Vaccine Quality Must Be Guaranteed
A number of parties have asked the government not only to guarantee the immunization coverage, but also the vaccine’s quality.
JAKARTA, KOMPAS – A re-immunization program for diphtheria was held simultaneously in Jakarta, Banten, and West Java on Monday as part of the outbreak response immunization (ORI) program in three provinces.
However, a number of parties have asked the government not only to guarantee the immunization coverage, but also the vaccine’s quality for effectively establishing immunity among the community.
Quality assurance includes the quality of the vaccine, the standard of the cold chain system, program management, communications, surveillance, post-immunization control and immunization services.
The chairman of the Indonesian Pediatric Association (IDI), Aman Bhakti Pulungan, said that uneven coverage of basic immunization could cause disparities in the level of immunity among people.
As a result, children would be vulnerable to disease. "We are often lulled by the data on high immunization coverage. In fact, cases of diphtheria and measles have reappeared,” he said.
The immunization programs’ quality must be assured to immunize the people against the disease, and so that the government doesn’t need to repeat the program in certain areas due to uneven immunization coverage.
The reemergence of disease and re-immunization programs have a major financial impact. In addition to diphtheria, measles continues continues to reappear. In Puncak Jaya district, Papua, 134 cases of measles have been found since November.
According to the immunization and monitoring head of the Papua health office, Togu Sihombing, the cases were triggered by low immunization coverage due to difficult geographical conditions.
In Indonesia, the complete basic immunization program consists of one dose of the hepatitis B vaccine, one dose of the BCG vaccine, three doses of the DPT-HB-HIB vaccine, four drops of the polio vaccine, and one dose of the measles vaccine. Basic immunization can prevent tuberculosis, diphtheria, pertussis, measles, polio, tetanus, and hepatitis B.
According to chairperson Siti Noordjannah Djohantini of Aisyiyah, the Muhammadiyah women’s branch, the government should be able to uncover the cause of the public’s rejection of vaccination.
"The government’s communication and networking with the people should be improved," she said. Some citizens’ rejection of vaccination had hampered the immunization program in East Java, such as in Malang and Blitar.
According to Malang health office head Asih Tri Rachmi Nuswantari, some people considered vaccination unnecessary, or they refused to be vaccinated for religious beliefs.
With regard to ensuring vaccine quality, the West Sumatra provincial government closely monitors the storage and delivery systems for vaccines. "Regular officers should be trained," said the West Sumatra health office’s surveillance and immunization and monitoring head, Ali Akbar.
Re-immunization
Yesterday, the diphtheria ORI program was delivered simultaneously in the three provinces of Jakarta, Banten, and West Java. A similar program is planned to be carried out in other areas in January 2018.
Health Minister Nila Djuwita F Moeloek said the ORI would be implemented gradually. In the first phase, the program will be conducted in 12 districts and cities in three provinces for eight million children under the age of 19 years.
"ORI is also being conducted independently in other regions, such as East Java and South Sumatra," she said on Monday during a re-immunization event at the SMA Negeri 33 high school in Cengkareng, West Jakarta.
Each child should receive three vaccines in the first, second and sixth months for optimal immunization. According to health monitoring and quarantine director Elizabeth Jane Soepardi at the Health Ministry, the vaccines delivered as part of the ORI program in the three provinces was obtained from the surplus vaccine stock for 2017.
Jakarta health office head Koesmedi Priharto said that the diphtheria, pertussis, tetanus (DPT) immunization program in December 2017 was expected to cover 1.23 million children.
Starting January 2018, the citizens of all three areas will receive their second round of vaccination. Jakarta Governor Anies Baswedan hoped that Jakarta residents would be free from diphtheria and other health problems before the 2018 Asian Games that Jakarta will be hosting.
In South Tangerang, a number of public health centers (Puskesmas) had yet to implement the immunization program. The DPT immunization program will begin on Wednesday at the Rawabuntu Puskesmas once the vaccines are received from the Health Ministry. Meanwhile, a re-immunization program was conducted in West Java, including Purwakarta, which recorded the highest number of diphtheria cases in West Java with 27 cases.
Economic impact
According to a study of 73 low-middle income countries, including Indonesia, that was published in the June 27 edition of the World Health Organization (WHO) bulletin, public immunization programs have an economic impact on the government.
A complete basic immunization program could prevent 20 million global deaths, 500 million cases of illness, and nine million cases of disability from 2001-2020. By 2020, the immunization programs carried out since 2001 are predicted to prevent losses of about US$350 million due to illness. Of that amount, $240 million in losses are attributed to the decline in productivity due to premature deaths. From 2011-2020, a potential $4 million in losses due to the cost of medical treatment could be avoided.
(ADH/DD04/INA/WIN/PIN/UTI/FLO/WER/SEM/ZAK)