Indonesia will launch a booster campaign, but most people will have to pay | DayDayNews

Medan, Indonesia – Indonesia officially launched its vaccine booster program on Wednesday to provide free vaccines to the elderly and those who cannot afford it, according to the health ministry.

But the decision to let the majority of Indonesia’s 270 million residents buy boosters out of their own pockets has sparked controversy.

“Why did the government suddenly come up with the idea of ​​a booster? If it’s because the government is worried about waning antibodies, that’s okay, because it’s related to the pandemic,” Pandu Riono, an epidemiologist and professor at the University of Indonesia, told Al Jazeera.

“But if it’s related to a pandemic, then the vaccine should be free.”

The government has not confirmed how much the vaccine booster will cost, although estimates have been published online using data from the UNICEF Vaccine Market Dashboard, which lists vaccine prices in different countries.

Potential prices range from $2.75 for AstraZeneca to $23 for Pfizer’s booster.

“There are rumors that the price of the vaccine is around 300,000 rupiah (US$21), but in reality, they may charge more in private clinics, so the price per injection may be as high as 1 or 2 million (US$70-140) ),” Alexander Arifianto, a researcher in the Indonesia program at the S Rajaratnam School of International Studies in Singapore, told Al Jazeera.

“Putting a price tag on a booster increases vaccine hesitancy. The higher the cost, the more people will hesitate to get it.”

vaccine fight

Indonesia’s vaccine program has already encountered difficulties, including a slow rollout and problems with vaccine procurement.

Only about 117 million of Indonesia’s more than 270 million people have been fully vaccinated since the campaign began on January 13 last year.

A little girl in glasses, a white t-shirt and a light blue face mask is vaccinated against COVID while her mother holds her handIndonesia has started vaccinating primary school students, but COVID-19 vaccination coverage varies widely across the archipelago, with only 20% fully vaccinated in some areas [Willy Kurniawan/Reuters]

After Indonesia participated in the manufacturer’s late-stage trial, most people received the China-made Sinovac vaccine.

And big Differences in vaccine coverage between different parts of the archipelago.

The populations of Jakarta and Bali are almost completely vaccinated, while regions such as Aceh and West Papua have managed to vaccinate only about 20 percent of their residents, according to the Ministry of Health.

“I’m not sure if the paid vaccine program will help cover a large population in Indonesia. Less than 50% [all] Indonesians are fully vaccinated and the government needs to encourage others to get vaccinated first,” Arif Anto said.

With so many still waiting for the all-important first shot, “Indonesia will remain vulnerable,” he said.

He added that while expecting people to pay for boosters out of their own pockets is a serious concern, a more pressing issue facing the government is procuring the necessary vaccines.

“Middle-income countries like Indonesia have struggled to get vaccines like Moderna and Pfizer because [the makers of those vaccines] Prioritize countries that can prepay quickly,” he said.

When the booster plan was announced earlier this month, Health Minister Budi Gunadi Sadikin told the media that Indonesia would need 230 million doses of boosters, about half of which are currently in stock. It is unclear where Indonesia plans to source the additional lenses.

mixed message

On Sunday, Indonesia’s food and drug monitoring agency authorized the use of Sinovac, Pfizer, AstraZeneca, Moderna and Zifivax, another Chinese-made vaccine, for the booster program.

A masked woman wearing a black turban and a peach jacket stands with other passengers on a Jakarta subway train as COVID cases dwindle to a few hundred a dayCoronavirus cases were only a fraction of what was at the peak of the delta wave last July, but the government proposes a booster campaign for the country amid concerns over Omicron [File: Tatan Syuflana/AP Photo]

The next day, the Ministry of Health released a complex set of instructions explaining which boosters people could get based on their initial shot.

Unlike the rest of the world, Indonesia advises people to stick to a single product – receive two doses Kexing Be told they can only have one Sinovac booster, those who get Moderna can only have Moderna, and those who get Pfizer Jab can only have one Pfizer or Moderna booster.

Meanwhile, neighbouring countries such as Singapore and Malaysia have encouraged vaccine mixing, and advised those vaccinated with Sinovac to get mRNA boosters from Pfizer or Moderna.

Mixed injections are also recommended in many countries around the world, as it is thought to promote a better immune response.

In December, a study in Oxford, England found that people better immune response When they received their first dose of AstraZeneca or Pfizer-BioNTech, they received Moderna nine weeks later.

But analysts said Indonesia’s booster policy may reflect the government’s existing resources and procurement difficulties.

“Providing booster vaccines only to priority groups like the elderly looks like a vaccine ration if the government can’t get enough vaccines,” Arifianto said.

“It’s going to cause problems for other people. It’s a huge country with a huge population and an uneven health structure.”

Indonesia has reported more than 4 million COVID-19 cases and nearly 150,000 deaths since the pandemic began, the highest death toll in the Asia-Pacific region.

While the current case fluctuates between 400 and 500 per day – Peak Score Documented last July – there are concerns about Omicron.

More than 150 people have been confirmed to be infected with the more transmissible variant since it was first reported in Indonesia last month. Most cases are related to international travelers entering Indonesia, but local transmission cases have also been detected in cities such as Jakarta, Surabaya and Medan.

priority group

Omicron’s arrival prompted the government’s decision to start a booster program ahead of schedule, which was initially supposed to start after vaccine coverage reached 70 percent.

But analysts fear it could further disrupt existing vaccination programs.

“Maybe some people don’t need a booster, but they’re worried, so they’ll pay for it and run out of vaccine,” Riono said.

“In some areas, people haven’t had the first or second dose. The government should make rules that the third dose can only be given in areas where 60 or 70 percent of the population has been vaccinated.

“Even so, it should only be people in priority groups, such as older adults and people with comorbidities or people who deal directly with the public.”

Glory Nainggolan is a student in Medan.She is fully vaccinated against COVID-19 but worried about booster immunizationsGlory Nainggolan is a student in Medan. She is fully vaccinated against COVID-19 but is concerned about the need for a booster immunization.She thinks they should be reserved for people working in health care [Supplied]

In Medan, trainee Catholic priest Friar Fernando told Al Jazeera he was still waiting to hear about a potential booster injection. He prefers not to reveal his full name.

In the initial vaccination campaign, clergy were prioritized for their interactions with the public.

He said it was unclear who would be eligible for the free vaccine this time around.

“As far as I know, this time only healthcare workers are considered essential workers,” Fernando said. Frontline workers stepped up their efforts last July as the delta wave hit, meaning some 1.3 million people, most of them healthcare workers, have received their third shot.

Ahead of Wednesday’s election campaign, survey group found that 55 percent of Indonesians disagreed with the concept of a booster vaccine, which Arifianto said could be due to cost and a lack of clear public health information.

In Medan, fully vaccinated student Glory Nainggolan told Al Jazeera she was concerned about the impact of a third vaccine on her health.

“I think two vaccines are enough. I’m worried that if I have a third vaccine, the side effects will be very strong,” she said. “The side effects I experienced last time after my second vaccination have been much stronger.”

“I don’t think it’s necessary for ordinary people, and the booster should be reserved for healthcare workers who are battling the virus every day.”