Immunisations: saving all our children

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THERE has been an increasing number of parents who have made a choice not to vaccinate their children. The implications of this action are far-reaching and will impact the health of our children for years to come. As consultant paediatricians from all over Malaysia, in government service, private practices or universities, we would like to share our concerns with parents.

It is important to note that there has been no public health or medical initiative that has changed the lives of children as much as vaccines. Yes, clean water supply, better economic and housing conditions have contributed significantly to health improvement. But vaccines have made major impact on disease transmission, especially in children.

Millions of children worldwide have survived because of the introduction of immunisation programmes. In Malaysia we have seen the dramatic reduction in mortality and morbidity (sickness, death and damage to children), to the point where we hardly see serious illness like polio or tetanus except in the non-immunised communities like recent immigrants from less privileged countries.

Thousands of Malaysian children have been protected over the years and we should be proud that our country has been regarded by the World Health Organisation as one with a very successful immunisation coverage.

But this is changing … As the anti-vaccine lobby gains ground, some parents are making the choice not to vaccinate their children. The impact of this decision is felt not only in their children alone, but also in the lives of other children who have not managed to receive their immunisation but came into contact with unvaccinated children with illness.

This month a 52-day-old baby died of pertussis (whooping cough) in Malaysia. Pertussis is a readily preventable disease but this baby was too young for the vaccine, which is given at two months of life. The decreasing community (herd) immunity, as a result of more parents omitting vaccines, has resulted in this baby losing the protection that we as a community could have given the child.

This is not an isolated event. In addition some children also die or get seriously ill because they were not offered vaccination by their parents. With the loss of herd immunity, your child may potentially get infected now or as an adult, or even get infected by their own children in the future.

Why are parents making this choice in the face of decades of successful immunisation programmes? There are a number of reasons.

Side effects

Do vaccines have side effects? Of course they do. All medications and vaccines have risks of side effects. Some parents in reading about the side effects become worried about the safety of vaccines. However, side effects need to be taken in the context of the bigger picture. These side effects are less common than many day-to-day activities that we engage in.

Vaccines are safer than most things in life, for example driving a car or a motorbike. More than 8,000 Malaysians will die from road traffic accidents in Malaysia this year. An additional 35,000 will get seriously damaged. This does not seem to stop Malaysians from driving. You are hundreds of times more likely to get a ‘side effect’ or die from driving than from getting a side effect from a vaccine. Similarly getting any one of the vaccine-preventable diseases will be more serious compared to the risk of vaccine side effects.

Loss of historical memory/perspectives

Those of us, who are older in this group, remember the massive outbreaks we had for diphtheria, of seeing many children die of tetanus or, of children being maimed by polio. This situation was very much akin to the current dengue outbreaks that worry all Malaysians.

As we control diseases better, the public loses memory of the devastating effects of these conditions on their families and the community. Hence the fear of side effects, rather than that of the infection to be protected from, become relatively more important.

Of note, even as recent as two to three years ago, we were struggling with a large measles epidemic in some states in Malaysia due to reduced vaccine coverage. Similar measles outbreaks have also occurred, in the past few years, in developed countries like the USA and UK due to falling immunisation rates.

Dubious practitioners

There are many dubious individuals, with titles of uncertain reliability, who claim to be experts, advising against vaccines. They argue for a ‘holistic’ way of life and even suggest that natural infection of diseases is better for children than immunity through vaccination.

We hope that parents will evaluate these individuals and their claims carefully. Most of these claims have no or minimal scientific basis or evidence.

False information and concerns

Some parents are reluctant to use vaccines as they have been given false information as to their content. They fear that vaccines contain foreign proteins that may conflict with their religious beliefs. Others believe vaccines may have heavy metals like mercury or toxins that can cause autism.

Vaccine production is a rigorous process and current vaccines used in children are safe. Numerous studies have clearly shown that there is no evidence to support any link between vaccines and autism.

We appeal to parents to protect all the children of Malaysia with the use of vaccines. It is important to remember that vaccines do not just protect your child, they protect all the children and susceptible adults (such as the sick and the elderly) that you and your child come in contact with.

For the sake of your children and ours, for the sake of all Malaysian children, we hope parents will support the use of vaccines. We extend blessings on your children and hope that we will always be available to serve the children of Malaysia.

Thank you.

114 government, private and university consultant paediatricians.