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Fulltext Adherence towards different vaccines of childhood immunization of under five year old children

Zamzaireen Zainal Abidin, Muhamad Hanafiah Juni, Faisal Ibrahim

Malaysian Journal of Medicine and Health Sciences, 2017;13(3):61-69.
MyJurnal

Introduction: Adherence towards childhood immunization (completeness and timeliness), with consideration of age-dependent-seroconversion, is the basis for children protection. Despite high global and national immunization coverage, vaccine preventable diseases’ are rising. This study aimed to determine adherence (completeness and timeliness) towards different vaccines of childhood immunization and associated factors among mothers of under five children. Methods: Cross-sectional study design was conducted at a health clinic in Seremban. Total of 320 mothers of under five children attending child health clinic selected via systematic random sampling. Data collection was via validated self-administered questionnaires and proforma, analysed using SPSS version 22. Associations between categorical variables determined by chi-square tests. Results: Consented respondents were 314; resulting in response rate of 98.1%. Adherence (completeness) was 98.09% but only 56.5% - 97.1% of respondents adhered in terms of timeliness. Types of transportation was significantly associated with adherence (completeness), p=0.041. Employment status was significantly associated with adherence (timeliness) towards BCG (p=0.008), Hepatitis B dose one (p=0.018) and dose two (p=0.040) vaccines. Education level was significantly associated with adherence (timeliness) towards DTaP/IPV/HiB dose four (p=0.019). Maternal age and usage of government clinic were significantly associated with adherence (timeliness) of MMR dose one, p=0.030 and p=0.017 respectively. Conclusion: Adherence (completeness) was high but varying adherence towards vaccine timeliness. Transportation types associated with completeness. Employment status associated with BCG, first and second doses of Hepatitis B vaccines’ timeliness. Education level associated with fourth dose of DTaP/IPV/HiB. Maternal age and usage of government clinic associated with timeliness of first dose MMR.

Matched MeSH terms: Immunization*
Fulltext Risk perception of childhood immunisation among the public in Kota Kinabalu, Sabah

Zaki, R.A., Roffeei, S.N., Hazwan, A.E., Musa, N.

JUMMEC, 2018;21(2):38-44.
MyJurnal

Objective: The study was designed to determine the risk perception of the public population in Kota Kinabalu towards childhood immunisation.
Methodology: This was a cross-sectional study where self-administered questionnaires were distributed to the public in Kota Kinabalu. The respondents who consented were 18 years old and older. The illiterate persons and the foreigners were excluded. The calculated sample size was 400. Only 313 samples collected were suitable for analysis using SPSS v21.0.
Results: Fever, pain swelling and allergic reaction were correctly identified as risks of immunisation. Autism, mental retardation and even death could also result from vaccination. Of the total respondents, 76.7% agreed with the practice of childhood vaccination, 70.0% thought that childhood vaccinations were safe and effective and 58.1% felt that its benefit outweighed the risk. Other than that, 32.0% refused childhood vaccination from fear of its risks, and this fear was the main reason for the refusal of childhood vaccination. Age, marital status, race and income were the factors which influenced parental willingness to vaccinate their children (p<0.05).
Conclusions: Most participants understood the risks of childhood vaccination, but few agreed to the practice of childhood immunisation for herd immunity. Public health campaigns are needed, to increase the understanding and acceptance of childhood vaccination especially in the rural community.
Keywords: Childhood Immunisation, Parental Risk, Perception, Public Acceptance

Matched MeSH terms: Immunization
Fulltext Prevalence of Red Blood Cell Alloimmunization among Transfused Chronic Kidney Disease Patients in Hospital Universiti Sains Malaysia

Yusoff SM, Bahar R, Hassan MN, Noor NHM, Ramli M, Shafii NF

Oman Med J, 2020 Sep;35(5):e177.
PMID: 33083035 DOI: 10.5001/omj.2020.95

Objectives: Red blood cell (RBC) immunization is a common complication in blood transfusion recipients. Patients with chronic kidney disease (CKD) eventually develop anemia, which is multifactorial, and requires regular blood transfusions, which exposes patients to the development of RBC antibodies. We sought to determine the prevalence and specificity patterns of RBC immunization and its risk factors among transfused CKD patients.
Methods: We conducted a cross-sectional study over one year from January to December 2018 in the Transfusion Medicine Unit, Hospital Universiti Sains Malaysia. A total of 249 samples were recruited from CKD patients who received a blood transfusion (at least one-pint), which only match for ABO and Rh(D) antigen. The serum was screened for the presence of the RBC antibody using the gel agglutination technique (Diamed gel cards). Samples with positive antibody screening were subjected to antibody identification.
Results: Of the 249 transfused CKD patients, 31 (12.4%) developed RBC immunization. Thirty (12%) were alloimmunized, and one (0.4%) was autoimmunized. Anti-Mia was the most common antibody (n = 14, 46.7%) among alloantibodies, followed by anti-E (n = 7, 23.3%). There was a significant association between pregnancy history with the development of antibodies whereas, no significant association was found between sociodemographic background, stage of CKD, hemodialysis status, underlying medical illness, and number of packed cell transfusions with the development of RBC antibodies.
Conclusions: One-eighth of our patient cohort had RBC alloimmunization, and the risk was increased in patients with a history of pregnancy. We propose Rhesus RBC phenotyping and to supply blood match Rhesus antigen in CKD patients, especially patients of reproductive age.

Matched MeSH terms: Immunization
Typhoid toxoid for specific prophylaxis of typhoid fever

Yu H

Journal of the Malaya Branch of the British Medical Association, 1940;3:374-83.

Matched MeSH terms: Immunization
The traveling athlete: issues relating to the Commonwealth Games, Malaysia, 1998

Young M, Fricker P, Maughan R, MacAuley D

Clin J Sport Med, 1998 Apr;8(2):130-5.
PMID: 9641444
Matched MeSH terms: Immunization
The travelling athlete: issues relating to the Commonwealth Games, Malaysia, 1998

Young M, Fricker P, Maughan R, MacAuley D

Br J Sports Med, 1998 Mar;32(1):77-81.
PMID: 9562173
Matched MeSH terms: Immunization
Fulltext Recombinant measles virus vaccine expressing the Nipah virus glycoprotein protects against lethal Nipah virus challenge

Yoneda M, Georges-Courbot MC, Ikeda F, Ishii M, Nagata N, Jacquot F, et al.

PLoS One, 2013;8(3):e58414.
PMID: 23516477 DOI: 10.1371/journal.pone.0058414

Nipah virus (NiV) is a member of the genus Henipavirus, which emerged in Malaysia in 1998. In pigs, infection resulted in a predominantly non-lethal respiratory disease; however, infection in humans resulted in over 100 deaths. Nipah virus has continued to re-emerge in Bangladesh and India, and person-to-person transmission appeared in the outbreak. Although a number of NiV vaccine studies have been reported, there are currently no vaccines or treatments licensed for human use. In this study, we have developed a recombinant measles virus (rMV) vaccine expressing NiV envelope glycoproteins (rMV-HL-G and rMV-Ed-G). Vaccinated hamsters were completely protected against NiV challenge, while the mortality of unvaccinated control hamsters was 90%. We trialed our vaccine in a non-human primate model, African green monkeys. Upon intraperitoneal infection with NiV, monkeys showed several clinical signs of disease including severe depression, reduced ability to move and decreased food ingestion and died at 7 days post infection (dpi). Intranasal and oral inoculation induced similar clinical illness in monkeys, evident around 9 dpi, and resulted in a moribund stage around 14 dpi. Two monkeys immunized subcutaneously with rMV-Ed-G showed no clinical illness prior to euthanasia after challenge with NiV. Viral RNA was not detected in any organ samples collected from vaccinated monkeys, and no pathological changes were found upon histopathological examination. From our findings, we propose that rMV-NiV-G is an appropriate NiV vaccine candidate for use in humans.

Matched MeSH terms: Immunization
Immunization

Yogeswary S

Family Practitioner, 1984;7<I> </I>:35-40.

Matched MeSH terms: Immunization
Fulltext Acute necrotizing encephalopathy of childhood: a severe case with fatal outcome

Yee Lin Lee, Hasyma Abu Hassan, Intan Hakimah Ismail

Malaysian Journal of Medicine and Health Sciences, 2020;16(2):323-325.
MyJurnal

Acute necrotizing encephalopathy of childhood (ANEC) is a rare condition which is important for clinicians to recognize as it has a high mortality rate and can result in significant neurological morbidities. It presents as acute encephalopathy with radiological findings of symmetrical brain lesions in bilateral thalami, putamen, brain stem teg- mentum, internal capsule, periventricular white matter and cerebellar medulla. Intravenous methylprednisolone is the mainstay of treatment. Immunoglobulin therapy and therapeutic hypothermia may be used as adjunctive therapy in cases with severe clinical and neuroradiological presentation. We present a case of severe ANEC and discuss the clinical manifestations, neuroimaging and management options.

Matched MeSH terms: Immunization, Passive
Fulltext Universal oral vaccine for influenza infections

Yap, Wei Boon, Toong, Seng Tan, Sharifah Syed Hassan, Jeffrey Cheah

Jurnal Sains Kesihatan Malaysia, 2018;16(2):51-64.
MyJurnal

Each year, influenza A infections have caused tremendous death rate as high as 300,000-500,000 globally. Although
there are effective anti-influenza agents and vaccines, high mutational rate among influenza A viruses renders dramatic
decline in the effectiveness of anti-influenza agents or vaccines in certain individuals. The situation is further complicated
by limitations in influenza vaccine production, for instance, long production period, limited vaccine capacity and lack
of cross-protection against various influenza A virus strains. To solve these issues, development of universal influenza
vaccine based on conserved antigens such as non-stuctural protein 1 (NS1) has been endeavoured. NS1 protein is highly
conserved in all influenza A virus strains known by far, produced abundantly on infected cell surfaces and responsible for
maintaining virulence. Furthermore, cytotoxic T-lymphocytes that are active against NS1 were also reported to be able
to avoid shedding of influenza in hosts. To better inhibit influenza infections, oral immunization has long been proposed
due to feasibility of this method to be implemented and safer for recipients while able to target influenza A viruses from
the entry point. Lactobacillus has been vastly studied for its roles as bacterial carrier in oral vaccine development due
to its significant probiotic properties. For examples, stimulation of immune responses in oral and airway mucosal layers,
high colonization in oral and airway mucosal layers and great natural adjuvant effects. In this light, influenza universal
oral vaccine developed using NS1 dan Lactobacillus should be further studied in influenza oral vaccine design.

Matched MeSH terms: Immunization
Repeated dose toxicity evaluation of a cold chain-free, live, attenuated oral cholera vaccine in Sprague Dawley rats

Xian TH, Parasuraman S, Sinniah K, Ravichandran M, Prabhakaran G

Vaccine, 2019 01 29;37(5):711-720.
PMID: 30630696 DOI: 10.1016/j.vaccine.2018.12.027

The repeated dose toxicity of a prototype cold chain-free, live, attenuated oral cholera vaccine containing 5 × 106 CFU/mL of the VCUSM14P strain was evaluated in Sprague Dawley (SD) rats (single dose administered daily for 30 days) to ascertain its safety for clinical use. Repeated dose toxicity studies for cholera vaccines in the literature have administered 2 or 3 fixed doses at 7, 14, 21 or 69 day intervals. The present study reports an evaluation of 30 repeated doses of cholera vaccine administered at three different concentrations (Group II (1.25 × 106 CFU), Group III (2.5 × 106 CFU) and Group IV (5 × 106 CFU)) in SD rats. The liquid vaccine was administered orally to the rats with the respective dose every day, and normal saline was administered to the control group (Group I). No significant difference (P > 0.05) was observed in the body weights and biochemical parameters of the rats after 15 and 30 repeated doses compared to those of the control group. However, compared to those of Group I, a significant increase (P 

Matched MeSH terms: Immunization Schedule*
Fulltext Cost-effectiveness analysis of infant universal routine pneumococcal vaccination in Malaysia and Hong Kong

Wu DB, Roberts C, Lee VW, Hong LW, Tan KK, Mak V, et al.

Hum Vaccin Immunother, 2016;12(2):403-16.
PMID: 26451658 DOI: 10.1080/21645515.2015.1067351

Pneumococcal disease causes large morbidity, mortality and health care utilization and medical and non-medical costs, which can all be reduced by effective infant universal routine immunization programs with pneumococcal conjugate vaccines (PCV). We evaluated the clinical and economic benefits of such programs with either 10- or 13-valent PCVs in Malaysia and Hong Kong by using an age-stratified Markov cohort model with many country-specific inputs. The incremental cost per quality-adjusted life year (QALY) was calculated to compare PCV10 or PCV13 against no vaccination and PCV13 against PCV10 over a 10-year birth cohort's vaccination. Both payer and societal perspectives were used. PCV13 had better public health and economic outcomes than a PCV10 program across all scenarios considered. For example, in the base case scenario in Malaysia, PCV13 would reduce more cases of IPD (+2,296), pneumonia (+705,281), and acute otitis media (+376,967) and save more lives (+6,122) than PCV10. Similarly, in Hong Kong, PCV13 would reduce more cases of IPD cases (+529), pneumonia (+172,185), and acute otitis media (+37,727) and save more lives (+2,688) than PCV10. During the same time horizon, PCV13 would gain over 74,000 and 21,600 additional QALYs than PCV10 in Malaysia and Hong Kong, respectively. PCV13 would be cost saving when compared against similar program with PCV10, under both payer and societal perspective in both countries. PCV13 remained a better choice over PCV10 in multiple sensitivity, scenario, and probabilistic analyses. PCV13s broader serotype coverage in its formulation and herd effect compared against PCV10 were important drivers of differences in outcomes.

Matched MeSH terms: Immunization Programs/economics*
Fulltext The feasibility and acceptability of self-sampling and HPV testing using Cepheid Xpert® HPV in a busy primary care facility

Woo YL

Journal of virus eradication, 2019 Mar 04;5(Suppl 1):10-11.
PMID: 30997147

Malaysia's approach to reducing the burden of HPV-related disease has centred on adolescent vaccination and cervical screening with Pap smears. While the vaccination programme has been broadly successful, Pap smear screening has been less successful. In an effort to improve screening uptake, the ROSE 1.0 pilot aimed to create more efficient screening, with improved quality and lower total cost.

Matched MeSH terms: Immunization Programs
Fulltext COVID-19: A call for awareness or mandatory vaccination even in pandemics?

Wong YJ, Lee SWH

J Glob Health, 2021 Jan 30;11:03005.
PMID: 33643615 DOI: 10.7189/jogh.11.03005
Matched MeSH terms: Immunization Schedule; Immunization Programs/trends*
Four is better than nine. a combined diphtheria-tetanus-pertussis-hepatitis B-Haemophilus influenzae type b vaccine for routine immunization in Malaysia

Wong SL, Soosai P, Teoh YL, Han HH, Lefevre I, Bock HL

Southeast Asian J. Trop. Med. Public Health, 2008 May;39(3):474-83.
PMID: 18564687

Malaysian infants would have to receive nine injections during the first few months of life in order to be protected against disease caused by hepatitis B (HBV), diphtheria, tetanus, pertussis and Haemophilus influenzae type b (Hib) if single HBV and Hib vaccines were used. We evaluated a combined DTPw-HBV/Hib vaccine administered at 1.5, 3 and 5 months after a birth dose of hepatitis B vaccine (HBV). One month after completion of the primary vaccination, 99% of subjects had seroprotective anti-HBV antibody levels, and at least 98% had seroprotective antibodies against diphtheria, tetanus, and Hib, and were seropositive for pertussis antibodies. The immune response to the combined vaccine was comparable to that induced by separate injections with DTPw, HBV and Hib vaccines. Overall, the DTPw-HBV/Hib vaccine was as well tolerated as separate administration of DTPw, HBV and Hib vaccines. The combined DTPw-HBV/Hib vaccine induces protection against five diseases as recommended in the Malaysian routine vaccination schedule. Use of the combined DTPw-HBV/Hib vaccine can reduce the required number of injections from nine to four in the first few months of life.

Matched MeSH terms: Immunization Schedule
Fulltext A decade of Japanese encephalitis surveillance in Sarawak, Malaysia: 1997-2006

Wong SC, Ooi MH, Abdullah AR, Wong SY, Krishnan S, Tio PH, et al.

Trop Med Int Health, 2008 Jan;13(1):52-5.
PMID: 18291002 DOI: 10.1111/j.1365-3156.2007.01967.x

Japanese encephalitis virus (JEV) is an important encephalitis virus in Asia, but there are few data on Malaysia. A hospital-based surveillance system for Japanese encephalitis (JE) has been in operation in Sarawak, Malaysia, for the last 10 years. JEV is endemic in Sarawak, with cases occurring throughout the year and a seasonal peak in the last quarter (one-way anova, P < 0.0001). Ninety-two per cent of 133 cases were children aged 12 years or younger; the introduction of JE vaccination in July 2001 reduced the number of JE cases (84 in the four seasons prior to vs. 49 in the six seasons after, McNemar's test, P = 0.0001). After implementation of the programme, the mean age of infected children increased from 6.3 to 8.0 years (Student's t-test, P = 0.0037), suggesting the need for a catch-up programme.

Matched MeSH terms: Immunization Programs
Generation of IgG antibodies against Strongyloides stercoralis in mice via immunization with recombinant antigens A133 and Ss-IR

Wong MTJ, Anuar NS, Noordin R, Tye GJ

Acta Trop, 2024 Mar;251:107122.
PMID: 38246399 DOI: 10.1016/j.actatropica.2024.107122

Strongyloidiasis, caused by the nematode Strongyloides stercoralis, remains a threat to global public health, and a vaccine would be useful to control the disease, especially in developing countries. This study aimed to evaluate the efficacy of recombinant proteins, A133 and Ss-IR, as potential vaccine candidates against strongyloidiasis by investigating the humoral and cellular immune responses in immunized mice. Respective antigens were adjuvanted with Complete Freund's Adjuvant (prime) and Incomplete Freund's Adjuvant (boost) and administered intraperitoneally (prime) and subcutaneously (boost) to female BALB/c mice. For antigen-only doses, only antigens were injected without adjuvants. Altogether, 1 prime dose, 4 booster doses, and 2 antigen-only doses were administered successively. ELISAs were conducted to assess the antibody responses, along with flow cytometry and cytokine ELISA to elucidate the cellular immune responses. Results showed that A133 and Ss-IR induced the production of IgG1 and IgG2a, with A133 generating more robust IgG2a responses than Ss-IR. Flow cytometry findings indicated that effector CD8+T-cells and memory B-cells activity were upregulated significantly for A133 only, whereas cytokine ELISA demonstrated that a Th1/Th2/Th17 mixed cell responses were triggered upon vaccination with either antigen. This preliminary study illustrated the good potential of recombinant A133 and Ss-IR as vaccine candidates against S. stercoralis. It provided information on the probable immune mechanism involved in host defence and the elicitation of protection against S. stercoralis.

Matched MeSH terms: Immunization
Role of men in promoting the uptake of HPV vaccinations: focus groups' finding from a developing country

Wong LP

Int J Public Health, 2010 Feb;55(1):35-42.
PMID: 19771393 DOI: 10.1007/s00038-009-0072-4

OBJECTIVES: Better outcomes of human papillomavirus (HPV) vaccination would be expected if men become full partners and advocates in vaccination initiative. Men involvement has important implication especially within the context that they are equally responsible for spreading the virus.

METHODS: Twenty-seven men took part in four focus group discussions carried out to assess men's attitudes toward the HPV vaccine between October and November 2007.

RESULTS: The results revealed that men have low awareness about the newly release vaccine and minimal knowledge of HPV and its association with cervical cancer. When provided with information, most men were in favor of protecting their spouses, partners, or daughters from cervical cancer using the vaccine. They were aware of the effects of men's risk behavioral patterns on women's risk for acquiring HPV infections. Many needed assurance about the vaccine's long-term safety and efficacy. They also expressed concern over the high cost of the vaccine. Men in this study played an influential role in the vaccination decision of their child and sexual partners. Many were in favor of male vaccination for cervical cancer prevention of their spouse or partner.

CONCLUSIONS: Vaccine advocacy should put special emphasis on men as sexual partners, husbands, and fathers from a gender equality and partnership perspective. The findings are useful in facilitating the development of strategies for effective immunization initiatives.

Matched MeSH terms: Immunization Programs/utilization*
Fulltext Current issues facing the introduction of human papillomavirus vaccine in China and future prospects

Wong LP, Han L, Li H, Zhao J, Zhao Q, Zimet GD

Hum Vaccin Immunother, 2019;15(7-8):1533-1540.
PMID: 31017500 DOI: 10.1080/21645515.2019.1611157

The introduction of human papillomavirus (HPV) vaccination in China aims to prevent HPV infection in all women. The issues that China might face include high cost of vaccines made in other countries, shortage in HPV vaccine supply, negative events attributed to vaccination (whether justified or not) that jeopardizes the general public's confidence in the HPV vaccine, cultural and literacy barriers, and sensitivity to receiving a vaccine for a sexually transmitted disease. Ensuring the effective delivery of the HPV vaccine in China, a country with vast economic, geographical, and cultural complexities, will require a commitment of significant resources. In light of the high price of imported vaccines, the availability of locally manufactured HPV vaccines would greatly facilitate the national HPV vaccination program. New evidence supporting the efficacy of a two-dose regime in younger adolescents would also be advantageous in terms of affordability and logistical simplicity of vaccine administration. Furthermore, it would potentially enhance the compliance and uptake, especially for hard to reach women in remote regions.

Matched MeSH terms: Immunization Programs/economics; Immunization Programs/organization & administration*
Fulltext Cost-based COVID-19 vaccination and willingness to pay: A post-pandemic review

Wong LP, Lee HY, Alias H, Zimet G, Liu T, Lin Y, et al.

Hum Vaccin Immunother, 2024 Dec 31;20(1):2313860.
PMID: 38359815 DOI: 10.1080/21645515.2024.2313860

The primary objective of this paper is to serve as a valuable resource for policymakers who are confronted with the evolving landscape of the coronavirus disease 2019 (COVID-19), considering both free and cost-based vaccination approaches. The potential consequences of shifting from free to cost-based vaccination are explored, encompassing its impact on global vaccine equity and prioritization, economic well-being, healthcare systems and delivery, public health policies, and vaccine distribution strategies. Examining past studies on willingness to pay for the initial COVID-19 vaccine dose and booster shots provides insights into how individuals value COVID-19 vaccinations and underscores the significance of addressing issues related to affordability. If COVID-19 vaccinations incur expenses, using effective communication strategies that emphasize the importance of vaccination and personal health benefits can increase willingness to pay. Making COVID-19 vaccines accessible through public health programs or health insurance can help alleviate financial barriers and increase vaccination rates.

Matched MeSH terms: Immunization, Secondary

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