Vaccination pixabayMarch 7 – The increase in preventable diseases like measles and diphtheria has frightened the government enough into considering making vaccinations mandatory for children entering school.

According to the Ministry of Health (MOH), Malaysia saw a whopping 891.8 per cent increase in measles over the past five years, rising from 195 cases in 2013 to 1,934 cases in 2018. Last year, MOH recorded six deaths from measles, all of whom were not immunised; five deaths from diphtheria, of which four were not vaccinated; and 22 deaths from whooping cough, of whom 19 were not immunised.

The number of vaccine rejections at government clinics rose from 637 cases in 2013 to 1,603 cases in 2016. MOH said its advocacy efforts led to a small decrease in vaccine rejections to 1,404 cases in 2017.

Disturbingly, Malaysia’s measles, mumps and rubella (MMR) vaccination rate fell to 89 per cent in 2018, below the 95 per cent coverage required for herd immunity. Herd immunity means that a certain percentage of people must be immunised to prevent a disease from infecting a population, including a small number of those who cannot be vaccinated.

Because measles is so contagious, where a person with the disease can infect 12 to 18 other people (compared to Ebola where one case leads to two other infections, or HIV and SARS where one leads to another four cases), the required vaccination rate for herd immunity is very high.

And yet another major study has disproved links between autism and the MMR vaccine.

Currently, Malaysia does not have legislation requiring vaccinations for children before they can attend school, unlike in the United States.

But even the US has been facing measles outbreaks since the start of the year – despite previously declaring the elimination of the disease in 2000 thanks to the measles vaccine – because of non-medical exemptions from vaccines that are permitted under various state laws.

Even though all 50 states in the US have laws that require vaccinations for students attending school, 47 states allow exemptions on grounds of religious belief against immunisations. Seventeen states allow philosophical exemptions, where one can object to vaccinations because of personal, moral or other beliefs. Exceptions are Mississippi, California, and West Virginia that only allow medical exemptions to vaccines. All school immunisation laws also provide exemptions from vaccines for children on medical grounds.

If Malaysia is to enact any legislation requiring vaccinations for children entering school, lawmakers should learn from America’s example and not allow any exemptions except for medical reasons.

I am not normally in favour of excessive government intervention, but the issue at hand is public health, not so much individual liberty. Unvaccinated children pose a public health risk.

Parents have the right to raise their child however they see fit, but they do not have the right to do things that endanger other children and put everyone else at risk of serious harm and even death.

Feel free to teach your child that the earth is flat or that evolution isn’t real, but you do not have the right to spread diseases because of your uninformed choices.

One’s right to personal freedom ends when it harms another.

Halal concerns, which can be classified under religious belief, aren’t valid either. Public health trumps religion. In any case, MOH has already said that vaccines in public hospitals are all halal.

Malaysia should impose laws that prohibit children from attending kindergarten, school and college if their parents refuse vaccinations for any reason except on medical grounds.

Education Minister Maszlee Malik has seemingly opposed proposals to mandate vaccinations for children entering school, saying that vaccines and the right to education were two different things and all Malaysians must have access to education without discrimination.

Maszlee makes a fair point about access to education, but this is about the greater good. Children will not be able to study if they get sick and later die from measles or other preventable diseases.

Besides enacting legislation, health and education authorities should create easy administrative processes and forms for these educational institutions to deny entry to unvaccinated children. School authorities must not allow children to enroll without proof of vaccination from a doctor.

This procedure can be easily implemented.

Doctors who falsify vaccine certification, which was allegedly done for some Malaysians who go on the haj to Mecca, must be stripped of their medical license.

MOH officials and health care providers must also continuously educate the public on the need for childhood immunisation and readily counter fake news about MMR vaccines.

Legislation is one thing, but changing people’s minds is another.

The government should also consider creating a national database for people’s vaccination information, which is accessible to all public and private health care providers, so that doctors can remind parents during clinic visits for their child to take any missed immunisation shots.

All these require simple operating procedures to be effective.

The government has been patient enough with anti-vaxxers. It is time that the Pakatan Harapan administration did what Barisan Nasional could not – put their foot down on these willful spreaders of disease.