A novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) epidemic outbreak started in Wuhan City, Hubei Province, China, in December 2019 and subsequently spread globally with a 3.4% mortality rate of 87,137 confirmed cases as of March 1, 2020 and currently in February 16, 2024 it caused 0.9% mortality rate of 703,305,215 nationwide confirmed cases.1,2 The coronavirus disease 2019, or COVID-19, was named the disease by the World Health Organization (WHO) and poses a significant threat to public health, including Malaysia.3 The virus's global spread was attributed to sustained human-to-human transmission, leading to exported cases worldwide and WHO announced it as a pandemic on March 11, 2020.2,4
It is a newly discovered novel strain of coronavirus detected on December 31, 2019.2 Utilising the angiotensin-converting enzyme 2 (ACE2) receptor, like SARS-CoV, the virus predominantly spreads through the respiratory tract.5 Clinical symptoms exhibited by COVID-19 patients included fever, cough, fatigue, and, in some cases, gastrointestinal infection symptoms.6 Vulnerability to infection and a propensity for severe outcomes, such as acute respiratory distress syndrome (ARDS) and cytokine storms, were observed notably in the elderly and those with underlying diseases.7 The SARS-CoV-2 was initially treated as secondary and tertiary prevention under the level of disease prevention aiming for early diagnosis from prompt, optimised and sustained care, rehabilitation, and disability prevention.8 Subsequently, when the virus characteristic was established the prevention level focused on primordial and primary prevention, including the health education, health promotion, new vaccine development and immunisation.8
The genetic sequence of SARS-CoV-2, the virus that causes COVID-19, was published on January 11, 2020, triggering intense global research and development activity to develop a vaccine against the disease. The development of COVID-19 vaccines represents an unparalleled collaborative endeavour globally.9 Most vaccine developers are from private/industry organisations, with North America leading in development activity.10 The most advanced candidates have entered clinical development, including mRNA-1273 from Moderna, Ad5-nCoV from CanSino Biologicals, and INO-4800 from Inovio.10 Most candidates aim to induce neutralising antibodies against the viral spike (S) protein, preventing uptake via the human ACE2 receptor.11 International cooperation and planning were needed to ensure vaccine creation, production, and fair distribution of COVID-19 vaccines went smoothly.10 By the beginning of 2021, the goal is to have a vaccine that can be used in emergencies. The landscape is a helpful resource that can help with essential parts of researching and developing the COVID-19 vaccine. It serves as a guide for continuous portfolio management at the Coalition for Epidemic Preparedness Innovations (CEPI).10
Developed by WHO and UNICEF, the Global Immunization Vision and Strategy (GIVS) plans to improve national immunisation programs and protect as many people as possible from more COVID-19 through immunisations, including new vaccines available to everyone qualified. This study look at the advantages and disadvantages of public vaccine programs worldwide.12 ASEAN member states have taken several thorough steps to combat the COVID-19 pandemic, such as showing a shared dedication to national and regional plans.13 In Indonesia, National Economic Recovery (PEN) was initiated by allocating Rp 126.2 trillion in additional financial incentives (13). The government has also increased PCR test manufacturing and is approaching the introduction of a possible COVID-19 vaccine, with broad availability expected by the first quarter of 2021.14 In European countries such as Italy, The immunisation method was staged, beginning in February 2021 with the elderly aged 80 years or older and gradually expanded to younger age groups, with priority groups identified for vulnerable individuals.15
Malaysia initially recorded a moderate increase in reported COVID-19 infections until March 2020, after a four-day religious gathering was hosted in Sri Petaling, Kuala Lumpur. This event, which drew 16,000 participants, including 1,500 from outside Malaysia, generated the highest number of positive COVID-19 cases in Southeast Asia.16 As of April 2020, 5,251 COVID-19 cases were reported in Malaysia, growing exponentially and peaking in mid-April. The government implemented preventive measures such as the Movement Control Order (MCO) and the Enhanced Movement Controlled Order (EMCO) to control the spread of the virus.17 Malaysia launched a COVID-19 vaccination program prioritise to high-risk populations, such as frontline healthcare professionals, military and security personnel, and essential service providers (18). People with disabilities or those with special needs and several underlying medical conditions that increased their risk of developing severe COVID-related illnesses were included in the priority categories. Regardless of citizenship status, a free and voluntary immunisation program was available to all Malaysians. To lower the rate of infections, hospital admissions, and deaths, the government aimed to vaccinate at least 80% of the population by February 2022.18
National COVID-19 Immunisation Programme (PICK), launched in February 2021 in Malaysia, aimed to vaccinate eighty percent of the country's population. The vaccinations were provided at no cost to Malaysians and foreigners residing in Malaysia who had willingly enrolled for them.19 The COVID-19 Immunization Task Force-Adolescent (CITF-A), formed in September 2021, planned to achieve full immunisation coverage for 80% of Malaysians aged 12 to 17 when schools reopened. This included students in private schools, adolescents in protection and rehabilitation programs, those in refugee communities, homeless people, and non-citizens staying in Malaysia. Malaysia, a Southeast Asian nation, has had challenges with the pandemic and as of July 14, 2022, 4.6 million cases and 35.8 thousand fatalities had been reported.18 Variations in the sociodemographic backgrounds of Malaysians, particularly those who reside in more distant locations, may be responsible for variations in the vaccine uptake rate. A more profound comprehension of the factors contributing to the disparities in vaccination rates among different demographic subgroups may have substantial consequences for the policy and practice of public health. Consequently, this research aims to investigate the prevalence of vaccine uptake and associated factors among remote communities in Malaysia.