There is a hope that when vaccinations take place, the pandemic will end immediately. However, historically, no vaccine can stop a pandemic. Indonesia is now observing the vaccination probability.
By
Ahmad Arif
·6 minutes read
There is a hope that when vaccinations take place, the pandemic will end immediately. However, historically, no vaccine can stop a pandemic. Indonesia is now observing the vaccination probability.
Vaccines usually undergo years of research and testing prior to clinical trials and require additional time for evaluation before usage. However, in just a year, scientists and companies have produced a number of Covid-19 vaccines. As of Sunday (17/1/2021), 68 vaccines are in clinical trials on humans and 20 vaccines are in the final stages of testing.
Eight vaccines have been injected under emergency use of authorization (EUA), two vaccines have gained approval for full use and only one vaccine has ceased production after clinical trials. This is a major achievement in the 220-years history of vaccine discovery.
In Indonesia, the Food and Drug Monitoring Agency (BPOM) approved the emergency use of the Covid-19 CoronaVac vaccine produced by Sinovac Biotech, China. According to the head of BPOM Penny K Lukito, approval was given because the analysis of the efficacy of the CoronaVac vaccine from clinical trials in Bandung showed that this vaccine was able to reduce the incidence of Covid-19 by up to 65.3 percent.
The Sinovac vaccine also meets safety aspects and its quality has met the standards for good drug manufacturing methods.
The Sinovac vaccine has been declared to have met the requirements of the World Health Organization (WHO) guidelines to get emergency use authorization (EUA). The standard of vaccine efficacy set by WHO is at least 50 percent. The Sinovac vaccine also meets safety aspects and its quality has met the standards for good drug manufacturing methods.
Armed with this EUA, Covid-19 vaccination in Indonesia kicked off on Wednesday (13/1), marked by the first injection on President Joko “Jokowi” Widodo and then followed by a number of other figures.
Health Minister Budi Gunadi Sadikin hopes that Indonesia will complete the vaccination program in the shortest possible time. If it is delayed, there will be more casualties.
For that reason, RI needs 426 million doses of vaccine by the end of 2021. "It is hoped that by the end of December 2021, 181.5 million people will be vaccinated," said vaccination spokesperson from the Ministry of Health, Siti Nadia.
Benefits and limitations
Chairman of the Covid-19 task force of the Indonesian Doctors Association, Zubairi Djoerban, said that the Covid-19 vaccine is urgently needed and is expected to reduce the risk of death, especially among health workers. An efficacy of 65.3 percent means that a group of people is proven to be protected if exposed to this virus.
The immunogenicity of the vaccine is 99.23 percent so that if infected, the antibodies fight the virus so that it does not trigger severity. "We don\'t need to compare it with other vaccines. As long as the vaccine gets EUA from the BPOM, meaning that it meets safety and efficacy, it should be used first," said Zubairi.
A molecular biologist who graduated from Harvard Medical School, Ahmad Rusdan Handoyo Utomo, agrees that the Covid-19 vaccine is needed to ease the burden on the health facilities that are now overwhelmed. However, he is pessimistic the the vaccines can immediately control the pandemic, let alone end it. "We must be prepared to live with Covid-19. Yet, [we have to find out] what are the ways so that this disease does not lead to more severity and death," he said.
All current clinical trials of the Covid-19 vaccine are designed only to see its effect on reduction of symptom and severity, but are not designed to prove to prevent infection and transmission.
We do not ignore the benefits of vaccines, but we must not raise and give false hopes.
Although the risk of contracting symptoms is low, those who are vaccinated can transmit Covid-19 to people who have not received the vaccine. "This needs to be informed [to the public] so that those who are vaccinated adhere to health protocols. We do not ignore the benefits of vaccines, but we must not raise and give false hopes," he said.
Indonesian epidemiologist at Griffith University, Dicky Budiman, said that historically pandemics cannot end with vaccines alone.
"Smallpox was only eradicated after 220 years This eradication is not only due to vaccines, but also changes in people\'s behavior and surveillance. Vaccines are complementary to pandemic control,” said Dicky, who also mentioned polio as an example which was successfully controlled only after 30 years of vaccine discovery.
There are three keys for the vaccine to be effective in stopping transmission, namely high efficacy, low transmission curve or viral reproduction rate and wide coverage. "The failure of the Ebola vaccination was due to failure to flatten the curve and the low coverage, even though the efficacy is high," he said.
Viral mutation
Another factor that must be taken into account is the fact that SARS-CoV-2, the virus that triggers Covid-19, continues to mutate. Until mid-January 2021, according to the viral genome database at Nextrain.org, there have been 15,898 mutations in the nucleic acid levels that cause 9,781 changes in the viral amino acid.
A number of studies have shown that in vitro or laboratory testing has the potential to escape the immune response so that SARS-CoV-2 can circumvent the vaccine-induced immune response.
The majority of these mutations had little effect on the biological structure of the virus. However, more and more new variants resulted from the mutations are worrying. A number of studies have shown that in vitro or laboratory testing has the potential to escape the immune response so that SARS-CoV-2 can circumvent the vaccine-induced immune response.
Now, the vaccination program is running and we must support it entirely. Along with vaccination, we must tackle some urgent homework. One of them is potentially the collapse of health facilities, especially in Java, due to a flood of patients. So it is necessary to immediately increase the capacity of the health services.
However, the efforts in downstream will not be enough if the transmission rate is exponential. Thus, in the medium and long term, the rate of transmission and increase in cases must be controlled through strengthening surveillance and changes in behavior. The survey includes increased capacity for testing, tracing and isolation, as well as maintenance. In terms of behavior, it means that residents must wear masks, wash their hands and keep their distance.
Without control of transmission, not only will the rates of cases and deaths increase, but vaccinations can fail. Moreover, uncontrolled cases provide the opportunity for new, more dangerous mutations to emerge.
(This article was translated by Kurniawan Siswoko).