Diphtheria death - we have failed our children

LETTER | The recent death of yet another young child from diphtheria, an easily preventable disease by immunisation, is a national tragedy. We should ask ourselves some searching questions: When a young child dies from a preventable, immunisable disease, whose responsibility is it?

First, of course, it is the parents who failed to vaccinate the child. But these are not “bad” parents who intentionally want to harm their child. But there is no denying the fact that their reluctance to immunise the child caused his death. Were they ignorant and unaware of all the other children who have died recently? There has been sufficient media coverage to share that in 2018, there were 18 young children with diphtheria, with five deaths.

So why did they expose their child to such a risk? My colleagues and I have explored immunisation refusal by parents in the Malaysian context (WY Lim, Amar-Singh, Netia Jeganathan, et al 2016). All the parents who are reluctant to vaccinate their children are educated Malay and Muslims. The data from the Ministry of Health (MOH) will reveal the same profile. So why do they take such a dangerous course of action?

It is because of the second group of people responsible for this child and other children’s deaths. This is the group that is very loud on social media and quick to give “expert” opinions but fail to be present to take responsibility when children die from easily preventable diseases. They are the alternative and complementary medicine practitioners and some medical doctors. They have brainwashed and misled parents. Religious sensitivities to them are more important than the lives of our children.

None of us is denying the fact that vaccines have side effects but any sensible review of historical and scientific data will show how vaccines have helped control many lethal diseases that used to kill and damage thousands of children. The re-emergence of diseases, long controlled in the past, is due to these anti-vaccine practitioners.

I want to ask all of us why we do not take these anti-vaccine proponents to task? They are the ones who are primarily responsible for the death of a young boy.

Thirdly, we have the Health Department and government authorities. They cannot absolve themselves of the responsibility of the death of children from immunisable disease. They have the authority and power to act. The Child Act is powerful legislation, crafted to protect children. Why don’t we use it when a child dies from negligence? Firm action of this nature will be a deterrent to others who are hesitating about vaccinating their children.

When parents fail to protect children, the state must do so; that is the reason laws to protect children are created. The Health Department and government authorities also have a responsibility to vulnerable children (those with cancer and on chemotherapy, young babies, those with autoimmune diseases, etc) who cannot yet be vaccinated. They are at high risk of dying if we do not arrange immunity in the community.

Finally, all of us are also responsible. We as a society can advocate together for our government to act. It is our responsibility as a society to push for compulsory vaccination today before more children die. I have experienced a number of epidemics, including two diphtheria epidemics in the 1980s and I would not want us to return to the days when we lost so many children. We cannot regress to becoming a Third World nation.

Some suggestions on what may work:

1. As a society, we need to make the primary immunisation schedule compulsory for all children (i.e the critical vaccines covered by MOH). This will not be easy to enforce but we should aim to protect all children. All elected representatives should advocate for and support this initiative.

2. There is a need to actively address misinformation that is being circulated. This is not just the role of MOH but of all health care practitioners both government and private. Parents want what’s best for their children and we should offer them evidence-based information.

3. We must recognise that a segment of the population distrust the government and health care professionals, and hence are more likely to use alternative medicine. Therefore it is important that the government and MOH are very transparent and honest about vaccines and their side effects. Data on this should be readily available online.

4. Finally, when children die or are injured by common vaccine-preventable diseases, the government, welfare and Health Department should use the Child Act. Neglecting a child’s health is not an acceptable practice for any parent.

We must recognise and acknowledge that we have failed our children again and again and again. How many children will need to die before we act? The Health Department, government and society (all of us) must act now to make sure it does not happen again.

The writer is a senior consultant paediatrician.

The views expressed here are those of the author/contributor and do not necessarily represent the views of Malaysiakini.