Coronavirus: Concerns increase over Indonesia’s spitting vaccinations

JAKARTA, INDONESIA – Indonesia has significantly recovered from a peak in coronavirus cases and deaths in the middle of the year which was one of the worst in the region, but with its vaccination efforts halted due to logistical challenges and other problems, and with holidays approaching, experts and officials warn that the island nation may soon face another increase.

Indonesia started its vaccination earlier than any other country in Southeast Asia on January 13, and as infection and death rates rose in July and August, the program increased to more than 1 million shots per day.

But as the world’s fourth most populous nation, it had much more to do than most, and today only 33% are fully vaccinated and 16% partially, far behind its smaller neighbor Malaysia, which has 76% fully vaccinated, according to Our World in Data.

Most vaccinations have been distributed in the more urban areas of the archipelago nation’s largest islands, Java and Bali, while many on smaller, more rural islands – where healthcare systems are often rudimentary and the population tends to be older – have not been reached, said Dicky Budiman, an Indonesian epidemiologist and academic adviser to the government.

As more people travel back to these areas during the holidays, there is a greater risk that the virus will spread to these populations, some of whom have been partially protected by their isolation, he said.

“It will not be as bad as what we saw in July and August, but if we look at the first wave, in January 2020, it may be similar because of their vulnerability,” he said.

Since Indonesia started its vaccination program early, it is also more likely that efficiency is now declining, he said. Boosters are planned but will probably not start until the beginning of 2022.

The government urges people to avoid travel if they can and has increased restrictions in all provinces over Christmas and New Year, but about 20 million people are still expected to holiday on the popular islands of Java and Bali over the weekends.

Budiman said the country should speed up the vaccination program now, while cases are down and health care systems are not overwhelmed.

Indonesia has reported more than 4.25 million cases and 143,000 covid-19 deaths among its 270 million people. On top of the most recent increase in July, it hit 56,757 cases per day when hospitals were overwhelmed by sick patients and ran out of beds and oxygen supplies.

With a poor result of testing and case reporting, many have questioned the official figures and the Ministry of Health admitted this week that there have probably been about four times as many cases as officially listed.

A spokesperson for the Ministry of Health, Siti Nadia Tarmizi, noted that a study of antibodies in Jakarta residents earlier this year indicated that almost 50% of the people in the capital had been infected with covid-19.

Budiman said his own research suggests that as many as 30-35% of the Indonesian population have had covid-19 – which could be a golden edge on the vaccination cloud, as many would have developed a natural immunity to the virus.

“But it is still far from the threshold for herd immunity, and we know that immunity from both vaccinations and infections is declining,” he said.

In addition to problems with distribution to remote areas, the predominantly Muslim Indonesia faces growing hesitation against vaccines from many over the belief that shots other than the Chinese-made Sinovac are not “halal” or permitted under Islamic law, even if the Indonesian Ulema Council, the highest Islamic body, has said that all vaccines are allowed.

Safrizal Rahman, head of the Indonesian Medical Association in Aceh province, on the northwestern tip of the island of Sumatra, said officials needed to reach out to local religious leaders to get their support to move forward with vaccines.

“We have to make it a priority, because they are role models for society,” he told the Associated Press.

Aceh currently has only about 35% of its residents partially vaccinated, up from about 30% in September, and it is facing increasing headwinds, including the growing spread of disinformation, he said.

“Our education is still lacking compared to what people learn on social media,” he said. “Unfortunately, what comes out on social media is a lot of scam, but it is more influential in society than what is available in official sources.”

It has not helped that the prominent voice of former Health Minister Siti Fadilah Supari, who has served time for a corruption conviction, has been one of those sources who advise against obtaining the vaccine with reference to fully revealed conspiracy theories.

As the number of cases has decreased in recent times, the feeling of urgency to get vaccinated has also decreased, and the World Health Organization has noted sharp reductions in the number of shots given three weeks in a row, most recently by 11.3% from November 15 to 21.

The government is trying to increase things again and will obtain 102 million vaccine doses in December through purchases and donations from other countries.

More cold storage will also be added, so that each province would have at least one facility equipped to hold large quantities.

Noting that the virus had recently spread in Europe, Indonesian Health Minister Budi Gunadi Sadikin urged people earlier this week not to be lulled into a false sense of security by the current low number of cases.

He stressed that they should take any vaccine that becomes available, noting that AstraZeneca, Pfizer and Moderna have been shown to be more effective than the more popular Sinovac.

“Do not worry, these vaccines have been shown to be safe, do not hesitate to vaccinate yourself immediately,” he said.

“Do not let what happened in Europe happen to us,” he added.

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