The vaccine, migrant workers and herd immunity

 

There is an ongoing discussion in Malaysia whether we should offer Covid-19 vaccination to migrant workers in Malaysia free of charge.

Some Malaysians are indignant that our tax money might be used to subsidise these migrants, especially those who are undocumented. Others argue for free Covid-19 vaccination for migrant workers based on human rights principles and 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-19 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-19 is very low. 

Malaysia’s case fatality rate is now 0.36 percent - in other words, 0.36 percent of those who got infected by the Covid-19 virus died (717 divided by 198,208 - Jan 28, 2021 figures). 

And the 717 deaths are 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 percent or thereabouts.

Malaysians of 20 to 50 years have a similarly low risk of succumbing to Covid-19, 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 grandparents.

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-19 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 are 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 percent of the population - assuming that on the average, a person with Covid-19 will transmit enough viruses to cause the infection of another five people.

If 80 percent of the population was immune, then four of those five people who get the infecting dose of the virus will not get Covid-19 as they already have immunity. Only one person gets Covid out of the five. This means that there will no longer be an exponential increase in infection rates that can overwhelm our hospitals with the 10 percent or so of cases who are ill enough to require hospital care.

Let us look at the numbers - our population is 31 million. We have six million migrant workers and another 200,000 refugees. So altogether there are 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 six million children 12 years and below and 0.5 million pregnant women. 6.5 million is 17.5 percent of 37.2 million.

In other words, we could achieve our 80 percent immunisation 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 million is 34 percent of 37.2 million. We only achieve a vaccination rate of 63 percent - far short of the 80 percent 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. This way, we achieve herd immunity that will protect the older members of our families and enable us to open up the economy for people to return to earning their living.

So it would make a lot of sense for us to give the Covid-19 vaccine free to everyone, including migrant workers and refugees. We should also reassure them that there will be a moratorium on immigration offences for the next 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.

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DR JEYAKUMAR DEVARAJ is PSM national chairperson. - Mkini

The views expressed here are those of the author/contributor and do not necessarily represent the views of MMKtT.