Commentary: Indonesia’s questionable decision on vaccinating only those aged 18 to 59

LONDON: The Indonesian authorities coverage to exclude the aged (aged 60 years and above) within the first section of the free COVID-19 vaccination program may hinder the vaccine’s impression in reducing mortality charges.

The authorities has prioritised early-stage vaccination for well being staff, civil servants and residents aged 18 to 59. 

The CoronaVac vaccines from Chinese firm Sinovac won’t be used to vaccinate aged residents aged 60 nd above.

Considering the big COVID-19 mortality charges in Indonesia, the very best in Southeast Asia and dominated by those within the 60 years and above age bracket (45 per cent of the whole confirmed deaths from COVID-19), this coverage is problematic.

READ: COVID-19: Hurdles ahead for Indonesia as it aims to vaccinate 180 million people in 15 months

In addition, this coverage is inconsistent with Indonesia’s prioritisation of recipients to be vaccinated introduced by the federal government on Jan 4.

This information additionally incorporates the technical suggestion from the World Health Organization (WHO) to prioritise well being staff within the first section of vaccination, after which civil servants and those aged 60 and above within the second section (estimated to be January to April 2021).

14095426 This, in accordance to the federal government, will present oblique safety throughout age teams.

READ: COVID-19: Why Indonesia is vaccinating its working population first, not elderly

The authorities additionally claimed knowledge isn’t out there but on CoronaVac vaccine security for senior residents.

Furthermore, the National Agency of Drug and Food Control (BPOM) to this point has only authorised CoronaVac vaccines for residents aged 18 to 59 years outdated.

Outbreak of the coronavirus disease (COVID-19), in Sao Paulo

FILE PHOTO: An worker picks up a vial containing CoronaVac, Sinovac Biotech’s vaccine towards the coronavirus illness (COVID-19), at Butantan biomedical manufacturing heart in Sao Paulo, Brazil January 12, 2021. REUTERS/Amanda Perobelli

But these claims are questionable.


In September 2020, Sinovac launched preliminary outcomes of their section 1 and a pair of scientific trials in China for wholesome individuals aged 60 years and above. 

The similar vaccine is at present being examined in a section 3 scientific trial in Bandung, Indonesia.

The preliminary outcomes indicated that the CoronaVac vaccine confirmed good immunogenicity (capability to set off immunity) towards the virus that causes COVID-19.

The vaccine was deemed protected to use for wholesome individuals aged 60 and above. There have been no severe hostile results associated to the vaccine in scientific trial volunteers.

READ: Commentary: This 71-year-old wants you to get a COVID-19 vaccine once you can. Here’s why

Turkey, considered one of Sinovac section 3 scientific trial websites, granted emergency use authorisation for CoronaVac, concentrating on well being staff and those above 65 in its early section of vaccine roll-out. Turkey’s President Recep Tayyip Erdogan, 66, was the primary recipient of the CoronaVac vaccine.

Empirical proof relating to CoronaVac vaccine security and efficacy from a trial involving aged in Brazil has additionally been circulating.

Unfortunately, the information (from China and Brazil) weren’t thought of within the analysis by the National Agency of Drug and Food Control (BPOM) of Indonesia.

READ: Commentary: Pharmaceutical firms saved the world with COVID-19 vaccine in record time. But credit goes to others too


Based on scientific trials outcomes of assorted COVID-19 vaccines which have been launched, present vaccines are confirmed to cut back the danger of symptomatic COVID-19 with various ranges of efficacy.

But, these trials haven’t answered exactly how efficacious these vaccines are in lowering the danger of transmission or an infection.

Virus Outbreak Brazil

An aged girl will get a shot of China’s Sinovac CoronaVac vaccine as a part of a precedence COVID-19 vaccination program for the aged at a drive-thru vaccination heart in Rio de Janeiro, Brazil, on Feb 1, 2021. (Photo: AP/Silvia Izquierdo)

The section 3 CoronaVac scientific trial protocol in Brazil, for instance, acknowledged that the first endpoints are: One, the efficacy in lowering the danger of symptomatic COVID-19 circumstances; and two, the security of the vaccine in adults (aged 18 to 59) and the aged (aged 60 and above).

Recently, preliminary outcomes from the section 3 scientific trial in Brazil confirmed 50.39 per cent efficacy in reducing the incidence charge of symptomatic COVID-19 (with 95 per cent confidence interval: 35 to 62 per cent).

There is not any dependable proof from the trial on the efficacy towards the transmission of the virus.

READ: Commentary: Could Indonesia be Southeast Asian hub for Chinese COVID-19 vaccine?


Data on CoronaVac vaccine security and efficacy for those aged 60 and above can be found to be additional evaluated by the BPOM.

Kusnandi Rusmil, principal investigator of the CoronaVac Vaccine scientific trial analysis workforce in Indonesia, acknowledged that knowledge relating to vaccine security on the aged might be obtained from scientific trials in different nations.

BPOM has the proper and obligation to request such knowledge for additional evaluation in order that suggestions for CoronaVac vaccine use in Indonesia can doubtlessly be prolonged to the aged inhabitants instantly.

READ: Commentary: Misinformation threatens Singapore’s COVID-19 vaccination programme

BPOM ought to instantly contemplate preliminary scientific trial outcomes from each location, testing the CoronaVac vaccine in a extra complete and detailed method. This knowledge can present proof relating to vaccine efficacy and security within the aged.

The variations between pattern dimension and traits in each scientific trial location would possibly have an effect on efficacy and security outcomes and must be evaluated proportionally, primarily based on the general scientific trial knowledge throughout places.

READ: Commentary: Here’s why taking the vaccine is necessary even if it’s optional

Amid the excessive mortality charge within the aged group due to COVID-19, overwhelmed healthcare services in varied cities, and restricted vaccines availability, the federal government ought to prioritise aged within the first section of the vaccination roll-out.

By prioritising vaccination for aged, Indonesia might optimally cut back the hospital burden and COVID-19 deaths amidst a restricted vaccine provide throughout the first vaccination section.

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Bimandra Djaafara is a PhD scholar in infectious illness epidemiology on the Imperial College London.

Fahrin Ramadan Andiwijaya is Research Assistant at Universitas Mataram.

Fiona Verisqa is a PhD candidate in Biomaterials and Tissue Engineering at UCL.

Ihsan Fadilah is NIHR Fellow on the Department of Biostatistics and Health Informatics, King’s College London.

Kartika Saraswati is a DPhil scholar in Clinical Medicine on the University of Oxford.

Nursidah Abdullah is a MSc scholar in Public Health and Health Promotion at Swansea University.

Rizka Maulida is a PhD scholar on the Centre for Diet and Activity Research (CEDAR) on the University of Cambridge.

This commentary first appeared on The Conversation.

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