THE pneumococcal conjugate vaccine (PCV) was first made available in our country in 2005. Within a few years, healthcare professionals in Malaysia had begun calling for the inclusion of PCV into our national immunisation programme (NIP) following the growing practice in other countries.
This move reflected widespread recognition of the vaccine’s importance in preventing some of the most devastating diseases caused by the Streptococcus pneumoniae bacterium. Based on Malaysian studies, its impact is profound, as shown below:
1. Pneumonia (inflammation of the lungs) kills about 10.2 in 10,000 children under five years of age;
2. S. pneumoniae is believed to cause 23.4% of bacterial meningitis (inflammation of the brain membrane) cases in our country;
3. Bacteraemia (blood infection), which may lead to shock and organ failure, occurs in about 30 in 100,000 children under five years old in Malaysia; and
4. There are about 500,000 cases of pneumococcal otitis media (middle ear infection resulting in deafness) in children under two years old every year.
For the parents and other family members, there is untold grief and trauma when any child becomes permanently disabled or dies as a result of pneumococcal disease. Parents not only have to care for their sick children, but most low- or middle-income families will also have to struggle with debilitating hospital bills. Their livelihood may be put at risk if they have to take time off work, leading to salary cuts or even job loss. This can put tremendous stress on the individuals, disrupt everyday lives and even break some families apart.
As a children’s health advocacy initiative by parents, we in MyHealth Outreach were very moved by the plight of all parents and children affected by pneumococcal disease. Thus, we decided to play our role and actively advocate for the inclusion of PCV in the NIP. In 2013, we ran a “Say YES to Pneumococcal Disease Protection” petition. Over 20,000 parents and paediatricians expressed their desire to have PCV in the NIP. We presented the results to our former health minister but were sorely disappointed that the ministry was unable to fulfil the public’s wish.
Fast forward to 2018, we were very encouraged when Pakatan Harapan pledged, in its election manifesto, to provide PCV to all Malaysian children under two years old. Inspired by our current Health Minister’s passion and commitment to realise the promise, MyHealth Outreach started an online petition in English (http://chng.it/D9nB4zYxc6) and Bahasa Malaysia (http://chng.it/p7kshMBsG4) in April.
We are truly delighted to declare that over 135,000 parents in total have expressed their support to introduce PCV into the NIP. Some shared heartbreaking stories (for example www.facebook.com/PCVforMYbaby/videos/2293272157599214/) about how their children had suffered from the disease and hoped that other kids could be spared a similar fate. Most, however, expressed that they would welcome the vaccine if given for free, as the cost is prohibitive or even unaffordable.
We hope the Pakatan government will look upon the petition results as the people’s approval. Incorporating PCV in the NIP will lead to the betterment of Malaysian children and their parents as well as society at large in 10 important ways:
1. Prevent illness and even death associated with pneumococcal disease in children;
2. Reduce disease severity and improve survival in children infected by S. pneumoniae;
3. Protect all Malaysian children, especially those from lower income (B40) families who cannot afford the vaccine otherwise;
4. Make the vaccine accessible nationwide through government health clinics that are also able to serve families living in rural areas;
5. Promote compliance with the national immunisation schedule when PCV is administered together with other vaccines;
6. Build herd immunity which reduces the spread of pneumococcal disease among vulnerable groups (immunocompromised children and the elderly);
7. Reduce the need for antibiotics, thereby slowing the development of antibiotic resistance;
8. Reduce the burden of treating pneumococcal disease on the healthcare system;
9. Reduce financial and social hardship, and even loss of productivity or income, arising from having to care for children stricken or permanently disabled by the disease; and
10. Enhance Malaysia’s exemplary standing in providing universal coverage in delivering preventive healthcare to all our people.
Based on the reasons mentioned here, it is time we heed the World Health Organisation’s (WHO) call to provide PCV as part of our NIP. To date, 144 countries have complied, with 136 providing PCV at the national level, five sub-nationally, and three to selective high-risk groups.
As parents in Malaysia, we hope our Health Minister and the government will provide PCV to safeguard the health and well-being of this and future generations of children from the ever-present threat of pneumococcal disease.
AHADDHANIAH CHAN ABDULLAH
Founder and programme director