Learning from Malaysia’s AstraZeneca Vaccination

Chee Loh
4 min readMay 11, 2021


The decision of the authorities to make the AstraZeneca vaccine a voluntary opt-in option for individuals living in the Klang Valley has proven to be an interesting phenomenon.

Let’s start by looking at some basic wins and losses regarding this policy, and then we will take a closer look at some of the new dynamics this policy has created, and what we might learn from them.

Photo by Daniel Schludi on Unsplash

The first major win from this decision was that all 268,000 vaccination slots were taken up in just over three hours. We should expect this to result in well over 200,000 Malaysians being vaccinated within a few months.

There is still a long way to go, but this will almost certainly create a substantial dent in the Covid-19 curve as well as the easing of the pressure on the healthcare system in the Klang Valley.

For all we know, next to the imposition of MCOs, this move may be the first phase of the most effective countermeasure against the pandemic.

The vaccine online sign up process can probably be chalked up as a draw — extremely frustrating in the beginning, but eventually alright for the most part, from most anecdotal accounts.

As far as losses go, there might not be any major avoidable loss.

Obviously, there is a big problem regarding the manner in which this system excludes those outside the Klang Valley, and how it gives an advantage to those who are tech-savvy and equipped with good internet access. It also does not provide any priority to individuals who may need the vaccine more than others.

These are all legitimate concerns. However, in the grand scheme of things — given the controversy surrounding AstraZeneca; the government’s policy decisions in this regard were possibly the best amongst a limited number of difficult choices.

Most interesting perhaps is the effect this opt-in policy has had on vaccine registration as a whole.

Data has not emerged regarding how many people who had not previously registered for vaccination decided to register in order to get the AstraZeneca vaccine after the announcement that it would be made available on a first come, first served basis.

I suspect the number could be substantial, and it could be worthwhile to study the effect of making this option available as there are a number of factors worth examining.

First might be the effect of making the prospect of getting vaccinated more present and real. When it was only the previous system, there really was no telling when one would get vaccinated. It often felt like a really distant horizon, with no promising timeline.

And then, of course, there was the whole hesitancy surrounding being an early adopter. When a product is somewhat controversial, a lot of people wait to see what the rest of the crowd does first — especially when there is no scarcity, or perceived risk of scarcity.

I suspect this was a factor in the original slow take-up.

The opposite of this phenomenon is when everyone seems to be making a run for a product. Basically, there is a critical mass that sets off a scarcity scare. The kids call it “FOMO” or “fear of missing out”.

I have a feeling this happened last Sunday (May 2) as well, as it became increasingly apparent that people were registering for AstraZeneca in droves.

Regarding this, I have a confession to make — I was one such person.

I fear the derision of many of my friends for admitting this, but I too was vaccine-hesitant. As in the example above, there was no real pressure for me to register earlier.

There was little to suggest that not registering right away would necessarily mean I would have to wait much longer to get a vaccine — when there is no concrete timeline, then what is the difference between ‘later’ and ‘a bit later than later’ after all?

That Sunday though, everything got a little bit more real.

My own decision-making process went a little something like this: There were really only two ‘rational’ approaches: one, to get vaccinated as soon as possible, and two, to wait ‘as long as possible’ for more data to come in regarding the vaccines.

I realised that there was no ‘sweet spot’ with regards to how long one was willing to wait regarding long-term data concerning the vaccines. Whether it’s one or two years from now, data regarding any long-term effects of the vaccines or such will still not be perfect.

In that time however, as has been often argued, the risks from Covid-19 (especially the risks from what some are calling ‘long Covid’) are much more clear and present dangers.

So I figured since the chance was there to do this relatively soon, it was time to take the leap.

I will definitely admit that the feeling that those slots were being gobbled up quickly definitely added to my sense of urgency.

I have been reflecting for a while, and haven’t quite figured out how best to use these reflections in order to come up with concrete policy recommendations regarding how to approach the rest of the vaccination process, but I do feel that there is something important to be learnt from this entire episode.

We do hope that such opt-in options will become available throughout the country, and that it will somehow prioritize people according to vulnerability and need.