Unvaccinated youngsters, middle-aged outnumbering vaccinated elderly in severe cases, say HTAR doctors

Severe cases among unvaccinated younger people are outnumbering cases among vaccinated elderly people, which could be linked to vaccine hesitancy, according to doctors at a Covid-19 hospital in Klang.

This comes as more than 55% of the population in Malaysia are fully vaccinated and almost 80% of Klang Valley residents have completed their vaccination.

Consultant emergency medicine specialist Dr Ahmad Tajuddin Mohamad Nor told Bernama about two-thirds of Covid-19 patients treated at Hospital Tengku Ampuan Rahimah (HTAR) in Klang are below 60 and almost all have not been vaccinated.

“Almost all (of those under 60 who were hospitalised) have not been vaccinated. There is still that group missing out on vaccinations,” he said.

Tajuddin, who is also the head of the Emergency and Trauma Department at HTAR, said they started noticing the trend at the start of the fourth wave in late June. He said at that time, they did not think vaccine hesitancy was a major reason for their patients’ vaccination status as vaccinations were not as widespread then.

However, now that vaccines have been easily available through walk-ins for almost two months, he suspects vaccine hesitancy is playing a bigger role.

“The middle-aged, the younger ones… some of them are partially vaccinated (with) one dose, or will be missing (the vaccinations) altogether,” he said.

Vaccine sceptics or anti-vaxxers now comprise the majority of hospitalisations and deaths in countries that started vaccinations early, such as the US and Israel.

Recently, a study on hospitalisation and death rates among the unvaccinated by the US Centers for Disease Control found that unvaccinated Americans were 10 times more likely to be hospitalised and 11 times more likely to die than vaccinated ones.

According to the health ministry, the unvaccinated currently account for almost 80% of hospitalisations in Malaysia.

Tajuddin said the vaccination status of patients has had a significant impact on the outcome of patients at HTAR.

“We noticed that stark difference. If you’re vaccinated, it’s very unlikely you’re going to turn any worse,” he said.

“If you (are unvaccinated and) present yourself in less severe stages, you may deteriorate quite rapidly. So if you’re coming in at Stage Four – someone who is dependent on oxygen – and you’re not vaccinated, that is a red flag for us.”

He added that all of the Covid-19 cases they receive at the hospital have at least one comorbidity.

HTAR director Dr Zulkarnain Mohd Rawi confirmed the trend, estimating that 70% of admissions are unvaccinated. He said that about 80% of deaths occur among the unvaccinated, though he did not specify the age group.

He also said many of the younger patients who took a turn for the worse had undetected diabetes prior to hospitalisation.

“The younger ones… they have comorbidities, obesity, diabetes and never underwent a medical check-up. When they’re admitted to the hospital, that is when we find out they have diabetes,” he said.

Tajuddin said he believed some people in the younger age group might decide against getting the vaccine thinking that they have enough protection against the new virus.

“I think the memory is that it started as a disease of the elderly or those with medical conditions. I think maybe that gave a sense of false security to the younger ones,” he said.

He said younger people were also more likely to go out more often and not adhere to the preventative guidelines.

According to health ministry data, about 6% of residents in Malaysia or 1.46 million have not registered for vaccination. All registered adults have received at least one dose with none waiting for their first dose. Those who have not registered for the vaccine include the diehard vaccine sceptics or people who are unable to overcome barriers to access, whether technical or geographical.

Aided by NGOs including Mercy Malaysia, the Malaysian Red Crescent Society and Imaret, the ministry has been engaged in reaching those who may have problems accessing the vaccine, such as those in rural areas and migrant workers.

“Registration is not a precondition for vaccination. Walk-in vaccinations are open in most places around Malaysia.

“Furthermore, there are immense outreach efforts involving every means at our disposal – helicopters, boats, you name it – to vaccinate the digitally gapped,” tweeted Dr Mahesh Appannan, head of data at the Crisis Preparedness and Response Centre (CPRC) in response to a question by Teluk Intan MP Nga Kor Ming.

Anti-vaxxers are believed to represent only a small percentage of the population. However, it has not stopped them from sharing misinformation and actively trying to discourage people from getting their shot on social media. Some are also selling fake digital vaccination certificates to the non-vaccinated to enable them to dine in at restaurants, go to the cinema and, in certain cases, travel interstate.

Public health experts and employer groups have voiced support for vaccine mandates in the future should enough residents refuse to get vaccinated despite outreach efforts.