Free COVID-19 Vaccination
& Booster Programme

• An additional dose given to those who has completed their primary 2 doses of COVID-19 vaccine.
• Highly recommended.
• The protection provided by the primary dose(s) of the vaccine decreases over time.
• Booster dose helps people maintain the immunity against COVID-19 for a longer period of time.

• Clinical guidelines on COVID-19 vaccination in Malaysia (4th edition)
• COVID-19 Vaccine Booster Dose from Rhode Island Department of Health (https://covid.ri.gov/boosterdoses)

• Yes. Dangerous new COVID-19 variants are forming.
• It is safer to vaccinate and take booster shots to protect against COVID-19.
• COVID-19 booster vaccine is highly recommended because:
• Primary series of vaccine becomes less effective over time so individuals have risk for COVID-19 infection.
• SARS-CoV-2 variants causes more severe infections and increase hospital admission rates.
• Protects individuals from the severe infection symptoms (e.g. hospitalisation, ICU admissions,death).
• Helps to regain prolonged immunity against COVID-19.

• Clinical guidelines on COVID-19 vaccination in Malaysia (4th edition)
• Emergence of SARS-CoV-2 New Variants and Their Clinical Significance (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9167142/)

• The immunity formed after completion of vaccination decreases after 4–6 months after completing primary series of vaccines (proven by clinical trials done in Israel, United States.

• WHO - Coronavirus disease (COVID-19) Vaccines
• BMJ Elapsed time since BNT162b2 vaccine and risk of SARS COV2-infection (Published on 25 November 2021)
• SARS-CoV-2 in Malaysia: A surge of reinfection during the predominantly Omicron period
• Six Month Safety and Efficacy of the Pfizer COVID-19

• Yes, booster doses will ensure prolonged and stronger protection from the primary vaccination series.
• Prevent severe illness, hospitalization, deaths and against new COVID-19 variants.
• Clinical trials showed limited waning amongst symptomatic cases 10 or more weeks post booster dose, absolute effectiveness of booster vaccines (Pfizer) against hospitalization/death and reduced mortality rate.

• Nature Medicine Journal - Effectiveness of COVID-19 booster vaccines against COVID-19-related symptoms, hospitalization and death in England
• The New England Journal of Medicine – Pfizer vaccine booster and mortality due of COVID-19

• Approved by the National Pharmaceutical Regulatory Division (NPRA) for use in Malaysia
• Safe
• Effective
• Crucial to protect vulnerable populations from severe symptoms from the COVID-19 infection/death
• Reducing the infection rate of front-liners and elderly home caregivers

• Clinical guidelines on COVID-19 vaccination in Malaysia (4th edition)

• In Malaysia, only the Cominarty® (Pfizer) vaccine has been approved and licensed to be used as a booster vaccine.
• Other vaccines can only be considered if Cominarty® (Pfizer) is contraindicated (unsuitable) for the individual.

• Clinical guidelines on COVID-19 vaccination in Malaysia (4th edition)

• Easily available.
• Very effective in reducing serious symptoms/preventing death.
• Bivalent vaccines requires approval of the conditional registration given by the Drug Control Authority.
• Reports from China showed the subvariants from there has been detected in Malaysia.
• A surge of COVID-19 infection is expected in the coming weeks.
• All who have received their first booster dose > six months ago are highly recommended for second booster.
• Not advisable to wait for the bivalent vaccine.

• 12-17 years old with risk of severe medical conditions (e.g. chronic heart, lung, kidney, liver disease) after 4-6 months from their last vaccination.
• Adults aged 18 and above who have completed vaccination at least 3-6 months ago.
• All adults above 60 years old after 4-6 months from their first booster dose.
• Priority is for the following populations:
  • High risk individuals with pre-existing medical conditions
  • Senior citizens
  • Frontline workers (health and non-health personnels)
  • Residents and staff in long-term health care centers such as elderly care centres
  • Pregnant or breastfeeding women
  • Individuals that need to travel abroad

• Second COVID-19 Booster dose available to all above 60 years and for high risk adults and adolescents [https://protecthealth.com.my/second-covid-19-booster-dose-available-to-all-above-60-years-and-for-high-risk -adults-and-adolescents/]

• Vaccination should be deferred until the person has recovered from the acute illness (if symptomatic) and has met criteria to discontinue isolation.

• Ministry of Health Malaysia's Guidelines on COVID-19 vaccination (https://covid-19.moh.gov.my/)

• Yes, it is highly recommended.
• Statistics from CDC shows people who had COVID-19 and unvaccinated are likely to get the infection.
• Booster dose provides an additional protection against COVID-19 after one’s recovery from the infection.

• Benefits of Getting A COVID-19 Vaccine [https://www.cdc.gov/coronavirus/2019-ncov/vaccines/vaccine-benefits.html]

• Yes. Very much likely as the booster dose is not 100% effective in COVID-19 prevention.
• COVID-19 infections post booster dose are less severe.

• COVID-19 after Vaccination: Possible Breakthrough Infection [https://www.cdc.gov/coronavirus/2019-ncov/vaccines/effectiveness/why-measure-effectiveness/breakthrough-cases.html#:~:text=People%20who%20are%20vaccinated%20may,than%20people%20who%20are%20unvaccinated]

• Yes. vaccines are not 100% effective at preventing COVID-19 infection, even in those who are fully vaccinated.
• It takes 1-2 weeks after booster vaccine for it to become fully effective.
• Research shows people who have taken the vaccine and gotten COVID-19 infection or vice versa has a better level of protection against COVID-19.

• COVID-19 Vaccines Work [https://www.cdc.gov/coronavirus/2019-ncov/vaccines/effectiveness/work.html#:~:text=COVID%2D19%20vaccines%20are%20effective%20at%20preventing%20severe%20disease%2C%20hospitalization,is%20called%20a%20breakthrough%20infection]

• Yes. The COVID-19 vaccine is safe and effective during pregnancy.
• Those who are pregnant have a higher risk of developing severe COVID-19 illness.
• If infected during pregnancy, it may complicate the pregnancy and harm the mother and the unborn child.
• No safety concerns for babies born to women who were vaccinated against COVID-19 during pregnancy.
• DATA from The Ministry of Health Malaysia's Guidelines on COVID-19 vaccination:
  • Pregnant women can be vaccinated between 14-33 weeks of gestation, but to be recommended after doctor’s consultation.
  • Priority for pregnant women who are frontliners, or with comorbidities such as diabetes or obesity (high-risk).
  • If a women confirms pregnancy after first dose, she is recommended to defer the second dose until after 14 weeks of pregnancy.

• Ministry of Health Malaysia's Guidelines on COVID-19 vaccination (page: 69)

• Recommendations extracted from the Malaysia's Guidelines on COVID-19 vaccination from the MOH:
  • For moderately to severely immunocompromised individuals: minimal interval between the primary series of vaccination and the additional dose should be 28 days.
  • Booster dose for an elderly individual residing in aged care facilities: minimal interval between the 1- or 2- dose primary series and the booster dose should be 6 months.

• Ministry of Health Malaysia's Guidelines on COVID-19 vaccination (page: 69)

• Not necessarily. Vaccine efficacy as below:

1st Dose	2nd Dose	Booster	Study Result
PFIZER	PFIZER	PFIZER	62% reduction in infection risk
AZ	AZ	PFIZER	60% reduction in infection risk
SINOVAC	SINOVAC	PFIZER	95% reduction in infection risk
SINOVAC	SINOVAC	AZ	94% reduction in infection risk
SINOVAC	SINOVAC	SINOVAC	75% reduction in infection risk

• Interim data from a clinical trial conducted by The University of Oxford supports flexibility in the mixing of vaccine; specifically Oxford/AstraZeneca and Pfizer-BioNTech, but does not apply to pregnant women as this population was not included in the study.

• Clinical guidelines on COVID-19 vaccination in Malaysia (4th edition)
• Safety and Immunogenicity Report from the Com-COV Study – a Single-Blind Randomised Non-Inferiority Trial Comparing Heterologous And Homologous Prime-Boost Schedules with An Adenoviral Vectored and mRNA COVID-19 Vaccine (https://papers.ssrn.com/sol3/papers.cfm?abstract_id=3874014)

• Yes
• The components (formulation) of COVID-19 boosters are the same as those of the current COVID-19 vaccines.

• The dosage for one Pfizer-BioNTech COVID-19 booster dose is 0.3ml.

Additional dose:

• For those who did not respond well to primary vaccination series (immunocompromised).
• Given at least 28 days after completing the primary vaccination series.

• Given to those who had an adequate initial response.
• Immunity may have waned over time (waning immunity).
• Given 6 months after completing the primary vaccination series.

• Common side effects :
• Pain
• Redness
• Swelling at the injection site
• Tiredness
• Headache
• Muscle pain
• Chills
• Fever
• Nausea
• On a positive note, these symptoms will usually get better after a few days.
• Severe side effects can occur but mostly rare. Four examples of such:
• Anaphylaxis: Severe allergic reaction - hives, respiratory problems, low blood pressure, or significant tongue or lip swelling.
• Thrombosis with thrombocytopenia syndrome (TTS): A condition that interferes with blood clotting or forms blood clots.
• Myocarditis and pericarditis: Inflammation of the heart muscle is known as myocarditis, while inflammation of the heart's outer lining is known as pericarditis.
• Guillain-Barre Syndrome (GBS): An uncommon condition where the immune system of the body destroys nerve cells, leading to muscular weakness and occasionally paralysis.
• Deaths: Rare

• Centers for Disease Control and Prevention (https://www.cdc.gov/coronavirus/2019-ncov/vaccines/faq.html)

• No. The absence of side effects after vaccination does not mean the vaccine is not working.
• If one experiences side effects from the booster dose, it is the individual’s immune response to the vaccine.
• Different individuals’ immune systems react in different ways due to different contributing factors including age, health, environment, nutrition, and gender.

• Clinical guidelines on COVID-19 vaccination in Malaysia (4th edition)

• Yes.
• A COVID-19 booster is not compulsory for being fully vaccinated
• Being fully vaccinated also does not guarantee the optimum level of protection.
• Individuals are best protected when they receive their primary COVID-19 vaccination series and booster shots on time.
• The type and brand of vaccines; and definition of fully vaccinated is subject to change according to recommendations from MOH and will be updated from time to time.

• Clinical guidelines on COVID-19 vaccination in Malaysia (4th edition)
• Latest COVID-19 Vaccination Policy (https://mysejahtera.moh.gov.my/en/covid-19/latest-malaysia-covid-19-vaccination-policy)

• Yes.
• An employer may require that their workers to get booster shot, my also make it mandatory.
• Statistics reported by the Ministry of Health (MOH) showed 2839 workplace COVID-19 clusters involving 282,729 cases up till 12 September 2021.
• COVID-19 booster dose is not mandatory but is highly recommended for the working population.

• COVID-19 Management Guidelines For Workplaces. (https://covid-19.moh.gov.my/garis-panduan/garis-panduan-kkm/ANNEX_25-COVID-19_MANAGEMENT_GUIDELINES_FOR_WORKPLACES_08102021.pdf)

• Yes.
• The COVID-19 vaccines are not 100% effective at preventing COVID-19 and one can still spread the virus.
• The safest way forward is to still adhere to the following preventive measures to stop the spread of the virus:
• Maintain physical distancing (1 to 2 metres apart).
• Wear protective mask, especially in crowded, closed and poorly ventilated places.
• Wash your hands often with water and soap or clean it with 60% - 70% alcohol-based gel, foam, or liquid sanitiser.
• Cough or sneeze into bent elbow.
• Avoid crowds and poorly ventilated space.