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The first Southeast Asian country to receive COVID-19 vaccines will primarily vaccinate the 18-59 age group, starting with the first to fight pandemics, such as healthcare workers, the police and the military.
The United Kingdom (UK) launched the western world’s first vaccination program by vaccinating a 91-year-old woman, and many other countries have followed similar strategies.
The United States has also launched its vaccination program against a group of the elderly, following the recommendations of the Centers for Disease Control and Prevention that healthcare workers and residents of nursing homes should be vaccinated first, followed by the critically ill people.
As mortality from COVID-19 continues to rise, national governments are trying to address the sensitive issue; who should be the first to get the vaccines, which companies are rushing to approve as soon as possible. Currently, Indonesia’s strategy is different from others, and the question arises as to which strategy other developing countries will choose, given their difficult efforts to ensure sufficient doses for all their populations.
“Our goal is herd immunity,” said Amin Soebandrio, director of the Eijkman Institute for Molecular Biology in Jakarta. – When the most active and most contacted people in the 18-59 age group are vaccinated, they will form a kind of fortress to protect other groups. The result will not be as effective if we use our limited supply of vaccines for the elderly with fewer contacts ”.
Vaccination of workers
Indonesia prioritizes those with the highest levels of mobility due to the nature of their work, as well as regions with the highest incidence of coronavirus, and is concentrating efforts on using the vaccine as a means of slowing the spread of infections.
Health workers in Java and Bali, accounting for more than 60 percent. 1.2 million cases will be assigned. The doses of the Chinese vaccine Sinovac Biotech Ltd. were received on December 6. Later, those who are in the first ranks of the pandemic will be vaccinated in the rest of the country.
Vaccination is due to begin on January 13, subject to approval by the national drug regulator.
The government has set a budget of 246 million. dose target for herd immunity: the number of vaccines needed for a country to vaccinate 107 million people, or 67 percent. their target age group of 18 to 59 and only 40 percent. of the entire population. This figure is much lower than the generally accepted definition of mass immunity: 60-72%. of the entire population of the country.
This government objective will be achieved with the receipt of 155.5 million. doses from Sinovac and Novavax Inc., as well as another 116 million possible orders from Pfizer Inc., AstraZeneca Plc. and Covax.
In addition to hoping to replenish vaccine supplies, it is looking to develop its own vaccines, which are named after the national flag, Merah Putih (“red and white”).
Other experts are wary of Jakarta’s vaccination plan.
“The Indonesian population is young, so it may affect their thinking, but I think vaccinating older people makes sense,” said Raina MacIntyre, professor of global biosafety at the University of New South Wales. “But in the end, with limited vaccine stocks, the difference between age-based strategies is not great.”
Difficult decisions
The fourth-largest country in the country classifies the elderly, people with health problems and pregnant women at the end of the vaccine because it does not have data to guarantee the safety of COVID-19 vaccines for these groups, said the minister of Cheers, Terawan Agus, December 10. Putranto.
The vaccines made by Sinovac have been tested in the 18-59 age group, so the government is reluctant to vaccinate people in other age groups.
A day after the UK began distributing Pfizer, the country’s national health service had to issue a warning that people with severe allergies should not be vaccinated with the vaccine.
The warning came after reports that two vaccinated people had an allergic reaction.
“This is an issue that is associated with suffering,” said Djohansjah Marzoekis, president of the Indonesian Bioethics Forum. “Whoever develops severe symptoms and possibly dies from the virus, and who feels only a small effect and heals itself in the long term,” it is on the basis of the answer to this question that we must decide who should be vaccinated first. “
As in other countries, the elderly population of Indonesia accounts for the highest percentage of deaths from COVID-19.
Those older than 60 years represent 39 percent. of the 19,111 people in the country who died of COVID, between 46 and 59 years old. in the age group this percentage is slightly lower: 36 percent.
Finally, the decision of who will get vaccinated is determined by one important factor: how much vaccine a country can quickly buy.
“Developed countries can start vaccinating the elderly population knowing they have enough vaccine doses to vaccinate the entire population, but our case seems to be different,” said CB Kusmaryanto, member of the Indonesian Bioethics Commission. Our choices are particularly difficult. There are no good options, only the less bad ones. When Indonesia only has enough vaccines to vaccinate those most likely to infect others, it is these people who should be vaccinated as a matter of priority. “
The South Asian country has started with 125.5 million. Sinovac CoronaVac vaccine dose and the first 3 million dose batch has already arrived in the country.
The country expects to receive the shipment of the Pfizer vaccine no earlier than the third quarter, while vaccines developed by AstraZeneca and the University of Oxford will begin shipping in the second quarter, Reuters reports.
“I don’t think it is possible to categorically state which approach is the correct one,” said Peter Collignon, professor of infectious diseases at the Australian National University, adding that Indonesia’s strategy could slow the spread of the disease, although it may not affect the mortality rate.
“Indonesia’s different strategy than the US and Europe is valuable because it will show us if they will have a more dramatic impact than Europe or the US. But I don’t think anyone knows the answer.”
Professor Dale Fisher from the Yong Loo Lin School of Medicine, National University of Singapore, said he understood the logic of the Indonesian approach.
“Younger working-age adults are generally more active, more communicative and travel, so this strategy should reduce the spread of the virus in society faster than vaccinating older people,” he said. – Of course, the elderly are at higher risk of serious illness and death, so their vaccination has an alternative logic. I see benefits in both strategies. “
At the end of December, it was announced that foreigners would not be allowed to enter Indonesia from the beginning of this year, to prevent the spread of the new COVID-19 strain found in the UK.
Foreign Minister Retno Marsudi said the ban would apply from January 1-14.
© Zuma Press / Scanpix
During this period, only people of Indonesian citizenship will be allowed to enter the country, with the exception of foreign officials with at least ministerial status. But even they will only be able to enter the country under a strict health protocol, the minister said.
Foreigners can still enter Indonesia until Thursday, but only after showing a negative RT-PCR coronavirus test two days before departure.
“Upon arrival in Indonesia, they (foreigners) will have to perform another RT-PCR test and if the result is negative, they will have to isolate themselves for five days after arrival,” Marsudi said.
Foreigners will have to retest after self-isolation and if the result is negative, they will be allowed to continue their journey. The same procedure will apply to Indonesian citizens entering the country.
The new ban was announced on the day that 5,554 new coronavirus cases were approved in the country, bringing the total to 719,219. A total of 21,452 patients died from the disease in the country, including 215 people who died the day before.
Almost the entire island of Java is considered a red zone in terms of impact, and health workers warned of the decrease in hospital beds to treat infected patients, and warned of a possible increase in new cases after the end of the year vacations.
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