Back in February 2019, we were shocked by the death of a two-year-old boy from Johor Bharu who was believed to have died due to diphtheria and multiorgan dysfunctions. The child was never immunised. Not long after that, another five children were tested positive for the same disease. All were vaccinated but it was reported that all of them also had a contact with the unvaccinated child. Three deaths were recorded from diphtheria during the first quarter of the year of 2019. Then, very recently, we were again faced with the news of ‘mysterious illness’ sweeping the Batek tribe’s Orang Asli in Kuala Koh, claiming at least 15 lives. The culprit? Measles. The Orang Asli practised a nomadic lifestyle making it hard for the medical team to reach them and vice versa. As a result, many of them are not fully immunised. Worse, they are also malnourished, making the fight against measles a hard one to win if they are already contracted by it.
While these are two different scenarios with different causes, both cases had lead to eruptions of debates on the importance of vaccinations and whether it should be made mandatory or not in Malaysia as the country has not mandated for its compulsion yet. In this article, we shall take a look at what are vaccinations and the concerns around it.
What is a vaccine?
According to the Malaysian Health Ministry, a vaccine contains antigen(s) that is formulated using parts or whole of virus or bacteria, either killed or weakened. And because these antigens are either dead or weakened, it’s almost impossible to get any disease from it. In fact, the antigens introduced in vaccines are much lesser and weaker than those in our environment that we breathe in daily. The working mechanism of a vaccine is fairly simple. When a vaccine is inserted into the body, our antibodies will remember these antigens and develop protective immunity against them. Therefore, when our body is faced with a similar antigen in the future, it has already developed a defence system against it, significantly decreasing our risk of getting an illness.
“Wait, if that’s the case, then how come the five kids in Johor were tested positive diphtheria too when they were all vaccinated?”
That’s most probably because there is a breakdown in our herd immunity. When a person is vaccinated, he doesn’t just protect himself from the disease, he is also stopping the chains of transmission as an immunised person could not transmit the disease to others. Once enough people in a community are immunised against a disease, the chance of an outbreak to happen will be significantly lower. In a susceptible community, extremely infectious diseases like measles can infect 12 to 18 other persons. That’s why some scientists believe that we probably need to vaccinate 17 out of every 18 people in the community to stop the transmission of the disease. That is approximately 94 per cent! However, in the case of Orang Asli in the Batek tribe, only 61.5 per cent of them received the first dose of the Measles-Mumps-Rubella (MMR) vaccination and 30 per cent for the second dosage, according to the Ministry of Health (MOH). This may be the biggest cause of the outbreak. Despite this, in recent years, it has been reported that more parents are opting to not get their child vaccinated. Many vaccine proponents find this agitating because this act is seen as compromising others’ safety. But rather than playing the blame game, let’s take a look at the possible reasons as to why some parents are so against vaccination, so could understand where they are coming from.
Popular anti-vaccine arguments and misconception about immunisation
Immunisation leads to autism
In 1997, Wakefield et al wrote a fraudulent paper linking the measles, mumps, and rubella (MMR) vaccine to autism. The paper was then retracted 16 years later after it was found that the data was falsified and there is no causal link between the vaccine and the disease. Most recently, in 2017, another two scientists, Christopher Shaw’s and Lucija Tomljenovic wrote a journal article claiming that aluminium adjuvants in vaccines affect brain functions, leading to autism. Again, the paper was retracted due to the manipulation of data. Nonetheless, these papers are still very popular amongst those who are against vaccinations (a.k.a. ‘anti-vaxxers’). Thimerosal, a mercury-based preservative used in many multi-vial vaccine preparations to prevent bacterial growth has also been blamed as the cause of autism. Interestingly enough, this substance can only stay in the body for a short while, making it very hard to build up to a level that will endanger the body. A recent study also found that actually autism developed during pregnancy i.e. even before a child receives any immunisation. Hence, looking at this evidence (or the lack of evidence, to be exact), perhaps it is safe to say that the correlation between vaccination and autism is non-existent.
The belief that homoeopathy and natural remedy are the best ways to fight diseases
Data collected by the MOH shows that more parents are refusing to immunise their children because they believe that homoeopathy and natural remedy are a better and safer alternative. However, there has been no scientific research to prove its effectiveness in protecting children against diseases that are otherwise prevented by vaccines. Plus, homoeopathy also does not provide any biological explanation as to how super-dilutions of a ‘remedy’ may treat disease because often, a homoeopathic remedy is very diluted, not even a single molecule of the active ingredient it was made from remains.
It was better sanitation, hygiene and lifestyle that reduces infectious disease rate
While the above statement is not wrong, disease like smallpox was only fully eradicated after the introduction of a vaccine, not just because there were better sanitation and lifestyle. A study conducted in Italy also found that vaccination alone prevented more than 4 million cases of death from infectious disease, and approximately 35 per cent of this number covers children below the age of 4 years old. The elimination of an infectious disease is multi-factored, so we certainly cannot say that vaccines deserve all the credits. Nonetheless, if it gives us better protection against these deathly diseases without harming us, wouldn’t it be best if we opt for it?
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Multiple vaccinations can overload the body’s immune system
Various researches have been conducted to study the effect of giving multiple vaccines simultaneously but none of the findings shows that chronic illness can be attained from these procedures. To add, every time a new vaccine is introduced and licensed, it would also be tested together with the recommended vaccines we are already using to ensure its compatibility. Of course, some combination may cause effects like fever and swellings, but they are always temporary. Furthermore, our babies’ immune system fights more active antigens in their environment (e.g. when breathing). So, these weakened and dead antigens in the vaccine should not be the one we are worried about.
Perhaps one of the most popular arguments in Malaysia comes from Muslims who are worried that the vaccine might be contaminated with porcine DNA which is not permissible in the religion. Nevertheless, the majority of Muslim scholars and experts in the Islamic law around the world have concluded that porcine gelatin used in vaccines is acceptable as usually there will be genetic modification applied to the DNA. Some fatwas (Islamic rulings) even hold that vaccination is a compulsory preventive measure to save lives. Some Christians orthodoxy and denominations do have a theological objection against immunisation citing interference of divine providence as their reasoning, but many Christians believers are in support of immunisation. For Buddhist, there are some debates on the use of vaccine-derived from a life form, because the first of the Ten Buddhist Precepts is “not taking life.” But again, most of modern Buddhists would get vaccinated for protection. Generally, most major religions in the world do not have any resistance against vaccination. In fact, many argue that if the risk of not vaccinating brings more hazard, it would be immoral not to vaccinate.
How vaccination saves lives
Some people cannot get immunised for various reasons. Not that they don’t want to, but they are more susceptible to danger if they are vaccinated. These include newborns because they are too young, people who are allergic to the vaccine, elderly with an impaired or weakened immune system, as well as cancer and organ transplant patients. So what protects these immuno-compromised patients? Herd immunity. Still, herd immunity cannot guarantee full protection because those who are against vaccinations tend to cluster together in communities. The higher the number of people resorting to avoiding vaccination, the higher the chances of Vaccine-Preventable Diseases (VPDs) to make a comeback. It is true that vaccination is a right, hence you have an option to not take it. But remember, when you decide to not vaccinate your little ones, you are not just risking their lives, you are also endangering others around you.