Measles, Chickenpox Vaccinations Stay Low After Worrying Drop During MCO

Malaysia’s MMR and chickenpox vaccine uptakes drastically declined in March and April, showing no signs of recovery in May.

KUALA LUMPUR, July 16 — As schools reopen, a paediatrician expressed concern about Malaysia’s levels of childhood immunisation against measles and chickenpox that fell during the Covid-19 pandemic and remained depressed post-lockdown.

Immunise4Life programme chairman Dr Zulkifli Ismail highlighted statistics that showed a 65 percentage point decrease in the measles, mumps and rubella (MMR) vaccine uptake in March this year compared to March 2019, followed by a 72 point drop in April 2020 compared to the same month last year, and a 61 point decline in May 2020 compared to the same month in 2019.

The numbers of children receiving the measles, mumps and rubella (MMR) vaccine from January to December 2019 vs January to May 2020 in Malaysia. Graphic from Dr Zulkifli Ismail.

Malaysia implemented a strict nationwide lockdown during the Covid-19 outbreak for almost seven weeks from March 18 to May 3, allowing people to only travel within 10km from their residence for basic necessities under the Movement Control Order (MCO).

“During the MCO, we have seen less infectious diseases because the children are at home and not exposed to their peers and other children. When the MCO is lifted, and children go to school, that’s the time when we dread.

“With the drop in MMR uptake, we fear an outbreak towards the end of the year or early next year,” Dr Zulkifli told CodeBlue.

Schools reopened nationwide yesterday for most secondary school students and Years Five and Six pupils, while Years One to Four pupils are scheduled to return to primary school on July 22.

Dr Zulkifli, a consultant paediatrician, said Malaysia was prioritising measles elimination, but expressed concern that the government may not meet the target it set with the World Health Organization (WHO) amid the anti-vaccine movement targeting the MMR vaccine.

Malaysia reportedly plans to eliminate measles by 2023, after twice delaying the target in 2012 and 2018. WHO’s verification of measles elimination for a country requires at least three years’ absence of endemic measles virus transmission.

“MMR (mumps, measles, rubella) trend is worrying. There is no increase in May and as it is given at nine months and one year, parents tend to forget these,” he added.

The numbers of children receiving the chickenpox or varicella vaccine from January to December 2019 vs January to April 2020 in Malaysia. Graphic from Dr Zulkifli Ismail.

He also raised the significant drop of the varicella or chickenpox vaccination during the MCO, as uptake of the optional vaccine declined by 41 percentage points in March 2020 compared to March 2019, further dropping by 83 points in April this year compared to the same month last year.

“The uptake has drastically dropped and shows no signs of recovering in May 2020.”

The Ministry of Health (MOH) said last month that a comparison of infectious outbreaks from the first to the 22nd epidemiological week of 2019 and 2020 saw a drop of 58.3 percentage points in measles cases, a 44.6 percentage point decrease in hand, foot and mouth disease (HFMD) cases, and 44.4 percentage point decline in chickenpox infections. Measles is a very contagious disease that can lead to complications and death.

At the same time, MOH expressed concern about a decline in the rate of immunisation of babies and children during the coronavirus outbreak as parents fear taking their children to the clinic, stressing that childhood immunisation is necessary to avoid vaccine-preventable diseases.

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