Ministry of Health Malaysia has rolled out the 3rd Dose (Booster Vaccination) for COVID-19. Many people will be asking these questions:
Q: Who should get it first?
A: Frontliners; Senior citizens (>60 years old); High risk patients with co-morbidities.
Q: When should I get it?
A: After at least 6 months from your 2nd dose Covid-19 vaccination or as soon as it is offered to you if you are in the susceptible group.
Q: How do I know if I am in the susceptible group?
A: The older you are the more susceptible you are, the more medical conditions you have ie Diabetes mellitus, hypertension, heart disease, kidney disease etc. the more susceptible you are. The lower your Covid-19 neutralizing antibodies below the cut off point, the more likely you will get infected with Covid-19.
The general guiding principles on whether or not you should be getting your booster dose for Covid-19 vaccination are:
- Covid-19 vaccination benefits far outweigh the risks. It is generally safe and efficacious for the vast majority. So, if you have no doubts or reservations toward the vaccine, then go ahead and get it the booster shots.
- If you have issues or concerns about getting the booster vaccination, then prove that you really do not need it, then there is no urgency or compulsion for you to get it.
- If you want to reject the Booster Dose (Covid-19 Vaccination), you better have a solid good reason for doing so. Otherwise you are putting yourself and others at risk of getting Covid-19 infection and its complications.
This is the conclusion that I derived from Dr Timothy's post advising doctors on Covid-19 vaccination booster dose. He is the Consultant Infectious Disease Specialist of Gleneagles Hospital Kota Kinabalu. Below is the verbatim transcript of his post:
Q: What if a patient would rather have a Sinovac booster instead of a Pfizer booster? (Those who had 2 previous Pfizer or 2 previous Sinovac)
A: Take the Pfizer, but if the patient is still worried then take the Sinovac anyway. (Any booster is) better than not having a booster shot.
Q: What is the level of antibodies that is adequate to give protection against Covid-19?
A: We don't really know what is the level
of antibodies that are needed to reduce the risk of severe disease ie a cutoff
point although it is written in the lab form. However, the higher the better.
Low titres also does not mean the person does not have any immunity.
Q: If the antibody levels are high, should we advice a high risk person ie older age group or those with co morbidities, to still take the booster dose?
A: No harm taking but I would not push for them to take it.
Q: In that case should we then advice people to do antibody levels before advising them to take the booster?
A: There is no recommendation to take the
antibody levels before a booster as most will be low unless they had been
infected earlier.
Q: Is there any situation you would advise taking an antibody level before advising a patient to take a booster?
A: I would
if the patient had severe side effects from the 1st 2 doses.
Q: A patient had mild Covid last year, 2020 and now has already completed 2 doses of the vaccine. Should he get a booster?
A: So this would be the 4th
exposure to the Covid Ag. I wont push for it. No harm getting it though.
Q: If the patient had 2 doses and then still got the Covid 19 infection (ie breakthrough infection), should the patient get the booster?
A: I really think this is unnecessary.
These are all my own personal opinions.
Thank you
Dr. Timothy William
