Case for lifelong immunisation

ACCORDING to the United Nations Department of Economic and Social Affairs 2024, Malaysia is undergoing a significant demographic shift with profound implications for its healthcare system. This transition underscores the urgent need to strengthen preventative care measures, particularly through adult immunisation.

The National Immunisation Programme (NIP), introduced in the 1950s as part of a maternal and child health initiative, currently offers free vaccines against 13 childhood diseases. This is more than double the original six recommended by the World Health Organisation Expanded Programme on Immunisation.

However, an additional seven recommended vaccines covering illnesses such as chickenpox, dengue, Covid-19, hepatitis A, meningococcal disease, influenza and rotavirus are only available at private healthcare facilities for a fee. This two-tiered system limits access for many adults, particularly the elderly.

While over 90% of Malaysian children are vaccinated against 13 diseases, adults and seniors remain vulnerable to various vaccine-preventable illnesses, such as influenza, pneumonia, and shingles. Influenza alone costs Malaysia RM3.3bil annually in healthcare expenditures, primarily due to the hospitalisation of unvaccinated seniors.

Meanwhile, cervical cancer remains the third-leading cause of cancer-related deaths among Malaysian women despite the human papillomavirus (HPV) vaccine being given free for teenage girls since 2010.

Globally, the Covid-19 pandemic exacerbated the gaps in immunisation coverage. A joint report by GlaxoSmithKline plc (GSK) and IQVIA found that over 100 million adult vaccine doses were missed in 2021 and 2022 alone.

Vaccines are not only about preventing illness; they also enable a better quality of life. In Malaysia, a modelling study found that implementing a national influenza immunisation programme for seniors could prevent over 66,000 influenza cases and more than 3,000 hospitalisations annually.

To protect its ageing population, Malaysia needs a robust, cost-effective, and multi-pronged national lifelong vaccination strategy that combines fiscal pragmatism with public trust. Key recommendations include:

1. Universal access: Expand the NIP to cover essential adult vaccines (influenza, pneumococcal, and HPV for all genders), leveraging “sin taxes” on tobacco and sugary drinks or through public-private partnerships to subsidise the cost of doses.

2. Transparency on adverse events: Launch a public-facing adverse events following immunisation (Aefi) dashboard to clarify facts and dispel myths.

3. Electronic immunisation registry: Establish a centralised e-registry to track vaccination status and automate reminders for supplementary boosters.

4. Public awareness campaigns: Train healthcare professionals to serve as vaccine advocates and collaborate with religious and community leaders to address halal concerns and misinformation.

5. Corporate accountability: Offer tax incentives to companies providing their employees flu jabs, as such programmes can save up to RM90.30 per worker annually in productivity gains.

As Malaysia approaches aged population status, immunisation must evolve from being a childhood rite to a lifelong practice.

It is an essential investment in national health, productivity, and resilience for every stage of life.

DR WONG CHUAN LOO

Lecturer

Faculty of Health and Medical Sciences

Taylor’s University