Improve Vaccination Infrastructure

The acceleration of Covid-19 vaccination is constrained by limited vaccine supply, infrastructure and human resources. Some vaccines are still awaiting the results of the Food and Drug Monitoring Agency’s (BPOM) study.

KOMPAS/ABDULLAH FIKRI ASHRI

Health workers prepare to inject the Covid-19 vaccine at traders in the Morning Market, Cirebon City, West Java, Wednesday (17/3/2021). A total of 139 traders and market officers participated in the activity.

JAKARTA, KOMPAS – The country is facing a number of challenges in efforts to accelerate its Covid-19 vaccination program. Apart from the limited availability of the vaccine, the readiness of supporting infrastructure and human resources needs to be improved.

The Health Ministry’s spokesperson for the vaccination program, Siti Nadia Tarmizi, said on Wednesday (17/3/2021) in Jakarta that a number of efforts must be carried out to accelerate Covid-19 vaccination in Indonesia. The limited supply of vaccines means that vaccination must be carried out based on priorities, namely health workers, senior citizens and public service workers.

Indonesia expects to receive 91 million doses of vaccine until May 2021. Meanwhile, with the country targeting to inoculate 181.5 million people, around 363 million doses is needed. This means that the supply of vaccines until May 2021 accounts for only about 25 percent of the country’s needs. Large numbers of vaccine will only arrive after June 2021.

Also read: Indonesia Awaits Assessment Results from BPOM

Based on such a situation, Nadia said that several schemes related to vaccination sites, distribution of vaccinators and efforts to suppress vaccination delays, were prepared.

The number of vaccinators continues to be increased.

In regard to vaccination sites, the government has formulated four options, namely vaccination based on government-owned or private-owned health facilities, as well as those held in several state institutions such as the Indonesian Military (TNI), the National Police, and offices. Mass vaccinations will also be more intensively carried out through both mobile and on-site method.

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“The number of vaccinators continues to be increased. As of 29 January 2021, there were 40,329 vaccinators in total. The number continued to increase to 81,770 vaccinators at the end of February. Training is still conducted to raise the number, especially in regions where there are not enough vaccinators,” Nadia said.

Another challenge is related to the improvement of communication, as there are still people who refuse to be vaccinated. There are also a lot of fake news related to vaccinations circulating. Therefore, cooperation of all parties is necessary to provide understanding and education for the public.

Also read: Limited Supply Main Challenge in RI’s Vaccination Drive

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Situation in a number of regions

A number of regions have reported that the Covid-19 vaccination for educators, elderly citizens, and public service workers is continued to be implemented. A total of 114 high school teachers in South Sumatra have been vaccinated at the Siti Fatimah Regional General Hospital (RSUD) in Palembang, as part of the plan to inoculate 2,000 high school teachers in the city.

Meanwhile, 1,500 elderly people in Palu, Central Sulawesi, have been injected with the Covid-19 vaccine. No post-immunization accidents or harmful side effects were reported after the vaccination.

“There are no reports of KIPI [post-immunization accidents] that are dangerous,” said Palu Health Agency’s Disease Prevention and Control and Environmental Health division head Lutfiah.

Also read: Help the Elderly Access COVID-19 Vaccines

The elderly receive vaccines at health facilities, including community health centers and hospital near their houses. Vaccination of the elderly began early this month.

In West Sumatra, the second phase of Covid-19 vaccination for the elderly is progressing rather slowly, compared to the vaccination for public service workers. Based on data from the West Sumatra Health Agency, there were 3,009 elderlies who were vaccinated from 28 February to 16 March 2021, or accounted to 0.68 percent of the targeted 442,033 recipients. The number of public service workers who have been vaccinated is 24,869 people or 6.21 percent of the targeted 400,274 people.

KOMPAS/LARASWATI ARIADNE ANWAR

Elderly people wait in line outside the Health Ministry training center on Jl. Hang Jebat in Kebayoran Baru, South Jakarta, on Tuesday. They received a message broadcast on WhatsApp notifying recipients of free vaccinations for elderly people in the area. However, it turned out that the free vaccine was being offered only to elderly people with South Jakarta-registered ID cards and that the number was limited to 1,000 people per day.

Vaccination postponement

The BPOM is still carrying out further study of the AstraZeneca vaccines, following reports of blood clotting as a side effect. In the meantime, the country is delaying the rollout of the AstraZeneca vaccine.

BPOM head Penny K Lukito said the review was conducted with a team of experts from the National Commission for Drug Evaluation, the National Commission on Post-Immunization Accidents (Komnas KIPI), and the Indonesian Technical Advisory Group on Immunization (ITAGI). The review is conducted to carry out precautionary principle.

“Wait until the end of this week. We are intensively monitoring and communicating with European drug authorities as well as the WHO [World Health Organization],” Penny said on Wednesday.

Also read: We Need Greater Vaccine Variety

A deeper study was carried out even though the batch of the Astra Zeneca Covid-19 vaccine that arrived in Indonesia was different from those that allegedly triggered blood clotting. The vaccines that Indonesia received are also produced in different facilities.

Previously, the WHO stated on 12 March 2021 that it had received information on cases of blood clotting in AstraZeneca vaccine recipients. The organization, however, stated that there was no reason to stop using the vaccine by following the use of the emergency use listing (EUL).

MARKKU ULANDER/LEHTIKUVA/AFP

A medical worker holds a syringe to give a jab with the AstraZeneca vaccine against the Covid-19 coronavirus to a patient, at a vaccination centre in Vantaa, Finland on March 11, 2021. - Around 540 000 people have received at least one vaccination dose against the Covid-19 coronavirus in Finland.

Yesterday, the WHO said no association between blood clots and the AstraZeneca vaccine had been found. However, some countries have suspended the use of the vaccine as a precautionary measure while the investigation is still underway. The emergency use authorization (EUA) for the vaccine, however, is not revoked.

There is no evidence that the Covid-19 vaccine triggers blood clotting.

So far, the European Medicines Agency (EMA) has been reviewing the blood clotting cases and if it is related to the use of the AstraZeneca vaccines. The agency stated that, however, the benefits of the jab outweighed the risks.

Also read: Indonesians Get More Vaccine Options in Inoculation Drive

“There is no evidence that the Covid-19 vaccine triggers blood clotting. The frequency of blood clotting is the same as that occurred in the general public,” said Ines Atmosukarto, a vaccine researcher from Indonesia who works at the John Curtin School of Medical Research at the Australia National University. The delay of the use of the AstraZeneca vaccine is considered to be based more on precautionary measure and political nuances, rather than scientific aspects.

Griffith University epidemiologist Dicky Budiman added that the benefits of the vaccine are far greater than the risks. Protracted suspension of vaccine rollout is risking the implementation of the country’s inoculation program and increasing the severity of Covid-19 for the elderly. (NSA/JOL/RAM/VDL/ESA/AIK/TAN)

This article was translated by Camilia Adianti.