JAKARTA (INDONESIA) – Indonesian President Joko Widodo received the nation’s first coronavirus vaccine live on television last month, however, his ambitious inoculation campaign has stumbled, and is already facing glitches from factors such as refrigeration, distrust and disinformation.
“Disaster,” said Pandu Riono, a University of Indonesia epidemiologist when asked what his expectations are from the coming months.
“Healthcare will have already collapsed. Already there are many stories about people dying on arrival, in emergency and on the way because they are searching for a hospital. Even the graveyards are running out of space.”
Budi Gunadi Sadikin, the new health minister, told health ministry officials of his concerns about the vaccination rollout, as soon as he was appointed in late December, a source familiar with the programme said.
The health ministry declined to comment on the report.
COVID-19 task force spokesman Wiku Adisasmito said the government was giving it its all with available resources, and rather than focus on “negative predictions” it was working hard to implement “comprehensive health protocols, vaccines and clinical care at the same time”.
Separately, the health ministry has demanded increasing the testing and contact tracing.
In its first phase, Indonesia plans to vaccinate around 1.5 million healthcare workers by February 21, which according to the health ministry is in progress.
Jokowi, as the president is known, has said he hopes 181 million people will be vaccinated in the next 12 months, or about 1 million per day for a two-dose vaccine.
Indonesia is currently vaccinating about 50,000 people per day, according to the health ministry.
From the capital Jakarta, vaccines will be sent out to more than 10,000 health centres across the country.
“Just imagine you have a fridge full of vaccines and the power goes out,” said Ines Atmosukarto, a molecular biologist who works on vaccine development. “All those doses will have to go in the bin.”
In places such as Bengkulu, on Sumatra island, some health centres do not have any cold storage or stable electricity, said Herwan Antoni, head of the local health agency.
“The wastage or spoilage ratio will be incredibly high,” he said.
Senior health ministry official Siti Nadia Tarmizi dismissed shortfalls in the country’s cold chain, saying it fell in line with WHO requirements, and it secured medical fridges, some of which were solar powered.
The ministry, she added, has also enlisted Unilever Indonesia, which is providing more than 200 ice cream refrigerators for vaccines.
“Getting it is not a problem,” said Diah Saminarsih, senior advisor for the WHO director general in Geneva.“Distributing it is a potential problem.”
Health experts say the first phase was always going to be the easiest, if there is good data of healthcare workers and most are willing recipients.
In Gowa, in South Sulawesi province, up to 200 medical workers had delayed their shots out of the belief that it had dangerous side effects or was haram, which meant that it was forbidden for Muslims, or because they had co-morbidities, said Gaffar, a senior official there who uses one name.
Ni Nyoman Sri Antari, the head of the health office in the provincial capital Jayapura, said, in Papua, some medical workers rejected vaccines in fear of a “global antichrist conspiracy”.
Public health experts say the glitches are even more reason to ramp up on the basics of testing, tracing and isolating.
“They need to go back to good old-fashioned public health measures,” said Ines, the molecular biologist. “It is not as sexy…we like to think there is a magic solution in the form of a pill or a jab.”
Even as the inoculations begin, the pandemic is worsening.
Epidemiologists say there may be over 3 million, with a death toll well above the 31,000 recorded.
Indonesia has secured nearly 330 million vaccine doses from China’s Sinovac, AstraZeneca and Novavax. It currently has only around 3 million doses of Sinovac’s CoronaVac, which are ready to use.
Novavax and AstraZeneca vaccines are slated to arrive in the second quarter.
Dicky Budiman, a pandemic researcher at Australia’s Griffith University, said it would take two, possibly three years, so as to complete the programme, instead of the ambitious January 2022 target.
“Vaccines cannot lead this effort,” he said, “The speed of the vaccine cannot match the speed of the virus transmission.”