Limited Supply Main Challenge in RI’s Vaccination Drive

KOMPAS/FERGANATA INDRA RIATMOKO

Dancers sprinkle flowers when Dalang Sih Agung Prasetya starts performing a puppet show with the Pandawa Gumolong play at Mendut Studio, Mungkid, Magelang, Central Java, Sunday (14/3/2021). Apart from being a means of exploring the art of wayang, the puppet show is also aimed at disseminating the importance of vaccination to end the Covid-19 pandemic.

JAKARTA, KOMPAS – The availability of vaccines is the main obstacle to Indonesia’s COVID-19 inoculation drive, which has only prioritized people in high-risk groups. The country can only speed up its vaccination program, with a target to administer 1.5 million jabs per day, starting in mid-2021.

“Our problem is the vaccines’ limited availability. From March to April, there are only around 10 million doses available, so we set [a target to give] 300,000 shots per day. Until June, there are going to be only 80 million doses of vaccines [for 40 million people], which only amounts to 24 percent of the targeted 181 million people,” Health Minister Budi Gunadi Sadikin said in an online discussion held by the Gadjah Mada University Alumni Family (Kagama) in Jakarta on Sunday (14/3/2021).

The national COVID-19 task force data as of Sunday shows that 4.02 million people have received the first dose of the vaccine, while 1.46 million have received their second jab. Meanwhile, the country recorded 4,714 new confirmed COVID-19 cases on Sunday, bringing the total number of infections nationwide to 1.41 million.

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After vaccinating its health workers, the country moved to prioritizing the elderly as almost 50 percent of senior residents with COVID-19 need to be hospitalized.

We can only accelerate [vaccinations] in the second half of the year.

“We have 21.6 million elderly who must be vaccinated by June. If it goes smoothly, we will start to vaccinate the [general] public in July,” Budi said.

With such a limitation, people who have yet to have their turn are asked to be patient while still adhering to the health protocols.

“We can only accelerate [vaccinations] in the second half of the year. We have to [administer] 1.5 million vaccine jabs per day,” Budi continued.

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The Health Ministry’s spokesperson for the vaccination program, Siti Nadia Tarmizi, said the elderly, mainly those in Jakarta and other provincial capitals with the highest COVID-19 transmission rate, were prioritized. Vaccination for public service workers has also started, prioritizing older members of the group.

KOMPAS/RHAMA PURNA JATI

A health worker prepares a vaccine before vaccinating a journalist at the Siti Fatimah Hospital, Palembang, Sunday (14/3/2021). Vaccination of journalists is considered important because this group is susceptible to infection.

In order to speed up vaccination of the elderly, the government is collaborating with a number of organizations. Nadia underlined that those who are eligible for the inoculation must first register themselves.

“Do not just come [to the vaccination site] with your ID, as claimed in some false reports,” she said.

According to Transportation Minister Budi Karya Sumadi, his ministry is committed to supporting the vaccination program in terms of logistics and delivery.

“We are refocusing our budget to help the vaccination [program]. The transporting of [vaccines] has strict requirements; for example, a certain temperature,” he said.

Based on Kompas’ observation, many senior residents of Jakarta have yet to participate in the COVID-19 vaccination program. Some elderly who are migrants have yet to realize the importance of COVID-19 vaccination to protect them from the pandemic.

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Raharjo, 78, a resident of neighborhood unit (RT) 008 and community unit (RW) 004 in Palmerah, West Jakarta, for example, did not know how to register for the vaccination program. He was waiting for city officials to come to his home and register him for the program, but they never came.

“No one ever recorded [my data]. I wanted to come to the Puskesmas [community health center] but I can’t because I have to look after my friend’s [fuel] kiosk,” he said.

What’s more, Raharjo does not own a smartphone or a gadget that would enable him to easily access online registration. He is also very unfamiliar with technology.

KOMPAS/RADITYA HELABUMI

The atmosphere of the Covid-19 vaccination at Istora Senayan, Jakarta, Saturday (13/3/2021).

A number of challenges

According to Siti Nadia, there have not been any serious cases related to post-immunization accidents (KIPI).

“The ratio of severe side effects is 4.2 per 1,000 injections. Most [side effects] are aches, redness and itching; then there’s muscle pain, fever, fatigue, nausea and headache. After one day on average or maximum two days, the more severe side effects disappear,” she said.

Gadjah Mada University School of Pharmacy professor Juris Ikawati explained that in addition to maintaining the availability of vaccines, distribution and storage infrastructure, as well as vaccinators, public acceptance rate is also a challenge for COVID-19 vaccination in Indonesia.

“There are residents who have doubts about the benefits of vaccination, as well as its safety and halal status,” Juris said.

Moreover, the possibility of repeating vaccine injections in the future must also be taken into account, because immunity to COVID-19 through natural infections or vaccines is likely temporary.

Antibodies from this vaccine can decrease. It is predicted that additional vaccinations need to be given in two years.

“Natural immunity starts to decrease after 60 days, so it is recommended that COVID-19 survivors be vaccinated again after three months. For the vaccine itself, there is no accurate date on how long the immunity lasts. However, the hope is that it can last up to one year,” Juris said.

The emergence of new virus variants has also become a challenge in COVID-19 vaccination. Recent research published in The Cell journal on Friday (12.03.2021) shows that a number of new variants of SARS-CoV-2 are able to evade the immune system, which adds to previous findings on the decrease of vaccines’ efficacy in responding to the new variants.

Alejandro Balazs of Harvard University’s School of Medicine, who is the lead author of the study, said that the neutralizing antibodies induced by the Pfizer and Moderna COVID-19 vaccines were significantly less effective against the variants from Brazil, Japan and South Africa.

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“The three new strains first found in South Africa were 20 to 40 times more resistant to neutralization, and the two strains first discovered in Brazil and Japan were five to seven times more resistant compared to the original SARS-CoV-2 virus," Balazs said.

Padjadjaran University (Unpad) COVID-19 vaccine clinical trial research team member Kusnandi Rusmil said the existing COVID-19 vaccines were still effective at preventing virus mutations in Indonesia. The acceleration of vaccination needs to be encouraged so that herd immunity can be achieved immediately and to anticipate other potential mutations.

The COVID-19 vaccine made by Sinovac, which is in the third phase of clinical trials in Indonesia, has a 65.3 percent efficacy rate.

“Antibodies from this vaccine can decrease. It is predicted that additional vaccinations need to be given in two years,” he said.

This article was translated by Camilia Adianti.