Dr Dzulkefly: Move forward soonest with pneumococcal jabs plan

It was a phone call that caught Datuk Seri Dr Dzulkefly Ahmad by surprise but one that he was happy to oblige.

The former health minister admitted the pneumococcal vaccination (PCV), a recent addition to the National Immunisation Programme (NIP) that was budgeted for this year, has taken a backseat in light of the Covid-19 pandemic.

“Now that we are having a slight breather from Covid-19, it will be good to remind the ministry to detail out its plan moving forward,” said Dr Dzulkefly.

“While the priority given to battle Covid-19 is understandable, the overall health of the general population must still be managed.”

Dr Dzulkefly and his team played a crucial role in bringing to fruition this Pakatan Harapan pledge that was supposed to be implemented this month.

However, a change in government earlier this year followed by the pandemic saw various projects go on the backburner as the economy took a beating.

The government handed out billions of ringgit in subsidies to help Malaysians and businesses survive the harsh impact of the pandemic which has recorded more than 10 million cases and almost 500,000 deaths worldwide.

As Malaysia is on the road to recovery, the attention is now back on the vaccination programme for which RM60 million was set aside under Budget 2020.

But Dr Dzulkefly was quick to add that it is only fair to give the ministry some time to re-strategise its rollout for “various other health matters”.

“However, it would be most regrettable should the government decide to roll back the implementation of this new programme in the NIP.”

The Department of Statistics Malaysia revealed that in 2017, the principal cause of death in rural areas was pneumonia (13.4 per cent). In 2018, it was reported that pneumonia was the main cause of death in newborns and children aged up to 14. From the 234 deaths recorded, 170 were below the age of five.

The World Health Orgnisation (WHO) recommends the inclusion of PCV in childhood immunisation programmes worldwide.

Health director-general Datuk Dr Noor Hisham Abdullah, had during the height of Covid-19 in April, reminded parents to continue immunising their babies and children, offering a glimmer of hope that the pneumococcal jab cause has not been forgotten.

Tenders for the supply of the vaccination were called by the ministry in March but there has been no news since. As the clock continues to tick, industry players are kept on the edge of their seats wondering who will eventually succeed.

It remains unclear if the government will go with PCV13, PCV10 or take up a 10-valent pneumococcal conjugate vaccine produced by a new player.

According to WHO, PCV10 and PCV13 are licensed for immunisation of infants and children from six weeks to five years of age against invasive disease, pneumonia and acute otitis media caused by the respective vaccine serotypes of S. pneumoniae. PCV13 is additionally licensed for the prevention of pneumococcal disease in adults aged above 50.

In the Malaysian context, PCV13 seems the best choice based on a report ‘Pneumococcal Conjugate Vaccine for Children Below Five Years Old‘ by the Health Ministry’s Health Technology Assessment Section.

Given the current situation, it may boil down to ringgit and sen.

There’s also the need to continuously educate parents about the importance of vaccination no thanks to the small but persistent influence from anti-vaxxers.

Dr Dzulkefly said no one would dare argue about the importance of vaccination as it is the only proven line of defence against the ravages of vaccine-preventable diseases.

“It is the only weapon to not only flatten the epidemic curve but to boost the critical mass of protected individuals to achieve herd immunity as to tame the pandemic.

“Emphatically I must say the Health Ministry should not let go of its guard against mass immunisation of our children against pneumococcal invasive disease especially since it was budgeted for introduction into the NIP.”

Dr Dzulkefly admitted that the ministry’s scope of responsibility is very wide and each is no less important than the other.

“So we must understand that the ministry’s business is not a zero-sum game. Everything needs due attention,” he added.