avail. Some just clicked to confirm, out of anxiety, and then decided not to show up. One senior complained that he was given two doses of Sinovac because of health issue, but now they want to give him Pfizer as booster!

Many people are of the opinion that the decision to mix two Sinovac jabs with Pfizer as booster shot is not substantiated by findings of any study or analysis of data collected by the Ministry of Health thus far. It is callous to say the least, subjecting the vulnerable seniors to unknown and unnecessary risks. This is especially so in the midst of many experts, including a WHO scientist, warning and cautioning the use of heterologous vaccinations by individuals. (https://www.reuters.com/business/healthcare-pharmaceuticals/who-warns-against-mixing-matching-covid-vaccines-2021-07-12/..... ) The Chinese government is also very prudent and responsible, stating that there will be no mixed booster shots until scientists are sure.  (https://www.scmp.com/news/china/science/article/3153424/no-mixed-covid-19-booster-shots-china-until-scientists-are-sure)

Therefore, our burning question is: Why not give a third Sinovac to these seniors as booster? After all, a study in Turkey involving 30 million vaccinated citizens has indicated that the highest level of protection was seen in people who received three doses of inactive vaccines (Sinovac), rather than in those who received two doses of inactive vaccines and one booster shot of an mRNA vaccine (Pfizer). (https://asia.nikkei.com/Spotlight/Coronavirus/COVID-vaccines/3-doses-of-Sinovac-is-better-than-mixing-with-Pfizer-Turkish-minister) Our neighbor Singapore down south is doing just that now, giving three doses of Sinovac to those who do not want mRNA vaccine as booster. Can we do the same here?

 

MOE needs to be more proactive

 ( A slightly edited version, re titled Revolutionise pedagogy at schools, was published in the Sun, 14 June 2021) 

Recent news reports about 20,000+  Covid cases among children and 20+ school clusters have raised alarm and concerns among many, especially parents. With the current surge in Covid cases nationwide and worldwide, it looks like the battle with the virus will be a long haul, as expected. Even though the long-awaited vaccines are now available, and will be administered to all Malaysian soon, it is unlikely that we will be out of the woods in the near future. What’s more, the recent emergence of more contagious and dangerous new variants and mutants only makes the battle more formidable and the future more uncertain. Perhaps it is timely now for all Malaysian stakeholders in education to learn from the past year and seriously re think outside the box, to plan for the re-opening of schools if and when it does happen in July as announced.  

Based on what we have learned since March 2020, we have to start our re thinking with the following premises in mind:

1)      We cannot assume that the pandemic will end soon – even now with the arrival of vaccines and the attainment of herd immunity -- be proactive and prepare for the long haul

2)      We cannot impose complete shutdown of schools for the long term, and assume that most of our students are able to learn effectively online, or that online learning can supplant face-to-face learning in schools

3)      We must change our mind sets to take this crisis as an opportunity to re model schools and  transform education in schools in the real sense

4)      We must take steps so as not to subject the 2021 cohort of SPM, STPM and other examination- class students to the same predicament of their 2020 counterparts

5)      Although the 2020 SPM results seem to suggest an overall improvement rather than a decline as most people expected, we must proceed to analyze the results of the examination in greater details. Such analysis must be done to identify knowledge/skill  gaps which may provide useful information for the re planning and adjustments of school curriculum and tertiary education programs for the 2021 and 2020 cohorts respectively.  

Thus far, complete shutdown of schools seems to be the favorite solution since March 2020,  even at times when circumstances were not as dire as March this year when schools re opened briefly, much to the chagrin or even shock of many. My point is, during the intermittent periods of school opening in that one year, plans could have been in place to re model schools to allow examination class students more access to classroom learning, with other students attending classes on a rotational basis, as this writer has advocated as far back as April 2020.  Will the MOE (Ministry of Education) be willing to try this model when schools are deemed safe to reopen later, in the near future? 

Not too long ago, Sibu succeeded in getting the permission to have their pupils attend schools on a rotational basis. Some independent Chinese schools in peninsular Malaysia did the same since sometime last year. One of them has sufficient resources to divide an examination class of over 40 students into two, with half of them attending the class, while the other half following the same lesson simultaneously in another classroom with a large TV screen. This was done on a rotational basis. If I remember correctly, schools in Germany also implemented rotational schooling since August last year. These were all attempts to ensure social distancing in an over-crowded classroom or school. Without such measures, schools must surely be the most crowded ‘public’ place -- by today’s standard -- other than the morning and night markets?! It is time the MOE seriously think about how to implement rotational schooling as a new norm, to reduce crowding in the classroom and schools in the not so distant future. 

As announced by MOE earlier this year, the complete shutdown of schools nationwide for months on end, will not be repeated this year. Is this good and comforting news for the parents and even teachers? Probably no, especially in schools with high enrolment of one to two thousand students or more, and classroom with more than 40 students, which is not uncommon in many vernacular schools. Thus, rotational schooling is certainly worth serious consideration if we have to adopt the new norm of reducing students’ exposure to viral load, avoiding crowd and maintaining social distancing.  

MOE has talked about plans to build more classrooms or provide better internet access and devices to schools and students, but all these involve high cost and are not achievable in a short time. Relying on the PdPR (home-based learning) guidelines and the less than adequate DidikTV  programs is certainly no solution too for the majority, as we have learned.

Should we then continue the hype of online learning, and lull ourselves into believing that it is indeed the best and only solution, regardless of what survey data have told us about the lack of accessibility to devices and broadband among the majority of our 5 million plus students in schools? The ad hoc distribution of 150,000 devices will certainly not help close the digital divide between the haves and have-nots. In fact, the majority of students who have missed out on learning during the school shutdown last year are not confined to those in the B40, they also include many of the M40. Unfortunately, these parents have no voice, their complaints are seldom, if ever heard.  

Frankly, to say that the public is disappointed with the lack of foresight and planning by our MOE is an understatement. If only they have heeded opinions and suggestions from various stakeholders in the past year, they could have acted proactively then to minimize disruption in schooling, and will be better prepared this year. As mentioned above, as far back as April last year, in newspapers and social media, this writer has advocated that MOE make plans to revolutionize and transform teaching-learning in schools, to re model schools for the long term. I would like to reiterate here ideas shared then:

1)     In the worst case scenario without any better alternatives in sight, students should go to schools on alternate days or on a rotational basis, to reduce class size for social distancing. This sounds unthinkable, even unacceptable to many, but desperate time needs desperate measure. Each class can be split into two groups with the teacher repeating the same lesson to them on two separate days. This way, students can at least learn something in schools, albeit maybe half of what is supposed to be learned in the syllabus. Otherwise, as has happened last year, without an inclusive online and e-learning strategy, even with the much vaunted PdPR and DidikTV, majority of the students are whiling away their time at home.

2)     All is not lost in the above scenario as learning can still be optimized to match the conventional 5-day classroom teaching, if teachers are able to use blended learning and the flipped classroom approach effectively. Lessons are properly planned whereby students are given a variety of learning materials for directed reading or activities and/or assignments to complete at home for one day. This is followed by face-to-face interactions and discussion—where real learning is said to take place -- the next day in the classroom. This way, it is possible to condense two days’ lessons into one day in the classroom and one day at home. The devil is in the details for creative teachers to figure out how best to achieve this goal.

Needless to say, now is actually the time to revolutionize and transform teaching-learning for the long term. The MOE should have made plans to upskill teachers for online and e-learning not only in terms of technology, but more so in pedagogy. Master teachers should have been identified to help  develop content in PdPR to build a repository or library of resources (e.g. sample lesson plans) for e-learning and online learning to support blended learning and the flipped classroom approach, which can effectively improve the quality of learning and at the same time reduce face-to-face classroom teaching through a rotational schooling system.

3)     From April last year till now – more than one year later – if only each class teacher has collected detailed information about his students’ access to devices and broadband, such vital information can now be used to re-organise and re-shuffle all classes:  Students with adequate access to devices and broadband can be re-grouped into a class under the tutelage of teachers who are savvy in both the technology and the pedagogy of online teaching-learning. These students can opt to stay away from school for online and e-learning from home (PdPR), with occasional face-to-face classroom sessions with their teachers, and practical work in the laboratories. They can free up physical space in the classroom for their classmates – who have no means for engaging in online learning – to continue with the conventional classroom teaching-learning with other teachers.

The above suggestions are only general ideas which are to be mixed and matched, or modified according to differing circumstances in different schools. Primary and secondary schools are different, and urban schools definitely vary from rural ones. No top down single approach from the MOE will work for all, one size doesn’t fit all. How these ideas are to be mixed and matched or optimized will depend much on the ingenuity, creativity and problem-solving skills of each individual teacher under the leadership and organizational skills of the school principal and his core senior or master teachers. Needless to say, schools must be given some degrees of autonomy in implementation and operation, perhaps with the oversight and support of state and district education departments.   

As of now, students sitting for the SPM and STPM examinations by end of 2021 are already complaining that they are not well prepared because of the lost year of learning in 2020. Although the MOE has announced that these examinations will be postponed to February and March 2022, will this deferment help much if a plan is not in place now to make up for the missed classes and learning during the lost year? Flipped classroom and blended learning may well be the answer for accelerating learning to make up for missed lessons in 2020, with rotational schooling to reduce class size and overcrowding when and if schools reopen. In short and in conclusion, schools must now be re modelled to transform education, not just during this pandemic, but right into the future. 

What's the SOP for administering vaccine jab?

(Published in the Star 24 May 2021)

Of late, several video clips have been making the rounds on social media, alleging that some people were injected with empty syringes or that insufficient doses were administered. Although at least one of such video clips had since been found to be a case of misunderstanding, others are still awaiting investigations. This has naturally alarmed the public, prompting some to take precautionary measures when they turned up for their vaccination. One of my friends, a retired dentist, asked to see the bottle and the syringe after her jab, as she wanted to take photos, but was refused and told to respect the nurse’s job! A very delicate situation indeed. Another friend who went to another vaccination center had no such problem. The nurse was very professional, showed her the vial and syringe both before and after the jab.

Such different experiences at two vaccination centers beg the question: Does the SOP for the nurses who administer jabs require them to show the vial and syringe before and after each jab? If yes, well and good, ALL nurses should just follow the SOP and no questions will be asked. If no, I think it is high time the authority reviews the SOP to ensure such transparency in the vaccination process.

In conclusion, it must be emphasized that although we have utter respect for and confidence in our thousands of dedicated frontliners, there is no denial that such malpractice though rare, can happen, as has already been found out in some other countries.        

Speeding up Second Phase Registration and Vaccination

Elderly wary of vaccines 

(A slightly edited version with this title was published in the Star 16 April 2021)

The Minister of Health is wondering why most of the seniors have not registered for the second phase vaccination. Although I have not done a survey to find the exact answer, many people including medical and other professionals from this age group have shared with me their thoughts related to this matter. One of the main reasons is that they are waiting to see if the authority will eventually be “enlightened” and “caring” enough to give them the choice of what vaccine they want to be inoculated with. Many feel outraged that they do not have a choice of what is injected into their bodies!

Given that most of the vaccines now available worldwide have not been ADEQUATELY tested, and that some involve relatively new technology; their preference for a vaccine they deem more widely “tried and tested” and therefore “safer”, is perfectly understandable.  Besides, there is also the perception that some ministers, both past and present, have used the “delay strategy” – not to mention other covert ways -- to get their preferred vaccines. So, these seniors harbor the hope that if they wait and see, they too may get their choice vaccine later!

What can the government do to speed up registration and vaccination for the coming second phase involving these “wait and see” seniors? Firstly, let us bear in mind that seniors are a very vulnerable group, many with complicated or even multiple medical pre conditions that warrant careful considerations when it comes to vaccination. Secondly, risk factors have to be minimized when choosing a vaccine for them, in light of various negative reports about undesirable and longer term side effects of some new tech vaccines, whether proven or not at this point in time. As such, those seniors who are well informed would surely be more willing to register for vaccination if they are given a choice. As it is now, it does look to them like “register now, and you risk not knowing what vaccine you are going to be injected with!”

At this juncture, I would also like to refer to a letter to the editor “Don’t deny right to choose vaccine” (The Sun, 22^nd Feb. 2021). Various people have also voiced similar opinion since then, but all to no avail so far. Not too long ago, the government finally announced that they will be getting the private hospitals involved to speed up registration and vaccination. This is good news.  Perhaps now is the time to seriously consider giving the public, especially the seniors, a choice. The MOH can just announce which hospital is using which vaccine so that people who prefer that particular vaccine can register with the hospital concerned. This will kill two birds with one stone: Speed up registration and vaccination, and at the same time, give people a choice. From what I heard recently, in Singapore, each vaccination center only carries one type of vaccine. So, the public effectively get to choose the vaccine they prefer when they register with the center of their choice. Is this not something we can do here in Malaysia?  In addition, since the government is looking into setting up vaccination centers in big factories and workplaces, why not include recreational clubs with sizable senior membership, such as the Royal Lake Club and Royal Selangor Club in the Klang Valley?

Finally, to protect the vulnerable seniors and to attain herd immunity nationwide as soon as possible, we cannot wait for the private hospitals to procure their own vaccines. It will be too long a wait, knowing that currently there is an acute shortage of vaccines worldwide. We have to start the government vaccination programs in private hospitals NOW and not later.

Don’t deny right to choose vaccine

 Published in The Sun, 22nd Feb. 2021

Amidst the rush to get ourselves vaccinated against the corona virus, many are wondering why is it that we the taxpayers are denied the right to choose the type of vaccine we prefer. Is it not a tenet of democracy that we should have this right of choice? Maybe both the legal experts and the medical professionals can weigh in with their views and enlighten the public? We heard that in some countries, Republic of Serbia for one, people there actually have a choice of which vaccine they prefer to be inoculated with.

Perhaps this is also an opportune time for the Malaysian government to carry out a survey to find out which vaccine is preferred by the rakyat of Malaysia. This can be easily incorporated into the registration process, whether in MySejahtera or other platforms. We also believe that this whole exercise of vaccination should be carried out with absolute transparency, making public details such as the distribution of the different vaccines by phases, and by states in the country. In this context, needless to say, we are particularly interested to know what kind of vaccine all the ministers --  especially those who were involved in vaccine procurement -- will be receiving, for the sake of accountability, if nothing else. Last but not least, as recipients of the vaccine, we would like to know if the authority will inform us about which vaccine we are receiving, before we turn up for the vaccination.

Remodelling Schools (in post Covid 19 Era)

(Published in the Sun on 15^th April 2020)

More than two months into MCO, and it looks like we still do not have a solid plan in place to re model our schools or transform teaching-learning to meet the challenges brought upon us by the Covid-19 pandemic. There are claims that with the closure of schools, many have switched to online and e-learning, but such efforts are hardly the new norm, they are probably confined to some urban or private schools where both teachers and students are more tech savvy, and have access to the necessary devices and broadband. For the vast majority of the nearly 5 million students with limited access to both devices and broadband, the government has rolled out Program TV Pendidikan or Kelas@rumah which runs for only two hours a day! This is certainly inadequate and many parents complain that the content delivered seems to be rather arbitrary, not specific with regard to both subject syllabus and levels of learning.

The latest announcement by the Ministry of Education is that when schools reopen, hopefully in the not too distant future, every classroom should not have more than 16 or 17 students, in accordance with the requirement of social distancing. This is not tenable except for maybe private schools and those schools in the rural area which are under-enrolled. Replacing conventional classroom teaching by the much touted online and e-learning seems to be the only solution if Covid-19 prolongs its hold or even stays for good until a vaccine is available. But this is simply not feasible nationwide, because a survey by the MOE of 900,000 students show that ownership of computers and tablets is only 6% and 9% respectively, although smartphone ownership is much better at 46%. In addition, all such devices are often shared among family members and school going siblings, thus putting further limit and strain on accessibility. Increasing access to devices and broadband is a must to narrow such digital divide between the haves and have nots in online and e-learning. But again this is an unachievable goal within a short time for now as it involves immense financial resources and prudent planning. Let us not forget that bridging this digital divide has been a goal since the era of the Smart Schools in the 1990s and where are we today? Not much has changed or improved. The reality is that a top down nationwide implementation of inclusive online and e-learning to replace conventional schooling is impossible at this point in time, not just here in Malaysia, but also most countries worldwide.  

Given the grim scenario described thus far, here are some practical suggestions and ideas that should be considered to minimize disruption to conventional schooling for an expected extended period of time to come:

1)     In the worst case scenario without any better alternatives in sight, students should go to schools on alternate days or on a rotational basis, to reduce class size for social distancing. This sounds unthinkable, even unacceptable to many, but desperate time needs desperate measure. Each class can be split into two groups with the teacher repeating the same lesson to them on two separate days. This way, students can at least learn something in schools, albeit maybe half of what is supposed to be learned in the syllabus. Otherwise, as it is now, without an inclusive online and e-learning strategy, majority of the students are whiling away their time at home.

2)     All is not lost in the above scenario as learning can still be optimized to match the conventional 5-day classroom teaching, if teachers are able to use blended learning and the flipped classroom approach effectively. Lessons are properly planned whereby students are given a variety of learning materials for directed reading or activities and/or assignments to complete at home for one day. This is followed by face-to-face interactions and discussion—where real learning is said to take place -- the next day in the classroom. This way, it is possible to condense two days’ lessons into one day in the classroom and one day at home. The devil is in the details for creative teachers to figure out how best to achieve this goal.

Needless to say, now is actually the time to make plans to revolutionize and transform teaching-learning for the long term, with or without Covid-19 and social distancing. The Ministry of Education should plan for upskilling of teachers for online and e-learning in terms of technology and more so in pedagogy. Master teachers should also be identified to help industry develop content to build a repository or library of resources for e-learning and online learning to support blended learning and the flipped classroom approach which can effectively improve the quality of learning and at the same time reduce face-to-face classroom teaching.  

3)     In every school, each class teacher should collect detailed information about each of his student’s access to devices and broadband. With such vital information, each school can re-organise and re-shuffle all its classes so that students with adequate access to devices and broadband will be re-grouped into a class under the tutelage of teachers who are savvy in both the technology and pedagogy of online teaching-learning. These students can opt to stay away from school for online and e-learning from home, with occasional face-to-face classroom sessions with their teachers and practical work in the laboratories. They can free up physical space in the classroom for their classmates – who have no means for engaging in online learning – to continue with the conventional classroom teaching-learning with other teachers.

The above suggestions are only general ideas which are to be mixed and matched, or modified according to differing circumstances in different schools. Primary and secondary schools are different, and urban schools definitely vary from rural ones. No top down single approach from the Ministry Education will work for all, one size doesn’t fit all. How these ideas are to be mixed and matched or optimized will depend much on the ingenuity, creativity and problem-solving skills of each individual teacher under the leadership of the school principal and his core senior or master teachers.