EACH year, the vaccination coverage of most childhood vaccines in Malaysia is between 94 and 98 per cent.
Ironically, while one would assume that children in remote rural areas are the ones falling off the radar, there appears to be a growing number of urban children who are not being immunised, said director-general of Health Datuk Dr Noor Hisham Abdullah.
According to official statistics, the number of parents refusing to immunise their children has tripled in the last three years, from 470 to 1,282.
They have largely been influenced by anti-vaccination groups (who blame vaccines for a range of health problems), opting instead for traditional or alternative medicine for their children.
“Malaysia has achieved low levels of vaccine-preventable diseases (VPD) for diseases such as diphtheria and neonatal tetanus, but that does not mean these diseases have disappeared completely.
“Many of the viruses and bacteria are still circulating in this country and that is why it is important that children, especially infants and young children, receive the recommended immunisations on time,” said Dr Noor Hisham.
He said the majority of the younger generation had not seen cases of childhood vaccine-preventable diseases such as polio, pertussis and diphtheria, but since people travelled a lot nowadays, including to and from countries where many VPD were relatively common, it posed a risk to children who were not immunised.
“While we acknowledge the contributions of traditional and complementary medicine like homeopathy to the healthcare of our people, we would like to advise the public to seek appropriate medical treatment and make informed healthcare decisions.”
He said, even though vaccination was not practised in homeopathic medicine, the Malaysian Homeopathic Medical Council has stressed that the administration of vaccines, as scheduled by the ministry, must be carried out.
Dr Noor Hisham said immunisation was important to prevent diseases which can lead to unnecessary illnesses, disabilities and deaths among children.
“With the growing trend in the use of social media, we need to increase efforts through social media to convey the importance of vaccinating children.
“VPD are prevented through herd immunity, meaning a large proportion (more than 95 per cent) of the population are protected against the diseases. This will halt the transmission of the bacteria or viruses. However, when herd immunity is disrupted, for example when there is an influx of unvaccinated children in the area or many people refuse vaccines, then the number of VPD will rise.”
However, Dr Noor Hisham stressed that it was necessary to make a distinction between parents who refused vaccination and those who were anti-vaccination.
“Parents who refuse vaccination do not equate to parents who are anti-vaccination. The ministry is collecting this information from our health clinics to better understand the situation.”
Among the reasons for the increasing number of parents who refuse to vaccinate their children, is the influence of the Internet and family members.
“Apart from a lack of understanding of the importance of immunisation to keep children safe, there is a vast amount of information in the media and parents may not know what is right and what to believe as there is much confusion arising from contradictory information in the public domain.
“For example, an article in the media states ‘Obtaining natural immunity has far greater benefits than vaccine-induced immunity”. This is true, but the article does not tell the reader all the facts.
“For instance, natural immunity carries a higher risk of complications and debilitating conditions from the disease than getting immunity from the vaccine. The omission of important information can sway the parents into refusing to allow their child to be vaccinated.”
He said parents were also unaware of the dangers and complications of the 10 VPD listed in the National Immunisation Schedule for children under 5. The diseases are tuberculosis, hepatitis B, diphtheria, pertussis, tetanus, polio, Haemophilus influenza type B, measles, mumps and rubella.
“Without vaccination, epidemics of many VPD could return.”
Dr Noor Hisham said reasons given by anti-vaccine groups included doubts about the content of vaccines, fear of side effects and the belief that traditional or homeopathic medicine should not be mixed with modern medicine.
“The MOH (Health Ministry) has stringent procedures that must be followed before vaccines or drugs are registered for use in this country.
“The animal-derived content of all products, including vaccines, need to be declared. When the MOH chooses vaccines, we ensure that they are free of porcine elements.”
Dr Noor Hisham said Jakim (Department of Islamic Development Malaysia) had declared that vaccination was harus (permissible), according to the principle of Maqasid Syariah, as it prevented dangerous diseases such as measles, tuberculosis, whooping cough, diphtheria, tetanus and polio that threatened the lives and health of children.
“At the same time, Jakim is cautious in giving the harus status. For instance the vaccine for rotavirus has not been approved as harus.”