Sustaining effective COVID-19 control in Malaysia through large-scale vaccination

Jayasundara, Pavithra, Peariasamy, Kalaiarasu M., Law, Kian Boon, Abd Rahim, Ku Nurhasni Ku, Lee, Sit Wai, Ghazali, Izzuna Mudla M., Abayawardana, Milinda, Linh-Vi, Le, Khalaf, Rukun K. S., Razali, Karina, Le, Xuan, Chong, Zhuo Lin, McBryde, Emma S., Meehan, Michael T., Caldwell, Jamie M., Ragonnet, Romain, and Trauer, James M. (2021) Sustaining effective COVID-19 control in Malaysia through large-scale vaccination. Epidemics, 37. 100517.

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Abstract

Introduction: As of 3rd June 2021, Malaysia is experiencing a resurgence of COVID-19 cases. In response, the federal government has implemented various non-pharmaceutical interventions (NPIs) under a series of Movement Control Orders and, more recently, a vaccination campaign to regain epidemic control. In this study, we assessed the potential for the vaccination campaign to control the epidemic in Malaysia and four high-burden regions of interest, under various public health response scenarios.

Methods: A modified susceptible-exposed-infectious-recovered compartmental model was developed that included two sequential incubation and infectious periods, with stratification by clinical state. The model was further stratified by age and incorporated population mobility to capture NPIs and micro-distancing (behaviour changes not captured through population mobility). Emerging variants of concern (VoC) were included as an additional strain competing with the existing wild-type strain. Several scenarios that included different vaccination strategies (i.e. vaccines that reduce disease severity and/or prevent infection, vaccination coverage) and mobility restrictions were implemented.

Results: The national model and the regional models all fit well to notification data but underestimated ICU occupancy and deaths in recent weeks, which may be attributable to increased severity of VoC or saturation of case detection. However, the true case detection proportion showed wide credible intervals, highlighting incomplete understanding of the true epidemic size. The scenario projections suggested that under current vaccination rates complete relaxation of all NPIs would trigger a major epidemic. The results emphasise the importance of micro-distancing, maintaining mobility restrictions during vaccination roll-out and accelerating the pace of vaccination for future control. Malaysia is particularly susceptible to a major COVID-19 resurgence resulting from its limited population immunity due to the country's historical success in maintaining control throughout much of 2020.

Item ID: 72267
Item Type: Article (Research - C1)
ISSN: 1878-0067
Keywords: COVID-19, Vaccination, Variants of concern, Mathematical modelling
Copyright Information: © 2021 The Authors. Published by Elsevier B.V. This is an open access article under the CC BY-NC-ND license.
Date Deposited: 09 Feb 2022 12:26
FoR Codes: 49 MATHEMATICAL SCIENCES > 4901 Applied mathematics > 490102 Biological mathematics @ 30%
42 HEALTH SCIENCES > 4202 Epidemiology > 420205 Epidemiological modelling @ 70%
SEO Codes: 20 HEALTH > 2004 Public health (excl. specific population health) > 200404 Disease distribution and transmission (incl. surveillance and response) @ 80%
20 HEALTH > 2002 Evaluation of health and support services > 200205 Health policy evaluation @ 20%
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