Childhood Vaccinations Saw A Significant Drop in 2020(1), Now Doctors Are Pleading With Families To Return To Them

One only needs to open up their social media feeds and they will see the endless news about COVID-19 and monkeypox². We’ve had a few years to get into the habit of practising good hygiene habits with our kids, such as wearing masks, hand sanitising and also keeping the environment that they’re growing up in clean.

However, there is only so much we can do at home and we cannot guarantee that our kids won’t get exposed to infectious diseases, which are a leading cause of death in children³ because they have a weak immune system at their young age⁴. 

Infectious diseases such as smallpox have been eradicated⁵, while others drastically reduced through vaccinations over more than 50 years. 

Unfortunately, in 2020, there was a significant drop in childhood vaccinations worldwide, due to lockdowns and movement restriction orders around the globe⁶. 

Childhood vaccinations help children stay well and healthy for themselves, families and the community, and protect them from vaccine-preventable diseases.

Dr Rakhee Yadav, Consultant Paediatrician & Head of Department of Paediatrics, Ara Damansara Medical Centre, believes that now more than ever, parents need to be vigilant with their children’s health and the most preferred method for reducing your child’s risks of being exposed to these diseases is by vaccination. 

“With the pandemic and the emergence of ongoing new diseases, parents cannot afford to be indifferent about their children’s health. The trend of parents not vaccinating their children is worrying and we cannot let this continue,” she says.

According to an article published by the WHO, UNICEF data confirms that this is a red alert for child health. We are witnessing the largest sustained drop in childhood immunisation in a generation. The consequences will be measured in lives⁶.

While a pandemic hangover was expected last year as a result of COVID-19 disruptions and lockdowns, what we are seeing now is a continued decline. COVID-19 is not an excuse. “We need immunisation catch-ups for the missing millions or we will inevitably witness more outbreaks, more sick children and greater pressure on already strained health systems” urged the UNICEF⁶.

Parents Need To Go Back To Vaccinations: National Immunisation Programme And Beyond

Malaysia has long provided free immunisation services for children to prevent major childhood diseases. The National Immunisation Programme (NIP) was introduced in the early 1950s followed by the Expanded Programme for Immunisation (EPI) in 1989. Malaysia currently provides immunisation against 13 major diseases that affect children⁷. This helps strengthen their immune systems by stimulating defence cells and protecting them from possible life-threatening complications⁴. 

Medical experts also recommend that parents take extra precautions against other diseases that are life-threatening and dangerous for children. Dr Rakhee Yadav shares more about these additional recommended vaccinations.*

Additional Recommended Vaccines 

According to Dr Rakhee, there are five diseases that commonly affect children which are not included in the National Immunisation Programme. They are⁸: 

Rotavirus

A highly contagious disease that can infect children aged five or below. It infects the intestine lining and causes severe diarrhoea and vomiting⁹. About 22% to 50% of cases of diarrhoea in Malaysian children are caused by Rotavirus¹⁰.

Varicella

More commonly known as Chickenpox, this infection causes rashes, skin blistering and uncomfortable itching. It is highly contagious and is spread through contact and respiratory fluids. The vaccine against the Varicella Zoster virus will help prevent chickenpox and other serious complications^11,12,13.

Influenza

Influenza (flu) differs from the common cold in that it can cause severe infections of the respiratory tract including the throat, nose and lungs. In addition, the symptoms include fever, sore throat, muscle pain and fatigue¹⁴. Failure to get treatment for the effects of the influenza virus can put the child at greater health risks such as pneumonia, lung diseases and heart problems¹⁵.

Hepatitis A

Hepatitis A is a highly contagious, short-term liver infection caused by the hepatitis A virus. It can spread through close, personal contact with an infected person or contaminated food that contains the virus. While it rarely causes death in children, the disease can lead to complications such as abdominal pain, liver failure and jaundice¹⁶.

Meningococcal

Meningococcal meningitis is a type of bacterial infection that causes inflammation of the lining of the brain and spinal cord. The disease mostly occurs in children and adolescents but 5% to 10% of those infected do not show symptoms of the disease. Without proper treatment, among the complications that can occur are nervous system problems such as paralysis, deafness and can cause death¹⁷.

Diseases With No Specific Treatments: Vaccines Are A Preferred Defence

Doctor Rakhee stressed that these five diseases mentioned have no specific treatment. Therefore, one of the preferred defences against them is prevention through vaccines. She added that these diseases are easily transmitted in childcare centres and schools, which is why the Malaysian Ministry of Health recommends these five additional vaccines for infants and children.*

"It is normal for children to experience fever, pain at the injection site and lethargy after the vaccination. This is just a temporary discomfort and the benefits are long-term,” said Dr Rakhee. 

In her opinion, while the Ministry of Health and National Immunisation Programme provides comprehensive protection to the community by preventing diseases, it is the responsibility of parents to give maximise protection for their children with these recommended additional vaccines.

When and where should I get these 5 additional recommended vaccines?⁸ 

These additional vaccines are available at private clinics and hospitals. The above schedule is a guideline for parents to decide if their children should complete these supplemental vaccines and they should consult a paediatrician for more information. 

Let us take care of the health of our children and those around us. Prevention is always better than cure.

Dr Rakhee Yadav is a Consultant Paediatrician at Ara Damansara Medical Centre (ADMC) and Baby & Beyond Child Specialist Clinic Publika. She is a strong advocate for childhood vaccination and early childhood nutrition. She is a proud mother of four with a passion for travelling.

*This information is provided as a professional service by MSD. The views expressed in the publication reflects the experience and opinions of the authors.

MY-ROT-00238 Aug/2022

REFERENCE:

1. World Health Organization (WHO). COVID-19 pandemic leads to major backsliding on childhood vaccinations, new WHO, UNICEF data shows.Available from: https://www.who.int/news/item/15-07-2021-covid-19-pandemic-leads-to-major-backsliding-on-childhood-vaccinations-new-who-unicef-data-shows. Last Accessed 02 Jun 2022.
2. Centers for Disease Control and Prevention (CDC). Monkeypox. Available from: https://www.cdc.gov/poxvirus/monkeypox/response/2022/index.html. Last Accessed 12 Sep  2022. 
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4. MyHealth. Immunisation: Facts and Myths. Available from: https://www.myhealth.gov.my/imunisasi-fakta-dan-kemusykilan/. Last Accessed 02 Jun 2022.
5. Andre FE, Booy R, Bock HL, Clemens J, Datta SK, John TJ, Lee BW, Lolekha S, Prltola H, Ruff TA, Santosham M, Schmitt HJ. Vaccination greatly reduces disease, disability, death and inequity worldwide. Bull World Health Organ [Internet]. 2008;86(2). 
6. World Health Organization (WHO). COVID-19 pandemic fuels largest continued backslide in vaccinations in three decades. Available from: https://www.who.int/news/item/15-07-2022-covid-19-pandemic-fuels-largest-continued-backslide-in-vaccinations-in-three-decades. Last Accessed 12 Sep 2022.
7. Immunise4Life. The Malaysian National Immunisation Programme (NIP). Available from: https://immunise4life.my/the-malaysian-national-immunisation-programme-nip/.  Last Accessed 21 Jun 2022.
8. Immunise4Life. 5 Additional Recommended Vaccines for Children. Available from:    https://immunise4life.my/5-additional-vaccines-for-children/. Last Accessed 13 Jun 2022.
9. Children’s Hospital of Philadelphia. A Look at Each Vaccine: Rotavirus Vaccine. Available from: https://www.chop.edu/centers-programs/vaccine-education-center/vaccine-details/rotavirus-vaccine. Last Accessed 02 Jun 2022.
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11. Centers for Disease Control and Prevention (CDC). About Chickenpox. Available from: https://www.cdc.gov/chickenpox/about/index.html. Last Accessed 13 Jun 2022.
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13. Centers for Disease Control and Prevention (CDC). Chickenpox Prevention and Treatment. Available from: https://www.cdc.gov/chickenpox/about/prevention-treatment.html. Last Accessed 13 Jun 2022.
14. Centers for Disease Control and Prevention (CDC). Key Facts About Influenza (Flu). Available from: https://www.cdc.gov/flu/about/keyfacts.htm. Last Accessed 02 Jun 2022.
15. Rothberg MB, Haessler SD, Brown RB. Complications of Viral Influenza. The American Journal of Medicine [Internet]. 2008:121(4). 
16. MyHealth. Jangkitan Virus Hepatitis A. Available from:  https://www.myhealth.gov.my/jangkitan-virus-hepatitis-a/. Last Accessed 02 Jun 2022.
17. MyHealth. Penyakit Meningitis (Meningococcal). Available from:
    https://www.myhealth.gov.my/penyakit-meningitis/. Last Accessed 02 Jun 2022.

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