BY LOH FOON FONG
PETALING JAYA: Parents are increasingly giving vaccination a miss for their kids. Doctors, however, are far from pleased with the trend. They point to the rising risk of children getting stricken with preventable diseases.
Some feel that this risk has been heightened by the presence of many migrant workers in the country whose vaccination status is not known.
Malaysian Paediatric Association subcommittee chairman for immunisation Datuk Dr Zulkifli Ismail said there was increasing refusal and hesitancy to accept childhood vaccination, especially among the more educated parents.
He said these children did not only face the risk of suffering diseases but could face complications and other long term consequences from them.
Dr Zulkifli cited the case of an eight-month-old baby who had 250ml of fluid drained out from the left of his chest and was warded in intensive care unit for two weeks because his parents did not want the pneumococcal conjugate vaccine (PCV).
The infant had suffered from cough for one month and fever and breathlessness for a few days when admitted to hospital. Chest X-rays showed pneumonia with fluid in his chest, he said.
“The hospital bill was 18 times the cost of the total course of the vaccine, not including the risk of hospital-acquired infection, pain of IV drips and the chest drain and psychological trauma,” he said.
In another case, a one-year-old boy was never given the primary vaccines because his grandmother was against it.
He had been coughing for three months and did not get well despite being given traditional remedies.
Dr Zulkifli said tests found the bacteria which causes pertussis or whooping cough present.
He said the boy need not have coughed for so long if he had taken the DTaP vaccine given at ages two, three and five months with a booster at 18 months.
Health director-general Datuk Dr Noor Hisham Abdullah said the number of parents refusing vaccination was rising with families with children aged below two, increasing from 470 cases in 2013 to 1,292 cases last year. However, the numbers should be more because statistics collected did not include private health clinics, he said.
Among reasons for vaccination refusal were doubts over the safety of vaccine content, the belief that homeopathy medication and traditional remedies should not be mixed with modern medicine, and the halal concern.
Hospital Kuala Lumpur consultant neonatologist Dr Irene Cheah said in the process of avoiding vaccination, some parents also reject vitamin K injections. As a result, one baby died from bleeding in the brain and another suffered brain damage a few months ago, she said.
The injection is given at birth to prevent bleeding in the brain or gut which could be life threatening or lead to delayed development such as cerebral palsy, she said.
Bad experience a reason some avoid inoculation
PETALING JAYA: A previous bad experience is one reason some parents have chosen not to vaccinate.
Bessie, 34, who did not want her real name published, saw her first child, now aged six, fully vaccinated according to the government recommended schedule.
However, it was her experience with her second child, now aged four, that altered her thinking.
The child seemed to have an adverse reaction to the Hepatitis B vaccine when given the jab at one-month-old.
“She was vaccinated in the morning and the swelling and discomfort started not long after and the following night.
“She cried persistently for three hours and gave one very loud, high-pitched scream,” she said.
Bessie said her daughter continued to have fever for a few days, along with a swollen thigh for more than a week.
“Later, I found out she had brain inflammation and after that, I noticed behavioural change and loss of eye-contact,” she said.
As her daughter grew older, she had speech delay, she said.
She said there was no fever or illness prior to the vaccination and the baby was a healthy, fully breastfed baby.
A father of fraternal twin daughters from Subang Jaya, Dan, 36, spoke of the trauma his children went through 10 days after their second and third month shots, which were the first and second doses of DTP, polio and Hib vaccines.
He said both his twins had fever.
However, the older twin suffered a seizure twice: on Nov 19, 2009 and Dec 19, 2009.
When she had the second seizure, she had to be rushed to the hospital and admitted into the intensive care unit for two days.
“The older twin also gave out a sudden ‘weird’ high-pitched scream and it sometimes happened in the middle of the night. She’d also suddenly throw her head backwards,” he said.
The doctor said the seizures were due to E. coli infection but at the sixth month, Dan decided to stop all vaccines for the twins until he researched further.
“I later learned that this was a sign of encephalitis (swelling of the brain), which can be triggered by vaccines,” he said.
Report if children suffer ill effects, parents advised
PETALING JAYA: Parents are encouraged to notify the National Pharmaceutical Control Bureau of any symptoms they think might be linked with vaccination.
Health director-general Datuk Dr Noor Hisham Abdullah said a committee would investigate the incidence.
“If there is a safety issue with the implicated vaccine, a warning shall be given to all health facilities and the community,” he said in an email reply.
He said that the bureau had received 102 reports or 0.0025% of adverse events following immunisation (AEFI) in 4.1 million doses of vaccination given to children aged below two in Malaysia last year.
“Most AEFI cases reported involve minor reaction at injection site, mild fever and rash which were resolved uneventfully,” he said.
Dr Hisham said AEFI reports received for all age groups showed a decreasing trend, 1,068 cases reported last year compared with 1,777 in 2013.
While most cases of AEFI had been mild, in severe cases, children would need to be hospitalised, such as in cases of anaphylactic shock or Acute Demyelinating Encephalomyelitis or death following immunisation, he said.
“The suspected severe AEFI cases will be thoroughly investigated and if found related to the vaccination, the child will not be subjected to the same vaccine type,” he said.
Parents could lodge reports of AEFI to any government or private health facilities that administer vaccines or fill up the form – “Consumer Complaints Relating To Medicine” – which could be downloaded from the bureau website http://portal.bpfk.gov.my/ or fax to 03-7956 7151 or mail it to the bureau.
Asked why Malaysians still get infected with certain diseases that they had been immunised from, he said certain districts had lower coverage.
“This is contributed by a highly mobile population, working parents and to some extent the vaccine hesitancy group.
“At the same time, we have influx of immigrants of unknown vaccination status,” he said.
Dr Hisham pointed out that with immunisation, smallpox had been eradicated and the world was declared free of smallpox in 1980.
The last reported case was in 1978 (laboratory acquired) and 1977 was the last case in community.
Health Minister Datuk Seri Dr S. Subramaniam said when the Government introduced the use of the various vaccines, it would weigh the pros and cons and would only use it when they were convinced that the advantages far outweigh the disadvantages.
