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Jakarta, Indonesia – Questions over the potential use of pork products in vaccines are worsening vaccination reluctance in Indonesia, experts have warned, urging Muslim officials and leaders in the Southeast Asian nation to step up efforts to gain public trust ahead of a mass vaccination campaign against Covid-19.
Pig gelatin is used as a stabilizer in some vaccines. But pork consumption is strictly prohibited or “haram” for Muslims, who make up 87 percent of Indonesia’s 273 million people, raising concerns that it may hamper vaccination in the most Southeast Asian nation. affected by covid-19.
Dr Dicky Budiman, an epidemiologist who has helped formulate the Indonesian Ministry of Health’s pandemic management strategy for 20 years, said halal certification for covid-19 vaccines was essential.
“Halal is more than just food – it more incorporates all aspects of the lifestyle for practicing Muslims,” Budiman said.
“If you’re doing business, you have to do it in a halal way and not cheat on people. When it comes to vaccines, halal certification is practically compulsory in Indonesia as it ensures that the production process from start to finish conforms to Islamic teaching.
The Indonesian government has been praised by health experts for not placing its hopes on a single vaccine against covid-19.
It has placed binding orders for 100 million doses of AstraZeneca, 50 million doses of Novavax, 50 million Pfizer, 53 million COVAX / GAVI – a global organization working to ensure poor countries have access to COVID vaccines -19, and 125 million more. of Sinovac in China.
However, the government has yet to approve a single vaccine candidate.
AstraZeneca, Novavax and Pfizer all said there was no pork products in their vaccines. But Sinovac has refused to disclose the ingredients of its COVID-19 vaccine or to say specifically if it contains pork gelatin.
The MUI, Indonesia’s main Muslim religious body that makes decisions on halal certification, also appears to be sleeping behind the wheel.
He finished his study of the Sinovac vaccine a month ago but has not yet announced his decision.
“Many people in Indonesia believe in conspiracy theories about COVID-19 and one of the reasons for this is that the government has not had a clear strategic communication campaign,” Budiman said.
“Sinovac must also be very clear on the ingredients of its vaccine and MUI should announce its decision on halal certification without further delay.”
‘It was a mess’
Indonesia, which has reported more than 758,000 COVID-19 infections and more than 22,500 deaths since the start of the pandemic, has already received three million doses of the Sinovac vaccine and plans to receive doses of AstraZeneca and Pfizer in the coming weeks.
But with the authorization and halal certifications for the vaccines still pending, it is not clear when the country will be able to roll out its vaccination program.
Ahmad Utomo, a molecular biology consultant in Jakarta who specializes in diagnosing lung infections, said the government’s failure to allay concerns about pork products in vaccines is a classic example of its inability to communicate with the public throughout the pandemic.
“The problem is that of public confidence. There is a deep mistrust of the government regarding covid-19 which was exacerbated by scientific miscommunication from Purwanto in the early stages of the pandemic, ”he said, referring to former Indonesian health minister who said the country was safe from covid-19 because of the prayer.
“Aggressive moves by some government officials to get vaccinations to start in November when there was no sign of vaccine efficacy or BPOM [Indonesia’s agency for drug and food control] the approval was also unproductive, ”he said. “Scientists were caught in the middle. It was a mess.
Reluctance to vaccines has been on the rise in Indonesia for many years and was further exacerbated during the pandemic, according to the World Health Organization (WHO).
An August survey of the Indonesian Ministry of Health found that 27% of those surveyed were reluctant to take a covid-19 vaccine – a group that the survey found “crucial for a successful vaccination program” .
Their reasons ranged from religious beliefs, fear of vaccine side effects, and uncertainty about the effectiveness of covid-19 vaccines.
“I’m not sure if I take it because my aunt told me there is pork,” a practicing Muslim woman from West Kalimantan province who, like many Indonesians, told Al Jazeera Vita. has only one name. “Maybe Muslims can have it if there is a specific purpose. But I would have to study the Quran to find the answer.
But Sadiyah said halal certification did not worry him. “I’m more worried about the other ingredients. Will it make me healthy or sick? Because at the moment I am in good health.
Yasmin Libbing, a commodity specialist who supplies German medical tools to hospitals in Central Java, said reluctance to the virus was widespread in his hometown of Semarang.
“Many people are against it and many are pro-vaccine. There is no deal, ”she said. “But the doctors I talk to every day, they tell me that they won’t trust them until they get through all the clinical trials.”
Obstacles ahead
The joint WHO-Ministry of Health investigation also found that a third of Indonesians wanting to be vaccinated against covid-19 were unwilling or unable to pay for it. Before being replaced by a cabinet reshuffle in December, former health minister Terawan Agus Putranto said the government planned to cover the cost of just 30% of the 107 million people expected to receive covid vaccines. 19 by 2022.
Following the public backlash, President Joko Widodo jumped into the fray, claiming that covid-19 vaccines would be free to all Indonesians.
Budiman welcomed the move, saying free vaccines were essential to achieve herd immunity during pandemics.
“But the government should have a clear strategic communication policy to fight against ‘infomida’ and provide the public with precise data on the efficacy and risks of each vaccine to prevent rumors from multiplying”, a- he declared.
“This way, it can be left to individuals to decide whether or not they want to be vaccinated.”
MUI is expected to approve COVID-19 vaccines containing pork gelatin, citing greater good. But if the past reaction of the Indonesian public to other vaccination programs is anything to say, accepting the coronavirus program could prove difficult.
Between 2017 and 2018, Indonesia undertook the world’s largest measles and rubella vaccination campaign. More than 67 million children have received a new combined measles and rubella (MR) vaccine from India.
The first phase in 2017 was successful, with more than 35 million children vaccinated on the main island of Java. Measles and rubella cases have fallen by more than 90%.
But things turned south in 2018 when the MUI of the Riau Islands, an archipelago scattered between Sumatra and the Malay Peninsula, alleged that the MR vaccine contained pork gelatin and was therefore banned.
The Jakarta MUI issued a statement supporting this assessment and subsequently, in Sumatra, Indonesia’s second most densely populated island, the MR vaccination rate fell to 68%.
In Aceh, an ultra-conservative Muslim province on the northwestern tip of Sumatra, turnout fell to just 8%, according to the health ministry.
MUI tried to go back with a follow-up statement saying the MR vaccine was cleared for use by Muslims. But by then, measles cases had increased.
By 2019, Indonesia had returned to where it was before the campaign with the third highest measles rate in the world.
British medical journal The Lancet said vaccine reluctance was on the rise around the world and Indonesia’s experience with the MR vaccine was a warning.
“Political leaders and health ministries must continue to engage with religious scholars and communities to generate both a common understanding and a clear message regarding the benefits of immunization,” the newspaper said.
“The health and survival of Indonesian children depend on it.”
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