Make Vaccination Mandatory, Get Pharmacists Involved

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Kuala Lumpur, Feb 23, 2019 – The Malaysian Pharmaceutical Society (MPS) would  like to reiterate its stand on making vaccination mandatory for all citizens in a bid to lower the spread of vaccine preventable diseases and mortality rates in the country. The subject of anti-vaccination has, unfortunately, once again emerged as health records show an increase of diseases mainly due to the reduced number of children obtaining the required shots.

Even photo-sharing platform Pinterest has blocked certain searches related to vaccinations since last year as the results were leading to “harmful misinformation”.  The anti-vaccination views by a doctor during a recent television show have further fuelled the debate as anti-vaccine supporters – enjoying the limelight on social media despite many not being an immunologist or medical expert and having limited knowledge about healthcare – continue to have a misguided belief that vaccination is not safe.

Such debates are not new. Over the years, health experts, scientists and even
religious leaders have assured the masses that being vaccinated is generally
safe and necessary for the greater good in controlling and eradicating diseases
and illnesses. The mufti of Perlis, Perak and Federal Territories have even gone on      record to stress the importance of vaccination for the wellbeing of a child.

 In 2015 and 2016, the Ministry of Health had engaged with MPS to combat the
problem of vaccination gaps. Our stand then was to get the government to
make vaccination mandatory for all. However, the decision-makers then were
of the view that such a stand was “harsh”.

“Unfortunately, we have seen the number of vaccine preventable diseases rise due to more people avoiding vaccination,” said MPS president Amrahi Buang.
Amrahi recalled that in June 2018, the Ministry of Health said it had recorded 724 measles cases in the first five months of that year compared to 592 cases in the corresponding period in 2017 – a 22.3 per cent increase. “It was said  then that the main contributor to the rise in measles cases was due  to low measles, mumps and rubella immunisation coverage.”

A similar trend was seen in Europe where 72 people died in 2018. Statistics
showed that from 2016 (5,273 cases) to 2018 (82,596 cases) there was a
staggering rise of outbreaks by almost 1,500 per cent!

Within this region, a recent measles outbreak in the Philippines killed at least
136 people as the number of cases continue to rise as government officials
continue to urge parents to have their children protected against measles and
other curable diseases through “clinically proven vaccines”.

Ahmad Badri Abdullah, a research fellow at the International Institute of
Advanced Islamic Studies Malaysia, said Pertussis (whooping cough) had
increased from 497 cases in 2014 to 655 cases in 2015 while tetanus cases
doubled in 2015 from 12 cases in the previous year.

The World Health Organization had in January listed vaccine hesitancy as one
of the biggest threats to global health this year. The world body said
vaccination is one of the most cost-effective ways of avoiding disease as it
prevents two to three million deaths a year while “a further 1.5 million (deaths)
could be avoided if global coverage of vaccinations improved.

“In some nations, vaccinations are mandatory. If a child doesn’t get vaccinated,
he or she cannot attend school,” said Amrahi, stressing how serious certain
nations are in addressing this matter. It is compulsory for children in America, Italy and Singapore, among others, to be vaccinated.

“If Malaysia had made vaccinations mandatory in 2016, we could have reduced the number of cases of preventable diseases, including measles. It is important now more than ever to make vaccination mandatory as anti-vaxxers continue to share and viral misleading information about vaccine safety. It is evident there is poor health literacy among urban and non-urban communities.” .

Amrahi added that,  “If we are to achieve the Measles Elimination Programme’s
(MEP) target by 2022, which we missed in 2018, we have to modify and
improve our approach towards combating vaccination hesitancy. And if we are to ensure vaccine coverage is high during epidemics, pharmacists should be allowed to vaccinate as it reduces the chances of patients missing the window of opportunity to get the vaccine, as it takes time to get appointments at clinics and hospitals due to patient load.”

Amrahi added that pharmacists are ready to assist in advocating vaccination,
monitoring adverse event following immunisation (AEFI) and should be
allowed to vaccinate people. It is time to update the National Immunisation Programme (NIP) to officially include pharmacists, who are the most accessible health care providers, as vaccination advocates and providers. We cannot just confine the vaccination
services to government health facilities and private clinics/hospitals.

MPS has repeatedly reminded the powers-that-be of the synergistic role of
pharmacists in the healthcare ecosystem and how, specifically, community
pharmacists are able to reach out to the masses and complement medical
practitioners in the private and public primary care sector.

“We would like to empower community pharmacists, allowing them to play a
bigger role in serving and taking care of our society. Vaccination by pharmacists is not new. Of course the pharmacists will have to be trained and undergo a proper programme before they can administer the vaccines. This will not only take a load off other health service providers, including the government, it will also increase vaccine coverage by providing more access to people to get their shots,” he said.

Worldwide, there is growing acceptance of the role of community pharmacist
vaccination. Some 44 per cent of 45 countries surveyed have community
pharmacist providing vaccinations.  Studies have shown that pharmacist intervention and participation in vaccination programmes have improved vaccination coverage.

Amrahi added MPS was more than ready to provide the government with the
implementation and content of the programme. “Even if we need a pilot study on this matter, MPS can do it. We pharmacists are a part of the health system and the country and we would like to serve the country and its people in any way possible,” he added.