Bridging The Gap On Adult Immunisation Among Malaysians

13 May 2024

The immunisation coverage gap exposes Malaysians to potentially life-threatening illnesses, especially those that can be prevented with a vaccine.

KUALA LUMPUR, May 13 — In Malaysia, while significant strides have been made in child vaccination campaigns, adult immunisation, especially among older people and those with chronic conditions, remain notably low.

This gap highlights a crucial need for expanded health care coverage to include adults, a matter of urgency underscored by recent research findings indicating a rise in adult vaccine-preventable diseases.

Dr Edward Chong, consultant geriatrician at Sunway Medical Centre, explains the issue of inadequate adult immunisation coverage, driving the importance of vaccination for high-risk groups, addressing barriers surrounding adult vaccination, and advocating for proactive vaccination actions among adults.

The Underappreciated Necessity Of Adult Immunisation

According to some findings, vaccinations against ten vaccine-preventable diseases in 73 low and middle-income countries between 2001 and 2020 are estimated to avert over 20 million deaths, save US$350 billion, and potentially increase economic productivity by US$820 billion.

Despite evidence of adult immunisation being compelling, the coverage is still low in Malaysia, compared to childhood vaccination, where childhood immunisation is covered by over 95 per cent under the National Immunisation Programme (NIP).

This coverage gap exposes these groups to potentially life-threatening illnesses, especially those that can be prevented with a vaccine.

“Immunisation efforts traditionally concentrate on children, overlooking the vital need for continued protection throughout adulthood. This is especially concerning as vaccine-preventable diseases typically can impact vulnerable populations such as the elderly, people with multiple chronic illnesses, and immunocompromised individuals,” explained Dr Chong.

One such importance is the pneumococcal pneumonia and influenza vaccines for the vulnerable population. With pneumonia, a formidable adversary in the array of vaccine-preventable diseases, has been responsible for 11.1 per cent of deaths among Malaysians, the top three causes of death among Malaysians.

Dr Chong also details the most crucial vaccines that adults in Malaysia should seriously consider getting, especially if they are approaching their 60s, have been immunocompromised, and have undergone cancer treatment or chemotherapy:

• Influenza (flu) vaccine is recommended annually and is important to protect the elderly and immunocompromised against the flu virus, which can lead to severe respiratory complications among those who are older or have a history of chronic lung disease, diabetes, cancer treatment or heart disease. Pregnant mothers can also benefit from being vaccinated to prevent respiratory problems with their babies if they get it during pregnancy.
• Pneumococcal vaccines are essential in preventing pneumococcal pneumonia, which is considered one of the major causes of death among the elderly. This bacterial infection can lead to pneumonia, septicemia (infection of the blood) and meningitis (inflammation of the coverings of the brain and spinal cord). This vaccine is also essential for the elderly, those going for their Hajj or Umrah pilgrimages, those with chronic medical illnesses such as lungs, heart or liver disease, cancer treatment, or diabetes.
• Covid-19 vaccine, an essential vaccine for everyone, especially the elderly and those with weakened immune systems, to protect against ovid-19 and its complications.
• Varicella (chickenpox) vaccine for women planning for pregnancy and individuals who haven’t had chickenpox in households with newborn babies, as this can help protect the newborns from complications such as encephalitis (inflammation of the brain), pneumonia or hemorrhagic complications.
• Tetanus, diphtheria, and pertussis (Tdap) vaccine for all adults who have completed their base vaccines more than ten years ago. Once they have received their Tdap shot, a tetanus and diphtheria. A booster shot should be administered every ten years. For those in contact with small children, Tdap as the first dose may be more appropriate to prevent the transmission of pertussis.
• Hepatitis B vaccine: This vaccine is recommended for adults who have not been previously immunised. Screening for immune status should be done for those at higher risk of this infection such as healthcare workers, intravenous drug abusers, close contacts of a case of those chronically infected, and those with chronic medical diseases including chronic renal failure or liver disease.
• Meningococcal vaccines: Certain immunocompromised individuals with a history chronic lung disease, diabetes or heart disease as well as the elderly may also be recommended to receive meningococcal vaccines to protect them against meningitis and bloodstream infections caused by Neisseria meningitis. which can lead to severe respiratory complications. This vaccine is also important for people who are going for Hajj.

“The recommended age for the general population to consider essential vaccinations is 60 and above for the pneumococcal and influenza vaccines, but it is important to consider other vaccines such as Tdap, especially if you share the household with newborn babies, infants, or pregnant women to protect your loved ones from transmission of diseases.

“Influenza vaccines are also recommended every year,” said Dr Chong.

However, the risks of non-vaccination are profound and multifaceted.

“Any vaccine-preventable disease, if severe enough, is likely to result in irreversible complications to your health,” added Dr Chong.

Myths And Misconceptions About Adult Immunisation

There are numerous misconceptions about vaccination, which may cause the public some concerns:

• Myth 1: Vaccines are only necessary for children. Adult vaccination protects against diseases that are harmful or even fatal to the elderly and immunocompromised individuals for all stages of life.
• Myth 2: Adult vaccines are not safe. Vaccines are thoroughly tested and monitored, offering a safer option than facing the diseases themselves.
• Myth 3: Healthy adults do not need vaccinations. Even healthy adults can benefit from vaccinations to prevent the spread of illness to more vulnerable populations, including the elderly and those with chronic medical conditions.
• Myth 4: Vaccines can cause the diseases they’re meant to prevent. Vaccines cannot cause these diseases; they use inactivated viruses or parts of the virus to build immunity.

In light of these insights, the need for adult immunisation in Malaysia is clear. It extends beyond an individual concern; it is a matter of public health.

“Prevention is better than cure,” said Dr Chong, advocating for adults to be proactive about their health and wellbeing, especially when a vaccine can prevent it.

Source: CodeBlue

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