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That shot at prevention

Wednesday, Apr 25, 2012
New Straits Times
By Kasmiah Mustapha and Syida Lizta Amirul

When it comes to babies, vaccination is almost always a passe topic among parents, most of whom think that other than those provided in the country's National Immunisation Programme, other recommended vaccines are not necessary for their newborn or toddler. Some urban parents have also been influenced by the Internet and other sources and are now opting not to vaccinate their children.

This worries paediatricians. "This (not vaccinating kids) is at the cost of protection of these children and of others who may be too young to be vaccinated. Since these parents have not seen the diseases concerned, they are not aware of the consequences of their decision - unless their child is unfortunate enough to get infected," paediatrician Datuk Dr Zulkifli Ismail says.

Dr Zulkifli is also past president of the Malaysian Paediatric Association and chairman of the Asian Strategic Alliance for Pneumococcal disease prevention.

Owing to herd immunity, with large enough coverage, children who are not vaccinated will still be protected, benefiting from those who have been vaccinated. For herd protection to have an effect, there must be at least 80 to 90 per cent of the population at risk who have been vaccinated. "With more parents not vaccinating their children, this herd effect will subside," he says.

"The Health Ministry is concerned and so are we paediatricians. The trend is not so large and not that worrying now, but we need to put in some effort to inform the public about vaccines especially since it is no more like what it used to be in the past. There are many more antigens in the vaccines and there are also convenient combination vaccines,"

PREVENTION FIRST

"Vaccination is prevention and it is an investment in health. If we are to practice what we preach about prevention being better than cure, then we should be advocating vaccination. It is not new and it has been shown to be safe and effective in reducing serious diseases," Dr Zulkifli says.

He says for vaccines under the NIP, those who reject them are mainly urban parents, perhaps since the population has access to worldwide information and a fair amount is by anti-vaccine lobbyists. Some parental groups - especially in the United States and United Kingdom - believe that vaccination is unnecessary. They had questioned the need to vaccinate children especially as some of the diseases are no longer around.

They also say some of the vaccines have side effects, claiming that these shots can cause other issues such as autism. "In the 1980s when there was widespread rejection of the DTP (diphtheria, tetanus and pertussis) vaccine in the UK, many babies succumbed to pertussis. When the article on MMR (measles, mumps, rubella) and autism was published, MMR vaccination in the UK dropped the subsequent year resulting in an increase in measles cases, including many deaths. The article in the Lancet has since been withdrawn and the authors proven to be fraudulent. Possibly the last local case of diphtheria occurred in the mid-80s among a religious cult group that refused vaccination for its members," he says.

The rural population, he says, will send their children for the vaccines in the NIP because of their contact with the community nurses who are their neighbours. "The problem is getting information on other recommended vaccines to them, especially with the relatively high price of these vaccines."

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