Child Development, Parenting
Dr JoAnn Rajah A/P Sebastian Rajah, General Paediatrician at Firststep Child Specialist & Member of the Malaysian Paediatric Association (MPA)
Do you have mixed feelings about childhood vaccinations? Worried about all the diseases that might harm your child? To answer some of the big questions that have been lingering on most parents' mind, we've got Dr JoAnn Rajah, General Paediatrician at Firststep Child Specialist & Member of the Malaysian Paediatric Association (MPA) who shared her thoughts on this topic.
PARENT: I have mixed feelings about childhood vaccinations. Some of my friends are wary and afraid. Doctor, should I vaccinate my children?
Dr JoAnn: As a doctor who has listened to the struggles of my own patients, I empathise greatly with parents who experience uncertainty regarding childhood vaccinations. Jeffrey Kluger, TIME magazine editor-at-large and the author of ten books on various topics, said: "Vaccines save lives; fear endangers them. It's a simple message parents need to keep hearing."1 I couldn't agree with Mr Kluger more.
Parents, the answer is yes, you must vaccinate your children against harmful infectious diseases. If more people get vaccinated, vaccination coverage will increase, which means that the population will be more widely protected and less likely to be at risk of developing a vaccine preventable disease (VPD).2 Today, we are lucky to have access to clinical research validated by the World Health Organisation (WHO) and our Ministry of Health (MoH) Malaysia, proving the validity, efficacy and safety of vaccines that help thwart life-threatening VPDs. It is important for you as a parent to listen to the data and to not allow misinformation to sway you from protecting your child. Ask your paediatrician or family doctor whom you trust about the life-saving benefits of childhood vaccinations.
PARENT: But there are so many diseases out there! How do we figure out which diseases to immunise our infants from?
Dr JoAnn: I strongly suggest that parents refer to our country's National Immunisation Program (NIP) as the Health Ministry has identified childhood vaccines that provide the best protection from the most crucial diseases. As an example, the 6-in-1 Hexavalent vaccine currently in the NIP provides infants and young children protection from 6 deadly diseases with just 3 primary doses at 2, 3, 5 months, and an additional booster at 18 months.3
With a total of 5 shots of the Hexavalent vaccine, including the Hepatitis B dose at birth, your child will be safe and protected from 6 VPDs, namely Pertussis (Whooping Cough), Diphtheria, Tetanus, Poliomyelitis, Haemophilus Influenzae Type B and Hepatitis B.3 These are diseases that will cause illness, disability or even death in our young children if they are not properly protected.
PARENT: How dangerous is pertussis or whooping cough?
Dr JoAnn: Pertussis – more commonly known as whooping cough due to the "whoop" sound the infected person makes when gasping for air after a fit of coughing – is a disease newborn infants are especially vulnerable to. It is also referred to as the "100 day cough" because pertussis infections can last up to 10 weeks or more.4
This disease is highly contagious, more so than other infectious diseases, as a single infected person can potentially spread pertussis to 17 other individuals.5 The incidences of pertussis have increased in recent times due to a phenomenon known as "pertussis resurgence".6 About 50 percent of infants below one year of age who get pertussis will require hospitalisation.
Parents whose babies were infected with pertussis have had to go through the worry of seeing their babies' intense coughing fits along with other respiratory complications due to the child's immature respiratory system. In severe cases, pertussis can lead to pneumonia, convulsions, brain damage or even death. About 1 in 400 infants with pertussis die because of pneumonia or brain damage.7
KEEP UP THE BIG 6 FIGHT is a public education effort, reminding parents to protect their young children from 6 life-threatening diseases with the 6-in-1 Hexavalent vaccine in the National Immunisation Program (NIP).
PARENT: I have not heard of diphtheria. What is it?
Dr JoAnn: Diphtheria is an illness caused by bacteria (germs) where the throat and nose are infected, causing breathing difficulties. It produces a poisonous toxin that kills cells in the lining of the throat and can also attack the heart, nerves and kidneys.7 Although diphtheria is infrequently heard of, it has caused 4,370 deaths globally in 2019, out of which 3,650 deaths (83.5%) occurred in children under the age of 5.8
PARENT: What could happen if my child were infected with poliomyelitis?
Dr JoAnn: Poliomyelitis (Polio), an infection of the nervous system caused by a virus called poliovirus, can cause meningitis with headaches and stiffness in the neck and back. About 1 in 100 people infected get a severe form of the disease which causes paralysis or fatality.7 Many who survive polio are paralyzed for the rest of their lives. There is no cure for polio, it can only be prevented. Failure to eradicate polio could result in 200,000 new cases every year, within 10 years, worldwide.9
PARENT: What do I do to get my child vaccinated with the 6-in-1 Hexavalent vaccine?
Dr JoAnn: It is an easy process for parents in Malaysia to have their children vaccinated. All you need to do is to bring your child to the closest Klinik Kesihatan for childhood vaccine shots as per the NIP. At your 1st appointment, nurses at the Klinik Kesihatan will advise you of your child's vaccination schedule and next visit.
Now that we have progressed to the endemic phase of the COVID-19 pandemic – especially with everyone going out again – it is most advisable for parents to ensure their children are up-to-date with their vaccinations such as the 6-in-1 Hexavalent vaccine as scheduled in the NIP.
1.TIME. Ideas-Health. Yes, Vaccines Really Are Safe and Effective. Here's Why. https://time.com/5530611/vaccines-safe-effective/
2.National Library of Medicine. Human Vaccines & Immunotherapeutics https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4635899/
3.From the desk of the Director-General of Health Malaysia https://kpkesihatan.com/2020/11/17/kenyataan-akhbar-kpk-17-november-2020-pertukaran-jadual-imunisasi-kebangsaan-untuk-kanak-kanak-susulan-pertukaran-kepada-vaksin-enam-serangkai-difteria-tetanus-pertussis-polio-hepatitis-b/
4.https://www.cdc.gov/pertussis/fast-facts.html
5.i. Centers for Disease Control and Prevention. Epidemiology and prevention of vaccine-preventable diseases. 13th edition. Chapter 16: Pertussis. Hamborsky J, Kroger A, Wolfe C, eds. Washington D.C. Public Health Foundation. 2015:261-78. Available at https://www.cdc.gov/vaccines/pubs/pinkbook/pert.html. Accessed on 18 May 2020. European Centre for Disease Prevention and Control. Disease factsheet about pertussis. Available at https://ecdc.europa.eu/en/pertussis/facts. Accessed on 18 May 2020. iii. Kilgore PE, Salim AM, Zervos MJ, Schmitt H-J. Pertussis: microbiology, disease, treatment, and prevention. Clin Microbiol Rev. 2016;29(3):449-86. Liu BC, McIntyre P, Kaldor JM, Quinn HE, Ridda I, Banks E. Pertussis in older adults: prospective study of risk factors and morbidity. Clin Infect Dis. 2012;55(11):1450-6.
6.https://bmcpediatr.biomedcentral.com/articles/10.1186/s12887-021-02507-4
7.Caring for Kids.cps.ca. 5-in-1 or 6-in-1 vaccine https://caringforkids.cps.ca/handouts/health-conditions-and-treatments/5-in-1-or-6-in-1-vaccine
8.Diphtheria. Level 3 cause. Institute for Health Metrics and Evaluation https://www.healthdata.org/results/gbd_summaries/2019/diphtheria-level-3-cause
9.World Health Organization. Poliomyelitis. Does polio still exist? Is it curable? https://www.who.int/news-room/questions-and-answers/item/does-polio-still-exist-is-it-curable
Dr. JoAnn RajahFirststep Child SpecialistGeneral PaediatricianHealth MinistryHexavalent vaccineKlinik KesihatanNational Immunisation ProgramPertussisWhooping Cough
Lily Shah
With a background of empowering women through talkshows on all thing Womanhood, it was natural for Lily to start empowering women on one of the biggest role they carry (a mother) after having one of her own. As a millennial mum with 2 young boys herself, she understands what new parents are going through and seeks to empower, inspire and ease parents on their biggest adventure yet- Parenthood!
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