With funding and vaccines at his disposal, Jokowi may still be unable to execute a free COVID-19 vaccination program as questions remain among Indonesians about the drugs’ safety and their halal status.
By Umair Jamal
Indonesia announced in mid-December that it will offer free COVID-19 vaccination to its citizens once the country starts its immunization program.
“I can say that the COVID-19 vaccine for the public is free. Once again, it’s free, there’s no charge at all,” said President Joko “Jokowi” Widodo recently.
Earlier this month, Indonesia received 1.2 million doses of a coronavirus vaccine from China’s Sinovac Biotech Ltd and the country is scheduled to receive another 1.8 million doses of the Chinese vaccine in January. Jokowi has instructed his finance minister to reallocate spending from other budgets to support the free vaccine program.
With COVID-19 cases rising rapidly in Indonesia, Jokowi’s government is under pressure from the public to contain the crisis. However, the success of the immunization program depends on whether the government can address the public’s safety concerns and convince them that the vaccine complies with Islamic laws.
Is the free vaccine program a result of mounting pressure on the government?
Indonesia has been struggling to contain coronavirus cases in the final weeks of the year, recording over 5,000 cases per day since the beginning of December. The country reported some of its highest daily increases in COVID-19 cases and deaths in the last week of December amid a third wave of the pandemic.
Over the last few months, Jokowi’s government has faced criticism over its poor handling of COVID-19.
During the early months of the pandemic, Jokowi’s government was more worried about the impact on the country’s economy, trade and tourism. In February, when many countries were imposing restrictions on international travel and tourism, Jokowi planned to attract tourists with offers of discounts of up to 30% on vacations. The Indonesian government even allocated almost US$5.2 million to social media influencers to promote the country as a destination amid the initial COVID-19 outbreak.
In March, Jokowi finally revealed that his government had withheld information from the public on coronavirus cases to prevent widespread panic. “Indeed, we did not deliver certain information to the public because we didn’t want to stir panic. We have worked hard to overcome this, since the novel coronavirus outbreak can happen regardless of the country border,” Jokowi said in a statement.
While the country has since imposed large-scale restrictions and barred foreigners from entering, the pandemic has taken a toll on the country’s health system. The country has only four doctors and 12 hospital beds per 10,000 people, and less than three intensive care beds per 100,000.
So far, Indonesia has recorded over 719,000 COVID-19 cases and more than 21,000 have died from the disease. Indonesia has the highest number of infections and deaths from the pandemic in Southeast Asia.
Jokowi may be emphasizing the mass vaccination program not only to contain the pandemic but also to shield his government from further criticism. After making the announcement of free COVID-19 vaccines for all, Jokowi also replaced then-health minister Terawan Agus Putranto, who was heavily criticized for his mishandling of the pandemic.
In a wider cabinet reshuffle, Jokowi also replaced five other ministers in the trade, tourism, fisheries, social affairs and religion ministries. While Jokowi may have shifted gears to contain the pandemic, his efforts still face significant challenges.
Even if the vaccine is free, will Indonesians get immunized?
The Sinovac vaccine has passed clinical trials in Indonesia but still has not been approved for emergency use by the country’s food and drug agency. Indonesia’s health ministry has also shortlisted several other coronavirus vaccines. However, Jokowi’s vaccination drive may face challenges beyond issues of approval or vaccine availability.
In Indonesia, the halal status of any potential COVID-19 vaccine remains a key challenge and may disrupt the new vaccination program. Many vaccines are produced using pig products, including gelatin, which helps as a stabilizer and offers protection against the effects of temperature. Indonesia’s Islamic leaders may issue a fatwa, or religious decree, to declare the Sinovac vaccine “haram”, or forbidden. A controversy over a vaccine’s halal status could undermine the government’s entire vaccination program.
“Our studies have found that some Muslims in Indonesia feel uncomfortable with accepting vaccinations containing these ingredients,” even if Muslim authorities approve them, said Rachel Howard, director of the healthcare market research group Research Partnership.
In 2018, the Indonesian Ulema Council, the country’s chief Muslim clerical, decreed that a measles vaccine was not in compliance with Shariah because it contained gelatin. Indonesia’s measles vaccination campaign suffered a huge setback after the decree and cases of the disease in the country spiked following the announcement.
In a bid to address the issue proactively for COVID-19, Indonesia’s government sent a delegation of Muslim clerics to China in October to inspect Sinovac Biotech facilities and clinical trials. So far, Biotech has not revealed the list of ingredients the company is using in the vaccine.
If a vaccine is deemed halal in Indonesia but does contain pig products, people still may not choose to receive the vaccine. In November, Indonesia’s ministry of health conducted an online survey to gauge the public’s views, perceptions and concerns about COVID-19 vaccination. The survey, implemented with the help of UNICEF and the WHO, found that there are significant concerns regarding vaccine safety and effectiveness. Views on vaccines varied based on factors ranging from economic status to geographical region and the availability of information about the vaccine.
The survey noted that there is high demand for accurate information about immunization and recommended clear public communication strategies, among other measures. The study also suggested that “more in-depth research to understand concerns and perceptions toward a COVID-19 vaccine and how misinformation, disinformation or an ‘infodemic’ may contribute to these concerns.”
These efforts to assure the Indonesian public that the vaccine is safe and complies with Islamic laws will be key to a successful immunization program.