The vaccine, migrant workers and herd immunity

There is an ongoing discussion in Malaysia whether we should offer Covid vaccination to migrant workers in Malaysia free of charge. Some Malaysians are indignant that our tax money might be used to subsidize these migrants especially those who are undocumented. Some others argue for free Covid vaccination for migrant workers based on human rights principles as well as on the pragmatic grounds that we need to do so to achieve herd immunity.

But has anyone done a survey as to what migrant workers themselves think? Are they waiting with bated breath for the vaccine? I seriously doubt it. Because for them, Covid isn’t as serious a threat as it is for Malaysians. Migrant workers are, on the whole, fairly healthy adults between the age of 20 and 50 years. The chance of them dying of Covid is very low. Malaysia’s case fatality rate is now 0.36% – in other words 0.36% of those who got infected by the Covid virus died (717 divided by 198,208 – 28/1/2021 figures). And the 717 deaths is mainly of those above 60 years and those with other illnesses like diabetes and heart failure. That means that the case fatality rate for migrant workers would be 0.05% or thereabouts.

Malaysians of 20 -50 years too have a similarly low risk of succumbing to Covid, but we want to take the vaccine because we are afraid that otherwise, we will bring the virus back into our homes and infect our parents and grand parents. This aspect does not worry migrant workers – their parents and grandparents are not here with them. And if you add in the cost of the vaccine and, for the undocumented migrants, the risk of getting arrested on immigration charges, the risk-benefit balance will render many migrant workers particularly unenthusiastic about getting the Covid vaccine.

Is that a problem for us? Of course it is. The whole purpose of mass vaccination is to create herd immunity so that we can reduce the lockdown measures that is stifling our economic life and causing severe hardships to the many Malaysian families whose breadwinners have suffered a big drop in income. To achieve herd immunity we need to vaccinate some 80% of the population – assuming that on the average, a person with Covid will transmit enough viruses to cause the infection of another 5 people. If 80% of the population was immune, then 4 of those 5 people who get the infecting dose of virus will not get Covid as they already have immunity. Only one person gets Covid out of the 5. This means that there will no longer be an exponential increase in infection rates that can overwhelm our hospitals with the 10% or so of cases who are ill enough to require hospital care.

Lets look at the numbers – our population is 31 million. We have 6 million migrant workers and another 200,000 refugees. So altogether there 37.2 million people residing in Malaysia. The government has said that children and pregnant women will not be given the Covid vaccine – that is about 6 million children 12 years and below and 0.5 million pregnant women. 6.5 is 17.5% of 37.2! In other words we could achieve our 80% immunization rate if all migrant workers also took the vaccine. But if all of them didn’t, then we would have 12.7 million not vaccinated – children, pregnant mums, migrant workers and refugees – and 12.7 is 34% of 37.2. We only achieve a vaccination rate of 63% – far short of the 80% we need to get herd immunity!

What should we do to overcome this problem? First we must understand that the Malaysian public benefits as much if not more if the migrant workers in our midst get vaccinated – for then we achieve herd immunity that will protect the older members of our families and also enable us to open up the economy so that people can go back to earning their living. So it would make a lot of sense for us to give the Covid vaccine free to everyone including migrant workers and refugees. We should also reassure them that there will be a moratorium on immigration offenses for the next one year. Thus they will be unafraid to come forward for testing, quarantining and vaccination. An enlightened policy towards migrant workers and refugees will greatly help us in our fight to get over this pandemic.

Dr.Jeyakumar Devaraj
Parti Sosiais Malaysia
former Member of Parliament for Sungai Siput

One Comment Add yours

  1. Foo Wong says:

    Every nRNA vaccine is not known whether it prevents infectiousness. We know that two doses provides protection for the vast majority of adults.

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