JAKARTA, Indonesia, May 4, 2023 – The Government of Indonesia is ramping up its effort to address the country’s decline in immunization rates caused by COVID-19 through a new focus on provinces with low vaccination coverage during the pandemic.
Over the next two years, the Ministry of Health aims to increase vaccination rates and notably reduce the number of zero-dose children in high priority provinces, with support from WHO, UNICEF and development partners.
COVID-19 led to a significant decrease in childhood immunization, due mainly to the wide disruption of essential health care services. UNICEF’s recently launched State of the World Children’s report reveals that globally 67 million children were not immunized over the last three years – the largest sustained backslide in childhood immunization in 30 years.
The decline in Indonesia affected national immunization targets. Fully immunized children coverage for infants aged 0-11 months reached 84.2 per cent in 2020 and 84.5 per cent in 2021. The number of zero-dose children rose from 10 per cent in 2019 to 26 per cent in 2021.
This backsliding put children at risk of contracting vaccine-preventable diseases like diphtheria, tetanus, measles, rubella, pertussis, hepatitis and polio. In response, the government mounted the national BIAN catch-up immunization campaign in 2022, that reached 26.5 million children with measles and rubella vaccines, 1.3 million with polio vaccines and 2 million with DTP-HB-Hib vaccines.
In 2022, Indonesia achieved 94.6 per cent full immunization coverage, exceeding the national target of 94.1 per cent. Yet, over the last six months there have been several outbreaks of vaccine-preventable diseases in areas that continue to have low vaccination rates.
“The Ministry of Health developed three strategies to increase routine immunization coverage,” the Ministry’s Director of Disease Prevention and Control, Dr. Maxi Rein Rononuwu said.
“First is by adding three types of children’s routine immunization from previously 11 vaccines to 14. The added vaccines are Rotavirus for anti-diarrhea and PCV vaccine for anti-pneumonia targeted for children, as well as HPV vaccine to prevent cervical cancer. The HPV is administered to girls on the 5th and 6th grade of elementary school to prevent the potential of cervical cancer when they turn into adults.”
“Second is by digitalizing immunization data through the Aplikasi Sehat IndonesiaKu (ASIK). There will be no more manual logging, all children’s immunization data will be stored in ASIK. The application will be integrated in the SatuSehat platform. Third, invitation to children’s immunization will be sent via the app,” Dr. Maxi added.
The government’s two-year plan also includes strategies to improve vaccine management and the immunization supply chain system and to build confidence in vaccines. Vaccine hesitancy among parents and caregivers – particularly with multiple injections required for routine vaccines – affected vaccine acceptance during the pandemic, along with vaccine misinformation and hoaxes.
According to the State of the World Children’s report – which is focused solely on immunization – Indonesia is one of 55 countries where vaccine confidence declined during the pandemic.
"UNICEF is committed to supporting Indonesia’s continued push to ensure that every child has access to life-saving vaccines,” said Maniza Zaman, UNICEF Representative. “This involves deliberate efforts to rebuild confidence in vaccines by assuring parents and caregivers about the safety and importance of immunization and by reducing the spread of hoaxes and misinformation.”
“Close collaboration across ministries, agencies and sectors is the key to catch up children who missed immunization in previous years. With that, we can exceed 95 per cent immunization coverage, which is the threshold for herd immunity, and close the immunization gap to prevent future outbreaks,” said WHO Representative to Indonesia, Dr N. Paranietharan. “WHO is committed to support Indonesia to deliver high quality and safe immunization to all children.”
In Indonesia, UNICEF and WHO have been working closely with the Government to raise awareness among caregivers about the importance of immunization, ensure access to immunization services, including in hard-to-reach areas, and strengthen the immunization supply chain system to maintain quality and efficacy of vaccines.