Kedah recorded the highest number of vaccine rejection cases in the country with 318 cases in 2015, more than the 239 cases in 2014.

Kedah Health director Datuk Dr Norhizan Ismail said the top three districts for 2015 are Baling (70 cases), Padang Terap (42 cases) and Kulim (41 cases).

Factors cited for the rejection were doubt over halal status of vaccine (75.8%), practising homeopathy (18.6%), no confidence in effectiveness of vaccine (0.9%), side effects in infants (1.5%) attitude (2.5%) and financial problems (0.6%).

"If we look at the breakdown, 99.3 per cent who rejected the vaccine are Malays while the rest are non Malaysian citizens," he told Bernama.

On June 22, a 2 year-old boy from Kuala Muda was admitted to Sultan Abdul Halim Hospital along with six siblings for suspected diphtheria.

Of the seven siblings, four of them aged 10 months, two years (who have since died), three years and four years were not immunised against diphtheria.

Norhizan said the halal status of the vaccine should not arise as the National Fatwa Committee decided that the vaccine is not unclean and has no elements of doubt its content.

"As such, we advise parents to ensure that their children receive immunisation according to the schedule set by the Ministry of Health," he added.