Protecting A Nation

The rising cases of vaccine preventable diseases (VPDs), including recent outbreaks of measles, involve children who have not been properly immunised.

Article reproduced from The Star, 19 April, 2016

Last year, the Health Ministry (MOH) reported two child deaths due to measles, 13 due to pertussis and one due to diphtheria.

Although vaccines for these diseases are widely available at government and private clinics, MOH reports that the number of parents refusing to immunise their children has tripled in the last three years to 1,541 cases last year.

Although there is a widely available vaccine for measles, children continue to die from this highly contagious infection, characterised by blotchy red rashes all over the body.
Although there is a widely available vaccine for measles, children continue to die from this highly contagious infection, characterised by blotchy red rashes all over the body.

Dr Kamarul Azahar Mohd Razali, head of the Paediatric Infectious Diseases unit at Hospital Kuala Lumpur, says that while some parents claim they do not have the time to bring their children in for scheduled vaccinations, there are others who actively avoid vaccines for unfounded fear of their children suffering irreversible side effects from perceived toxic or religiously inappropriate elements.

“Those who have not witnessed the devastating effects of VPD may not understand the need for protection.

“When people do not receive vaccines, the herd immunity of a community against deadly diseases is compromised because the number of people exposed to these highly contagious organisms goes up,” Dr Kamarul explains.

Herd immunity is acquired when 95% of the population is vaccinated and it ensures individuals, including children with compromised immune systems – who cannot receive vaccines or independently fight infections – are also protected against VPD.

This includes those who have immune deficiencies caused by genetic disposition and those undergoing treatment with immunosuppressive drugs (such as chemotherapy) and HIV- positive individuals.

Weighing actual risk

As with all medicines, vaccines can cause side effects but they are commonly mild, transient and treatable. “Adverse side effects due to vaccines are very rare,” Dr Kamarul stresses.

The real risk lies in the potential complications VPD can bring to young children who are not immunised. Unfortunately, there has been a surge in the number of such cases in intensive care units (ICUs) of late.

“Once an infection affects the brain, it can cause meningitis ( inflammation of brain tissues), which can damage the brain, especially among children below the age of two. Brain infection in these young children can cause blindness, cerebral palsy or even death in the worst cases,” says Dr Kamarul.

He relates the harrowing story of a 22- month- old child suffering from brain damage due to Haemophilus influenzae Type b (Hib) meningitis (inflammation of the lining of the brain and spinal cord) because her father refused vaccination.

“Even the most experienced among us have not seen such cases in a long time,” Dr Kamarul laments, stressing that this is primarily because immunisation programmes have been able to protect vaccinated communities thus far.

Vaccines are thoroughly evaluated in clinical trials before the Drug Control Authority of MOH approves them for public use. The use of the vaccines is continuously monitored after they are made available to the population.

For the greater good

The physical and emotional burden of VPD is borne both by the patients and their caretakers. The financial burden impacts not only the family involved, but also the overall healthcare system – high healthcare costs can be avoided and resources channelled to help patients in other critical disease management areas.

Medical professionals and hospitals must be equipped to deal with these diseases, which can spread quickly to cause serious health concerns in urban and rural communities alike. This is how an epidemic starts.

In May last year, 114 private, government and university consultant paediatricians signed a joint statement published on news portal Malay Mail Online urging parents to vaccinate their children after seeing too many parents refusing to protect their children even after decades of successful immunisation programmes have kept the nation safe.

Dr Kamarul echoes this plea to parents, saying, “Not only are vaccines cheaper than the overall cost of treating VPD, they are also the safest option in preventing an outbreak of diseases that would pose a greater threat to our loved ones and society at large”.

He also calls on parents and members of the community to seek information about infectious diseases and vaccines from reliable sources and professional bodies.

“Most parents who challenge vaccinations are influenced by anecdotal claims and unscientific reasoning. Always cross- check any information you are unsure of with healthcare professionals,” advises Dr Kamarul.

“Our children are our future. They need to be protected so that complications due to VPD do not rob them of the opportunity to achieve their potential.”

Understand Vaccines

With the oversaturation of information on the topic in public spaces such as social media, it may be hard to determine the truth about certain aspects of vaccinations.

Dr Kamarul Azahar Mohd Razali, head of the Paediatric Infectious Diseases unit at Hospital Kuala Lumpur, addresses some common concerns.

• Number of vaccinations – A long list of required vaccines may seem scary at first glance, but a child’s immune system is able to respond to multiple challenges.

In fact, a child’s immune system is already being exposed to many foreign antigens (substances not found naturally in the body) through food and day-to-day activities. Vaccines contain a comparatively smaller number of antigens. Therefore, when multiple vaccines are given at the same time or within a short period, they will not harm the child’s immune system.

Additionally, many of these vaccines today are delivered in combinations so children will only have to receive one jab for protection against several diseases, such as the three- in- one measles, mumps and rubella vaccine (MMR) vaccination.

• Halal compliance – Although there are some questions as to the use of animal-based enzyme in early stages of vaccine development, the Health Ministry (MOH), working closely with the Department of Islamic Development (Jakim), have delivered a well- researched consensus declaring vaccines permissible for Muslims.

• Side effects – The side effects of vaccines have been greatly misunderstood, especially since Andrew Wakefield’s controversial research paper published in The Lancet medical peer review journal in 1998.

However, it is important to note that The Lancet issued a complete retraction of the paper following reviews that concluded that elements of the paper were incorrect.

In actuality, new vaccines are friendlier than ever and common side effects that include mild fever or rashes are transient and treatable.

Severe side effects are rare and pale in comparison to the complications brought about by vaccine-preventable diseases.

• Homeopathy and natural medicine – Natural methods should only be used alongside solid medical treatment with scientifically proven efficacy, and this is true when considering homeopathy against vaccinations.

The only way to protect yourself and your child against deadly infectious diseases is through immunisation.