PETALING JAYA: As vaccines for children are only expected to be available at the end of June 2022, health experts warn of difficult months ahead as the young ones continue to be vulnerable to Covid-19.
Consultant paediatrician Datuk Dr Amar-Singh HSS said if the country does not move to vaccinate its population of five to 11 years old quickly, Malaysia may see more deaths and hospitalisations in this age group next year.
Currently, over 10% of all new Covid-19 cases occur in children aged between five and 11 years, said Dr Amar, adding that as at the end of November, 116 children were reported to have died since the beginning of the pandemic.
“Of this, 38 were aged zero to four years, 32 aged five to 11 years and 46 aged 12 to 17 years. And 85% of deaths have occurred since July 2021, showing the impact of the Delta variant on children.
“A total 28 of the 32 deaths in the 5 to 11 years age group occurred between July and October this year, averaging seven deaths per month and this happened even with all schools and kindergartens closed.
“As primary schools and kindergartens reopen, we can expect seven to 10 deaths monthly, or possibly more, for the next six to eight months in this age group.
“This does not take into account the one in 100 infected with Covid-19 that will be hospitalised, some seriously ill, with multisystem inflammatory syndrome of children (MIS-C), and the risk of Long Covid,” he said in a statement yesterday.
Among the signatories of the statement were consultant paediatricians Dr Hung Liang Choo, Datuk Dr Musa Mohd Nordin and Datuk Dr Zulkifli Ismail.
Malaysia must find another way to protect children from the virus, because as more adults and adolescents get vaccinated and schools and kindergartens open up, it can also be expected that this unvaccinated population of young children will have more infections, said Dr Amar.
“Note that adolescents aged 12 to 17 years now only account for 3.9% of cases due to the high rate of vaccine uptake,” he said.
Dr Amar said one suggestion is to give the Pfizer vaccine for teenagers or adults to children aged five to 11 years at a smaller dose because the vaccine approved for children is identical to that of older persons, except that children only need to be given 10mcg instead of 30mcg.
“The reduced dose Pfizer vaccine for young children is repackaged, not just a lower dose schedule but contains a different buffer allowing longer refrigeration at higher temperatures. Hence, it is the same vaccine, just repackaged.
“The problem will be that if Malaysia uses the adult formulation, it will be considered off-label use by the company,” said Dr Amar.
This means that it may open the government to litigation and should Malaysia opt for this approach, there will be a need for parental understanding and consent, and the National Pharmaceutical Regulatory Agency (NPRA) will also need to give conditional approval for such a move, he said.
As at Friday, 97.2% of the country’s adult population had been fully vaccinated against Covid-19, while for adolescents aged between 12 to 17, it stood at 86.9%, according to the Health Ministry’s CovidNow website.
However, the total population fully vaccinated is at around 78.1% while experts suggested that this may need to be over 80% due to the high transmissibility of Covid-19.
On Nov 22, Health Minister Khairy Jamaluddin was reported as saying that Malaysia is only expected to receive delivery of Covid-19 vaccines for children aged five to 11 towards the end of the second quarter of next year.
Prof Dr Moy Foong Ming from Universiti Malaya’s faculty of medicine said although the individual benefits of vaccination are lower among this group of young children compared to adults, as a majority of infected children only suffer mild disease, the risk of infection and its complications still greatly outweigh the risk of not getting vaccinated.
“Besides, we need to consider the population benefits such as the indirect protection of vulnerable members of the same household or class or school.
“Vaccination of this group of schoolgoing children will reduce the risk of disruptions to face-to-face schooling and other educational activities,” she said.
However, she noted that the government should take note of possible vaccine hesitancy by parents and start early to alleviate the parents’ worries by having an open dialogue.