PATHOGENIC microorganisms, including bacteria, viruses, parasites or fungi are the causes of infectious diseases.
These diseases can spread to humans through a number of ways, such as
person-to-person through direct touch, water or foodborne, or through the spraying of infectious particles into the atmosphere, and through insects such as mosquitoes.
The National Immunisation Program (NIP) is a government initiative to curb the spread of infectious diseases. The Ministry of Health Malaysia (MOH) introduced the NIP in the 1950s by providing free vaccination services to children in Malaysia.
Currently, the NIP protects children against 12 vaccine-preventable diseases - tuberculosis, Hepatitis B, diphtheria, tetanus, whooping cough (pertussis), polio, Haemophilus influenzae type b, measles, mumps, rubella, Japanese encephalitis (JE), and cancer caused by the human papillomavirus (HPV).
Children receive all these vaccines within the first two years of life, except for the HPV vaccine which is given to teenage girls at 13 years of age. Booster doses for some vaccines are also given during school age.
Since the introduction of the NIP, improvements have been made from time to time, including the introduction of the Hepatitis B vaccine in 1989, the Haemophilus influenzae type b (Hib) vaccine and Measles-Mumps-Rubella (MMR) in 2002 and the 5-in-1 combination vaccine in 2008, to ensure its implementation is in line with the developments in science and vaccine technology as well as taking into consideration the recommendation from the World Health Organisation (WHO).
This is important in ensuring that immunisation provides complete and optimal protection for children in Malaysia.
This year, MOH once again made improvements to the NIP by introducing a 6-in-1 vaccine and announcing a new immunisation schedule.
The implementation will be conducted in stages, which will start as early as Nov 2020 depending on the availability of this vaccine at MOH health facilities.
A STEP FORWARD
The Ministry of Health's disease control division, senior principal assistant director, Dr Jamiatul Aida Md Sani, says the move to introduce the 6-in-1 vaccine in the NIP was made with careful consideration by the National Immunisation Policy and Practice Committee.
She explains that the use of the 6-in-1 vaccine has been adopted by 49 countries around the world. Therefore, it is a good step forward in line with developments in other developed countries.
Previously, the 5-in-1 vaccine which prevented diphtheria, tetanus, pertussis, polio and Haemophilus influenzae type b (Hib) was given to each child aged 2, 3, 5 and 18 months in four doses.
Meanwhile, the Hepatitis B vaccine was given separately in three doses to each child after birth and at the age of 1 and 6 months. This means that seven injections were needed to prevent these six diseases.
Switching to the 6-in-1 vaccine which prevents diphtheria, tetanus, pertussis, polio, Haemophilus influenzae type b (Hib) and Hepatitis B, benefits children, of which only four doses of vaccine are required for each child (at 2, 3, 5 and 18 months).
Meanwhile, a separate Hepatitis B vaccine should only be given as one injection after birth. This means that the number of injections is reduced to five to prevent six diseases.
The Ministry of Health's family health development division, senior principal assistant director from the immunisation unit, Dr Rozita Ab Rahman says there are several advantages in the use of this 6-in-1 vaccine.
The main advantage is the reduction in the number of injections required and immunisation visits at health clinics.
"The second advantage is from the point of view of the comfort of the baby itself. Injections are painful for babies, even for a moment. Less injections means less episodes of pain and crying. Thirdly, healthcare personnel will have more time during clinic appointments to conduct assessments of babies' health and development such as their growth and sensory and intellectual development."
SAFE FOR CHILDREN
Norleen Mohamad Ali, senior principal assistant director, pharmacovigilance section, Centre of Compliance and Quality Control, National Pharmaceutical Regulatory Agency (NPRA), says the 6-in-1 vaccine is safe to use.
"In Malaysia, a vaccine goes through a strict and thorough registration process by the Drug Control Authority (DCA) under the Ministry of Health. After the approval for registration is granted, only then can the vaccine be used and marketed in Malaysia, including being introduced in the National Immunisation Programme."
Immunise4Life programme chairman and consultant paediatrician and paediatric cardiologist, Datuk Dr Zulkifli Ismail, also welcomes the changes made by MOH in introducing the 6-in-1 vaccine in the new immunisation schedule.
He says the decision to give this vaccine to babies and children in Malaysia is a good thing.
The Six Diseases Prevented By the 6-In-1 Vaccine
Diphtheria
Infection of the throat and nose that can cause breathing difficulties, heart failure, paralysis and death.
Tetanus
Infection of the nervous system that can cause muscle cramps especially in the jaw and neck and which often cause death.
Pertusis (Whooping cough)
An infection of the respiratory tract that can cause pneumonia, seizures, brain inflammation and can also cause death.
Poliomyelitis
Infection of the nervous system that can cause permanent paralysis and can be fatal.
Hepatitis B
An infection of the liver that can cause severe liver damage and lead to liver cancer.
Haemophilus influenzae type b
An infection that causes inflammation of the lining of the brain, bacterial infections in the blood and pneumonia and which can be fatal.
*This article is courtesy of the Immunise4Life programme by the Ministry of Health Malaysia, Malaysian Paediatric Association and Malaysian Society of Infectious Diseases and Chemotherapy, supported by the Vaccination is Protection for Kids initiative. For more information, visit www.ifl.my