Should you give it a shot?
IMMUNISATION is a word that has recently popped up in the news again. An alarming number of parents worldwide are choosing not to vaccinate their children. These numbers are increasing and is a cause of grave concern among healthcare providers.
The rise and spread of the anti-vaccination movement can be blamed for this drop in the immunisation rate among children. While medical professionals still believe that vaccination is essential to keeping society safe from various diseases, the anti-vax community believes vaccines cause more harm than good.
The fact remains that parents will always want what is best for their children, and if word spread that vaccines may potentially harm their precious babies, many would choose not to go for it. However, these individual decisions can affect the greater community, contributing to the likelihood of a disease epidemic.
Saying no to immunisation
The question of whether to vaccinate a child, a decision which was a given even a few years back, is proving to be a daunting one for many parents nowadays. The antivax movement is believed to have been sparked by a controversial article by British surgeon Andrew Wakefield, which was published in The Lancet in 1998. The article linked the mumps, measles and rubella (MMR) vaccine to autism in children.
While most anti-vaxxers still believe in Wakefield’s theory, numerous studies have since refuted the claims. The Lancet also later retracted the article, stating that the findings in Wakefield’s article were insufficient to establish a link between the MMR vaccine and autism.
Although autism remains the biggest reason cited by parents to keep their children away from vaccination, there are other reasons, too, such as the pain caused by the procedure, distrust towards pharmaceutical companies and fear of possible side effects.
Consultant paediatrician and paediatric cardiologist Datuk Dr Zulkifli Ismail believes the issues related to the side-effects or adverse events following immunisation (AEFI) have been over-emphasised. Serious adverse events are extremely rare and, when weighing the benefits against the risks, it is still much better to vaccinate.
“Vaccination has already removed smallpox from the face of this earth, and we are so very close to eradicating poliomyelitis and approaching the elimination of measles. Where we used to treat babies with neonatal tetanus and congenital rubella, these are now rarities, because of vaccination,” he stresses.
Another question raised by anti-vaxxers is the effectiveness of injecting germs, dead or otherwise, into the bloodstream of infants, whose immune system is still vulnerable. But, according to doctors, this is precisely the reason why vaccines should be administered during this stage, which is to help the growing immune system of babies create anti-bodies that would be useful in thwarting the diseases later on in life.
In addition to these fears, Dr Zulkifli cites another struggle that healthcare professionals face when administering vaccine to the Malaysian population. “The influence of anti-vaxxers and fear of pain are not very high on the list of reason why parents won’t vaccinate their child. This is in contrast with Western countries, where the fear of side effects and pain during injection was prominent,” says Dr Zulkifli.
“One oft-cited reason is religious beliefs – whether the vaccine ingredients are halal. The issue is quite disconcerting, especially because there are already religious edicts (fatwa) that support vaccination.
“The promotion of traditional, homeopathic and naturopathic medicine also ranks very high among locals who refuse vaccinations. Many people promote
The rise and spread of the anti-vaccination movement can be blamed for this drop in the immunisation rate among children. While medical professionals still believe that vaccination is essential to keeping society safe from various diseases, the anti-vax community believes vaccines cause more harm than good.
the idea that there are ‘homeopathic vaccines’ or traditional practises and food eaten by the Prophet Muhammad are enough protection for their children. It is hard to tell them how absurd this sounds without saying we don’t respect their religious beliefs,” he adds.
The future horrors in store
The fact is by choosing not to vaccinate, parents are not only risking the lives of their own children, but also society as a whole, as people depend on herd immunity for protection. Herd immunity only works when a sufficient number of people are immunised, thus offering protection to people who cannot be vaccinated for various reasons.
The consequences of anti-vax campaigns are becoming more apparent as vaccine-preventable diseases are making a comeback with a vengeance.
For instance, a measles outbreak in the United States at the start of this year is blamed on low vaccination rates. Malaysia, too, has had some cases of infant deaths caused by diphtheria in the recent past.
Dr Zulkifli, who is also chairman of the Immunise4Life programme and Asia Pacific Pediatric Association secretary-general, says, “As usual, it takes a catastrophe before people decide to wake up. After the diphtheria outbreak claimed two victims, we suddenly had a surge of parents who were initially hesitant about vaccinations coming forward requesting for the DTaP (diphtheria, tetanus and acellular pertussis) vaccine.”
According to him, the vaccination programme is a victim of its own success.
“With the decrease in these vaccine-preventable diseases, many parents do not see the need to vaccinate their kids, and when there is a drop in the number of vaccinepreventable diseases, people become complacent and forget how they got to where they are.”
The worst case scenario if more people became anti-vax is outbreaks of diseases that was thought to have disappeared.
“We could have measles outbreaks in kindergartens, nurseries, schools and play areas, which could lead to deaths,” warns Dr Zulkifli.
Dr Zulkifli opines, “The worst possible scenario is when people promote this pro-choice, antivaccine phenomenon, they are undermining the efforts of people who have worked to develop, promote and administer these vaccines for all these years. The truth is, we can move on to more complex treatments if we don’t have to keep going back to treating vaccine-preventable diseases.”
Are we jumping on the bandwagon?
The good news, according to Dr Zulkifli, is the vaccination rate in Malaysia is at more than 95%, except for MMR and Hepatitis B. Malaysia led the region in HPV vaccinations and was the first in the region to introduce Hepatitis B into its neonatal and childhood immunisation schedule in 1989. It was also the first in the region to introduce the Hemophilus influenzae type b (Hib) vaccine.
However, more needs to be done. Dr Zulkifli suggests the government make it mandatory for children to be vaccinated against at least diphtheria and measles before being allowed to enrol in school.
“Education campaigns should continue, too. We need to have continuous vaccine-related information as well. For example, the Health Ministry should give data related to the vaccination rate, incidences of vaccine-preventable diseases (VPDs) and hotspot areas of vaccination non-compliance.
Awareness can come from different media, even social media. The loud anti-vaccine lobby goes unchecked because the vacuum to counter their rhetoric is not filled.
Hence, there should be more social media penetration by credible health bodies, if we are to fight the anti-vax tide.