In conjunction with World Immunization Week from 24 to 30 April, the Ministry of Health held a National Immunisation Day 2023 on 31 May 2023.
The event was a collaboration between various divisions in the Ministry of Health’s Public Health Programme and Immunise4Life (link opens in a new tab).
THE BIG CATCH-UP
The theme of National Immunisation Day this year is ‘Tingkatkan liputan, kurangkan keciciran’ or ‘The Big Catch-up’.
Dr Zaliha Mustafa, our Minister of Health, revealed that this theme is in line with the expansion of Malaysia’s free pneumococcal vaccination programme to those born between 2018 and 2019. This expansion will commence from June 1.
Pneumococcal vaccine was included in the National Immunisation Programme (link opens in new tab) to initially cover children born from January 1 in 2020.
With this expansion, our Ministry of Health hopes to target 70% or 700,000 of the 1 million children aged 4 to 5 under the two-year programme.
“The nationwide pneumococcal vaccination programme will start on June 1 until May 31 next year and it will involve the ministry’s primary healthcare facilities,” she explained.
Interested parents can set an appointment for their children’s vaccination using the MySejahtera app.
WHY KIDS SHOULD GET THE PNEUMOCOCCAL VACCINE
Pneumococcal disease, an infection caused by bacteria called Streptococcus pneumoniae is contagious and may cause severe illness, so early diagnosis and treatment is important.
Children 2 years old or younger are vulnerable to such infection.
Hence, these children are also at risk of developing serious, potentially life-threatening complications such as:
Pneumonia, which is the infection and inflammation of the air sacs in our lungs
Ear infections
Meningitis, which is the inflammation of a membrane called meninges in the spinal cord and brain
Bacteraemia, or infection of the bloodstream
Pneumococcal pneumonia is a lung infection caused by the bacteria responsible for pneumococcal disease. Click on the image for a larger, clearer version.
Once the bacteria infect the bloodstream, they can find their way to parts of the body that are normally sterile, such as the peritoneum—that’s the membrane lining our abdominal cavity—as well as our joints and heart. This can lead to many more invasive diseases, such as peritonitis, arthritis, and endocarditis (inflammation of the inner layer of the heart) respectively.
Hence, parents with children that are eligible for the free vaccination should consider taking advantage of the expansion of Malaysia’s free pneumococcal vaccine programme. They can consult a doctor should they have any doubts and concerns about the vaccine.
FEATURED EXPERT DATUK DR CHRISTOPHER LEE KWOK CHOONG
Consultant Infectious Diseases Physician
Member of the Malaysian Influenza Working Group
FLU FACTS THAT ARE NOTHING TO SNEEZE AT
On board the plane, you have an 80% chance of getting the flu if there is an infected person–who may or may not have symptoms–sitting one row in front or behind you, within 2 seats to either side.
Flu viruses can survive for up to 48 hours on certain surfaces, including your overhead compartment handle, seat-belt buckle, video screen, food tray, arm-rest, and control panel.
You can try disinfecting the items mentioned in the above point, but it would be impractical to disinfect everything you will touch when you land, such as your luggage bag, trolley, the toilet flush, car door handle and so on.
TRAVELING SOON? HERE ARE 2 SIMPLE TIPS
Tip 1: Follow the COVID-19 SOPs when possible
Masking, although no longer promoted in most countries, may help reduce the chances of catching the flu.
However, it is less effective when those around you are not masked. This is where the next tip comes in.
Tip 2: Get the flu shot
The additional protection conferred by the annual flu vaccination is therefore recommended to prevent the disease.
When injected, the vaccine introduces inactivated flu viruses into the body. These have been killed and are unable to cause disease.
Instead, they stimulate your body to produce antibodies that will spring to your defense if you happen to be exposed to the flu.
Allow 2 weeks to reach the desired level of immunity before flying off.
MORE ABOUT THE FLU VACCINE
It gives you a better shot at beating the flu and reducing your risks of heart problems
Flu vaccination helps prevent severe flu-related infection, hospitalization, and death . It is also associated with a 34% lower risk of major adverse cardiovascular events . There was also an 18% reduced risk of death reported in patients with heart failure .
In people with type 2 diabetes, flu vaccination has been associated with a reduced risk of heart failure by 22%, stroke by 30%, heart attack by 19% and pneumonia by 15% .
With the COVID-19, flu, & RSV triple threat in the northern hemisphere, the flu shot is a good bet
Noting that flu viruses mutate constantly, Datuk Dr Christopher Lee explains that currently available flu vaccines have been updated to effectively fight virus sub-types that are circulating in the northern hemisphere at this time.
“This will help reduce your risk of contracting the disease. The flu vaccination is recommended for those travelling abroad, especially high-risk groups as the importation of flu cases through air travel can result in the spread of flu within the community,” he adds. “So, if you have not been vaccinated against the flu, now is a good time to get it done. The annual flu vaccination is your passport to healthy holidays. Don’t leave home without it.”
In Malaysia, flu can occur year-round. Older persons, especially those with chronic diseases such as diabetes and high blood pressure, are advised to make flu vaccination an annual priority, especially during the holiday seasons when mingling and traveling are often inevitable. It’s important to strike a balance between staying safe and creating beautiful memories!
DO YOU KNOW THAT YOU COULD END UP WITH A HEART ATTACK OR STROKE WHEN YOU GET THE FLU?
Recent studies have cautioned that influenza increases the risk of heart attack by more than 10 times in the first 7 days after contracting the flu.
This is especially so if you are 65 and over, regardless of whether you have a history of heart disease or are living with chronic illnesses such as heart disease, diabetes, lung disease and kidney disease. In industrialized countries, most deaths associated with flu occur among older persons aged 65 years and above!
Among older persons, influenza can present as a relatively mild respiratory illness; it may also present without any symptoms (no fever and/or no cough). It can also lead to fatigue and confusion, potentially setting off a sequence of catastrophic events.
Professor Datuk Dr Zulkifli Ismail, Technical Committee Chairman of the Immunise4Life Programme, explains: “It is not just a fever, runny nose, cough and body aches, it could seriously harm your heart.”
HOW THE FLU AFFECTS YOUR HEART
When the flu virus enters your system, your immune system strings into action.
Just like fights in real life, collateral damage may result; when an infection triggers a strong response from your immune system, the immune cells can alsodamage your own healthy tissues and organs.
One example is COVID-19, which can trigger very high activation of the immune system, resulting in the uncontrolled release of cytokines, small molecules that aid cell-to-cell communication in immune responses and stimulate the movement of cells towards sites of infection.
This uncontrolled release (“cytokine storm”) may lead in failure and death of many organs in the body.
An illustration of cytokine storm, sometimes called hypercytokinemia, and how it affects both healthy and infected cells. Click on the image for a larger version.
Studies suggest that the same inflammatory response described above can trigger effects that can damage the heart (cardiovascular events) when you have an influenza infection.
Dr Alan Fong, the President of the National Heart Association Malaysia (NHAM) and a consultant cardiologist, shares that your body’s immune response, when present along the direct effects of flu on the inner lining of your blood vessels or atherosclerotic plaques, may cause rupture of such plaques or blockage in the arteries–effects that can lead to a heart attack or stroke.
OLDER PERSONS ARE ESPECIALLY AT RISK WHEN THEY CATCH THE FLU
In older persons, there are changes that occur in the immune system that leads to a decline in the ability of the body to fight off infections such as the flu; this is known as immunosenescence.
Professor Dr Tan Maw Pin, a consultant geriatrician that chairs the Flu & Older Persons Sub-Committee of the Malaysian Influenza Working Group (MIWG), tells us: “In addition to this, ageing contributes to chronic, non-infectious, low-grade inflammation—known as inflammaging—which plays a key role in the cause and progression of chronic conditions such as cardiovascular diseases.”
She further adds that ageing also promotes the development and progression of atherosclerosis, the most common cause of acute coronary syndrome. This syndrome gives rise to situations in which the blood supplied to the heart is suddenly blocked.”
“Hence, when an older person gets the flu, all these factors put them at higher risk of developing a heart attack and stroke,” Prof Tan reiterates.
FLU VACCINATION CAN PROTECT YOUR HEART
Studies have found that the flu vaccination was associated with a 34% lower risk of major adverse cardiovascular events, and those that have recent acute coronary syndrome had a 45% lower risk.
There is also an 18% reduced risk of death reported in patients with heart failure.
For people with type 2 diabetes mellitus, studies have shown that the flu vaccination reduces the risk of heart failure by 22%, stroke by 30%, heart attack by 19% and pneumonia by 15%.
Flu vaccination does not require behaviour change or a daily intervention, yet it prevents cardiovascular events as well as as other evidence-based approaches such as statin therapy, antihypertensive therapy, and smoking cessation.
This article is contributed by Immunise4Life (IFL), a collaboration of the Ministry of Health Malaysia with the Malaysian Paediatric Association (MPA) and the Malaysian Society of Infectious Diseases & Chemotherapy (MSIDC).
The article has been edited by HealthToday for publication on this website.
For more information on flu, you can visit IFL’s website Act of Love (link opens in a new tab).
References:
Warren-Gash, C., Blackburn, R., Whitaker, H., McMenamin, J., & Hayward, A. C. (2018). Laboratory-confirmed respiratory infections as triggers for acute myocardial infarction and stroke: a self-controlled case series analysis of national linked datasets from Scotland. The European respiratory journal, 51(3), 1701794. https://doi.org/10.1183/13993003.01794-2017
Michos, E. D., & Udell, J. A. (2021). Am I getting the influenza shot too?: Influenza vaccination as post-myocardial infarction care for the prevention of cardiovascular events and death. Circulation, 144(18), 1485–1488. https://doi.org/10.1161/CIRCULATIONAHA.121.057534
Modin, D., Jørgensen, M. E., Gislason, G., Jensen, J. S., Køber, L., Claggett, B., Hegde, S. M., Solomon, S. D., Torp-Pedersen, C., & Biering-Sørensen, T. (2019). Influenza vaccine in heart failure. Circulation, 139(5), 575–586. https://doi.org/10.1161/CIRCULATIONAHA.118.036788
Vamos, E. P., Pape, U. J., Curcin, V., Harris, M. J., Valabhji, J., Majeed, A., & Millett, C. (2016). Effectiveness of the influenza vaccine in preventing admission to hospital and death in people with type 2 diabetes. CMAJ : Canadian Medical Association journal = journal de l’Association medicale canadienne, 188(14), E342–E351. https://doi.org/10.1503/cmaj.151059
Vetrano, D. L., Triolo, F., Maggi, S., Malley, R., Jackson, T. A., Poscia, A., Bernabei, R., Ferrucci, L., & Fratiglioni, L. (2021). Fostering healthy aging: The interdependency of infections, immunity and frailty. Ageing research reviews, 69, 101351. https://doi.org/10.1016/j.arr.2021.101351
While Malaysians these days are fully aware of the importance of COVID-19 vaccination, the Immunise2Protect campaign urges parents not to overlook other important childhood vaccinations for their children, particularly the chickenpox vaccine.
Immunise2Protect is organized by Immunise4Life, an expert-driven community education initiative to promote immunisation against vaccine-preventable diseases and to address issues surrounding vaccination hesitancy and refusal. This initiative is a collaborative effort of the Ministry of Health Malaysia, the Malaysian Paediatric Association (MPA) and the Malaysian Society of Infectious Diseases & Chemotherapy (MSIDC).
WHY VACCINATE OUR CHILDREN AGAINST CHICKENPOX?
Contrary to the still popular perception that chickenpox is a harmless bother, it can lead to dangerous complications that require hospitalisation or may even result in death.
Even the act of scratching the itchy lesions can lead to secondary bacterial infections of the skin and soft tissue.
Children with eczema or dermatitis may develop severe skin symptoms when they contract chickenpox.
Additionally, chickenpox may also cause infection of the lungs (varicella pneumonia), inflammation of the brain (encephalitis, cerebellar ataxia) and infection of the liver (hepatitis).
Another cause of concern is that once a child has caught chickenpox, the Varicella-zoster virus that causes the infection will continue to stay in an inactivated state in their spinal cord.
Later in life, as the child’s immune system weakens with age or stress, this virus can be reactivated to cause a very painful infection called shingles.
BENEFITS OF THE VACCINATION
The chickenpox vaccination helps prevent chickenpox.
Some people that are vaccinated against chickenpox may still get the disease. When that happens, the symptoms are usually milder with fewer or no blisters (they may have just red spots) and mild or no fever.
The chickenpox vaccination also helps protect from the serious complications that require hospitalisation.
