130,000 parents in support of including PCV in immunisation programme

LETTER | Dear Health Minister Dzukefly Ahmad,

The pneumococcal conjugate vaccine (PCV) was first made available in our country in 2005. Within a few years, healthcare professionals in Malaysia began 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 S. pneumoniae bacterium. Based on Malaysian studies, their impact is profound as shown in the snapshot below:

• Pneumonia kills about 10.2 in 10,000 children under five.
• S. pneumoniae is believed to cause 23.4 percent of bacterial meningitis cases in our country.1
• Bacteraemia, that may lead to shock and organ failure, occurs in about 30 in 100,000 children under five.
• Deafness due to middle ear inflammation (acute otitis media). In Malaysia, about 500,000 cases of pneumococcal otitis media occur in children under two every year.

For 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 the inclusion of PCV in the NIP. 

In 2013, we ran this petition 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 pre-election manifesto, to provide PCV to all Malaysian children under two.

Inspired by your personal passion and commitment to realise the promise, MyHealth Outreach started an online petition in English and Bahasa Malaysia in April.

We are truly delighted to declare that over 130,000 parents in total have expressed their support for your mission to introduce PCV into the NIP. Some shared heartbreaking stories about how their children had suffered from the disease and hoped that other children 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 that you and your colleagues in the Harapan government will look upon the petition results as the people’s approval. 

Incorporating PCV in the NIP will serve the betterment of Malaysian children and their parents, as well as society at large in 10 important ways:

Health-related benefits

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 (i.e., 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.

Economic and social benefits

1. Reduce the burden of treating pneumococcal disease on the healthcare system.
2. 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.
3. Enhances Malaysia’s exemplary standing in providing universal coverage in delivering preventive healthcare to all our people.

Based on the reasons mentioned above, it is time we heed the World Health Organization’s call to provide PCV as part of our NIP. 

To date, 144 countries have complied, with a 136 providing PCV at the national level, five sub-nationally, and three to selective high-risk groups.

As the parents of Malaysia, we are counting on you to safeguard the health and wellbeing of this and future generations of children from the ever-present threat of pneumococcal disease. 

Thank you for your compassion and for putting the needs of the people first.

AHADDHANIAH CHAN ABDULLAH is the founder and programme director of MyHealth Outreach.

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