To Vaccinate or Not to Vaccinate?

Dato Dr Musa Mohd Nordin   Consultant Paediatrician & Neonatologist

Datuk Dr Zulkifli Ismail   Consultant Paediatrician & Paediatric Cardiologist

John Lennon was once quoted as saying, “There are two basic motivating forces: fear and love.” And it couldn’t be more apt in the case of Megan Sandlin who first took a stance against vaccination when her daughter turned four months old.

It started innocently enough. “One day, I was talking with a friend who told me I should be wary of vaccines,” the mother of two recalls in an interview with Voices for Vaccines. “I was curious so I looked up vaccine ingredients online. I didn’t know any better so I clicked on the first few websites which my online search yielded. I didn’t understand much of what I read, but the ingredients sounded nasty and scary. I was confused with all that information and my friends insisted that vaccines were harmful so I decided against getting my daughter vaccinated when her six-month check-up came up.”

Initially, Megan felt relieved thinking she had made the right choice – and her anti-immunisation stance only grew stronger. “I started “liking” anti-vaccine pages on social media – websites which I now know masquerade as “information portals”. I was added to Facebook groups such as “Great Mothers Questioning Vaccines.” My friends were supportive and constantly assured me that my child was fine; that my breast milk was keeping her safe from diseases.”

But as time went by, Megan began having doubts. “I started noticing how several of these friends would believe in the most questionable controversies. That was my turning point. Soon, I was questioning their anti-vaccine stance.” She then seeked out “real science”, as she puts it. What she discovered confirmed her suspicions. “My friends told me that better sanitation – and not vaccines – was the reason for the drastic decline in disease incidences but I found graphs and statistics on the Center for Disease Control and Prevention (CDC) website which proved otherwise. I realised then that vaccine researchers weren’t out to scam us of our money. Vaccines are good.”

When her second daughter turned 10 months old, Megan decided enough was enough; it was time to begin vaccinating again. Now, she couldn’t be more relieved. “Both my kids are fine. I’m proud to be an immunising mum, to be giving my kids the best shot at a healthy life.”

Megan is just one of many parents who have been duped into taking an anti-vaccine stance. But some, unlike Megan still tightly cling on to their beliefs – stubbornly refusing immunisation for their little ones. Why is this so? How did these misconceptions arise in the first place? And how is the situation closer to home?

East meets West

Consultant Paediatrician & Paediatric Cardiologist Datuk Dr Zulkifli Ismail explains, “Many grow hesitant about vaccination when they read anti-vaccine lobbies on social media. Evidence-based information on sites like the CDC and Immunise4Life are either overlooked or taken out of context. People are more ready to accept the unconventional.” This readiness has led to certain Malaysian communities concluding that vaccines contain ‘haram’ contents. “Some Muslims shun vaccines once any ‘was-was’ (doubt) arises. This is further fuelled by conservative religious scholars who pass religious edicts prohibiting vaccination. But rest assured, all vaccines in Malaysia are permissible from a religious perspective. In fact, I talked about this in the recently published Immunisation Controversies: What You Really Need to Know book, so do give it a read.”

Consultant Paediatrician & Neonatologist Dato’ Dr Musa Mohd Nordin adds, “With the advent of the internet, we are akin to a global village where trends from the West are merely a Twitter or Facebook share away. The internet is saturated with news on vaccines and most people don’t check the authenticity of the news they read. Webmasters of anti-vaxxers utilise SEO and Google Analytics to ensure their websites are top-ranked in search engines. Most of these sites are either selling products (e.g. supplements, programmers or alternative medicines) or subscribe to ‘pay-per-click’ online programmers. The vaccination debate is a great way to make money and gain a huge following quickly. Hence, more Malaysian parents are leaning towards an anti-immunisation stance.”

What’s myth? What’s fact?

It doesn’t help that parents are concerned about the potential side effects which vaccines bring. “Some parents are concerned that too many vaccines being introduced to their babies at a given time can be harmful. Although some children do experience side effects from vaccination, these are typically mild such as fever, fussiness, malaise or swelling at the injection site. In extremely rare circumstances, the vaccines may experience allergic reactions but the incidence is probably less than one in a million. The truth is, the immune system is robust and the human body takes in far more antigens from the environment daily than it does from vaccines. In fact, the ‘toxins’ found in vaccines are also present in breast milk – and in even larger quantities. So, their fears are unfounded,” Dr Musa assures.

“Additionally, some believe vaccines are not necessary anymore because we no longer see children being infected with the terrible effects of vaccine-preventable diseases. We have actually become victims of our own success; immunisation has done so well in the previous generation that today’s generation is taking good health for granted, forgetting that our parents and grandparents vaccinated us in the past to protect us from infectious diseases. We don’t have to wait too long to see the consequences of parents opting out of vaccines. Already, diseases which were once almost wiped off (e.g. measles and mumps) are returning to some communities.”

Dr Zulkifli agrees. “There are those who are caught up in conspiracy theories, thinking that vaccines were invented by the Americans or Jews to subjugate the rest of the world. If this is true, why do the American and Israeli immunisation schedules contain more vaccines than those of our country’s? Ludicrous as it sounds, there are people who believe in anti-vaccine propaganda.”

The Autism- Vaccine Link

In 1998, a study by British surgeon and medical researcher Andrew Wakefield was published in The Lancet, claiming to have a found a link between autism and vaccines. This sparked a wave of panic among the masses resulting in a drastic drop in vaccination rates and the birth of the anti-vaccine movement.

Dr Musa is quick to dispel this notion. “The association between autism and vaccination is one of the biggest myths in the world of medicine. Researchers who referenced as many as 67 scientific papers have unequivocally debunked Wakefield’s claim.  His paper was found to be fraudulent and was retracted by The Lancet in 2012. The UK General Medical Council subsequently revoked his practicing license.”

But what about some parents’ claims that vaccines gave their kids autism? Dr Musa says, “A multi-centre US research team has identified 65 genes which contribute to autism. Autism is largely a genetic disorder.” Dr Zulkifli agrees. “The incidence of autism has been reviewed in numerous countries and no link with vaccination has been shown. In fact, kids are more likely to develop autism from prolonged television watching when aged below two years old than from immunisation.”

Vaccines are good for you!

Dr Musa stresses, “It’s illogical to avoid all forms of medical intervention solely because one wants to avoid risks. This paradigm of thought is incoherent and irrational because doing nothing (i.e. refusing vaccination) is also associated with risks, namely the heightened risk of acquiring vaccine-preventable diseases which may lead to disease outbreaks and an increase in hospitalisations, disabilities and deaths.”

“And not only is your own child at risk but other kids as well.” He cites an example. “An unvaccinated child is 6-35 times more likely to be infected with measles. Hence, they can easily pass on the infection to others. For instance, a measles outbreak occurred mainly among unvaccinated children in Malaysia several years back. This was traced back to the decline in MMR (mumps, measles and rubella) vaccine uptake. Remember, freedom of choice is a good thing but the freedom to harm others isn’t.”

“Vaccines are safe,” Dr Zulkifli assures. “No vaccine is ever released and approved by the National Regulatory Authorities (NRA) without first undergoing trials which usually take 10-15 years and involve tens of thousands of volunteers. Even after their release, these vaccines are constantly monitored. If any adverse reaction is detected, the vaccine will be recalled.” Dr Musa adds, “Creating a vaccine is a highly complex and regulated process. The exhaustive volume of scientific evidence speaks for itself that vaccines are safe and effective. So, there’s no need to worry.”

Dr Zulkifli concludes, “Take infectious diseases like smallpox, diphtheria and polio for example. Because of vaccination, they are now either eliminated or have decreased significantly. The World Health Organisation (WHO) puts it best: ‘Vaccination is the greatest achievement in public health, second only to safe water supply.’ Therefore, vaccination isn’t something to be feared but to be welcomed.’”

Now that you have heard from Dato’ Dr Musa Mohd Nordin and Datuk Dr Zulkifli Ismail, are you curious to find out what other key opinion leaders have to say on the matter? If you are, you will be glad to know that we are giving away copies of “Immunisation Controversies: What You Really Need to Know” for free! Write in to us at [email protected] or visit our Facebook page at www.facebook.com/HealthToday – and you can stand a chance to win a copy!

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