FEATURED EXPERT DR DATIN CLARENCE KAVETHA A/P S. S. DANIEL
Consultant Paediatrician, IMU Healthcare
and Lecturer, School of Medicine, International Medical University
Injections can be scary for both adults and children population in general. So why do we still do it?
WHY ARE THE MAJORITY OF VACCINES STILL GIVEN VIA INJECTIONS?
This is mainly because, by injecting directly into the muscle, the vaccines produce a good immune response and certainly provide adequate protection.
Many studies on needle-based vaccinations have demonstrated that these vaccines have good efficacy and high safety levels.
Furthermore, the World Health Organization (WHO) have set standards for vaccine administration, and needle-based vaccination is accepted by most countries and has become a standard practice.
INJECTIONS DON’T HAVE TO HURT (MUCH)!
There are certain vaccines that can be given into the skin instead of the muscle, hence they can be less painful.
This method uses a shorter and thinner needle, so it can also be less intimidating as well to some people.
ARE THERE ANY NEEDLE-FREE ALTERNATIVES TO RECEIVING VACCINES?
There are a few alternative vaccines that do not involve needles. All said, the choice of vaccine delivery still depends on the vaccine characteristics and the targeted disease.
Some needle-free alternatives include oral vaccines in the form of liquid or tablet for diseases like polio and cholera. However, some vaccines are not stable when given orally, mainly because the digestive enzymes in our stomach make it very challenging for most vaccines to work.
Nasal vaccines are also available for certain infections such as the flu—these vaccines are sprayed into the nose.
Having said all of these, I should point out that there is still ongoing research and development to produce alternative vaccine delivery methods that would be less painful and easier to administer.
SCARED OF NEEDLES? DON’T LET YOUR FEAR KEEP YOU FROM GETTING YOUR SHOTS
Bring a close friend or family member along with you.
Tell the staff that will administer the shot that you’re afraid of needles. Most of them will understand and do their best to soothe your anxiety.
Don’t look at the needle going into your arm. Distract yourself by looking at something else or chatting with the staff or your companion.
If your nerves are getting the better of you, take deep breaths and slowly count to 10.
On 17 August 2023, the Malaysian Society of Infection Control and Infectious Disease (MyICID), the National Cancer Society of Malaysia (NCSM), and the Malaysian Red Crescent (MRCS), in collaboration with Pfizer Malaysia, launched the MyPELINDUNG campaign.
It’s a public educational campaign aimed at mitigating the threat of COVID-19 in Malaysia by increasing the awareness levels of Malaysians on the importance of up-to-date vaccination and seeking of prompt COVID-19-specific treatment.
Group Photo On Stage
The Malaysian Society of Infection Control and Infectious Disease (MyICID)
Her Highness Dato' Seri DiRaja Tan Sri Tunku Puteri Intan Safinaz & Tan Sri Dato Sri Michelle Yeoh
The MyPELINDUNG campaign is a testament to the power of collaboration
Tan Sri Michelle Yeoh returns home to support the MyPELINDUNG initiative
The event was witnessed by Her Highness Dato Seri DiRaja Tan Sri Tunku Puteri Intan Safinaz
Among the luminaries gracing the launch were:
Her Highness Dato’ Seri DiRaja Tan Sri Tunku Puteri Intan Safinaz binti Almarhum Sultan Abdul Halim Mu’adzam Shah, Tunku Temenggong Kedah, who is the National Chairperson of the Malaysian Red Crescent
Datuk Dr Norhayati Rusli, Deputy Director-General of Public Health, Ministry of Health
Yang Berbahagia Tan Sri Dato’ Seri Michelle Yeoh, Oscar-winning actress
Dr Shaharudeen Bin Kamaludeen, the President of MyICID
Dato Dr. Saunthari Somasundaram, the President of NCSM
Professor Datuk Dr Zulkifli Ismail, the Chairman of Immunise4Life
Madam Luksanawan Thangpaibool, the Country Cluster Lead of Pfizer Malaysia, Pakistan and Brunei
A PRINCESS’S WORD OF WISDOM
“Just as it takes many drops to form an ocean, our shared actions—however small they may seem —can create significant impact in the fight against COVID-19,” says Yang Teramat Mulia Dato’ Seri Diraja Tan Sri Tunku Puteri Intan Safinaz.
She adds: “It’s through initiatives like MyPELINDUNG that we can harness our collective strength to navigate this health issue. Together, with the strength of unity and shared responsibility, we can contribute to a healthier, safer nation for all Malaysians.”
WAIT, ISN’T COVID-19 OLD NEWS?
Not so! Yes, Malaysia has made significant strides but the virus responsible for COVID-19 continues to circulate in our communities and can still lead to hospitalizations and even death, especially among high-risk groups.
Hence, the experts driving MyPELINDUNG advocates constant vigilance, updating of COVID-19 vaccinations, adherence to recommended health measures, and prompt seeking of COVID-19-specific treatment if one is tested positive.
VACCINATION IS KEY, EXPERTS SAY
MyPELINDUNG aims to reduce public hesitancy around the COVID-19 booster doses by disseminating scientifically-accurate information and addressing common concerns held by Malaysians about these boosters.
The campaign’s efforts will particularly focus on high-risk groups, as up-to-date vaccination (including booster doses) can reduce their risk of severe illness, hospitalization, and death.
Dr Shaharudeen Kamaludeen, President of MyICID, tells us: “It’s paramount that we understand the critical role vaccinations play in mitigating the severity of COVID-19. Vaccinations, including recommended booster doses, are our primary line of defence against this virus.”
He also adds that prompt medical consultation and treatment after a positive test for COVID-19 are equally vital.
Professor Datuk Dr Zulkifli Ismail, the Chairman of Immunise4Life, further emphasizes the importance of maintaining one’s up-to-date vaccination status.
“Full vaccination significantly reduces the risk of severe disease outcomes,” he says. “We urge everyone, particularly those in high-risk groups, to consider vaccinations as their personal shield against the virus, and to remember that this shield is most robust when all recommended doses, including boosters, have been administered.”
THE ACTRESS ADVOCATES
Tan Sri Dato’ Seri Michelle Yeoh concurs with the experts, adding that she herself had 2 brushes with the COVID-19 vaccine.
She participated in an educational video for MyPELINDUNG, a video that she is very proud of, and will continue to commit to encouraging Malaysians to remain vigilant and take the appropriate protective steps against COVID-19.
“Trust the science,” she urges.
PROMPT & QUICK TREATMENT CAN SAVE LIVES
“The most important thing to remember about treatment for COVID-19 is that it should be started as soon as possible after diagnosis to be effective,” states Dato Dr Saunthari Somasundram. “If you test positive for COVID-19, treatments are available that can reduce the likelihood of severe illness, hospitalization, and death. Please don’t delay because COVID-19 specific treatment must be started within days after you first develop symptoms to be effective.”
Tan Sri Michelle Yeoh concurs. “On screen, I’ve navigated flying stunts and leapt off moving vehicles, but life isn’t an action film, and we can’t afford to wait for the dramatic last-minute rescue. If you’re showing any symptoms, act fast, seek help at once.”
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.
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
Meningitis, which is the inflammation of a membrane called meninges in the spinal cord and brain
Bacteraemia, or infection of the bloodstream
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 PROFESSOR DR JAMES KOH KWEE CHOY
Head of Division of Medicine
School of Medicine
International Medical University (IMU)
Tuberculosis, often abbreviated as TB, has been around for a long time. In fact, it was known as “consumption” back in the 1800s.
Perhaps this is what many of us rarely spare this disease a thought unlike, say, dengue and COVID-19.
WHAT CAUSES TUBERCULOSIS
It is caused by the bacteria Mycobacterium tuberculosis.
TUBERCULOSIS CAN ATTACK DIFFERENT PARTS OF THE BODY
“It can attack different parts of the body, with the lungs–referred to as pulmonary tuberculosis– being the most common,” says Professor Dr James Koh Kwee Choy,
These different parts of the body include the lymph nodes and bones (usually the spine), in rare cases in the gut. The bacteria can also attack the brains of people with suppressed immune system, such as those living with HIV. Such cases of tuberculosis are called extrapulmonary tuberculosis (EPTB for short).
WHO IS AT RISK OF CATCHING THIS DISEASE?
According to Prof James, the most susceptible groups of people are:
People with lowered immunity, including young children whose immune system is still developing
People with suppressed immune system, such as those on chronic steroid therapy and people living with HIV
People living in overcrowded living spaces, such as the poor and migrant workers, as this close proximity makes it easy for the bacteria to be passed on from person to person
HOW EASILY DOES TUBERCULOSIS SPREAD?
Similarly to all respiratory diseases, it is spread by water droplets that come from coughing or spitting.
However, the bacteria responsible for this disease need to be in significant amount in water droplets for the disease to spread.
“You have to be in quite close contact and in a situation where there’s prolonged exposure. Generally, more than eight hours a day,” says Prof James.
It is also worth noting that the bacteria can become dormant in the body of the host, and someone with dormant bacteria will not pass the bacteria on to others.
Similarly, people with only extrapulmonary tuberculosis—the infection doesn’t affect their lungs—will not spread the bacteria to other people.
THE SYMPTOMS OF TUBERCULOSIS
Detecting tuberculosis at its early stage can be challenging because the symptoms may not show immediately.
“You could have been exposed long ago, and the bacteria will stay latent or dormant in the body and hibernate. Symptoms can come up months or even years later,” says Prof James.
SYMPTOMS OF PULMONARY TUBERCULOSIS (TUBERCULOSIS IN THE LUNGS)
Profuse sweating at night
Unexplained weight loss
Recurrent rise in body temperature in the evenings
SYMPTOMS OF EXTRAPULMONARY TUBERCULOSIS (TUBERCULOSIS IN OTHER PARTS OF THE BODY)
Swollen lymph nodes
Chronic back pain and fragile bones
A sensitive gut and
Seizures, headaches, confusion and even alterations in personality if the brain is infected
WHAT TO DO IF YOU BELIEVE THAT YOU HAVE TUBERCULOSIS
“Don’t wait to cough up blood,” says Prof James. “See a doctor if you have had a persistent cough for two weeks!”
Also see a doctor if you have unexplained night sweats and weight loss together with swollen lymph nodes or chronic back pain.
“If you are aware that you’ve been exposed to someone with TB, someone you share a working or living space with, then you might also want to see a doctor to be screened,” Prof James adds.
HOW IS THIS DISEASE TREATED?
Treatment is straightforward, but can take place over a long period of time.
Once the treatment is started, a person will be non-infective in ten to 14 days. In hospitals, a patient will be put in isolation but there is no prescribed quarantine period. “The most important thing is to wear a mask and wash your hands frequently,” Prof James says.
Antibiotics to overcome tuberculosis
“A combination of 4 antibiotics will be prescribed for a period of 6 months to a year, depending on which part of the body is affected,” explains Prof James.
There are newer medications can potentially treat tuberculosis within 3 months, but Prof James shares that, unfortunately, they are not yet available in Malaysia. “At the moment, we’re still using the old regime,” he says.
It is crucial to take these antibiotics on time and as prescribed by the doctor
Otherwise, the bacteria can become resistant to the antibiotics. “This can escalate into extensively drug-resistant TB (XDR TB) and multidrug-resistant TB (MDR TB) – or what is commonly known as superbugs!” Prof James warns.
“Those with MDR/XDR TB can spread it to others and unfortunately for that someone, because the bacteria is already resistant, it becomes very hard to treat. These cases will need a lot of alternative medications involving injections and much longer therapy for up to 2 years. It gets very, very complicated,” he further explains.
WHY ARE WE STILL CONCERNED ABOUT TUBERCULOSIS? WE ALREADY HAVE THE BCG VACCINE TO PROTECT US FROM IT
The Bacille Calmette-Guerin (BCG for short) vaccine is given to Malaysians when they are babies and at primary school.
While the vaccine confers protection against tuberculosis, its effectiveness decreases over the years,
“By the time we are adults, many of us no longer have immunity against the disease,” says Prof James.
Tuberculosis cases in Malaysia are on the rise
Malaysia is still considered a country with a high incidence rate, estimated at 92 per 100,000 population. Prof James reveals that we have about 20,000 to 25,000 new cases every year, with an average of 1,500 to 2,000 resulting deaths.
Interestingly, the number of cases went down during the lock down, when we were wearing masks and practicing social distancing as well as movement control orders. It is when the SOPs are relaxed that the number of cases is up again.
CAN’T WE JUST GET A BOOSTER SHOT?
Sadly, there is no such booster shot currently in existence!
Prof James advises that the best way to keep tuberculosis at bay is to ensure a healthy lifestyle. “Generally, a person who is healthy with a good immune system should be able to fight off TB on their own.”
It is also important to be aware of the symptoms and seek early treatment. “If left for too long, even after recovery, tuberculosis can leave scarring on the lungs that will forever curb a person’s lung capacity,” Prof James states.
Also, it is equally important to stay healthy after recovering from tuberculosis. “Maintain a good diet, exercise, don’t smoke. You can get re-infected with TB and that can be quite bad,” says Prof James.
FEATURED EXPERT ASSOCIATE PROFESSOR TS DR AFIZAN AZMAN
School of Computer Science
Faculty of Innovation and Technology
BLOCKCHAIN TECHNOLOGY UNBLOCKS LIMITATIONS IN MANY INDUSTRIES
Created in 2008, blockchain technology is a decentralized ledger that can be used to verify and trace multi-step transactions in healthcare, retail, supply chain, financial industries, and more.
Having reduced compliance costs and speed-up data transfer processing, users can also confirm secured transactions using this technology without the requirement for a central clearing authority.
Closer to home, Malaysia started its efforts in blockchain technology in 2015, with the Securities Commission (SC) and Bank Negara Malaysia (BNM) as important parties in the movement.
Moving forward, the Malaysian Industry-Government Group for High Technology (MIGHT) has said that Malaysia would be adopting blockchain by 2025 and many banking institutions are requested to explore and adopt this technology into their financial systems.
CURRENT PROBLEMS IN THE POST-COVID-19 HEALTHCARE SECTOR
Privacy issues when it comes to medical data
From a healthcare perspective, every healthcare institution treats medical data as a highly privacy-sensitive element. The thought of giving patients control of access to their records and the exchange of health data between institutions raises the risks of data exposure and opens up issues around trust and security.
However, currently the problems of the medical record system include a lack of security, difficulty in transferring medical records between multiple healthcare institutions due to system complications, human errors when recording, storing, and transferring patients’ data, and unwanted tampering of data.
Indeed, post-COVID-19, Malaysia for one has been dealing with issues related to the healthcare system. MySejahtera turned into a national scandal after the Public Accounts Committee (PAC) revealed that the COVID-19 contact tracing mobile application had been developed for the government without a contract with the application developers.
Inefficiencies of an outdated medical record system
When medical records are mixed-up, not up to date or stored incorrectly, this can severely endanger the well-being and health of a patient.
Hence, the inefficiency of an antiquated medical record system will surely jeopardize the patient’s transfer process between different medical institutes due to complications with the patient’s medical data exchange.
These issues can lead to more serious issues down the line
These issues can become a stumbling block that contributes greatly to even bigger, unfavourable problems such as heavy monetary losses to healthcare institutions due to complications with patient’s medical data, which can lead to legal consequences.
HOW BLOCKCHAIN TECHNOLOGY CAN ADDRESS THESE ISSUES
Ensures medical data integrity and privacy
Blockchain’s distributed ledger technology in healthcare makes it easier to:
Transfer patient medical records securely
Improve healthcare data security
Control the medication supply chain
Aid genetic code study in the medical field
It is known that the MySejahtera application had infused blockchain technology into its system during its conceptualization. The application could have functioned better had it covered the whole process ranging from user registration, vaccines supply-chain, contact to Pusat Pemberian Vaksin (PPV), medical officers, and more.
Help address major shortages in medications
The private general practitioner (GP) clinics, pharmacies, and hospitals in Malaysia suffered major shortages of various prescription and over-the-counter medications since last May, due to COVID-19 lockdowns in Shanghai, China, and Russia’s war in Ukraine.
More than an acute problem, the extraordinarily severe drug shortage in Malaysia this year revealed the need to boost the country’s medicine security for future international issues in the global pharmaceutical supply chain, as Malaysia is a net importer of pharmaceutical products.
Blockchain technology can help with medicine shortages through proper analysis at hospitals. Through this data analysis with untampered data, it can help to solve the issue in the pharmaceutical supply chain by establishing proof of ownership. Before reaching patients, drug ownership changes from the manufacturer to the distributor, and then to the pharmacist by easily cloning Radio Frequency Identification (RFID) tags. Using blockchain’s ability, more features can be periodically added to the chain.
Aid in improving overwork and toxic working culture in hospitals
The issue on the over workload and toxic working culture in public hospitals also can be solved if the Ministry of Health integrates digital innovation into its systems. Many manual processes can be automated and data transfer from one doctor to another can be updated timely at their fingertips, fostering a favourable environment between patients and doctors.
There are several processes and new regulatory procedures related to blockchain that need to be standardized and coordinated.
As a catalyst for change, Malaysia should look into this as a core pillar to move the needle forward. Blockchain technology is ready, and so are we.
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.
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).
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
FEATURED EXPERT PROFESSOR DR JAMES KOH KWEE CHOY
Head of Division of Medicine
School of Medicine
International Medical University (IMU)
MONKEYPOX IS CAUSED BY, YES, THE MONKEYPOX VIRUS
This virus belongs to the same family (Poxviridae) as the smallpox virus.
“The monkeypox virus was first isolated from a colony of monkeys in the 1950s, hence the name. Although it is called ‘monkeypox’, monkeys and humans are incidental hosts,” explains Professor James Koh Kwee Choy, an infectious disease consultant. “The actual reservoir is unknown, but is likely to be certain rodents.”
What we know it that the virus can be transmitted from animals, such as primates and rats, to humans. From thereon, the virus can be spread by humans to other humans and even other animals.
MONKEYPOX IS NOT A NEW DISEASE, AND IN FACT USED TO BE PRETTY RARE… UNTIL 2022, THAT IS
Monkeypox was first identified as a cause of disease in humans in the 1970s, when it was detected among certain populations in the Democratic Republic of Congo (at that time, the country was called Zaire).
Because outbreaks were rare and the spread was limited outside of the African continent, in the years after researchers assumed that the virus spread to humans in an ‘inefficient’ way.
Well, that assumption was definitely challenged in the May 2022 monkeypox outbreak!
“This outbreak is unusual because, in the past, the number of cases were small,” shares Prof James. “This time around, there is a wider and faster spread, and the symptoms or presentations are also different.”
In light of the outbreak, the WHO has since declared monkeypox an ‘evolving threat of moderate public health concern’.
YOU MAY HAVE MONKEYPOX IF YOU…
Develop a rash at or near your genitals or anus; other possible locations for the rash include your hands, feet, chest, face, and mouth
The rash may look like pimples or blisters, but will go through several stages (including scabbing) before healing
The rash can be painful or itchy
Some people may also have symptoms such as fever, swollen lymph nodes, aches in their muscles and back, headaches, coughing, sore throat, etc
Symptoms can vary from person to person; some may develop a rash first before other symptoms, while others develop the symptoms first and rash later, or they only develop a rash with no other symptoms
MONKEYPOX ISN’T ALWAYS FATAL, BUT THAT DOESN’T MEAN WE SHOULD TAKE IT LIGHTLY
Monkeypox has a recorded fatality rate of 1% to 10%.
Without any treatment given, the disease can usually resolve on its own between 2 and 4 weeks.
However, some people with monkeypox may develop severe complications, especially if they have existing health conditions or are undergoing treatments that weaken their immune system. These people will need hospitalization and close medical care.
MONKEYPOX CAN BE SPREAD THROUGH CLOSE & PROLONGED SKIN-TO-SKIN CONTACT
Prof James emphasizes that it is important to remember that transmission requires prolonged exposure to the infected person.
Brushing against someone in a crowded place, for example, or quickly kissing someone are unlikely to cause transmission.
So, what are the more likely means of transmission that we should be aware of?
Direct contact with the rash or body fluids of someone with monkeypox—note that this includes not just oral or penetrative sex but also touching, kissing and other face-to-face contact, hugging, massaging, and other intimate acts with the infected person
Prolonged contact with items that are or have been used by someone with monkeypox, such as clothing, bedding, towels, etc.
Prolonged exposure to the person’s respiratory secretions, which are produced when they talk, sneeze, cough, etc
An infected pregnant woman may spread the virus to the child she is carrying
It is also possible that one may contract monkeypox from eating poorly-cooked meat of infected animals, or from scratches and bites of infected animals
Someone with monkeypox can spread the virus from the time they develop their symptoms until the rash is fully healed.
MONKEYPOX IS NOT A ‘GAY PERSON’S DISEASE’—IT CAN AFFECT ANYONE AND EVERYONE
While it is certainly true that monkeypox currently affects a large population of men who have sex with men (MSM), it will be a mistake to assume that it is a disease that affects only these men.
As we have seen, the virus can spread through other means other than sex, so people that don’t engage in acts of intimacy with members of their own sex shouldn’t be complacent and assume that they are safe from it!
YES, THE SMALLPOX VACCINE MAY HELP, BUT THINGS ARE NOT SO STRAIGHTFORWARD
While smallpox and monkeypox are two different diseases, Prof James notes that the smallpox vaccine can help reduce the risk of catching the monkeypox by up to five times.
“Most Malaysians born before 1980 are vaccinated against smallpox as part of the National Immunisation Programme of that time,” Prof James notes.
Unfortunately, smallpox vaccines are not readily available. Therefore preventive strategies are important.
Thornhill, J. P., Barkati, S., Walmsley, S., Rockstroh, J., Antinori, A., Harrison, L. B., Palich, R., Nori, A., Reeves, I., Habibi, M. S., Apea, V., Boesecke, C., Vandekerckhove, L., Yakubovsky, M., Sendagorta, E., Blanco, J. L., Florence, E., Moschese, D., Maltez, F. M., Goorhuis, A., … SHARE-net Clinical Group (2022). Monkeypox virus infection in humans across 16 countries – April-June 2022. The New England journal of medicine, 10.1056/NEJMoa2207323. Advance online publication. https://doi.org/10.1056/NEJMoa2207323
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.
The survey is now closed. All parties involved would like to express their gratitude to everyone that participated in the study.
FEATURED EXPERT ASSOCIATE PROFESSOR DR ERWIN J KHOO
Consultant Paediatrician & Head of Paediatrics Department
International Medical University (IMU)
IT CAN BE CHALLENGING FOR A PARENT TO DETERMINE FACTS FROM FICTION WHEN IT COMES TO NEWS ON SOCIAL MEDIA
Netizens who are vaccine hesitant have an alarming footprint on social media. In a vicious cycle, their hesitance is likely to be fueled by health (mis)information obtained from a variety of sources, including news media such as the Internet and social media platforms.
As access to technology has improved, social media has attained global penetration. In contrast to traditional media, social media allow individuals to rapidly create and share content globally without editorial oversight. Users may self-select content streams, contributing to ideological isolation. As such, there are considerable public health concerns.
These worries may be magnified in the face of the ongoing COVID-19 pandemic. As the development and subsequent deployment of more vaccines are expected to play a critical role in downstream emerging pandemic control efforts, social media will remain a powerful tool. Most concerning is how (mis)information and (un)substantiated reports on its platforms will threaten to erode public confidence even well before the release of any scientific evidence.
It is not readily evident why social media is so disproportionately successful in promoting vaccine hesitancy as opposed to uptake. Social media users may represent a skewed population sample with baseline misperceptions regarding the benefits and side effects of vaccination whilst simultaneously lacking familiarity with the consequences of vaccine-preventable disease. Moreover, when evaluating the risks and benefits of vaccination in general, the risks may be overestimated and may seem more immediate, and tangible as compared to the more abstract potential benefits of disease prevention.
IF YOU ARE A PARENT WITH A CHILD UNDER 18, PLEASE SPEND 15 MINUTES TO HELP US BETTER UNDERSTAND THE SITUATION
SOcial MEdia on HesitAncy in Vaccine E-survey or in short, SOMEHAVE, is a multinational collaborative study between International Medical University (IMU), the Singapore’s National University Health System (NUHS), National University of Malaysia (UKM) and Universiti Malaya (UM)
The study uses unidentified e-survey for parents with the aim of seeking the impact of social media on vaccine hesitancy.