Do You Really Understand All The Vaccines Listed In Your Child's Health Booklet?

You might have read the news in 2020 that the pneumococcal vaccine has been added to our National Immunisation Programme or Schedule¹. As parents, we are usually given a health book containing all of our child’s details when they are born. The book also comes with a list of recommended vaccines for your child at different stages of their development. The pneumococcal vaccine in Malaysia was recently added to that list.

But this list can be pretty long and is often abbreviated. To a normal parent like you and me, we would look at all these different acronyms like “DTaP” or “MMR” and it would look completely foreign to us. Most of us are not familiar with the acronyms used for vaccines, their functions, or the specific diseases they represent.  We trust the doctor’s recommendations and faithfully attend all the appointments to ensure our child receives the necessary protection.  

Today, we will take an in-depth look into the newest addition to the list – the pneumococcal vaccine in Malaysia.

Pneumococcal Vaccine in Malaysia: Understanding Pneumococcal Disease

Firstly, let’s understand what pneumococcal disease is, which is a potentially serious infection that affects children due to a bacteria called Streptococcus pneumoniae. We won’t go too much into the scientific terms here.

Parents just need to know that this bacteria is commonly found in the nose and throat. People who carry this bacteria can spread it to others when they cough, sneeze or even breathe! Since we won’t know exactly who carries the bacteria, and before the pandemic most of us never wore a mask when going out, the bacteria could be widely spread.

But (not-so) fun fact:  Young children have the highest carrier rate for this bacteria and are the primary source for its spread within a community².

Is it serious?

In short, the answer is yes. This bacteria can infect your child’s organs – from their ears to their lungs to their brains and bloodstream. In less serious cases, your child might suffer from sinus infections. But if it affects your child’s lungs, the infection is called pneumonia, which can lead to cough, fever, and difficulty in breathing². In the most severe cases, death is the result. To put this into a local context, in 2016, pneumonia was the 3rd leading cause of death in children under five in Malaysia, accounting for 3.8% of under-five deaths².

Another infection that this bacteria can cause is Otitis media (middle ear infection), which happens in the middle ear and can cause pain, swelling, sleeplessness, fever, and irritability. In severe cases, it can cause bacterial meningitis, which infects a part of the brain and spinal cord. This can cause confusion, blindness, deafness, put the patient in a coma, or even lead to death.

Bacteremia, a dangerous infection of the bloodstream, can also occur⁴. This is a type of bacteria you want your child to avoid as it could lead to any serious outcomes.

As parents, we have a strong desire to keep our children safe from harm.  That includes following through on doctors’ recommendations for vaccines.

With that in mind, this article aims to empower you with the knowledge of what you’re protecting your child against. No worries, parents! It is normal for children to cry during vaccination especially when they see the needle. It can be tough to see them cry but know that the tears are a small price to pay for their future health.

So let’s talk about the vaccine itself.

Pneumococcal Vaccine in Malaysia: Everything You Need To Know

We know that this disease is preventable when children are given the vaccine⁴. The pneumococcal vaccine is given in three doses: the first two primer doses are given at age four months and six months, then the course is completed with a booster shot at age 15 months.

There are a few types of vaccines that help protect against this disease and the vaccine that Malaysia has chosen to include in the immunisation schedule is classified as PCV10⁵. This vaccine protects against the Streptococcus pneumoniae we mentioned earlier, more specifically, against serotypes 1, 4, 5, 6B, 7F, 9V, 14, 18C, 19F, and 23F. The PCV10 also induces antibody response to serotypes 6A and 19A⁷.

The pneumococcal vaccine will be injected into your child’s arm or leg and once it is administered, it encourages your child’s body to produce the mentioned antibodies against the pneumococcal bacteria.

Antibodies, as we know, are proteins produced by the body to cancel out or stop the disease-carrying organisms and toxins from reproducing or spreading. The PCV10 vaccine is expected to provide a substantially greater reduction in acute otitis media.

Since this vaccine is still fairly new to the wider population in Malaysia, data has yet to be collected on its overall effect on the death rates or infection rates. What we know is this: according to former Minister Datuk Seri Dr Adham Baba, the number of cases of children with pneumococcal disease increased from 17,446 in 2017 to 19,773 in 2018, making the introduction of the vaccine very timely and necessary¹.

Around the globe, countries such as New Zealand, Austria, Brazil, Kenya and Pakistan have introduced the vaccine into their NIP, and they have seen a large reduction in pneumococcal disease³. We can expect to see the same happen in Malaysia as we improve vaccination rates and the disease is less widespread.

Even if your child is previously unvaccinated against pneumococcal disease, it is still possible to give them the vaccine up to the age of 5³. Though children born before 1 January 2020 are not eligible to receive the vaccine at government hospitals or clinics as part of the free immunisation list, you can still get it at private clinics or hospitals.

It is important to prevent your child from getting infected with invasive pneumococcal disease. So, parents, please take this small, but important step in protecting your children.

The Asian Parent 3rd Issue – PCV NIP article (v0.1)
NP-MY-SYN-ADVR-240002   04/24
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For further information please contact your doctor

References:

1 Malay Mail. (2020, December 1). Health Minister: Free PNEUMOCOCCAL vaccination for children at health clinics STARTS today: Malay Mail. Malaysia | Malay Mail. https://www.malaymail.com/news/malaysia/2020/12/01/health-minister-free-pneumococcal-vaccination-for-children-at-health-clinic/1927749. 

2 Department of Health Services. (n.d.). Streptococcus pneumoniae, Invasive. WISCONSIN DIVISION OF PUBLIC HEALTH.
https://www.dhs.wisconsin.gov/publications/p4/p42093.pdf. 

3 Darus, N. M., Akmal, S. B., & Redzuan, A. M. (n.d.). Pneumococcal Conjugate Vaccine For Children Below Five Years Old. www.moh.gov.my/moh/resources/auto%20download%20images/587f11568fcaa.pdf. 

4 Saling, J. (n.d.). Pneumococcal vaccine schedule and side effects. WebMD.
https://www.webmd.com/children/vaccines/pneumococcal-vaccine-1

5 Shafie, A. A., Ahmad, N., Naidoo, J., Foo, C. Y., Wong, C., Pugh, S., & Tan, K. K. (2020, July 2). Estimating the population health and economic impacts of introducing a pneumococcal conjugate vaccine in malaysia- an economic evaluation. Human vaccines & immunotherapeutics.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7482775/. 

6 Malaysia chooses pcv10 PNEUMOCOCCAL Vaccine, Immunisation Starts December. CodeBlue. (2020, November 24).
https://codeblue.galencentre.org/2020/11/24/malaysia-chooses-pcv10-pneumococcal-vaccine-immunisation-starts-december/.

7  Soon, R. (2020, December 5). Hexavalent, pneumococcal vaccine update included in national immunisation schedule: Latest news for doctors, nurses and pharmacists: Infectious diseases. MIMS News.