Overview of Malaysia’s ageing landscape
In Malaysia, the percentage of individuals aged 65 and above will increase from approximately 7% in 2022, to 17% in 2050, transforming the demographic status from an ageing to aged society.[i]
With an ageing population, there will be a greater demand in healthcare and eldercare services to treat chronic and infectious diseases, as the likelihood of developing serious complications increases as individuals age due to frailty and weakened immune systems. For example, older adults are disproportionately affected by influenza, with those aged 65 and above accounting for up to 70% and 85% of influenza-related hospitalisations and mortality, respectively.[ii] This means that there is an urgent need to keep populations healthy, by focusing on preventive health such as life-course immunisation.
Tracking the progress of Malaysia’s healthy ageing and life-course immunisation agenda
Despite the benefits of vaccination, Malaysia has yet to recognise the importance of life-course immunisation as an important pillar of healthy ageing – Malaysia does not have a population-wide adult immunisation programme, as the National Immunisation Programme currently focuses on childhood vaccination.
The Ministry of Health in Malaysia has a list of recommendations for adult immunisation, including for high-risk groups, such as older adults and those with chronic conditions.[i] For example, annual vaccination against influenza is recommended for all individuals aged 6 months and above throughout the year. The third edition of the guidelines from the Malaysian Society of Infectious Diseases and Chemotherapy further recommends annual influenza vaccinations for older adults in nursing homes and hospital wards.[ii] While these recommendations exist, they are not widely conveyed or implemented, as they are not mandatory nor provided for free or subsidised.
As such, the uptake beyond childhood vaccination is low in Malaysia. For example, the estimated coverage of influenza vaccination among adults is 3%.[iii] This is still far below the coverage rate in other ASEAN Member States and the target set out by the World Health Organization at 75% to prevent annual epidemics.[iv]
That said, Malaysia has strengthened its policies in proactively addressing the impact of ageing populations. In Malaysia, the topic of healthy ageing has been articulated in various ministerial policy and development papers. In 2011, the National Policy for Older Persons was implemented by the Ministry of Women, Family and Community Development, which complemented efforts by the Ministry of Health’s National Health Policy for Older Persons in 2008.[v]
There is an opportunity to tap into these existing policies in order to strengthen the life-course immunisation agenda in healthy ageing.
Key challenges and solutions
At a 2022 roundtable discussion among various stakeholders in Malaysia, supported by Ageing Asia and Sanofi, experts discussed the key challenges and solutions including:
Recognising the importance of life-course immunisation
While Malaysia doesn’t yet have a population-wide adult immunisation programme, the country has progressive policies in addressing the coming challenges of an ageing demographic, and have learnings from a highly successful paediatric immunisation programme to leverage off in applying the learnings to a life-course immunisation programme.
Awareness and education
Awareness and understanding of the benefits of vaccination and the impact and complications of vaccine-preventable diseases remains low among the public, compounded by low advocacy from healthcare professionals.
Materials
Malaysia Key Takeaways – ‘The Decade of Healthy Ageing in ASEAN: Role of Life-course Immunisation’
Malaysia Key Takeaways and Action Plan – ‘Healthy Ageing and Life-course Immunisation Policy Dialogue’
Overview References:
[i] United Nations, Department of Economic and Social Affairs, Population Division. (2019). Probabilistic Population Projections Rev. 1 based on the World Population Prospects 2019 Rev. 1. [Online]. Available from: http://population.un.org/wpp/
[ii] Centers for Disease Control and Prevention (CDC). (2022). Flu & people 65 years and older. [Online]. Available from: https://www.cdc.gov/flu/highrisk/65over.htm [Accessed July 2022].
[iii] Ministry of Health Malaysia. (2022). Immunization schedule for the elderly. [Online]. Available from: myhealth.gov.my/en/immunization-schedule-for-the-elderly/ [Accessed July 2022].
[iv] Malaysian Society of Infectious Diseases and Chemotherapy. (2020). Guidelines for adult immunization: 3rd edition. [Online]. Available from: https://adultimmunisation.msidc.my/read-book/ [Accessed July 2022].
[v] Kamaruzzaman SB, Pang Y-K, Sekawi Z, et al. (2021). Perspectives on influenza in older adults in Malaysia: Insights into action on vaccination for high-risk adults. Ipsos. [Online]. Available from: https://www.ipsos.com/sites/default/files/ct/publication/documents/2021-06/Final_Perspectives%20Paper%20of%20Flu.pdf [Accessed July 2022].
[vi] World Health Organization. (2003). Fifty-sixth World Health Assembly: WHA56.19: Agenda item 14.14: Prevention and control of influenza pandemics and annual epidemics. [Online]. Available from: https://apps.who.int/iris/bitstream/handle/10665/78320/ea56r19.pdf [Accessed June 2022].
[vii] Radhi NAM & Arumugam T. (2019). Are we ready for an ageing Malaysia? New Straits Times. [Online]. Available from: https://www.nst.com.my/news/exclusive/2019/12/548012/are-we-ready-ageing-malaysia [Accessed July 2022].