Page 18 - nhms2016 maternal and child findings

4
National Health And Morbidity Survey 2016 : Maternal And Child Health (MCH) Volume II : Findings

higher amongst non-Malaysians (6.9%) compared to Permanent Residence and Malaysians. Those
with head of household without formal education had the highest incomplete Hepatitis B vaccination
(6.5%) compared to other education levels.

A total of 87.3% of children aged 12-23 months were verified as having received MMR vaccination,
with additional 9.3% self-reported as received MMR. Among those children aged 12-23 months, 3.4%
were found as not vaccinated against MMR (Table 4.1.2.6). The prevalence was highest in WP Kuala
Lumpur (6.0%), followed by Sabah (4.9%) and Selangor (4.7%). By profile, the non-vaccinated were
higher among non-Malaysian (10.5%), and those with head of household with no formal education
(15.8%).

Overall, 86.4% children were verified as having received complete primary vaccination by the age of
12 months, with an additional 8.9% self-reported as having completed their child’s primary
vaccination. A total of 4.5% of children received some vaccinations but did not complete all scheduled
primary vaccination by the age of 12 months, and 0.1% had not received any vaccination (Table
4.1.2.7). The prevalence of children with incomplete primary vaccination was highest in Selangor
(7.3%), followed by WP Kuala Lumpur (7.2%) and Sabah (7.2%). Incomplete vaccination was higher
among those residing in urban areas as compared to those in rural areas (5.3% vs 2.9%). By profile,
those who did complete their primary vaccination were those with mothers who do not have any
formal education (18.0%) and non-Malaysians (10.9%). Top three reasons given for incomplete
vaccination were lack of time (19.9%), the child being unwell (17.3%), and financial or geographical
barriers (16.6%). A total of 1.3% were due to vaccine refusal, 4.0% refused vaccination, 2.4% worried
about side effects, 2.1% did not trust the vaccine, 1.3% were doubtful about the halal status of the
vaccine, 0.9% due to religious beliefs and 0.6% had a previous bad experience (all these were
considered as decision by themselves) (Table 4.1.2.8). 6.2% of those who did not complete their
primary vaccination were due to different schedules used by private facilities, where MMR vaccine
was given later in life (Table 4.1.2.8).

A total of 6.2% children received more than 50% of their vaccination at private facilities. The
prevalence was higher in urban areas compared to rural areas (8.3% vs 2,0%). It was highest in WP
Kuala Lumpur (20.3%), followed by Selangor (14.4%) and Johor (5.8%). Examining the profiles of
these children, they had mothers who had completed their tertiary education and with higher
household income (Table 4.1.2.9). Top three reasons given for their preference were; shorter waiting
times (43.9%), only able to go to clinic for vaccination during weekends (22.0%), and panel doctors
(20.6%), as shown in Table 4.1.2.10.

When asked about their source of information about vaccination, majority (89.4%) mentioned doctors
as their source, with 1% get information from electronic news or website and with 0.6% reported
social media as their primary source (Table 4.1.2.11). Majority of the mothers do not have concern
on any vaccine. However 0.6% mothers had concern on MMR vaccine (Table 4.1.2.12). Majority of
the mothers believe that vaccines are protective, can prevent spread of disease, and are safe; 98.5%,
98.1%, and 98.2%, respectively.

Majority of them (98.5%) also reported that healthcare providers explained the side effects of the
vaccine. They were also receptive towards the introduction of a new vaccine with 97.0 % response
(Table 4.1.2.13).

4.1.3. Conclusion

In general, overall prevalence of children aged 12-23 months who completed their primary vaccination
was more than 90%, however only 86.4% were verified with vaccination cards. Incomplete primary
vaccination was higher among those with low education and non-Malaysians. About one-fifth of those
with incomplete vaccination were due to accessibility problems and one-tenth due to vaccine refusal.