FAQ on Covid-19 vaccination

Can I get COVID-19 after being fully vaccinated?

The simple answer is yes, it is possible to get infected with the SARsCoV-2 virus even after you have been vaccinated. However, evidence suggest that the disease severity is milder with lower likelihoods of transmitting it to others.

Following vaccination, the risk of infection and its complications decreases but the risk will not reduce to Zero; at least for the next few years. This is because the continued high global incidence makes new mutations more likely, and these mutations may reduce the vaccine’s future effectiveness.

Thus, the risk of infection to the virus will persist for the coming years. However, vaccines should help us in the short term of this pandemic by decreasing the immediate risk of infection and by decreasing the disease severity when infected. We should also plan for the long term by improving our preventive public health capacity, economy, and governance.

“The only way to be 100% safe from this virus is by isolating oneself from the broader population. For example, stay on an island or do not to come out of your home”

If so, then why get vaccinated?

Vaccines should help us in the short term of this pandemic by decreasing the immediate risk of infection and by decreasing the disease severity when infected.

We should calibrate the expectation of the community to how the vaccines will help us in this pandemic. It is not the silver bullet nor the prime solution. However, vaccines should help us in the short term of this pandemic by decreasing the immediate risk of infection and by decreasing the disease severity when infected.

This analysis, based on current evidence, estimates that the benefits of vaccination greatly outweigh concerns of its harm at a population level.

As there still is a risk of the disease following vaccination, what strategy should we use?

The virus has been let out of Pandora’s box, we must plan to live with the virus in a sustainable manner for the long term.

What is the protective effect of the Pfizer and BioNTech vaccine?

Vaccination reduces the risk of infection. In a WHO interim recommendation, the Pfizer and BioNTech (BNT162b2) vaccine has shown an efficacy of 95% based on a median follow up of 2 months. This was based on a December 2020 review of the initial results from vaccine research on this Vaccine.

This may be interpreted as that the risk of new infected over a 2-month period was 95% lower in the vaccinated group compared to the placebo group. More specifically:

• 8 of the 21,720 participants who received the vaccine (0.04%) was diagnosed with Covid-19 giving an absolute risk of 0.04%, compared to
• 162 of the 21,724 participants who received the vaccine (0.04%) was diagnosed with Covid-19 giving an absolute risk of 0.75%,
• This may be interpreted as a vaccine efficacy of 95% – Vaccination decreases the risk of new infection by 95% during the first ~2 months following the second dose.

A recent press release by Pfizer based on the 6-month follow-up data of 46,307 trial participants reported that the 6-month efficacy is approximately 91.3%. In addition, the vaccine was reported to be 100% effective against the South African variant (B.1.351). The vaccine was also reported as being 95-100% effective in preventing severe disease.

How does vaccination affect the Rt?

Vaccination reduces the proportion of population that is susceptible to the disease. This directly reduces the active transmission of the disease.

What about SOPs following vaccination?

SOPs are important but it is timely that the SOPs evolve and re-calibrate for a longer more sustainable approach to this pandemic.

Is there a risk of blood clots with any of the vaccines?

European Medicines Agency recommended that unusual blood clots with low platelet counts to be listed as a very rare side effect of Vaxzevria (previously known Astra Zeneca vaccine).

As of 4 April 2021, a total of 222 events have been reported among 34 million people who have been vaccinated. The absolute risk of this blood clot is 0.0007% or 7 event per 1,000,000 million recipients.

How will potential side effects impact vaccination uptake?

Fear rapidly propagates in the vacuum of knowledge and in a low trust environment.

We need to be transparent with the harm and benefits of the vaccine to maintain the trust of the public. It is important to get an appraisal of new scientific evidence before assuming its valid. All studies have caveats and assumption that need to be understood before interpreting the conclusions.

Polarization of opinion secondary to social media algorithms and poor vaccine literacy may lead to higher vaccine hesitancy. Thus, it is good to have an open mind when reading so called facts from any media and verify ones that seem to be important to you.

Trust and goodwill are key for higher vaccine uptake by the community. 

This Q&A was developed by Prof Dr Sanjay Rampal, Professor of Epidemiology and Public Health Medicine Specialist, University of Malaya, as a result of the following media interviews and articles :

A BFM interview titled “40 Healthcare Workers Infected After Vaccination” by Ms Sharmilla Ganesan and produced by Loo Jousie on 19 April 2021.

A CodeBlue article titled “Malaysia’s Fourth Covid-19 Wave Inevitable: Epidemiologists” by Ms Ashwita Ravindran on 19 April 2021.

A Bernama interview by Jessy Chahal and produced by Viswanathan on 20 April 2021.

An opinion piece in The Star titled “Vaccination benefits outweigh the harm” by Dr Sanjay Rampal on 22/4/2021