Professional Documents
Culture Documents
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Immunisation
Smallpox
•Caused by variola virus
•20-50% mortality
•Most survivors scarred with residual facial
marks, some left blind
Faces of the last cases of Smallpox**
1980
WHO, Peter
CDC/Barbara Rice
Davies
Videos
• Smallpox will kill you
• Smallpox patients
POLIO
POLIO 1919 ----------2000
12
Polio
13
Videos
• Growing up with Polio
• The Polio Story
• The Iron Lungs
PERTUSSIS
Videos
• The 100-day cough
• Elijah
• Pertussis
• Pertussis
DIPHTHERIA
DIPHTHERIA
Jenner 1749-1823
DARK AGE OF EUROPE 5-15 RENNAISANCE AND AGE OF SCIENTIFIC GLORY
1990
Hepatitis B
Rubella 1989
Measles 1986
1982
1980
Polio
1972
1970 Others to come:
DTP BCG • PCV ?
1960 1961 • RV ?
1960 • Meningococcal ?
Smallpox • Dengue ?
1950
1950
2009 Malaysian Immunisation Schedule
Birth 1mth 2mth 3mth 5mth 6mth 12mth 18mth 7yrs 15yrs
BCG
Hep B
DTaP
IPV
Hib
MMR
Sabah
Measles only
DT
Tetanus
Latest MoH
Immunisation
Schedule
Vaccine successes
Polio - worldwide Measles - US
60
Reported cases (000s)
40
EPI implemented
20 Vaccine introduced
40
Vaccine introduced
20
Antibody
• Protein molecules (immunoglobulin) produced
by B lymphocytes to help eliminate an antigen
Principles of Immunization
Active
• Protection produced by the person's own immune
system, “usually” permanent
• Immunity and immunologic memory produced,
similar to the natural infection but without the risk of
disease
Passive
• Protection transferred from another person or animal
as antibody
• This will afford temporary protection
• In infancy, transplacental transfer is the most
important source
Active
39
Passive
40
Cara Bertindak
Serangan 2 Organisma
41
Sources of Passive Immunity
• Almost all blood or blood products
• RSV-IGIV
– Human hyperimmune globulin
– Contains other antibodies
• Palivizumab (“Synagis”)
– Mouse monoclonal
– Contains only RSV antibody
Classification of Vaccines
viral or bacterial
• Live attenuated
• single dose e.g., BCG (related org, shared antigens)
• two doses if immunity likely to wane over time, e.g.,
rubella, measles
• three doses for a different reason: oral polio in
primary schedule because there are 3 serotypes of
poliovirus
• Inactivated
• multiple doses; a course typically consists of 3 doses,
+/- a subsequent booster
• primary response, secondary response
Live vaccine
• Attenuated agent (unstable)
• Amplification of response - gradual rise to peak response
then decline
• Variable but “long” duration of immunity -the immune
response produced is similar to that produced by the
natural infection
• protein-based
– subunit
– toxoid
• polysaccharide-based
– pure
– conjugate
Inactivated Vaccines
• Cannot replicate
• There will be minimal interference from circulating
antibody
• In general they are not as effective as live vaccines
• pneumococcal
• meningococcal
• Haemophilus influenzae type b
• No booster response
350
300
Number of measles cases
250
200
150
100
50
0
Jul
Jul
Jul
Jul
Jul
Apr
Apr
Apr
Apr
Apr
Jan
Mar
Jun
Jan
Mar
Jun
Jan
Mar
Jun
Jan
Mar
Jun
Jan
Mar
Jun
Aug
Aug
Aug
Aug
Aug
Feb
Sep
Feb
Sep
Feb
Sep
Feb
Sep
Feb
Sep
Oct
Oct
Oct
Oct
Oct
Dec
Dec
Dec
Dec
Dec
Nov
Nov
Nov
Nov
Nov
May
May
May
May
May
2008 (N=332) 2009 (N=56) 2010 (N=74) 2011 (N=1573) 2012 (N=2112)
Lab & Epi=110 Lab & Epi=55 Lab & Epi=70 Lab & Epi=1530 Lab & Epi=1720
Clinically=222 Clinically=1 Clinically=4 Clinically=43 Clinically=392
100
Milligrams
80
60
40
20
0
Breast Milk Vaccine Breast Milk Influenza
100
Milligrams
80
60
40
20
0
Breast Milk Formula Soy Formula Vaccines
80
Example of content in vaccine insert
• Active ingredient:
– A weakened form of chickenpox virus
• Inactive ingredient:
– Sucrose, hydrolysed gelatine, sodium chloride,
monosodium L-glutamate, sodium phosphate
dibasic, potassium phosphate monobasic,
potassium chloride, residual components of MRC-
5 cells including DNA and protein, sodium
phosphate monobasic, EDTA, neomycin, fetal
bovine serum.
Medical Research Council (MRC)-5
• Lung fibroblasts, taken from a 14-week old foetus. Aborted
due to serious maternal indication. Harvested in September
1966, in National Institute for Biological Standards and
Control, Hampstead Laboratories, Holly Hill, London, England
(Jacobs, J.P., Journal of Biological Standardisation, 1976, 4, 97-99)
• Foetal cells are used as they are able to replicate much more,
42-48 times before senescence
• Foetal cells are used for viral replication, unlike bacterias,
viruses are more difficult to culture, and some virus only
replicates in human cells.
• Now, no more foetal cells used, as the foetal cells harvested in
1960s are still kept and still duplicating
• It is not used as an ingredient, but used as a culture media
IMPORTANT ISLAMIC CONCEPTS
Concept of Dhorar (harm)
• Quranic Verses:
– Allah wants for mankind ease, and not difficulties
(Al-Baqarah)
– Don’t throw yourselves into disasters and
difficulties
• Purpose of sharia: to promote goodness and
prevent badness and difficulties (jalb al-
masalih wa dar’u al-mafasid)
Concept of Dhorar (harm)
• Fiqh Concepts and application
– Do not harm, or cause harm (la dhoror wa la
dhiror)
– Harm, permits the unlawful (adh-dhroruratu tubih
al-mahzurah)
– Harm (and the things it permits) are limited to its
limts (adh-dhoruratu tuqaddaru biqadariha)
Concept of origins
• The original rulings for anything is
‘permissible’ (al-aslu fi-l-ashya’ al-ibahah)
• The original rulings of anything related to
prayer and submission (to God) is not
permitted (Al-aslu fi-l-ibadah al-mamnu’)
• The original rulings of anything that gives
benefit is permissible (al-aslu fi-l-manafi’ al-
ibahah)
Concept of origins
• Everything is related to it’s initial intention (al-
umuur bi maqaasidiha)
Istihalah
• Literal = transformation and conversion of one material to other
material
• transformation of materials to other materials (non-reversible
transformation) (Qal’ahji, 1996).
• Zuhayli (1997) also defines Istihalah as transformation or conversion
of material to other material which involves conversion of the
composition and properties includes the conversion of filthy (najs)
materials into pure (thahir) materials.
• Hammad (2004) add that Istihalah is a transformation of filthy or
haram materials to other materials which include physical
appearance and its properties such as name, odor, taste, color and
nature.
• Therefore, Istihalah can be defined as a complete transformation
occurred physically and chemically (Aizat & Radzi, 2009).
Jamaludin, M. A., et al, 2011 2nd International Conference on Humanities, Historical and Social
Sciences IPEDR vol.17 (2011)
Istihalah
• Istihalah can be applied into various situations as agreed by
Hanafi, Maliki, Ibn al-’Arabi, Ibn Taimiyyah, Ibn al-Qayyim,
al-Syawkani and Ibn Hazm al-Zahiri school of thoughts.
They widely applied Istihalah method in natural and
synthetics transformation (Ibn Taymiyyah, 2005).
• As an example, the fermentation of wine to vinegar is
considered halal whether it undergoes natural or synthetic
process.
• Syafii and Hanbali school of thoughts tended to limit the
application of Istihalah in certain issues only. They only
accepted natural process of transformation without any
intervention of synthetic process. i.e. natural
transformation of wine to vinegar (al-Syarbini, 1994).
Istihlak
• The concept hyperdilution; when a ‘dirty’
material in small amount is mixed into a large
amount of ‘clean’ material. As such makes the
final material as ‘clean”.
Fatwa
• European Fatwa Council, and Islamic
Organisation of Medical Sciences ruled use of
porcine gelatine as permissible as it has
undergone istihalah.
• Majma’ fiqh (Saudi) allows istihalah, but has
reserves for gelatine, as they considers it as
incomplete transformation
European Fatwa Council - Gelatine
Q) The ingredients of some foods contain items which are denoted by the
letter “E” and a string of numbers. We were told that this denotes items
manufactured from Lard or Pork bone and marrow. If this is true, what is
the Shari’a ruling on such foods?
A) The items which carry the letter “E” and a string of numbers are additives.
Additives are more than 350 compounds, and could be either
preservatives, colouring, flavourings, sweeteners, etc. These are divided
into four groups according to their origin:
First: compounds of artificial chemical origin.
Second: compounds of vegetal origin
Third: compounds of animal origin
Fourth: compounds dissolved in Alcohol
• The ruling on all these compounds is that they do not affect the status of
these foods being Halal, due to the following:
The first and second groups are Halal because they originate from a
permissible origin and no harm comes from using these items.
European Fatwa Council - Gelatine
(Continued…)
• The third group is also Halal, because the animal origin does not remain the same
during the process of manufacturing. In fact it is transformed radically from its
original form to a new clean and pure form through a process called “chemical
transformation”. This transformation also affects the legal ruling on such
ingredients. Therefore, if the original form was unclean or Haram, the chemical
transformation changed it to another ingredient which requires a new ruling. For
instance, if alcohol changed and was transformed to vinegar, then it does not
remain Haram, but carries a new ruling according to the nature of the new
product, which is Halal.
• As for the fourth group, these items are usually colourings and are normally used in
extremely small quantities which dissolves in the final product form, which deems
it an excused matter.
• Therefore, any foods or drinks that contain any of these ingredients remains Halal
and permissible for the Muslim’s consumption. We must also remember that our
religion is a religion of ease and that we have been forbidden from making matters
inconvenient and hard. Moreover, searching and investigating into such matters is
not what Allah (swt) or His Messenger (ppbuh) ordered us to do.
•
European Fatwa Council - members
1. Professor Yusuf Al-Qaradawi, President of
ECFR (Egypt, Qatar) 17. Sheikh Dr. Ajeel Al-Nashmi (Kuwait)
2. Judge Sheikh Faisal Maulawi, Vice-President 18. Sheikh Al-Arabi Al-Bichri (France)
(Lebanon) 19. Sheikh Dr. Issam Al-Bashir (Sudan)
3. Sheikh Hussein Mohammed Halawa, General 20. Sheikh Ali Qaradaghi (Qatar)
Secretary (Ireland) 21. Sheikh Dr. Suhaib Hasan Ahmed (UK)
4. Sheikh Dr. Ahmad Jaballah (France) 22. Sheikh Tahir Mahdi (France)
5. Sheikh Dr. Ahmed Ali Al-Imam (Sudan) 23. Sheikh Mahboub-ul-Rahman (Norway)
6. Sheikh Mufti Ismail Kashoulfi (UK) 24. Sheikh Muhammed Taqi Othmani (Pakistan)
7. Ustadh Ahmed Kadhem Al-Rawi (UK) 25. Sheikh Muhammed Siddique (Germany)
8. Sheikh Ounis Qurqah (France) 26. Sheikh Muhammed Ali Saleh Al-Mansour
9. Sheikh Rashid Al-Ghanouchi (UK) (UAE)
10. Sheikh Dr. Abdullah Ibn Bayya (Saudi Arabia) 27. Sheikh Dr. Muhammed Al-Hawari (Germany)
11. Sheikh Abdul Raheem Al-Taweel (Spain) 28. Sheikh Mahumoud Mujahed (Belguim)
12. Judge Sheikh Abdullah Ibn Ali Salem 29. Sheikh Dr. Mustafa Ciric (Bosnia)
(Mauritania) 30. Sheikh Nihad Abdul Quddous Ciftci
13. Sheikh Abdullah Ibn Yusuf Al-Judai, (UK) (Germany)
14. Sheikh Abdul Majeed Al-Najjar 31. Sheikh Dr. Naser Ibn Abdullah Al-Mayman
15. Sheikh Abdullah ibn Sulayman Al-Manee’ (Saudi Arabia)
(Saudi Arabia) 32. Sheikh Yusf Ibram (Switzerland)
16. Sheikh Dr. Abdul Sattar Abu Ghudda (Saudi
Arabia)
European Fatwa Council - OPV
• European Council of Fatwa and Research (ECFR) which in 2003 opined that
“Out of piety, some brother Muslims in various parts of the world,
particularly in East Asia, have issued a fatwa that it is not permissible to
administer this vaccine (OPV) to children, due to the fact that porcine
trypsin is used in preparing it.”
• The Council argued as follows:
– a) what God forbids is the partaking of pork, and trypsin has nothing to do with pork
– b) even if we admit that trypsin is forbidden, the amount used in preparing the vaccine
is negligible, if one applies the rule that “when the amount of water exceed 2 qillas (343
litres)”, impurities no longer affect it”
– c) supposing that trypsin is unclean, it is thoroughly filtered, that it leaves no traces
whatsoever in the final vaccine d) in case the three arguments forwarded are still
insufficient, the haram (forbidden) is made permissible in cases of necessity. In their
concluding remarks they emphasized, “
• The Council urges Muslim leaders and officials at Islamic Centers not to be
too strict in such matters that are open to considered opinion and that
bring considerable benefits to Muslim children, as long as these matters
involve no conflict with any definite text.”
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Malaysian Fatwa Council
• Fatwa on Enoxaparine and Fraxiparine
• Fatwa on Meningoccal vaccine (Mencevax vs
Monumen)
• Fatwa on RotaTeq (Rotaviral vaccine) and
Biothrax (Anthrax vaccine)
Vaksin dan Islam bercanggah? |
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Vaksin dan Islam bercanggah? |
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Seminar Vaksin | Swiss-Inn, Kedah |
suhazeli.com
Seminar Vaksin | Swiss-Inn, Kedah |
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Seminar Vaksin | Swiss-Inn, Kedah |
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Beliau meletakkan keharusan itu
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Terserah kepada mereka untuk beri
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menegaskan bahwa kerajaan
mempunyai hak dari SEGI POLISI
dan UNDANG-UNDANG untuk
MEWAJIBKAN kepada anak-anak
kita.
120
100
100
80
80
No. of cases
% coverage
60
60
40
40
20
20
3 imported cases
in 1992
0 0
Marina |
250
150
0
50
100
200
300
1975
1976
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1977
1984
1985
1986
1987
1988
1989
1990
1991
1992
1993
111
1994
1995
Year
1996
1997
1998
1999
2000
2001
2002
Diphteria Cases, 1975 – 2015
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
2015
Nombor insiden
500,000
1,000,000
1,500,000
2,000,000
2,500,000
3,000,000
3,500,000
4,000,000
4,500,000
5,000,000
0
Tahun 1980
Tahun 1981
Tahun 1982
Tahun 1983
Tahun 1984
Tahun 1985
Tahun 1986
Tahun 1987
Tahun 1988
Tahun 1989
Tahun 1990
Tahun 1991
Tahun 1992
Tahun 1993
Tahun 1994
Tahun 1995
Tahun 1996
Tahun 1997
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Tahun 1998
Tahun 2003
Tahun 2004
Tahun 2005
Tahun 2006
Tahun 2007
Tahun 2008
Tahun 2009
Incidence Global 1981-2010
Tahun 2010
112
measles
pertussis
diphtheria
Incidence Rate
VPD Max Cases Peak Year 2001 Percentage of
Year reduction (%)
Smallpox 48,164 1901 0 100
Diphtheria 206,939 1921 2 99.99
Pertussis 265,269 1934 4788 98.2
Tetanus 1,560 1923 26 98.34
Polio 21,269 1952 0 100
Measles 894,134 1941 96 99.99
Rubella 57,686 1969 19 99.97
Mumps 152,209 1968 216 99.86
Haemophilus influenzae type-b 20,000 1992 51 99.75
http://radiofreethinker.com/2013/03/15/the-case-for-censoring-the-anti-vax-movement/
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Measles Cases in Malaysia; 1980 – 2015
700 120
600
100
500
80
400
60
300
40
200
20
100
0 0
1980
2002
1981
1982
1983
1984
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
2015
IR per 1mil. pop MCV1 Coverage MCV2 Coverage
https://reference.medscape.com/features/slideshow/vaccine-preventable-diseases#page=15
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Immunization Coverage, 2004 - 2015
100
95
90
85
80
75
70
65
2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015
BCG DPT (3) POLIO (3) Hep B (3) Measles Hib (3)
250
200
150
100
50
Sept
July
July
Nov
Nov
Nov
Nov
Nov
Sep
Sep
Sep
Sep
Sep
Mar
Mar
Mar
Mar
Mar
Mar
Jan '12
Jan '13
Jan '14
Jan '15
Jan '16
Jan '17
Jul
Jul
Jul
Jul
May
May
May
May
May
May
2012 2013 2014 2015
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2016 2017
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0
100
200
300
400
500
600
700
1976
1977
1978
1979
1980
1981
1982
1983
1984
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
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2000
2001
2012
2013
2014
2015
0
20
40
60
80
100
120
140
119
Incidence Rate of Pertussis in Malaysia
2011 – 2015
1.40
1.20
1.00
0.80
0.60
0.45
0.40
0.12
0.20
0.00
35 100
90
30
80
25 70
60
20
50
15
40
10 30
20
5
10
0 0
2000 2002 2004 2006 2008 2010 2012 2014
Incidence Rubella (per 1 mill. Pop) Incidence CRS (per 1000 LB)
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Effect of Vaccine Refusal
1800
1600
1400
Number of Cases
1200
1000
800
600
400
200
0
2013 2014 2015 2016
Refusal 637 918 1541 1603
Measles Cases 195 235 1316 1587
Rubella and (Member States from the Western Pacific Region (WPR) to set an
CRS elimination incidence target by 2015 of <10 per million)
MCV Coverage
<50% 0 0 0 0 3 2.1 0 0
TOTAL DISTRICTS 142 100 142 100 142 100 142 100
Effect of Vaccine Refusal
1800
1600
1400
Number of Cases
1200
1000
800
600
400
200
0
2013 2014 2015 2016
Refusal 637 918 1541 1603
Measles Cases 195 235 1316 1587
We should
https://www.skmm.gov.my/skmmgovmy/media/General/pdf/MCMC-Internet-Users-Survey-2017_v2.pdf
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Social Media Impact