Abstract
Background: Following the death of two unvaccinated siblings, eleven months and two years old of diphtheria in June 2016, the Ministry of Health Malaysia is now emphasizing the need to enforce compulsory childhood vaccination in Malaysia. Vaccination is the main health intervention to reduce child mortality. Despite the success of vaccination, there has been an increase in the number of vaccine hesitancy, especially among parents. Research has identified many factors associated with parental vaccine refusal and hesitancy toward childhood vaccination, which varies from religious, medical as well as personal belief factors. This complicates matters as childhood vaccination involves a balance between parents’ autonomy in deciding whether to vaccinate their children and the benefits to public health. Between parental autonomy in deciding to vaccinate their children and the benefits of vaccination to public health, which will prevail? Objective: This paper seeks to examine the ethical issues of enforcing compulsory vaccination for children in Malaysia. Results: if Malaysia were to come up with a legal framework of compulsory childhood vaccination, reference can be made to the legislated statutes in other countries, taking into account that some provisions such as exemptions to vaccination may be modified to suit it with Malaysian local circumstances and inhabitants. Conclusion: In improving health communication, aside from two way communications between parents and health officers, many other communication tools are also available. They include mass electronic media, digital media, print media, social mobilization and mobile technology.
Highlights
Unvaccinated individuals pose a public health threat to the society at large
PARENTAL AUTONOMY VERSUS PUBLIC HEALTH The parents approach to vaccination by making a decision based on parental autonomy places strong emphasis on the freedom, privacy and informed consent of parents in vaccine decision making
In the case of childhood vaccination, patient autonomy comes in the form of parental autonomy as parents are the one who can make decisions with regard to their children medical needs, even if that decision is a refusal to accept medical treatment i.e. vaccination
Summary
Unvaccinated individuals pose a public health threat to the society at large. The World Health Organization estimates that vaccines for diphtheria, pertussis, tetanus, and measles save between two and three million lives every year. The environmental factors included logistic barriers, limited accessibility to health care due to poor roads or inadequate public transportation, preparedness of community for immunization sessions and information dissemination among the community (Azhar, et al, 2012) It can be concluded from the studies that parents demand the autonomous right to make decisions regarding their child's vaccinations, they perceive their refusal as characteristic of good parenting, and they are critical of and distrust the medical establishment. Research has identified many factors associated with parental vaccine refusal and hesitancy toward childhood vaccination, which varies from religious, medical as well as personal belief factors This complicates matters as childhood vaccination involves a balance between parents’ autonomy in deciding whether to vaccinate their children and the benefits to public health. They include mass electronic media, digital media, print media, social mobilization and mobile technology
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