Eight provinces will be holding another diphtheria vaccination program in 2018 after three other provinces already started their campaigns.
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Kompas/Heru Sri Kumoro
A child receives a diphtheria shot at Syarif Hidayatullah hospital in South Tangerang on Wednesday (27/12). The vaccinations, which are for children aged 1-19, are being given for free until Dec. 29.
JAKARTA, KOMPAS – Eight provinces will be holding another diphtheria vaccination program in 2018 after three other provinces already started their campaigns this month. It is hoped that the re-vaccinations could control the cases of diphtheria, which has infected hundreds of people.
The eight provinces include Aceh, Lampung and East Java, the Health Ministry’s director general of disease prevention and control, Mohamad Subuh, said in Jakarta on Thursday (28/12). Re-vaccinations will be done in 70 regencies and cities across the eight provinces. As many as 24 million children aged 1-19 will be the targets of the vaccination.
Therefore, the re-vaccination in early 2018, which is a response to an extraordinary diphtheria outbreak, or a diphtheria Outbreak Response Immunization (ORI) program, will in total target up to 32 million children aged 1-19 in 11 provinces. Of them, as many as 8 million children will be targeted in Jakarta, Banten and West Java.
“A few provinces like South Sumatera and Lampung will take part next year because it is needed to support the security of the 2018 Asian Games,” Subuh said.
In the diphtheria ORI program of 2018, the Health Ministry is responsible for preparing the necessary materials, such as vaccines and syringes. The regional administration’s role is to prepare the operational funds.
In the period of January-December 2017, the number of diphtheria cases nationwide reached 903.
According to Subuh, it is estimated that the vaccine stock will be sufficient to fulfill demand until August 2018, when the third re-vaccination in the eight provinces is scheduled.
PT Bio Farma corporate secretary Bambang Heryanto said that his company will increase the production of the vaccine, which contains diphtheria components such as DPT-Hb-Hib, DT and Td.
By doing that, beyond the needs of the national basic immunization program, there will be an additional supply of diphtheria vaccines, including 1.2 million DT 10ds vials, 7 million Td 10ds vials and 4 million DPT-Hb-Hib vials.
Evaluation
So far, the number of diphtheria cases has continued to rise. In the period of January-December 2017, the number of diphtheria cases nationwide reached 903. In Cirebon regency, West Java, for example, there were six cases of diphtheria in 2017. According to Cirebon Health Agency head Enny Suhaeni, one of the patients died from the disease.
Diphtheria is an infectious disease that attacks the mucous membrane of the throat and nose caused by the bacteria Corynebacteri um diphtheria. The infection causes the formation of a thick covering at the throat, which could lead to difficulties breathing.
The government should not be satisfied with having good coverage at national and provincial levels.
The spread of diphtheria cases in 2017 in several regions, according to Subuh, is a matter that needs to be evaluated by all parties. For the Health Ministry and local health agencies, this shows that the immunization coverage has not been optimal.
Basic immunization at the village level should be even. The government should not be satisfied with having good coverage at national and provincial levels, because conditions in the field shows that vaccinations have not been evenly distributed across villages.
Another issue that must also be a point of evaluation is the cold chain quality in regions and whether it is already up to standard.
From 2015 to 2019, the Health Ministry is renewing the cold chain in regions. This year, only 92.7 percent of regions have been sent vaccine storage facilities that are in accordance with existing standards.
Furthermore, implementation of the immunization program needs to be evaluated. For example, is the delivery, storage and vaccination process done correctly? All these things greatly affect immunization quality.
Subuh stressed that immunization is a matter that concerns all related parties, not just the health sector. “Regions also play a role in immunization,” he said.
The regional administrations need to realize that immunization is also their responsibility.
Indonesian Pediatrician Association chairman Aman Bhakti Pulungan stressed that the diphtheria ORI program must be done simultaneously, not in patches like it is done now. This, he said, will curb the spread of the disease.
The spread of diphtheria is the result of weak health promotion and disease prevention efforts in regions, because the government has been focusing too much on therapy. The regional administrations need to realize that immunization is also their responsibility. All sector must be involved, including education.
Immunization for school children through School Children Immunization Month (BIAS) must be given more attention. Schools cannot be heedless because once the academic year starts, children, who should be having their fifth to seventh immunization, would miss it. This means that the series of immunizations they receive is incomplete and their immunity is not perfectly formed
