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The COVID-19 vaccine is available in Indonesia. The vaccination program has begun to be carried out by the government as an effort to break the chain of spreading Corona virus infection and reduce the number of COVID-19 cases which are still increasing. As your guide, here is some information about the COVID-19 vaccine that you need to know.

Regarding Vaccines and Things You Need to Know

What is a vaccine?

Vaccines are substances or compounds that function to form immunity against a disease. The vaccine content can be in the form of bacteria or viruses that have been weakened or killed, it can also be part of the bacteria or virus.

Vaccines can be given as an injection, by drinking drops, or via steam (aerosol).

Do you need to get vaccinated?

Vaccination is the process of administering a vaccine into the body. When a person has received a vaccine for a disease, their body can quickly produce antibodies to fight the germs or viruses that cause the disease when they are exposed to it.

Therefore, vaccination is important as a form of self-protection against disease, especially during the COVID-19 pandemic.

What is the difference between vaccination and immunization?

Immunization is the process of forming immune substances (antibodies) against certain diseases after a person has been vaccinated. In order for antibodies to form, a person must be given the vaccine according to the prescribed dose and schedule.

The vaccination schedule depends on the type of vaccine that will be given and the health condition of the person who wants to receive the vaccine.

So, what is immunity?

Immunity or immunity is the body's protection system against disease attacks.

Apart from undergoing vaccinations, adequate nutritional intake, adequate rest, regular exercise, and stress relief also need to be done to strengthen the body's immunity.

Why is vaccination important?

The benefit of vaccines is to prevent disease transmission, especially infectious diseases, because vaccines make the body recognize the bacteria or viruses that cause disease so that they can resist faster.

If you have received the COVID-19 vaccination schedule, you should do the vaccinations according to the schedule. Not only to protect yourself, but also those around you.

Vaccine Manufacturing Stage

What are the stages of making the vaccine?

To ensure its effectiveness and safety, vaccines must be researched and passed clinical trials which can take up to years.

The following are several steps in the process of making a COVID-19 vaccine:

1. Exploration

The exploration stage is the initial stage carried out through research in the laboratory to identify natural or synthetic antigens that can prevent a disease.

Antigen is a foreign object that can stimulate the formation of antibodies in the body. The exploration stage to determine this antigen can take a long time.

2. Preclinical studies

The preclinical study phase is carried out by giving vaccines to experimental animals to determine their effectiveness and safety. At this stage, researchers will also assess whether vaccines cause certain side effects.

3.

Phase I clinical trials

In phase I clinical trials, the vaccine will be delivered to several healthy adults. Its aim is to ensure the safety and effectiveness of vaccines in humans.

4.

Phase II clinical trials

Phase II clinical trials are carried out by giving vaccines to a larger number of people, with more diverse ages and health conditions.

After that, researchers will review and evaluate the effectiveness, safety, and proper dose of the vaccine, as well as assess the immune system's response to the vaccine given.

5.

Phase III clinical trials

In phase III clinical trials, vaccines will be given to more people with various conditions. Researchers will monitor the immune response and vaccine side effects over a period of time. This phase can take months to years.

6. Stage IV

After it has passed all clinical trials, vaccines can get a distribution license to be given to humans. In Indonesia, a vaccine distribution license is issued by the BPOM. However, even though it can be used in general, this new vaccine needs to be continuously researched and evaluated.

Vaccine Testing Phase and Expected Results

What is the expected outcome of the vaccine manufacturing?

The aim of conducting a series of clinical trials in the manufacture of vaccines is of course to ensure the safety and effectiveness of vaccines before they are given to the public.

Because the COVID-19 vaccine is still very new, research and evaluation are still underway to assess the body's response and possible side effects of the COVID-19 vaccine in humans.

The results to be achieved with the manufacture and administration of the COVID-19 vaccine are a reduction in the number of positive cases and deaths due to COVID-19, as well as the formation of herd immunity . That way, the economic and social impacts of this outbreak can also be minimized.

Profile of vaccines to be used in Indonesia

The following are several types of vaccines that have been approved by the Ministry of Health of the Republic of Indonesia:

1. Pfizer

Country of origin: United States

Base material: mRNA

Storage temperature: -70 ^o C

Effectiveness claim: 94–95% efficacy

Clinical trial phase: Has passed phase 3 clinical trials and obtained an Emergency Use Permit (EUA) from the U.S. Food & amp; Drug Administration (FDA)

Countries using: United States, Israel, United Kingdom, France, Bahrain, Canada, Saudi Arabia, Mexico, and Singapore

Side effects: Pain at the injection site, fatigue, headache, chills, joint pain, and fever

Reasons not yet brought to Indonesia:

• The government is finalizing a vaccine contract with Pfizer.
• Distribution of Pfizer vaccines is difficult because they have to be stored frozen at an ambient temperature of -70 ^o C.

2. Sinovac

Country of origin: China

Base material: Dead virus

Storage temperature: 2–8 ^o C (refrigerator temperature)

Effectiveness claim: About 65.3% efficacy (in Indonesia)

Clinical trial phase: Has passed the phase 3 clinical trial and obtained an Emergency Use Permit (EUA) from BPOM

Countries using: Indonesia, Brazil, Turkey, and China

Side effects: Pain or redness at the injection site, muscle pain, fever, and headache

Reasons to be brought to Indonesia:

• Storage can use a refrigerator or cool box, so that the distribution process of vaccines and the implementation of vaccinations is easier.
• The Sinovac vaccine is among the top 10 vaccine candidates and uses manufacturing methods that are already mastered by local companies, such as Bio Farma.

3. Moderna

Country of origin: United States

Base material: mRNA

Storage temperature: -20 ^o C

Effectiveness claim: 94.5% efficacy

Clinical trial phase: Has passed the phase 3 clinical trial and obtained an Emergency Use Permit (EAU) from the U.S. Food & amp; Drug Administration (FDA)

Countries using: Canada, Qatar, United States, United Kingdom

Side effects: Pain, swelling and redness at the injection site, fatigue, headache, muscle aches, chills, fever, and nausea and vomiting

Reasons for not being brought to Indonesia: The distribution process requires a fairly low temperature, which is -20 ^o C.

4. Oxford/ AstraZeneca

Country of origin: United Kingdom

Base material: Viral vector

Storage temperature: 2–8 ^o C (refrigerator temperature)

Effectiveness claim: 62-90% efficacy

Clinical trial phase: Has passed the phase 3 clinical trial and obtained an Emergency Use Permit from the UK Authority

Countries using: United Kingdom, India, Mexico

Side effects: Pain and swelling at the injection site, redness of the skin, low-grade fever, and headache

Reasons not yet brought to Indonesia: The government is in the process of purchasing the Oxford/ AstraZeneca vaccine and it is planned that 50 million doses of vaccine will be supplied to Indonesia.

5. Novavax

Country of origin: United States

Base material: Protein subunits

Storage temperature: 2–8 ^o C (refrigerator temperature)

Claim of effectiveness: Not yet known

Clinical trial phase: Currently undergoing phase 3 clinical trials

Countries using: United States

Side effects: So far no serious side effects have been seen

Reasons for not being brought to Indonesia: The Novavax vaccine is still in the phase 3 clinical trial phase and has not yet obtained a license to use.

6. Sinopharm

Country of origin: China

Base material: Inactivated virus

Storage temperature: 2–8 ^o C (refrigerator temperature)

Effectiveness claim: 79.34% efficacy

Clinical trial phase: Has passed the clinical trial phase phase 3 and obtained permission to use from health authorities in China

Countries using: China, Bahrain, United Arab Emirates

Side effects: So far, have had no serious side effects. Side effects are generally mild, such as fever, pain and swelling at the injection site, and headache.

Reason for being brought to Indonesia: Storage can use a refrigerator or cool box, so that the distribution process of vaccines and the implementation of vaccinations is easier.

7. Red and White - BioFarma

BioFarma in collaboration with the Eijkman Biomolecular Institute is still continuing to develop and research the COVID-19 vaccine. Clinical trials of this vaccine are planned to start around June 2021.

Vaccination Plan in Indonesia

Who are the vaccine producers that will be used in Indonesia?

• PT Bio Farma
• AstraZeneca
• China National Pharmaceutical Group Corporation (Sinopharm)
• Moderna
• Novovax Inc
• Pfizer Inc and BioNTech
• Sinovac Biotech Ltd.

What is the planned distribution pattern for the COVID-19 vaccine?

Vaccines, supporting equipment, and other logistics related to the vaccine administration process will be distributed to Puskesmas, clinics, hospitals and other health service facilities that have met the requirements for vaccination.

Not only medical personnel, distribution of the COVID-19 vaccine can also involve various parties, such as the TNI, Polri, and the Ministry of Transportation.

What are the criteria for people to receive the vaccine?

The following are some of the criteria for receiving the COVID-19 vaccine:

• Never been confirmed having COVID-19
• Body temperature is below 37.5 ^o C
• Blood pressure below 140/90 mmHg
• Not currently pregnant or breastfeeding
• Have no symptoms of ARI in the last 7 days and do not have certain medical conditions, such as allergies to vaccines, kidney disease, heart disease, blood disorders, or chronic digestive disorders
• Do not suffer from autoimmune diseases, such as lupus, rheumatoid arthritis, or Sjogren's disease
• For people with type 2 diabetes mellitus, blood sugar must be under controlled conditions and HbA1C below 58 mmol/ mol or 7.5%
• For people with HIV, the CD4 count must be more than 200
• Do not have lung disease, such as asthma, COPD, or tuberculosis, but for TB sufferers, vaccination can be done after 2 weeks of taking anti-tuberculosis drugs

If you haven't got the vaccine, what should you do?

Always apply health protocols, namely washing hands, wearing a mask, and maintaining a physical distance of at least 1 meter from other people. As much as possible, avoid traveling outside the home or hanging out with large crowds.

After traveling out of town or in a situation with a high risk of transmission of COVID-19, try to do a PCR test or a rapid antigen test and keep quarantine for 1 week, even if the test result is negative .

What are the stages of vaccine delivery in the community?

The government will provide the COVID-19 vaccine in stages, because there is not enough vaccine supply to be given to everyone at the same time.

The following is the schedule for the vaccine that has been planned by the government:

Period I (January – April 2021)

• Phase I: 1.3 million doses for health workers
• Phase II: 17.4 million doses for public officials who are unable to implement effective spacing and 21.5 million doses for the elderly (over 60 years of age)

Period II (April 2021 – March 2022)

• Stage III: 63.9 million doses for people with high risk of transmission
• Stage IV: 77.4 million doses for the general population using a cluster approach, according to vaccine availability

Vaccinations and Herd Immunity

What is herd immunity ?

Herd immunity or group immunity is a condition when most people in a group have immunity to an infectious disease. The more people who are immune, the harder it will be to spread the disease.

With the herd immunity against COVID-19, it is hoped that people who cannot receive vaccines due to certain conditions can also be protected from this disease.

So, what does herd immunity have to do with vaccinations?

When a person gets a vaccine, their body will develop specific immunity against the diseases that the vaccine can prevent.

That way, the person's immune system will be ready to fight bacteria or viruses that cause disease that enter, so that infection does not occur. Even if an infection occurs, the symptoms will be milder and the recovery will be faster.

Well , that way, automatically the rate of disease transmission will also decrease. So, the more people who receive the vaccine, the less the disease will spread.

The Importance of Health Protocols

After vaccination, is it okay to ignore health protocols?

The presence of a vaccine does not mean that it can immediately eliminate COVID-19. The potential for transmission of this disease remains, especially since vaccination in Indonesia is carried out gradually.

To achieve herd immunity against COVID-19, there needs to be around 60-80% of the total population who is immune to this disease. This means that at least 165 million people in Indonesia must get the COVID-19 vaccination.

This is one reason why achieving the vaccination target in Indonesia takes a long time.

Therefore, stick to health protocols by implementing physical distancing, wearing a mask when outside the house, washing hands diligently, and always maintaining endurance.

Do not ignore medical protocols, even when vaccinated

After receiving the COVID-19 vaccine, you are required to wait 30 minutes at the health facility where the vaccination was carried out. This is important so that doctors or nurses can make observations to prevent Post-Immunization Follow-up (AEFI).

If you do not show any symptoms after vaccination, you are welcome to go home.

Even after being vaccinated, you still have to comply with health protocols to prevent transmission of COVID-19, such as washing your hands, maintaining physical distance and wearing a mask when you are outside the home.

Also keep in mind that vaccines do not absolutely prevent COVID-19. After receiving the vaccine, it doesn't mean you can get together and party in a crowd. Stay away from crowded places and try to stay at home.

The risk of Corona virus transmission still exists even though you have received the COVID-19 vaccine. So, take care of yourself for the people you care about.

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