Vaccinating children: Consider all instances first

Dr Helmy Hazmi

KUCHING: Inoculation for children below the age of 12 in the state should be encouraged as data suggested that it is safe and effective, although there are several instances that must be considered, said public health physician Dr Helmy Hazmi

He was commenting on Datuk Seri Dr Sim Kui Hian urging the Malaysia National Pharmaceutical Regulatory Authority (NPRA) on Wednesday to take immediate steps to vaccinate children below the age of 12.

Dr Sim, who is Sarawak Disaster Management Committee (SDMC) advisor, said recent research publications of the use of the vaccines on children in the age group have been encouraging.

On this, Dr Helmy said that Pfizer and BioNTech on Monday announced that their vaccine was safe, well-tolerated, and resulted in strong neutralising antibody responses in children aged five to 11.

Therefore, Dr Helmy said that while he is in favour of immunising children, the needs of the community must be weighed and prioritised by making the best use of the resources available.

“We are currently facing two situations in the state — giving a third dosage to the elderly who are immunocompromised and have several underlying medical issues, or administering the first dose to children,” he said.

The Associate Professor with the Faculty of Medicine and Health Sciences in Universiti Malaysia Sarawak (Unimas) said that the immunisation goals for both groups were distinct.

He said that inoculation among children is aimed towards preventing infection both among themselves and with others which is consistent with the idea of ‘vaccinating the unvaccinated first’, and seemed more effective than giving a third dose to fully vaccinated individuals.

“Despite the fact that the Covid-19 death rate in children under the age of 18 is about 0.02 percent, there are reports suggesting that the infection rate in children has climbed by nearly 30 percent over the previous year,” he said.

On the possible effects of Covid-19 infection on children, Dr Helmy said that in most cases, infected children only showed minor symptoms such as fever and cough just as adults’ infection are, and they could also be asymptomatic.

“Nevertheless, there is a possibility that children will be severely infected and that will hospitalisation, especially for children of high risk such as those born prematurely, are obese, or have underlying health problems such as asthma or diabetes,” he said.

He also added that Covid-19 infection could cause a rare complication in children, namely the Multisystem Inflammatory Syndrome in Children (MIS-C).

“The Kawasaki disease-like disorder causes serious illness in children due to inflammation in the heart, blood vessels, and different organs,” he explained, adding that information on MIS-C was still scant but the medical field is continually studying it.

“In Malaysia, there have been a few cases of MIS-C documented and it is possible that this is only the tip of the iceberg.

“We might see more if there are more affected youngsters. More data is needed, and this could be a compelling reason to vaccinate youngsters as soon as possible,” said Dr Helmy.

Meanwhile, he said that the third dosage for the immunocompromised elderly with multiple comorbidities is aimed towards reducing hospitalisation, severity of infection, and mortality.

“When compared to other states, Sarawak has 3.2 deaths per 100,000 people, which is fourth from the bottom in the country; however, we cannot say that we are happy with this figure.

“Intensive care unit (ICU) and ventilator utilisation, on the other hand, are at 84.7 percent and 60.9 percent respectively, and the trend is incremental in recent weeks,” he said, adding that it was important to take note of these values, given that almost 90 percent adults were fully vaccinated.

Dr Helmy said that if the state is still planning to vaccinate children under the age 12 in the near future, children with underlying medical conditions should be prioritised as they have the worst outcome from Covid-19 infection.

“As for healthy children, we might want to consider including them into the National Immunisation Programme,” he said.

At the same time, Dr Helmy opined that vaccination for both groups could be implemented simultaneously if the state could provide it.