KUALA LUMPUR - Malaysia's Covid-19 vaccination strategy has come under scrutiny - including from a Cabinet minister - as concerns persist about a lack of access in rural areas even as mega vaccination centres open in the cities.

In the past week, reports of elderly vaccine recipients having to make long journeys to get their jabs exposed challenges within the system. In Kelantan, 90-year-old Gan Giok Hiang had a vaccine appointment in Kubang Kerian, some 45km from her home in Rantau Panjang. She was driven to the vaccination centre, at a big health campus, by her neighbour Syed Hassan Syed Bakar, according to a report in the New Straits Times.

Mr Idris Ahmad, a 67-year-old retired school principal, and his wife had to make a journey of almost two hours to get their vaccine shots. The couple live in Batu Pahat but their appointment was at a mega vaccination centre - called a PPV - in Johor Baru.

The mega PPV approach has raised concerns of overcrowding at such centres. It is also difficult for high-risk and vulnerable groups to make long journeys to these bigger vaccination centres.

"Mega PPVs are not adequate to get good and fast coverage," Malaysia Public Health Physicians Association president Zainal Ariffin Omar told The Straits Times.

"We need more small centres, mobile outreach, walk-in facilities especially in rural outskirts, and highly dense housing areas such as low-cost houses." He added that vaccines should be given to all public clinics in the suburbs and villages.

A non-governmental organisation that has launched a campaign to rope in volunteers to drive senior citizens to their vaccination appointments has also raised concerns about the flow of processes at some of the mega PPVs, and about the effectiveness of the outreach for the most vulnerable.

"Not all of the PPVs have a smooth flow. The protocols need to be the same at all the centres," said Ms Shyam Priah, the founder of Yellow House Kuala Lumpur.

"There are people in some remote areas who can't even come out for their vaccination. For these people, the vaccine needs to be given near their areas."

She said the government needs to start looking at other ways to execute its vaccination strategy, saying that much of it now caters to the able-bodied, and not to others designated as being in a high-risk group under Malaysia's ongoing phase two vaccinations.

One of the more surprising critics of the strategy has been Datuk Seri Redzuan Yusof, a Minister in the Prime Minister's Department.

In an interview with Malaysiakini, Mr Redzuan, who claimed to have been sidelined from National Security Council meetings that make decisions on the government's pandemic response, said mega vaccination centres are only for urban areas.

"There is no need to spend millions setting up mega vaccination centres when the government currently faces a fiscal deficit. We can utilise the clinics that we have all over the country," he said.

Malaysia started opening the mega PPVs in its bid to ramp up vaccination and meet herd immunity targets while dealing with a third Covid-19 lockdown, which will last until the end of the month.

The pace of vaccination has picked up since the opening of the centres, with the seven-day average reaching 110,000 doses in the first week of June.

The number stood at 124,618 doses on Friday (June 11) after hitting at least 150,000 a day for three days earlier in the week.

The national coordinating minister for immunisation, Mr Khairy Jamaluddin, has said the challenge is to maintain the current vaccination rate before raising it to between 200,000 and 300,000 doses a day from July. Malaysia aims to inoculate its entire adult population by the end of the year.

One PPV that started operating at the beginning of June is at the indoor Axiata Arena, near Kuala Lumpur's Bukit Jalil stadium.

It is taking 1,800 appointments a day, and is expected to gradually increase that to around 4,000 a day, its coordinator, Dr Mohd Fadli Mohd Fauzi, said.

The Axiata Arena is one of five new PPVs in Kuala Lumpur and Selangor. On Monday, a sixth will open at the Mines International Exhibition and Convention Centre, with 4,900 appointments a day, gradually increasing to 8,000 a day.

These six PPVs could be giving up to 30,000 vaccine shots a day - about 20 per cent of the country's current total, the immunisation task force said on Friday.

Mr Khairy also said the mega PPVs would help boost the vaccination campaign in Selangor, after the state's Sultan Sharafuddin Idris Shah criticised the distribution of the vaccine there.

Selangor has received only a little over 600,000 doses out of the 4.2 million distributed nationwide as at Friday. With 6.5 million people, the state accounts for one-fifth of Malaysia's population.

So far, 13.75 million people have registered for vaccination, 56 per cent of the country's adult population.

Malaysia's two poorest states have the lowest registration rates. Only 22 per cent of Sabah's adult population have registered for the vaccine, while in Kelantan, only 41 per cent of the targeted population have registered.

Almost three million people, close to 10 per cent of the country's population, have received at least one dose of the vaccine as at Friday, and 1.2 million people have been fully inoculated.