Displaying all 9 publications

  1. Chen ST
    J Trop Med Hyg, 1989 Dec;92(6):386-90.
    PMID: 2607571
    The infant immunization coverage for triple antigen (DPT) from 1968 and trivalent oral polio vaccine (TOPV) from 1972 to 1985 for Peninsular Malaysia are presented. It shows that immunization coverage improved when the recommended age for first dose of DPT was changed from the fourth to the second month of life in 1972 and declined when the recommended age for the first dose of DPT and TOPV was revised again from the second to the third month of life in 1980. The advantages of immunizing children early in life are discussed.
    Matched MeSH terms: Diphtheria-Tetanus-Pertussis Vaccine/administration & dosage*
  2. Aljunid SM, Al Bashir L, Ismail AB, Aizuddin AN, Rashid SAZA, Nur AM
    BMC Health Serv Res, 2022 Jan 05;22(1):34.
    PMID: 34986870 DOI: 10.1186/s12913-021-07428-7
    BACKGROUND: The decision to implement new vaccines should be supported by public health and economic evaluations. Therefore, this study was primarily designed to evaluate the economic impact of switching from partially combined vaccine (Pentaxim® plus hepatitis B) to fully combined vaccine (Hexaxim®) in the Malaysian National Immunization Program (NIP) and to investigate healthcare professionals (HCPs)' and parents'/caregivers' perceptions.

    METHODS: In this economic evaluation study, 22 primary healthcare centers were randomly selected in Malaysia between December 2019 and July 2020. The baseline immunization schedule includes switching from Pentaxim® (four doses) and hepatitis B (three doses) to Hexaxim® (four doses), whereas the alternative scheme includes switching from Pentaxim® (four doses) and hepatitis B (three doses) to Hexaxim® (four doses) and hepatitis B (one dose) administered at birth. Direct medical costs were extracted using a costing questionnaire and an observational time and motion chart. Direct non-medical (cost for transportation) and indirect costs (loss of productivity) were derived from parents'/caregivers' questionnaire. Also, HCPs' and parent's/caregivers' perceptions were investigated using structured questionnaires.

    RESULTS: The cost per dose of Pentaxim® plus hepatitis B vs. Hexaxim® for the baseline scheme was Malaysian ringgit (RM) 31.90 (7.7 United States dollar [USD]) vs. 17.10 (4.1 USD) for direct medical cost, RM 54.40 (13.1 USD) vs. RM 27.20 (6.6 USD) for direct non-medical cost, RM 221.33 (53.3 USD) vs. RM 110.66 (26.7 USD) for indirect cost, and RM 307.63 (74.2 USD) vs. RM 155.00 (37.4 USD) for societal (total) cost. A similar trend was observed for the alternative scheme. Compared with Pentaxim® plus hepatitis B, total cost savings per dose of Hexaxim® were RM 137.20 (33.1 USD) and RM 104.70 (25.2 USD) in the baseline and alternative scheme, respectively. Eighty-four percent of physicians and 95% of nurses supported the use of Hexaxim® in the NIP. The majority of parents/caregivers had a positive perception regarding Hexaxim® vaccine in various aspects.

    CONCLUSIONS: Incorporation of Hexaxim® within Malaysian NIP is highly recommended because the use of Hexaxim® has demonstrated substantial direct and indirect cost savings for healthcare providers and parents/caregivers with a high percentage of positive perceptions, compared with Pentaxim® plus hepatitis B.

    TRIAL REGISTRATION: Not applicable.

    Matched MeSH terms: Diphtheria-Tetanus-Pertussis Vaccine*
  3. Med J Malaya, 1959 Mar;13(3):248-60.
    PMID: 13666194
    Matched MeSH terms: Diphtheria-Tetanus-Pertussis Vaccine*
  4. Wong SL, Soosai P, Teoh YL, Han HH, Lefevre I, Bock HL
    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: Diphtheria-Tetanus-Pertussis Vaccine/administration & dosage*; Diphtheria-Tetanus-Pertussis Vaccine/adverse effects; Diphtheria-Tetanus-Pertussis Vaccine/immunology
  5. Michal Christina Steven, Jeffery Stephen
    Introduction:The incidence of pertussis has been said to increase over the years, and the affected patient-age group has also changed with the increasing number of cases amongst adolescents and adults. Therefore, adults require booster vaccination for protection against pertussis infection. Vaccination among healthcare workers (HCW) should be prioritized when a country implements an adult vaccine. However, the coverage of pertussis vaccination is still deficient among HCW due to low-risk perception. This study focused on finding the risk perception of pertussis in-fection amongst the HCWs based on the Protection Motivation Theory (PMT) and their acceptance to take pertussis vaccination. Methods: This was a cross-sectional study using online survey. The website link is given to the Health-care workers consisting of doctors, Assistant Medical Officers, nurses, and Environmental Health Officers. Results: A total of 853 responders responded to the questionnaire. Most of the respondents (81.5%) are willing to receive the pertussis vaccine. Independent t-test showed that the PMT score was significantly different between those willing and those not willing to take the vaccine (p-value < 0.001, t statistics (df)= 7.729 (325). Robust path analysis showed that sociodemographic factors (age, the institution of working and prior pertussis vaccination) (p=0.004), threat (p
    Matched MeSH terms: Pertussis Vaccine
  6. Michal Christina Steven, Jeffery Stephen
    Introduction: Pertussis is known to cause infection and reinfection to everyone irrespective of ages and countries. Therefore, adults do require vaccination for protection against pertussis infection especially the HCW. However, the pertussis vaccine coverage is low among HCW due to low-risk perception. Protection Motivation Theory (PMT) is one of the most cited theories to explain risk perception and intention to change. Therefore, we developed a questionnaire based on the subconstructs of the PMT to assess the acceptance of the pertussis vaccine amongst the HCWs in Sabah and Sarawak. The motive of this study is to validate this questionnaire to see its validity and reli- ability. Method: Data was collected using a self-administered questionnaire via an online survey (Monkey Survey). The questionnaire was given to 250 HCW. Items that were identified as a problem were modified to increase reli- ability. Further validation was done among 853 HCWs working in various parts of Sabah and Sarawak. Results: The Cronbach alpha of the overall construct of PMT during the first pilot study was 0.66 and improved to 0.82. Principal components factor analysis using varimax rotations showed that the first four factors explained 28%, 2%, 9% and 5% of the variance respectively. Both the one level and two-level modelling indicated that it’s a good fit model. Conclu- sion: The study instrument that was developed for the study has been tested and proven to be relevant to assess the risk perception of an HCW towards pertussis.
    Matched MeSH terms: Pertussis Vaccine
  7. Wan Jamaludin WF, Kok WH, Loong L, Palaniappan SK, Zakaria MZ, Ong TC, et al.
    Med J Malaysia, 2018 12;73(6):430-432.
    PMID: 30647224
    Immune Thrombocytopenia Purpura (ITP) secondary to vaccinations is rare, especially after autologous hematopoietic stem cell transplantation (HSCT). A 31-yearold female received autologous HSCT for relapsed Hodgkin Disease, with platelet engraftment at Day+14. One week after receiving second scheduled vaccinations, she developed severe thrombocytopenia (3x109/L) associated with pharyngeal hematoma. Bone marrow (BM) examinations were consistent with ITP, possibly secondary to Influenza vaccine. Platelet increment was poor despite high dose corticosteroids, intravenous immunoglobulin (IVIG), Danazol and Eltrombopag. A repeated BM biopsy was in agreement with ITP. Re-treatment with tapering doses of prednisolone resulted in stable platelet counts at 120x109/L a year later.
    Matched MeSH terms: Diphtheria-Tetanus-Pertussis Vaccine/adverse effects
  8. Hamat, R.A., Malina, O., Chua, Y.J., Seng, K.L., Zubaidah, M., Norhanim, K., et al.
    Little is known about the sero-prevalence of diphtheria anti-toxoid antibody levels among medical students in Malaysia. They too, just like other health care workers (HCWs) are at risk of contracting and transmitting diphtheria. Fortunately, this can be prevented by giving a specific vaccine: the diphtheria, tetanus and pertussis (DTP) vaccine. Nonetheless, data from local or regional surveys are needed before any decision is made by the respective authorities. General objective: We studied the epidemiology of diphtheria anti-toxoid antibody levels and vaccination history amongst medical students and staff in Faculty of Medicine and Health Sciences, Universiti Putra Malaysia. Specific objectives: We determined the level of diphtheria anti-toxoid antibodies amongst pre-clinical students and staff. Methodology: A total of 152 sera were collected from subjects aged 19 to 63, and diphtheria anti-toxoid levels were measured by an enzyme-linked immunosorbent assay. Results: One hundred and fifty-two (94.4%) blood samples out of 161 participants were successfully withdrawn, which comprised 105 (69.1%) and 47 (30.9%) medical students and staff, respectively. A total of 77.6% and the other 22.4% of the subjects had full and basic protection, respectively. Higher levels were predominant amongst males and they were 1.3 times more protected than females in 20-29 year-old group (85.1% vs 66.2%; odd ratios 1.25 [95% CI 1.03-1.50]; P=0.03). No significant difference in the levels of immunity among subjects for ethnicity and academic position (P>0.05). Recommendations: Level of full protection against diphtheria toxin should be clearly defined by broad population based studies using several comparable detection methods. Medical students and staff with basic protection should be closely monitored or should be given a booster dose for those who are at high risk of acquiring the disease. Thus, a standard degree of coverage should be clearly determined for health workers to prevent a potential outbreak. Conclusion: Students and staff possess immunity towards diptheria toxin however the level of full protective antibody is yet to be determined in future.
    Matched MeSH terms: Pertussis Vaccine
  9. Suleiman N, Shamsudin SH, Mohd Rus R, Draman S
    J Pharm Bioallied Sci, 2020 Nov;12(Suppl 2):S696-S702.
    PMID: 33828363 DOI: 10.4103/jpbs.JPBS_255_19
    Introduction: Practice of dispensing paracetamol (PCM) in post infants' vaccination remains debatable in Malaysia as the administration of PCM postvaccination in infants was found to cause the vaccine to be less effective, thus requiring appropriate regulation measures.

    Objective: This research aimed to investigate the prevalence of adverse events following immunization (AEFI) with/without PCM to be prescribed post infants' vaccination in Malaysia (possible associated factors: age, types and stages of vaccination, concomitant vaccines and drugs, and/vitamins).

    Materials and Methods: A retrospective cross-sectional study was conducted from 2011 to 2017. The AEFI was extracted from Quests 2, 3, and 3+ System of National Pharmaceutical Regulatory Agency (NPRA). The population of vaccinated infants was obtained from the Ministry of Health (MOH) Malaysia official website. The AEFI data were further categorized into (i) AEFI with possibility for PCM to be prescribed, and (ii) AEFI with no possibility for PCM to be prescribed. The data were analyzed using Microsoft Excel 2013, Portland, USA simple and multiple logistic regression tests, Statistical Package for the Social Sciences (SPSS) software programme, version 22.0 (IBM), New York, USA.

    Result: Various AEFI cases (359 infants) were reported. DTaP/Hib/IPV and measles-mumps-rubella (MMR) showed higher prevalence of AEFI with/without PCM to be prescribed post infants' vaccination cases per 100,000 population (2.07 and 2.21, respectively) than other types of vaccinations. DTaP/Hib/IPV (2 months) vaccination showed the highest value (3.00) among other age groups. Backward elimination presented DTaP/Hib/IPV (3-4 months) (95%CI; 0.231, 0.899%; P = 0.023) was the possible associated factor. Hepatitis B (1-5 months), DTaP/Hib/IPV (3-4 months), DTaP/Hib/IPV (5-12 months), concomitant vaccines as well as concomitant drugs and/ vitamins were the identified potential cofounders.

    Conclusion: Prescribing and dispensing of PCM post infants' vaccination may be confined to DTaP/Hib/IPV (2-4 months) and 12 months MMR groups.

    Matched MeSH terms: Diphtheria-Tetanus-Pertussis Vaccine
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