Vaccine Allotment Falls Short of Reaching the Elderly

KOMPAS/AGUS SUSANTO

A medical worker administers a Covid-19 vaccine to an elderly person at a community health center (Puskesmas) in Duren Sawit, East Jakarta, on Tuesday (23/2/2021). Each day, the health center administers 20-50 doses of vaccines for elderly people. Health Ministry Covid-19 vaccination spokesperson Siti Nadia Tarmizi said the current second phase of the vaccination drive was for public service workers and elderly people. In the case of the elderly, the first and second shot of the vaccine are given with a 28-day interval. For people aged 18-59, the vaccines are given with a 14-day interval. According to Health Ministry data, an additional 16,297 people received their first vaccine shots on Monday, bringing the total to 1,244,215 people. With the limited global supply of vaccines, the government prioritizes the vaccination of high-risk people to lower the mortality rate.

Elderly people are among the groups vulnerable to Covid-19 infection, but regional authorities seem to be ignoring the priority recipient policy in local vaccination drives. As a result, very few elderly people have been vaccinated.

JAKARTA, KOMPAS —Covid-19 vaccination coverage for the elderly is still far behind compared to other priority recipient groups such as health workers, civil servants and other social elements.

The vaccination drive in the regions relies on the vaccine supply quota for each local government, while a proportion of the supply is also channeled to other vaccine administrators, known as collaborators, including the local military and police, political parties and other public entities.

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A field inspection Kompas made to a number of vaccine warehouses in several regions found that the allocation of vaccine supplies to local governments was smaller than that for the military, police and nongovernmental administrators, such as political parties and the private sector.

In fact, although they receive a greater supply of vaccines, the police, military and private collaborators do not specifically identify the elderly as a priority vaccination target.

Of the targeted 21,553,118 elderly people nationwide, only 5,175,089 (24.01 percent) had received their first dose and 3,658,275 (16.97 percent) their second dose as of Thursday (26/8/2021).

The provincial administration of Central Java received a shipment containing 12,456 vials of the Sinovac vaccine from Jakarta on Friday (30/7). Only 4,980 vials of the shipment were allocated for the local government, while the rest were shared with the military and police at 3,378 vials each. One vial contains 10 vaccine doses.

When the Moderna vaccine arrived in the province in mid-August, the local police headquarters received 1,020,000 doses, compared to 170,000 doses for the provincial administration. This supply was then distributed to 35 regencies and cities, wholly to be used as boosters (third dose) for health workers.

During a regional leadership meeting, it was agreed that the local administration’s supply allocation would target priority community groups, especially the elderly and people with comorbidities.

KOMPAS/RADITYA HELABUMI

A health worker prepares vaccines during the mass Covid-19 vaccination for media workers at Basket Hall, Bung Karno Stadium complex, Senayan, Jakarta, on Thursday (25/2/2021). On the first day of the vaccination, the event was attended by over 1,000 media workers from various press companies. The mass vaccination for media will run until Saturday (27/2/2021), targeting 5,500 media workers. The Covid-19 vaccine is expected to protect the media workers from risk of Covid-19 transmission.

However, only 31.08 percent of the elderly in Central Java had received their first dose as of Tuesday (24/8), while 23.27 percent had received their second dose. The province has an elderly population totaling 3.68 million people.

The same situation has occurred in West Java. Several community health centers (Puskesmas), as the local administration’s extension to vaccinate the elderly, appear to be running out of their vaccine supplies.

Among them is a Puskesmas in Rancaekek of Bandung regency, which was unable to deliver its vaccination program on Friday (6/8) because their vaccine supple was running low.

The Puskesmas has a vaccination target of 80,000 recipients, but only 4,000 have been vaccinated since February.

Puskesmas head Lidya Tampubolon complained about its limited vaccine quota while non-health vaccination administrators had been allotted an abundant supply of vaccines. “Many communities have received vaccines while in fact, the stock at the Puskesmas is small," she said.

Five kilometers away from the Puskesmas is a textile company that is vaccinating 10,000 people. The vaccine drive was held by a labor union in collaboration with the police.

These nongovernmental vaccine administrators, he said, were not aware of the data on vulnerable groups.

West Java is home to 3.4 million elderly people who are priority vaccine recipients. However, only 19.64 percent had received their first jab and 13.64 percent their second jab as of Tuesday (24/8) West Java Governor Ridwan Kamil conceded that his administration did not have adequate capacity to optimize the vaccine drive for vulnerable groups like the elderly, as the vaccine supply quota was set by the central government and was also distributed supply beyond local administration. These nongovernmental vaccine administrators, he said, were not aware of the data on vulnerable groups.

“In such a scheme, we are just postmen. We cannot quantify the number of vaccines in the field," he said.

The local police said they were coordinating the vaccination program with the provincial government, and that both had received an almost equal amount of vaccines.

"Police headquarters will always look to establish coordination with the health offices in regencies and cities in program implementation," Adjunct Senior Commissioner Ani R, police officer from West Java Police’s medicine and health division, said.

KOMPAS/AGUS SUSANTO

There was an addition to the first stage on Thursday (28/2/2021) at the health center for those who had not been vaccinated. A total of 3,700 doses of Covid-19 vaccines have been prepared to be distributed to nine hospitals in Setiabudi district. Problems with vaccine data collection and distribution, which caused the first phase of the Covid-19 vaccination program to be prioritized for health workers, persist.

When asked about issue, Siliwangi Regional Military commander Major General Agus Subiyanto said that the TNI heeded the elderly as prioritized. "We are with the government. First, health workers, then the elderly and schoolchildren. Now, we are accelerating jabs for the elderly as well as schoolchildren and teachers, so that schools can reopen,” he said.

Vaccination stations

In addition to the vaccine allotment system, an ineffective strategy that failed to adopt an approach to draw the elderly to vaccine stations is also being blamed for the lagging vaccination coverage of the elderly, who are being treated like any other recipient.

While many of the elderly are willing to be vaccinated, they have been held back by access constraints.

"It\'s not that I refuse to be vaccinated, but the queue was long. I would have suffered dizziness. I wish the vaccination location was near my house," said Boni (62) from Depok, West Java.

Aware that nongovernmental vaccination administrators were unheedful of elderly recipients and that the supply was limited, the Central Java government rolled out a special program for vulnerable groups that started on Friday (13/8).

Governor Ganjar Pranowo said that if everyone demanded their own vaccine allocation, the health minister might become distressed about having to meet to the many requests for vaccine supplies.

“As long as [the vaccination] reaches the target, it’s OK. The fact is, it’s not. Those on the priority list should be vaccinated first. The elderly were not," he said.

The Salatiga Military District Command (Kodim) reported that it had received a supply of 87,000 vaccine doses.

Commander Lt. Col. (Inf) Loka Jaya Sembada said that the vaccination program was aimed at companies operating in the regencies of Salatiga and Semarang, with the latter providing the health personnel and absorbing the operational cost.

"We expect many company employees and members of the surrounding community to be vaccinated," said Jaya.

Meanwhile, senior commissioner Sumy Hastry Purwanti who heads the Central Java Police’s medicine and health division, acknowledged that the targeted recipients of the police vaccination program fell outside the priority groups, which she said were being handled by the provincial government.

"Our target is students, the public, workers and companies," Sumy said.

Other vaccination administrators, such as political parties, also do not target the elderly.

The Golkar Party’s Klaten chapter in Central Java recently administered 20,000 doses to party members and their families. With the supply allocation reportedly being determined by the central board, the party’s vaccination program was said to be apart from the provincial government’s elderly priority program.

"It is expected [that recipients] are Golkar Party constituents," said Triyono, who heads the Golkar Party faction in the Klaten legislature.

In South Tangerang, Banten, the Prosperous Justice Party (PKS) also held a vaccine drive that excluded the elderly, with legislator Paramitha Messayu pointing out that the vaccination program was entering the general population stage.

"The central government carried out [elderly vaccination] at the beginning. We are now vaccinating the public," she said.

Meanwhile, Hans Christopher, who heads the Indonesian Democratic Party of Struggle (PDI-P) South Tangerang board’s vaccination drive, said that they were prioritizing the vaccination of PDI-P board members, their families, other party cadres and the public.

The Health Ministry has acknowledged the hindrances to ramping up vaccination for the elderly owing to technological constraints and a lack of commitment on the part of regional administrations to proportionally allocate vaccines for the elderly.

“There is no privilege for certain circles. Elderly people have never refused to receive the health [vaccination] services. We have tried to bring the vaccination program closer to the people," said Siti Nadia Tarmizi, the Health Ministry’s director of contagious disease prevention and control. (FAI/DVD/IRE/NDY)

(This article was translated by Musthofid).