MANY women in Malaysia are missing maternal vaccinations, according to fetomaternal medicine consultant Professor Dr Jamiyah Hassan.
Some factors include low awareness, vaccine hesitancy, safety concerns and financial constraints.
This is a concern, especially when vaccine-preventable infections have been identified as significant contributors to neonatal mortality.¹
"There has been a slowdown in survival gains since 2010, particularly in neonatal mortality – referring to the death of a newborn within the first 28 days of life,²" said Dr Jamiyah.
In an open letter, she emphasised the importance of maternal vaccination in preventing diseases like pertussis and improving the survival rates of infants.³
"Maternal immunisation is an important strategy to reduce the disease burden of infections like pertussis," she said, calling for pregnant mothers to get the Tetanus-diphtheria-pertussis (Tdap) jab.
According to Dr Jamiyah, a mother can achieve a dual advantage by receiving vaccinations during pregnancy: boosting her own immunity and providing vital protection for her unborn child.
The antibodies developed in the mother's body are transmitted to the baby through the placenta, giving essential protection at the time of birth and continuing to shield the child for several months thereafter, until the baby receives their own vaccinations.
Currently, the pertussis vaccine is given via a six-in-one injection to babies in Malaysia at two, three and five months old, along with a booster jab at 18 months.
However, many of the pertussis cases and fatalities in Malaysia occur among babies below five months old — these babies have not achieved optimum immunity because they have not completed the doses of the pertussis vaccine.⁴
"To bridge this gap, maternal immunisation emerges as one of the most effective solutions," said Dr Jamiyah.
STEPS TO TACKLE PERTUSSIS SURGE
A recent report by the Health Ministry recorded 343 pertussis cases as of August, which is a sharp hike, compared to 11 cases in 2021 and 101 cases in 2022.⁵
There were also 24 fatalities, whereby 19 of them (79.1 per cent) involved babies under five months old.⁵
Following the surge of pertussis cases, the Health Ministry has announced it would provide pregnant women with the Tdap vaccine for free, starting next year.
Health Minister Dr Zaliha Mustafa said in a statement that, once implemented, all pregnant women, including non-citizens, can get a dose of the Tdap vaccine during their second or third trimester (between 13 and 36 weeks of pregnancy) at the ministry's healthcare facilities nationwide.⁵
"The implementation is expected to begin in 2024 after the procurement of the Tdap vaccine has been completed and the supply is made available at the ministry's health facilities nationwide.
"More information will be announced from time to time," said Dr Zaliha.
Dr Jamiyah said efforts like this are crucial steps in reducing the risk of vaccine-preventable diseases in newborns and promoting overall child health in Malaysia.
"I am heartened by the fact that the ministry is looking to take proactive measures to enhance accessibility to relevant preventive measures.
"I urge my peers to actively engage in discussions with their patients and recommend maternal immunisation, thereby raising awareness and fostering acceptance of this life-saving practice, and I firmly appeal to the ministry to sustain the momentum in reinforcing our maternal immunisation strategy," she added.
REINFORCING MALAYSIA'S IMMUNISATION STRATEGY
Malaysia joins the ranks of countries like Singapore, the United Kingdom and the United States, which recommend expecting mothers to receive the Tdap vaccine.
In Singapore, pregnant women are recommended to get the Tdap jab between 16 and 32 weeks of pregnancy, with subsidies provided at polyclinics for Singaporeans and permanent residents.⁶
Countries like the United Kingdom and United States recommend Tdap vaccination for pregnant women between 27 and 36 weeks of pregnancy, or between 13 and 26 weeks in Switzerland.⁷
According to obstetrician and gynaecologist Dr Milton Lum, the Tdap vaccine is recommended for every pregnancy, although not mandatory.⁷
"It is administered to all pregnant women unless they have contraindications, which is very rare, or they have objections," he said.
He added that the vaccine is given during the second or third trimester because that is when the level of antibodies in the maternal blood should be the highest. This ensures the maximum amount of maternal antibodies are transferred to the foetus.
Click here to learn about the importance of getting vaccinated.
References:
1. WHO. Newborns: Improving Survival & Well-Being factsheet. https://www.who.int/news-room/fact-sheets/detail/newborns-reducing-mortality.
2. WHO's The Global Health Observatory. Child mortality and causes of death. Child mortality and causes of death (who.int). Accessed 21 July 2023.
3. Frontiers. The Protective Role of Immunisation in Early Life. https://www.frontiersin.org/articles/10.3389/fped.2021.638871/full. Accessed 21 July 2023
4. Ova. Pertussis Cases In Malaysia Surge Up From 11 Cases In 2021 To 101 Cases In 2022. https://ova.galencentre.org/pertussis-cases-in-malaysia-surge-up-from-11.... Accessed 4 August 2023.
5. New Straits Times. Tdap for pregnant women starting next year. https://www.nst.com.my/news/nation/2023/08/948322/tdap-pregnant-women-starting-next-year. Accessed 28 August 2023.
6. SingHealth. Vaccinations recommended before, during and/or after pregnancy. https://www.singhealth.com.sg/patient-care/conditions-treatments/vaccinations-recommended-before-during-and-or-after-pregnancy. Accessed 28 August 2023.
7. The Star. Get vaccinated for whooping cough, say experts (Poll Inside) https://www.thestar.com.my/news/nation/2023/08/25/get-vaccinated-for-whooping-cough-say-experts. Accessed 28 August 2023.
Receive additional markdowns on maternity items with Shopee discount code.