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Indonesia plans to vaccinate its young working-age population against the coronavirus before the elderly, in contrast to much of the world that plans to put its vulnerable older people first.
The first Southeast Asian country to receive Covid-19 vaccine delivery will focus on inoculating people between the ages of 18 and 59, starting with those working on the front lines of the pandemic, such as healthcare workers, the police and the army. The UK started the oldest vaccination program in the western world with a 91-year-old woman last week, in line with most other countries.
Workers unload the Covid-19 vaccines at the Jakarta International Airport in Tangerang on December 6.
Source: Indonesian Presidential Palace / AFP / Getty Images
The United States also began its immunization program with the elderly this week, following the advice of the Centers for Disease Control and Prevention that health care Nursing home workers and residents should get vaccinated first, followed by those with pre-existing medical conditions.
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As the death toll from the pandemic continues to rise, governments are grappling with the question of who should receive first the many vaccines that companies are rapidly approving. While Indonesia’s strategy currently stands out, it may indicate how other developing nations might consider their own deployment given their struggle to obtain sufficient doses to cover their populations.
“Our goal is herd immunity,” said Amin Soebandrio, director of the Eijkman Institute for Molecular Biology in Jakarta. “With the most active and exposed population group, those from 18 to 59, vaccinated, they form a fortress to protect the other groups. It is less effective when we use our limited number of vaccines in the elderly when they are less exposed. “
Immunization of workers
Indonesia is targeting people who are more mobile due to their jobs, as well as regions with the highest number of coronavirus cases, as it focuses on using the vaccine as a tool to slow the spread of infections.
Health workers on the islands of Java and Bali, which account for more than 60% of confirmed cases, will receive the 1.2 million doses from China. The Sinovac Biotech Ltd. vaccine, which arrived on December 6, will be followed by front-line workers in the rest of the country.
An implementation date will be set when the country’s drug regulator gives the go-ahead.
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The government has set a target of 246 million doses to meet its herd immunity estimate – the number of vaccines they need to immunize 107 million people, or 67% of their 18- to 59-year-old target group and only 40 % of the total population. This is considerably lower than the generally accepted definition of mass immunity, which includes between 60% and 72% of the total population of a country.
That government target will be met with 155.5 million doses ordered from Sinovac and Novavax Inc., with another 116 million potential orders for Pfizer Inc., AstraZeneca Plc and Covax facilities. He is also looking to develop his own shots, named Merah Putih for the colors of the nation’s flag, in an attempt to complement his offering.
Other experts view Jakarta’s vaccination plan with caution.
An announcement of coronavirus testing in Bandung, West Java, on December 10.
Photographer: Dimas Ardian / Bloomberg
“Indonesia has a young population, so this may have influenced their thinking, but I think vaccinating older people makes sense,” said Raina MacIntyre, professor of global biosafety at the University of New South Wales. “Ultimately, however, with a limited supply of vaccines, the difference between age-based strategies is not great.”
Difficult decisions
The country that is home to the fourth-largest population in the world is putting older people, people with existing health problems and pregnant women at the end of the line because it does not have the data to ensure the safety of Covid-19 vaccines. for those groups, said Health Minister Terawan Agus Putranto on Dec. 10. Sinovac injections were tested in people ages 18 to 59, which is why the government is wary of inoculating people of different age groups.
A day after the UK began distributing the Pfizer vaccine, its National Health Service had to issue a warning that people with a significant history of allergies should not receive the injections after two people experienced reactions.
“The issue is a question of suffering,” said Djohansjah Marzoeki, president of the Indonesian Bioethics Forum. “Whoever develops severe symptoms or dies from the virus and who only has minor effects and recovers by himself, it is because of this question that we must decide who should be vaccinated first.
As in other countries, the elderly account for the majority of Covid-19 deaths in Indonesia. Those aged 60 and over accounted for 39% of the country’s 19,111 deaths, while 36% were between 46 and 59 years old.
Ultimately, the decision about who to vaccinate comes down to how many vaccines a country can get quickly.
“Developed nations can start with the elderly knowing that they have enough doses to cover the entire population, when that is not the case for us,” said CB Kusmaryanto, a member of the Indonesian bioethics commission. “Our options are extremely negative; There are no good options, only the least bad. When Indonesia only has enough to vaccinate those most likely to infect others, then it is the one to go first. “
