Vaccinate Against Rotavirus

This commentary, authored by Drs. Mathuram Santosham, Zulkifli Ismail, and Lee Way Seah, originally appeared in The Star on September 17, 2015.

From Kuala Lumpur to New York, global leaders are gathering this month to discuss the future of health and development. Critical to achieving the health goals launched at the UN General Assembly will be the paediatric issues discussed here in Malaysia this week, because preventable disease in children is still a serious public health – and economic – problem in much of the world.

Take diarrhoea, for example. Diarrhoea is a leading cause of child illness and death, and rotavirus is the most common cause of severe diarrhoea.

Addressing diarrhoeal disease, and rotavirus in particular, is key to improving child health here and in countries around the globe.

Annually, rotavirus results in dozens of deaths and more than 8,500 hospitalisations for gastroenteritis in Malaysian children under the age of five years.

These illnesses can have devastating consequences. Children who recover from a serious case of diarrhoea are more susceptible to the next illness that strikes. And since it takes two months for the intestine to fully repair itself after a bad bout of rotavirus, children cannot absorb nutrients as well, which can slow their growth during crucial stages of development.

In addition, treating rotavirus is expensive for both families and the nation. The typical out-of-pocket cost of hospitalisation for rotavirus in a 2006 study was RM833, and ranged up to RM3,170 – more than one quarter of the average monthly income of households surveyed.

Costs extend beyond hospital fees, since parents would miss many days of work each time their child is hospitalised with rotavirus. Children with rotavirus illnesses are likely to be severely dehydrated upon admission to hospital.

Because children can become infected with rotavirus and other causes of diarrhoea more than once, preventing illness in the first place is critical.

Vaccination is the best way to protect children from rotavirus. While improvements in hygiene, sanitation and drinking water are important to prevent diarrhoea in general, they cannot stop the spread of rotavirus.

Though the World Health Organization has recommended that rotavirus vaccines be introduced into every country’s national immunisation programme, in Malaysia the vaccines are only available in the private market. This means parents have to pay full price for the vaccine, so it can be out of reach for many families.

These vaccines are improving the health of millions of children, reducing healthcare costs and saving lives today in countries where they are in use. In the first four years of use in the United States, rotavirus vaccines prevented more than 176,000 hospitalisations, 242,000 emergency department visits and 1.1 million doctor’s visits among children under five years old, saving nearly US$1bil in healthcare costs. Two years after the introduction of the vaccine in Australia, there were over 6,500 fewer rotavirus-related hospitalisations in children under five years old. And in clinical trials in Asia, rotavirus vaccines were shown to reduce the risk of severe rotavirus diarrhoea by more than half – 51% – in the first year of life when children face the greatest risk of infection.

Globally, 77 countries have introduced rotavirus vaccines into their national immunisation programmes, including Muslim countries like Bahrain, Iraq, Morocco, Qatar, Saudi Arabia, Sudan and Yemen. Yet, not a single Asian country has introduced rotavirus vaccines nationally.

It’s time to protect all children from a disease that places tremendous burden not only on babies and small children who are hospitalised and sick, but also on the parents who worry at bedsides and shoulder the cost of treatment. The illnesses, anguish and hospitalisations can be prevented in the first place through vaccination.

We call on Malaysian and Asian leaders to stand up for our children by introducing rotavirus vaccines into national immunisation programmes. By doing so, we can take significant strides toward achieving the new global health goals.

Millions of children around the world have already benefited from these vaccines. Millions here in Asia depend on us. Let’s not let them down.

This commentary was also highlighted in Global Health Now on September 22, 2015.