Limited Supply Hinders Vaccination

Indonesia intends to vaccinate 181,5 million people age 18 and above in 2021. Limited vaccine supply remains a challenge in the Covid-19 vaccination process during the first semester of 2021. To optimise the vaccination program’s achievement, it is crucial for multi-parties that prioritise evidence-based policy to collaborate.

Limited vaccine supply remains a challenge in the Covid-19 vaccination process during the first semester of 2021. To optimise the vaccination program’s achievement, it is crucial for multi-parties that prioritise evidence-based policy to collaborate.

This was the main topic in KSIxChange#32 event, themed “Challenges and Reality of Covid-19 Vaccination Policy in Indonesia”. This online discussion was held by Knowledge Sector Initiative or KSI on Tuesday (23/3). Resource persons for this event included a representative from the Ministry of Health (MoH), dr. Dyan Sawitri, Deputy for Basic Research of the Eijkman Institute, Professor Herawati Sudoyo, and Group Leader of Data 61 CSIRO Australia, Mahesh Prakash. The discussion, which was aired on the Youtube channel Asumsi, was moderated by a researcher from the Center for Health Policy and Management (PKMK) of the Medical Faculty of Gadjah Mada University, Tri Muhartini.

The representative from the Ministry of Health, dr. Dyan Sawitri, explained that during the first semester of 2021, the number of vaccine supplies have only reached approximately 30 percent of the actual needs. This has hindered the vaccination process, making it short to achieving the target. However, she emphasised that the number of vaccine supplies will increase on the second semester of 2021. This will enable vaccine distribution to reach more recipients in accordance with the established target. “Incoming number of vaccines is currently still limited, so we have to make distribution priorities accordingly based on risk groups. After June, it will begin to increase,” she said.

Indonesia intends to vaccinate 181,5 million people age 18 and above in 2021. This target, said Dyan, is set to attain herd immunity. According to the recommendation from the World Health Organisation (WHO), herd immunity will be acquired when 70 percent of the population has immunity against the virus.

Dyan added that vaccine distribution has not become a problem because there is a mechanism in place to distribute it to health service centres at the local level. This mechanism had been running in the national immunisation program. Using this mechanism, vaccine distribution during the second semester will be accelerated, cooperating with various stakeholders, including private sector. “We have no problem distributing to the subnational level. The vaccine will be distributed as soon as it arrives,” she explained.

Related to vaccine needs in Indonesia, the Deputy for Research of the Eijkman Institute, Professor Herawati Sudoyo, said that currently, the merah putih vaccine continues to be developed. The process has entered animal clinical testing. Later on, when proven to stimulate antibodies in animals, the seed vaccine will be handed over to Bio Farma to pass the clinical testing phase. “We are not rushing it. We want to make sure that this product currently under development can be used for the people of our country,” she explained.

She thinks that collaboration with multi-parties in developing merah putih vaccine is essential. Cooperation with Bio Farma as the industry, for example, is done to ensure that vaccine development from the laboratory can reach the stage of procuring large number of supplies. In addition, the National Agency for Drug and Food Control (BPOM) is also overseeing the vaccine development process by providing a guideline on standards that must be met in each development stage.

As soon as it is ready to be distributed, merah putih vaccine will be primarily used domestically. One of the considerations of doing so is various virus mutations that may decrease the vaccine’s efficacy. However, there is always a possibility of distributing this vaccine to other countries.

From a scientific perspective, Hera continued, currently all parties are still learning. The nature of the Covid-19 virus is yet to be fully known, hence the need for global collaboration to study it, let alone with all the mutations showing up. Surveillance to study the virus’ genetic information sequence needs to be done, and its data shared. “In Indonesia, there are 14 institutions that have uploaded the data to Gisaid, which is stored in a data bank that can be shared all over the world. Data sharing and solidarity are crucial here,” she added.

Furthermore, the Group Leader of Data 61 CSIRO Australia, Mahesh Prakash, said that he has developed a model to handle Covid-19 for Australia, Germany, and Indonesia. In this model, there are similarities and differences in every country. Regarding the number of population, for example, the number of younger aged population in Indonesia is greater than Australia. The same is true for population density and habit to use public transportation. These factors need to be considered when mapping the virus transmission level. From there, policies can be made to control the spread. “We have cooperated with a number of institutions in Indonesia, including with West Java,” he said. 

This kind of modelling can also be done in relation with vaccination. The main question is how to optimise the impact of vaccination if the number of available vaccines is limited. Determining the target and allocation of vaccines will be the key. Therefore, high quality data is essential. He reminded that other factors still need to be considered in determining the target. “Even though it is concluded through modelling that vaccines must be given in certain areas, this must be reconsidered in the decision making process if it is questioned by the public,” he said.        

In this discussion, the Ministry of Health emphasised that in formulating the vaccine distribution policy, it has collaborated with various research institutions and other individuals. The Eijkman Institute also underlined that science will continue to develop and that the Institute would continue to support the Ministry of Health in implementing its policies.

This discussion was held to serve as KSI’s effort to support the Government of Indonesia in responding to post-COVID-19 development plan. KSI’s support especially focuses on the issue of policy making during this pandemic era, and building a more effective knowledge institutionalisation mechanism. This endeavour is expected to ensure that a healthy knowledge and innovation ecosystem is in place to respond to the pandemic and other urgent, global issues in the future. 

KSIxChange is an interactive discussion initiated by Knowledge Sector Initiative (KSI), a partnership between the Government of Indonesia and Australia, funded by the Australian Department of Foreign Affairs and Trade (DFAT). KSIxChange is held regularly, and aims to support the implementation of government programs by increasing public discourses based on using evidence in policymaking.