6.3 12-23 months did not complete their primary immunization

6.3 Benefits of childhood vaccination
towards children and societies.

            Awadh et al. (2014) stated that vaccine
was a preventive medicine that can avoid antibiotic resistance, empower women,
protect against bioterrorism, travel safely and mobility economic growth,
equity and peace and also increase life expectancy. Meanwhile, State of The
World’s Vaccines and Immunization which was a collaboration between WHO, UNICEF and World Bank (2009) found that
vaccines maintained human’s immune system by removing a major obstacle to human
development, it provided benefits toward all communities and entire population,
its impact more rapid than other health intervention programme in communities
and populations and lastly, vaccines were life-saving and cost-saving. This evidence
of powerful vaccines could be approved by United States’ Centers for Disease
Control and Prevention (CDC) that put vaccination at the top of its list of ten
great public health achievements of 20th century.

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6.4 Reasons of increasing of vaccine
hesitancy among populations

Based on report of Strategic
Advisory Group of Experts (SAGE) on vaccine hesitancy (2014), vaccine hesitancy
was defined as “delay in acceptance or refusal of vaccines despite availability
of vaccinations services. Vaccine hesitancy is complex and context specific,
varying across time, place, and vaccines. It is influenced by factors such as
complacency, convenience, and confidence”.

Anti-vaccine
conspiracy theories had significant and detrimental consequence. They reduced
intention by triggering about danger of vaccines and increasing powerlessness,
disillusionment and mistrust (Jolley & Douglas, 2014). Sutan et al. (2017)
also found that anti-vaccine movement used internet as a tool to disseminate
their arguments by providing misconception of childhood vaccination towards
community.

Ahmad et al. (2017) stated that 4.6%, which about
23 610 children aged 12-23 months did not complete their primary immunization
and did not receive any immunization. While 8.6% had completed their
vaccination for being immune but did not document and verify the data. Malaysia
had higher prevalence of incomplete immunization than United Kingdom but lower
than Vietnam, Thailand and countries in Africa regions. Meanwhile, Lim et al.
(2016) reported that rate of 
immunisation refusal was 3 per 10,000 children per year and immunization
defaulters’ rates was 30 per 10,000 children per year respectively, which most
of them missed MMR, third dose of HepB and third dose of DRaP/IPV/Hib. 87.5%
children from refusal group missed two or more vaccines while defaulter group
might miss one vaccine, which is 61.3%.

Moreover, Ahmad et
al. (2017) found that girls were prone for not having incomplete vaccination
due to they were more susceptible to get side effect of vaccine. Families from
urban areas, mothers that received pregnancy care at private clinics and did
not trust efficiency of vaccine in preventing disease are generally their
children did not complete primary immunization. This was because some private
clinics might have different immunization schedule and limited stock of
vaccine. Even though, many interventions were held such as reminder system,
community based education, incentives and immunization policies but it did not
effective to reduce anti-vaccination movement from parents.   

            Awadh et al. (2014)
conducted their study in Pahang only was concluded that parents who had
moderate knowledge about immunization were good in practise immunization while
young parents, which below 20 years old, lived in rural area and unemployed
parents had low level of knowledge about immunization due to did not have a lot
of experience and received good education. However, other demographic
parameters did not affect practise of childhood immunization such as gender,
race, religion and family size.