april, 2019 | The Health
issue: Vaccine
11
Table: National Immunisation Coverage, Malaysia 2011-2018p
Year 2011
2012
2013 2014 2015 2016 2017 2018p
BCG* 98.7 98.7 98.5 98.6 98.5 98.3 98.5 98.4
DPT-IPV//HiB Dos 3* 99.5
99.7
96.9
96.7
99.0
97.9
98.9
98.7
Hep B Dos 3* 97.1
98.07
96.3
96.3
99.2
97.9
98.2
100
MMR Dos 1** 95.2
95.4
95.2
92.0
93.1
94.3
93.5
96.6
Source: Health Informatic Centre, Ministry of Health Malaysia
Denominator – *Estimated At Birth
Denominator ** Estimated Children aged 1 - <2 years old (MMR Dose 1 achievement from year 2011 -2017)
Denominator ** For year 2018 – Estimated At Birth (MMR Dos 1)
With the ever-present risk in mind, we need to set
our vaccination target at 95 percent to protect our
children.
Questionable vaccine replacements
Presently in the market, we see anti-vaxxers offering
dubious products which they say can replace the role
of vaccines.
“First of all, we do know vaccination helps and it
protects our children. Irrespective of whether alter-
native ways work or not, there must be some sort
of proof. These alternative methods must undergo
scientific proof. So far, we have not seen such evidence
for these so-called alternative methods. What we have
now are the vaccines, and they certainly work at saving
lives.”
So what does the Ministry of Health (MOH) plan
to do regarding the vaccination situation in Malaysia?
“We will continuously keep a watchful eye on the
percentage of those who have been vaccinated. We are
definitely looking into those who are against or refus-
ing the vaccination. At the moment, what we offer to
do for parents who are refusing vaccination for the
kids is to refer them to a specialist for counselling. If
they still refuse, we have no choice but to comply with
their wishes until we have the compulsory vaccination
enforcement. In which we are still in the process of
researching.”
Selangor: One of the highest in rate of
anti-vaxxers
When it comes to the topic of health issues, it was
found that people who lived in rural areas tend to
be more affected compared to those in urban areas.
However does this concept apply in the vaccination
issue?
“Not really. I just think those who refuse vaccina-
tions are probably just a handful. There’s no specific
trend in either urban or rural areas. The refusal
rates in Sabah and Sarawak are very low. It’s higher
in Terengganu and Kelantan. The rate in Selangor is
actually high too.”
Petition for mandatory vaccination
A recent petition by Malaysian citizens to make vac-
cination compulsory was signed by more than 100,000
people. What are your thoughts on mandating com-
pulsory vaccinations?
“We are studying on whether we should enforce
vaccinations – whether it’s possible to do it and how
to do it. I think we need to understand the argument
against compulsory vaccines. Religious believes, some
citing complications which can arise from vaccines. In
regard to the religious believers, we’re attempting to
engage with them the merits of vaccines. In regards
to the safety and complications, the World Health
Organisation (WHO) has confirmed that the vaccine
is safe. There were some concerns about the MMR vac-
cine leading to autism, but all these remarks have been
proven wrong. There might be some side effects – fever
and slight pain at the area of injection but there are
no long term effects.”
Vaccinations are safe and effective
“We need to continuously emphasise that vaccinations
are safe and effective. It plays a vital role in preventing
the virus from making a comeback. Due to the low
MMR vaccination rate, measles are now becoming a
problem in Malaysia. This is partly caused by the low
rate of herd immunity.”
According to Dr Lee, similar cases are also occurring
in the United States and in the Philippines, therefore
Vaccination Incidence and Mortality rate
We will continuously
keep a watchful eye
on the percentage
of those who have
been vaccinated.
We are definitely
looking into those
who are against
or refusing the
vaccination. At
the moment,
what we offer to
do for parents
who are refusing
vaccination for the
kids is to refer them
to a specialist for
counselling. If they
still refuse, we have
no choice but to
comply with their
wishes until we have
the compulsory
vaccination
enforcement. In
which we are still
in the process of
researching.”
it is definitely a concern because it is affecting every-
one. WHO has even given a warning to make sure
parents are up to date on their kids vaccinations. He
hopes that the public understands by vaccinating your
child, you are not only protecting your child but also
his friends and other children.
“Secondly, we are living in an era of social media.
There will be a lot of information and misinforma-
tion circulating which are not vetted. In fact most of
these information do not come from official or the
authoritative sources. If the public are unsure, they
can always refer to Ministry of Health or to the appro-
priate professional organisations like the paediatric
association or the Malaysian Medical Association.
World Health Organisation also provides up to date
information. All these are relevant authorities are able
to provide appropriate advice and certify that vaccines
are indeed safe and effective,” reassures Dr Lee.
Do other countries face the same vaccination
issues?
“I think they also face such issues. In America it’s
not really because of religious believes, its more that
they want the natural way – not relying on vaccines.
It has nothing to do with a particular religion. This is
why we see this anti-vaccination issue in many other
countries.”
Everyone has a role to play.
“If I were to refuse my children from getting vaccinated,
it’s not just my kids who are affected, it affects other
children as well. We do hope that every single one takes
an initiative and responsibility to ensure their kids get
all their vaccinations.”
“We are still far away from the targeted percentage
of measles vaccination and if we don’t put a stop to
it, then measles, mumps and rubella will pose to be
a major public health thret in the future. We need to
address the decline in vaccination rates and hopefully
restore the 95% vaccination rate.” — The Health
Childhood Immunisation Coverage, 2017
B.C.G Immunisation Coverage of Infants 98.50%
DPT – HIB Immunisation Coverage of Infants (3rd Dose) 98.89%
Polio Immunisation Coverage of Infants (3rd Dose) 98.89%
MMR Immunisation Coverage of Child Aged 1 to < 2 years 88.80%
Hepatitis B Coverage of Infants (3rd Dose – Completed Dose) 98.15%
HPV Immunisation Coverage of Girls 13 Years (2nd Dose) 99.40%