Beyond Childhood: Protecting Malaysia’s Forgotten Vaccine Generation

DO NOT PUBLISH. PENDING.

We vaccinate kids. We raced to vaccinate against COVID-19. But what about everyone in between? As Malaysia ages, a forgotten generation of adults and seniors is being left vulnerable to preventable diseases and it’s costing lives, livelihoods, and billions.

WORDS DR WONG CHUAN LOO

FEATURED EXPERT DR WONG CHUAN LOO Lecturer School of Biosciences Faculty of Health and Medical Sciences Taylor’s University

When most people think of vaccines, childhood immunizations against measles, mumps or polio come to mind.

The COVID-19 pandemic reminded us that adults need protection too, but somewhere in between, an entire generation of Malaysians has been left behind.

A SIGNIFICANT DEMOGRAPHIC SHIFT

Malaysia is undergoing a significant demographic shift.

2021 data from the United Nations Department of Economic and Social Affairs projects that seniors will outnumber children by 2050.

Therefore, our nation must urgently rethink its approach to immunization as a lifelong public health strategy.

A NATIONAL IMMUNIZATION PROGRAMME IN NEED OF UPDATING

Malaysia’s National Immunisation Programme (NIP), introduced in the 1950s, currently offers free vaccines against 13 childhood diseases. This is more than double the original six recommended by the World Health Organization.

However, an additional 7 recommended vaccines for 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 leaves many adults, particularly seniors, vulnerable to vaccine-preventable diseases, widening the gap in public health protection.

THE HIGH COST OF LEAVING ADULTS BEHIND

While over 90% of Malaysian children receive vaccines under the NIP, adults remain exposed to diseases like influenza, pneumonia, and shingles.

Influenza alone costs Malaysia RM3.3 billion annually in healthcare expenditures, mostly from hospitalizations involving unvaccinated seniors.

Cervical cancer remains the third-leading cause of cancer deaths among Malaysian women, despite the human papillomavirus (HPV) vaccine being available for teenage girls since 2010. Expanding HPV vaccination to include boys and men could accelerate progress toward elimination.

Without addressing this gap, Malaysia’s elderly healthcare costs could soar to RM21 billion by 2040, with hospital admissions for seniors nearly double those of younger groups.

WHY LIFELONG VACCINATION MATTERS

Vaccines are not just about preventing disease. They enable longer, healthier, more productive lives.

• Modelling studies show that a national influenza immunization programme for seniors could prevent over 66,000 flu cases and more than 3,000 hospitalizations annually.
• Among diabetics, flu shots reduce hospitalization risk by 54%, while pneumococcal vaccines lower pneumonia risk by 41% in patients with lung disease and cut mortality by 22% among those with cardiovascular disease.

Hospital admissions, productivity losses, and healthcare costs from adults catching these infections are all preventable, especially if adult immunization becomes a national priority.

WHAT’S HOLDING ADULT VACCINATION BACK?

Despite the evidence of its benefits, adult vaccination uptake remains low.

For example, a 2023 study found that while 47% of healthcare employees attributed sick leave to flu, only 5% of seniors reported receiving a flu vaccine.

Possible reasons for low adult vaccination uptake include:

Policy Gaps

Adult vaccines are not covered under the NIP.

HPV coverage for girls stands at just 52%, compared to 96% in Indonesia.

Access Barriers

Rural clinics often face stockouts.

Adults in urban areas delay vaccines due to time and mobility constraints.

Vaccine Hesitancy

Persistent myths around vaccine safety, adverse effects, and halal compliance deter uptake.

Misinformation

Social media amplifies falsehoods, including pseudoscientific claims like “homeopathic vaccines”.

Healthcare Provider Gaps

Some practitioners lack training or confidence to advocate for adult immunization, sometimes even perpetuating misinformation.

A WAY FORWARD

To protect its aging population, Malaysia urgently needs a robust and sustainable National Lifelong Vaccination Strategy, combining public trust with fiscal pragmatism.

Key recommendations include:

Expand NIP Coverage

Include essential adult vaccines — influenza, pneumococcal, and HPV for all genders — with potential funding from ‘sin taxes’ or public-private partnerships.

Improve Transparency

Launch a public-facing Adverse Events Following Immunisation (AEFI) dashboard to address safety concerns and counter myths.

Centralize Records

Establish an electronic immunization registry to:

• Track vaccination status
• Automate reminders for boosters

Invest in Public Awareness

Train healthcare professionals as vaccine advocates.

Engage religious and community leaders to combat misinformation.

Incentivize Corporate Vaccination

Offer tax breaks for companies providing employee flu jabs,

This measure is proven to save up to RM90.30 per worker annually in productivity gains.

VACCINES FOR EVERY STAGE OF LIFE

As Malaysia approaches super-aged nation status, vaccines must evolve from a childhood rite of passage to a lifelong shield.

Immunization is no longer just a children’s issue. It’s a national investment in health, productivity, and resilience for every generation.