Vaccine and Vaccination against Covid-19

At the end of 2020, the world was relieved to hear the news about the production of a Covid-19 vaccine with an efficacy rate of above 90 percent.

There was a huge relief as the vaccine was among several vaccines with efficacy rates of above 60 percent that would be available shortly. With the supply of various vaccines, countries will have a lot more options to choose the most appropriate ones and at the same time to avoid dependence on only a single source. The good news certainly offers hope that the pandemic will soon be over.

Nevertheless, it should be realized that the presence of vaccines alone will not automatically end the pandemic. Treating somebody with a vaccine or vaccination will obviously increase the immunity of the person concerned. But it cannot end the pandemic if only given to a small number of people or groups. Ending the pandemic means that the extent of Covid-19 has to be drastically reduced. So, it isn’t just increasing somebody’s immunity to the

virus. Therefore, it requires vaccinating most of people in a community. From the world’s evidence and experience in previous battles against viruses, it is known that the spread of a virus will be reduced and ended if the greater part of a community has become immune to the relevant virus.

Also read: Covid-19 Vaccine Euphoria Deemed Dangerous

This condition is known as herd immunity. To achieve this, there’s a requirement for the minimum population to become immune to the virus. The minimum population may vary according to the relevant virus type, depending on the virus’ characteristics and its transmission rate. For example, it requires the immunity of at least 95 percent of the population to achieve herd immunity for the measles virus; the same is true of the polio virus, which requires the immunity of at least 80 percent of the population. In the case of Covid-19, it should be admitted that the characteristics of this virus aren’t much known yet. However, various world institutions estimate that a minimum of 70-90 percent of the population must become immune in order to achieve herd immunity (WHO, 2020).

If the assumption used to achieve herd immunity is 70 percent of the population, it requires the vaccination of around 5.5 billion people.

In this context, it can be said that the world still has to embark on a long journey to reach herd immunity and put an end to the Covid-19 pandemic. In 2020, the world population was recorded at 7.7 billion (Worldometers, 2020). If the assumption used to achieve herd immunity is 70 percent of the population, it requires the vaccination of around 5.5 billion people.

Also read: Optimal Vaccination, 3M and 3T

In Indonesia, with a population of around 268 million (Home Affairs Ministry, June 2020), it requires the vaccination of approximately 188 million people. The vaccination requirement figures certainly indicate fantastic numbers.

KOMPAS/ABDULLAH FIKRI ASHRI

A health worker injects a fellow medical worker with a vaccine during a simulation for Covid-19 vaccination at Puskesmas Talun, in Cirebon regency, West Java, on Wednesday (6/1/2021). The first round of vaccinations in Cirebon will target around 8,009 medical workers.

But we should be aware that the numbers will continue to rise in a natural way in line with population growth. Besides, the vaccination requirement figures can also increase if the minimum population percentage assumption is raised, for instance, to 80 or 90 percent.

Also read: New Hope from the Merdeka Palace

In view of the hard work in the future, the government of each country should prepare a vaccination strategy in an observant, accurate and measured manner. This should be done not only to ascertain the availability of all resources for society to carry out vaccination, but also to ensure the achievement of herd immunity and termination of the pandemic.

Rate of vaccination

The Indonesian government has fixed the official date to execute the vaccination against Covid-19 in the country. According to Health Minister Budi Gunadi Sadikin, the process started on 13 January 2021 and will last 15 months or until around April 2022.

For the determination that herd immunity can be achieved with the assumption of 70 percent in April 2022, two variables should be observed, which are the rate of vaccination and the rate of infection. In this context, the government should make sure that the rate of vaccination is higher than that of infection. Why is this so? It should be realized that the vaccination process is not in a vacuum room. When vaccination is going on, infection persists. That’s why the vaccination rate has to be higher than the Covid-19 infection rate. If the vaccination rate is lower, the achievement of herd immunity at the level of 70 percent will be more difficult or delayed because the increase in the number of confirmed Covid-19 cases will always be bigger than that in the number of people already immune.

As an additional information, no research has found yet that a recovered Covid-19 case will have immunity.

Also read: Ensure the Efficacy of COVID-19 Vaccination Drive

With regard to this, the government can make two approaches at the same time. The first is to increase the number of people vaccinated. At present the rate of Covid-19 infection in Indonesia is nearing 15,000 people daily. The pattern arising over the last year has still indicated a daily increase. To compensate for it, the government needs to vaccinate more than 15,000 people daily.

In its ideal calculation, if the government wants to achieve herd immunity with the minimum 70 percent assumption in 15 months, it requires the vaccination of around 12.5 million people monthly or about 417,000 people daily. In essence, the greater the number of people vaccinated by the government, the shorter the time to be taken by Indonesia to reach herd immunity, and vice versa.

In addition, for more effective achievement of herd immunity, it requires more accurate and proportional calculation of the pandemic situation in each region in Indonesia. It means that the region severely impacted by the pandemic certainly needs a great deal more vaccination than that slightly impacted.

The second approach is to reduce the rate of transmission. Attempts to curb the spread of the disease are no longer new for Indonesia. The government has realized this by imposing large-scale social restrictions (PSBB) and health protocols. What should be given due attention is that it doesn’t mean the attempts to reduce the transmission rate is unnecessary when the process of vaccination is underway.

Also read: Transmission Control Determines Vaccination Success

Any massive transmission of the disease will naturally bear the impact of increasing the need for vaccination. When this vaccination need cannot compensate for the transmission rate, the consequence is that the achievement of herd immunity will take a longer time. If this happens, Indonesia will face protracted health and economic crises.

For this reason, the efforts to curb the transmission rate should be made in conjunction with the process of vaccination so as to help achieve herd immunity within a short time.

The emergence of Covid-19 virus mutations should be considered because such mutations reportedly have a faster rate of infection than that of the Covid-19 virus itself. For this reason, the efforts to curb the transmission rate should be made in conjunction with the process of vaccination so as to help achieve herd immunity within a short time.

Availability of facilities

For the realization of both strategies at the same time, the government needs to make available adequate facilities. At least three important matters should receive attention. The first is arranging periodical vaccine procurement programs to ensure vaccine availability, drawing up plans and procedures for vaccine distribution, determining locations of vaccine storage in regions and preparing field medical personnel. With the very vast territory of Indonesia, this is not a simple undertaking. Accurate planning is thus needed to avoid any failure or mistake in each phase of vaccination.

ARSIP DINKES BANJARMASIN

Covid-19 vaccines produced by Chinese company Sinovac arrive in Banjarmasin city, South Kalimantan, on Tuesday (12/1/2021). In the first phase, the Banjarmasin City Health Office received 13,480 doses of the Covid-19 vaccine.

The second is to make sure that there’s no spike in infection cases that exceeds regional hospital capacity. Hospitals’ inability to serve Covid-19 patients will have the impact of bigger infection surges (induced by super-spreaders). To prevent this, periodical and transparent control is needed to ascertain not only data on regional hospital capacity but also on the number of tests, the rate of infection and the total of people already vaccinated. This is important to promptly anticipate any slightest deviation from the vaccination program.

Also read: The Battle against Vaccination Refusal

The third is to arrange vaccination priorities, involving the relevant groups as well as regions. One of the groups requiring the priority status is that of healthcare workers. Without adequate healthcare personnel, the vaccination program’s smooth execution can be hampered, even threatened with failure.

ARSIP PRIBADI

RIchard Mengko

In the case of regional priorities, the government should thoroughly observe the availability of vaccines, especially in regions with high case surges. Last, we can say that the development of Covid-19 vaccines is only an initial step to achieve herd immunity. There are still various tough jobs for the government to cease the pandemic. The government’s accuracy in arranging vaccine procurement plans, executing vaccination, providing facilities and infrastructure as well as public compliance with health protocols will be the primary key to determining the achievement of herd immunity within the shortest possible time. Hopefully Indonesia and the world can be free from the Covid-19 pandemic before long.

Richard Mengko, Retired Lecturer of Biomedical Engineering, Bandung Institute of Technology

(This article was translated by Aris Prawira)