ESSAY

HOW TO SOCIALIZE THE COVID-19 VACCINATION

PROGRAM IN INDONESIA

RACHELLITA PUJADIMARTA

0115111333205

UNIVERSITAS AIRLANGGA

FACULTY OF MEDICINE

MEDICINE

JANUARY 2021
Field : Life Sciences and Health Sciences

Topic : Problems and Solution of Covid-19 Vaccine Development in

Indonesia

How to Socialize The Covid-19 Vaccination Program in Indonesia

At the end of 2019 the world was shocked by the emergence of a novel
corona virus, SARS-COV-2, Human corona viruses were first discovered in the
1960s, this virus caused a symptoms like common cold cough to more dangerous
ones such as Severe Acute Respiratory Syndrome (SARS) and Middle Eastern
Respiratory Syndrome (MERS). Corona virus is transmitted through direct
contact or respiratory droplets. The number of cases in Indonesia are increasing
and in East Java, according to sources from the East Java Covid information, there
are 87797 confirmed cases. At this time, various efforts have been made by the
east java government to reduce the spread of the coronavirus, one of which is the
vaccination program.

As in other countries across the world, since the pandemic was first
declared in March 2020, the protracted COVID-19 outbreak has had a devastating
effect on the Indonesian health sector and economy. The country has made
extensive efforts to address challenges. The President of the Republic of Indonesia
formed a national team for the acceleration of the development of COVID-19
vaccines. The Presidential Decree no. 18/2020 issued on 3 September 2020
stipulates the formation of a COVID-19 vaccine development team which is
supervised by the Coordinating Minister of Economic Affairs. Additionally, the
Indonesian Ministry of Research and Technology is responsible for reporting to
the President on the day-to-day work of the team. The President signed and issued
a Presidential Decree on 6 October 2020 on the provision of a vaccine and the
implementation of vaccination program to combat the COVID-19 pandemic. It
stipulates that the government will arrange for COVID-19 vaccine provision,
distribution and vaccination. The Decree assigns a state-owned pharmaceutical
company, PT Bio Farma, to procure the vaccine in cooperation with several
international institutions. It also assigns the Indonesian Ministry of Health (MoH)
to manage vaccine distribution and the national vaccination programme. The
Ministry of Health (MoH) and UNICEF have signed a memorandum of
understanding (MoU) that will enable the procurement of vaccines at affordable
prices. The signing was part of Indonesia’s commitment to COVAX Facility, the
Gavi and WHO-led Access to COVID-19 Tools (ACT) Accelerator, which was
established to ensure the procurement and equitable distribution of COVID-19
vaccines to all countries. The Government of Indonesia (GOI) expects to receive
30 million doses of vaccine through a bilateral arrangement with different vaccine
manufacturers by the end of 2020 and an additional 50 million doses at the
beginning of 2021. As mandated by the Presidential Decree issued in early
October, the GOI intends to begin the vaccination process once a safe vaccine is
available. The National Immunization Technical Advisory Group (NITAG)
conducted a situation assessment regarding COVID-19 vaccination and has made
recommendations for access to priority groups. The MoH, with support from
NITAG and development partners, has developed a standard operating procedure
and road map for COVID-19 vaccination. These tools have been disseminated to
all provinces and other necessary preparations, including the vaccine introduction
readiness assessment tool (VIRAT). All processes have commenced
simultaneously.

Upon a request from NITAG, the MoH with support from UNICEF and
WHO, conducted an online survey in Indonesia to understand the public views,
perceptions, and concerns about COVID-19 vaccination Currently we see that the
government's plan to vaccinate covid-19 has experienced many obstacles from the
part of society, due the government’s efforts that are still not optimal in
disseminating vaccines to the community and it caused public anxiety about
vaccines. Approximately 74% of the respondents in Indonesia accept the
vaccination of covid-19, based on reports received from respondents only 69% of
people acceptance the vaccination and it comes from people with middle class
economic status, and the lowest is 58% from people with poor economics status.
There are several reasons people who refuse vaccination because they are not sure
about the efficacy and the side effects, also another reason is about religion
beliefs.

Currently the hope to stop the covid pandemic is a vaccine. Vaccines

manufactured by BioNTech / Pfizer has begun to be widely used as the first
licensed Covid-19 vaccine. Sinovac is currently running phase 3 clinical trials in
Indonesia and cooperate with state-owned pharmaceutical company Biofarma and
Padjajaran University. To ensure the safety and halal aspects of the vaccine which
were the reasons for the rejection, the Secretary General of the Ministry of Health
said the government had deployed a joint team to producing countries to ensure
this aspect, it is necessary to socialize the public regarding vaccination to build
public trust. Besides that, we must be considered with the fake news that always
appears especially related to vaccinations problems. even though the news does
not have a trusted sources but people are very easily influenced by the news.
Public communication is very important so that the vaccination program can run
and be structured according to the stages.

The government must involve community leaders, religious leaders, as

well as community religious organizations and others. optimizing the covid 19
task force at the provincial, district, sub-district and village levels to provide
counseling and education to the community. then to educational institutions both
formal and non-formal in order to conduct socialization to the middle to lower
class society. The community need to be vaccinated according to the WHO
Stategic Advisory Group of Experts on Immunization (SAGE) Roadmap is health
care workers with high risk for infection, groups with high risk of death or serious
disease and group with high risk of contracting and transmitting Covid-19. In
Indonesia, the peoples who targeted by the government vaccination program are:
health workers, military/police officers, and other public service officer;
community leaders, centra and local government officials, teachers; some groups
who had National Health Insurance (BPJS).

People’s perceptions towards health and disease prevention also played an

important role with many considering spirituality as a way to maintain health and
deal with disease. Other common contextual factors such as religious beliefs,
perceptions of pharmaceutical companies and socio-cultural-economic conditions
were also crucial for vaccine acceptance. Some also argued that the advice to wear
masks, wash hands and apply social distancing (3M) is enough. Those who
reported having been diligently following the 3M advice [("menggunakan
masker” (mask-wearing), “mencuci tangan” (hand-washing) and “menjaga jarak”
(social-distancing)] saw the benefits of this approach and questioned the risk-to-
benefit of adding a vaccine.

The following recommendations may be considered to ensure successful

deployment of a COVID-19 vaccine. Several actions are needed to be carried out
urgently, such as providing information about COVID-19 vaccine safety and
efficacy to the general public using clear, tailored communication approaches and
channels. Detailed recommendations are as follows:

 Develop a communications strategy that considers the diverse information

needs of the audience before, during, and after vaccine introduction,
especially those relating to the benefits of vaccine, safety, efficacy and equity
issues.
 Continue strong messaging and policy support provision for other COVID-19
mitigation measures such as 3 M (mask use, hand washing and physical
distancing) and promote them as a new social norm.
 Localise COVID-19 vaccine preparedness efforts as much as possible,
including tailoring Risk Communication and Community Engagement
(RCCE) approaches.
 Include front line health workers as the primary audience in communications
planning and build their capacity.
 Conduct more in-depth research to understand concerns and perceptions
toward a COVID-19 vaccine and how misinformation, disinformation or an
‘infodemic’ may contribute to these concerns.
 Find ways to reach the people who have the least access to information such
as poor and vulnerable people.
 Include behavioural interventions in RCCE planning, not just communication
messages. Consider including environmental “nudges” to address issues
related to concerns about cost, complacency (low-risk perception), and
convenience. Consider building out user profiles of early target groups in a
human-centered- design approach to ensure services provided are appropriate
and acceptable to mitigate risk.
 Make confidence-building part of every public action related to COVID-19
vaccine development and rollout—ensuring strong visibility of this aspect.
ive stream a plenary session of a national vaccine safety meeting outlining the
general research and development and vaccine safety approaches employed
by the government and experts.
o Speak with one consistent voice: choose a leading spokesperson.
 Plan for all contingencies and create a robust Vaccine-Related Events
Response Plan that considers all possible scenarios and responses.
 Involve religious leaders, professional organisations and Civil Society
Organisations.

However, concerns are raised about a rush to deploy a COVID-19 vaccine.

Applying “quick fix” and “short cuts” can lead to errors with disastrous
consequences. What regulators have to worry about is the atmosphere of hype
about the COVID-19 vaccine? Public claims about breakthrough research based
on poorly conducted studies or data collected through fraud is a real possibility.
All data which form the basis of any findings need to be scrutinized and should be
confirmed by other investigators. Relaxion on regulatory principles based on
political pressure and goodwill needs toberesisted,and one needstoprotectthe
interests ofvolunteers who are a part of such experiments.

Finally, vaccine development is a risky process, and one critical issue in

the COVID-19 vaccine would be the occurrence of ADE which may be disastrous
for those receiving the vaccine. Regulators have to take all precautions to
discourage candidate vaccines which may show such a phenomenon.
 .

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