KUALA LUMPUR, August 18 — The Perikatan Nasional government has announced that it will not use law enforcement to mandate childhood immunisation, despite rising vaccine hesitancy in Malaysia.
According to Health Minister Dr Adham Baba, the decision was made after a task force formed by the Ministry of Health (MOH) in 2019 examined the feasibility of mandating the vaccination of infants and children against potentially disabling and fatal diseases.
“Stakeholders — including government agencies such as the Ministry of Education; the Ministry of Women, Family and Community Development; and the Department of Islamic Development Malaysia (JAKIM); non-governmental organisations (NGOs) and related associations; as well as a panel of specialists such as paediatricians, family physicians and public health experts — were also involved in the process of gathering views from diversified angles on mandating immunisation,” Dr Adham stated in a written Parliament reply on August 13 to Kuala Selangor MP Dzulkefly Ahmad.
“However, after examining the aspects of implementation and the implications of practicing legal measures, MOH decided to approach this issue without implementing legal measures to mandate childhood immunisation in Malaysia.”
Former Health Minister Dzulkefly from Pakatan Harapan had requested MOH to state the ministry’s efforts to make the five-series vaccine injection (DtaP / IPV / HiB) compulsory in order to break the epidemiological chain of vaccine-preventable diseases in the community.
The National Immunisation Programme has been implemented since the 1950s. The five-series childhood vaccination programme (DtaP / IPV / HiB) began in 2008 to provide protection against five types of diseases, namely diphtheria, tetanus (lockjaw), pertussis (whooping cough), polio (paralysis caused by poliovirus), and Type B influenza (Hib) caused by Haemophilus bacterial infections.
Dr Adham stated that the task force had meticulously discussed the proposed amendments to the relevant Acts, as well the responsibilities of parents and guardians, while MOH has also studied existing laws in Malaysia as well as in other countries in the world.
It is to be noted that countries like Germany, Italy, the United States, and Australia impose fines on parents of unvaccinated children. Germany does not permit unvaccinated children to attend school. Germany imposes fines of up to €2,500 (RM 12,406), while in Italy, parents of unvaccinated children pay an €500 (RM 2,481) fine.
A study conducted by the Institute for Health Behavioural Research under Malaysia’s MOH in 2018 revealed that low awareness about vaccination benefits, constraints in availability, accessibility of affordable vaccines, wrong perception, worries about the side effects of vaccines, and reliance on alternative medicines contributed to the hesitance of Malaysian parents to vaccinate their children.
Dr Zulkifli Ismail, head of MOH’s Immunise4Life community education programme, reportedly stated in April last year that official vaccine refusal has been rising in Malaysia between 2013 and 2016. He stressed that Islam teaches prevention is better than cure, amid concerns among some Muslims that certain childhood vaccines are not halal. JAKIM’s official 2016 statement also endorses vaccination.
“However, MOH will strengthen and improve the existing delivery service, including increasing detection measures to identify missed cases as well carrying out more educational and promotional activities,” Dr Adham mentioned in the Dewan Rakyat.
Dr Adham also stated that high immunisation coverage of up to 95 per cent is required to ensure the success of the childhood immunisation programme for herd immunity, but he did not reveal the status of immunisation coverage for the DtaP / IPV / HiB jab.
“When a large group of communities is immunised against diseases that can be prevented by vaccines, the spread of bacteria and viruses will be difficult.
“This eventually will lead to herd immunity when the whole community is protected from vaccine-preventable infections through high immunisation coverage,” Dr Adham said.
The Health Ministry also provided the statistics of infected patients in 2019 for the five diseases as stated below:
- 16 cases of diphtheria were reported with six deaths. Five deaths involved children who did not have immunisation records. The incidence rate is 0.05 cases per 100,000 population.
- 30 cases of tetanus were reported with one death; the victim had no immunisation record. The incidence rate is 0.09 cases per 100,000 population.
- 915 cases of whooping cough were reported with 20 deaths; all the victims had no immunisation records. The incidence rate is 2.74 cases per 100,000 population.
- Three polio cases were reported without any fatalities. The incidence rate is 0.01 cases per 100,000 population.
- Four cases of disease caused by Haemophilus Influenzae Type B (Hib) were reported and no deaths were recorded. The rate of incidence is 0.01 cases per 100,000 population.
