KOMPAS / VINA OCTOBER
Officers provide Covid-19 vaccination services for residents at Tanjung Sari Health Center, Tanjung Sari Village, Natar District, South Lampung (12/1/2022). A number of health centers in Lampung began to provide booster vaccines for the elderly.
Giving the Covid-19 vaccine has been proven to be able to reduce the negative impact of Covid-19 transmission. The risk of serious illness, the need for hospitalization, and even death, can be reduced if a person has received a full dose of vaccination.
Even so, various studies show, the effectiveness of vaccines in forming immunity will decrease over time. The highest level of vaccine effectiveness occurs one to two months after vaccination. After that, the effectiveness of the vaccine decreased significantly after six months of administration of the vaccine. That’s the case with the various types of Covid-19 vaccines currently available.
From the meta-regression analysis reported by the World Health Organization (WHO) on December 22, 2021, a decrease in vaccine effectiveness occurred in the four types of vaccines studied, namely BNT162b2 (Pfizer BioNTech), mRNA 1273 (Moderna Covid-19), Ad26.COV2.S (Janssen), and ChAdOx1-S (AstraZeneca). The average effectiveness of the vaccine against severe disease decreased by eight percent after a six-month period in all age groups.
Vaccine effectiveness decreases in older age groups. In the over 50 age group, the vaccine’s effectiveness against severe disease decreased by 10 percent. Effectiveness against symptomatic disease also decreased by 32 percent in this age group.
Therefore, giving a booster dose is needed, especially in the elderly group. At least there are 120 countries that have started to give booster doses, including Indonesia.
Read too Considering the Type of Vaccine for the Third Dose
The WHO has provided recommendations for giving booster doses of the Covid-19 vaccine to the age group 60 years and over who received the primary dose of vaccine with Coronavac vaccine (Sinovac).
The booster dose vaccine can be the same type of primary or homologous vaccine or a different or heterologous type. Both are equally effective immunologically. This means that either giving a booster vaccine with the same type or a different type can increase the body’s antibodies.
The Food and Drug Administration (Badan POM) has previously issued an emergency use permit or EUA on five types of vaccines for booster vaccination. The five types of vaccines are CoronaVac, Pfizer, AstraZeneca, Moderna, and Zifivax vaccines.
Head of POM Penny K Lukito in Jakarta, Monday (10/1/2022) said each type of vaccine showed different levels of immunogenicity after 28 days of administration.
The type of vaccine given as a booster dose can be increased along with the latest developments from the results of research conducted. The vaccine, which has received an emergency use permit, has been tested for safety, quality and efficacy.
Although the emergency use permit has been issued by the POM, the choice of the type of vaccine to be given to the public is still decided by the Minister of Health. As a first step, the current vaccine will use a different type of vaccine.
Read too BPOM Issues Emergency Use Permits for Five Vaccine Booster Products
For the target who received the primary vaccine (main dose vaccine) with the Sinovac type, the booster vaccine given was half a dose of Pfizer vaccine or half a dose of AstraZeneca vaccine. Meanwhile, the target who received the primary vaccine with the AstraZeneca type could receive a booster vaccine with the Moderna vaccine as much as half a dose.
According to the Minister of Health, Budi Gunadi Sadikin, booster vaccines with different types of vaccines have a relatively equal or better antibody increase than booster vaccines with the same dose. Giving a booster vaccine with half a dose is also considered to be able to increase antibodies that are the same as or better than giving a single dose and have a lighter impact on post-immunization co-occurrence (AEFI).
COMPASS/TOTOK WIJAYANTO
Elderly residents participate in the third dose or booster injection program for the Covid-19 vaccine at the Kramat Jati Health Center, East Jakarta, Wednesday (12/1/2022). In the early stages, the vaccine booster, which is given free of charge to all Indonesians, will be prioritized for the elderly and vulnerable groups. The time span for the booster vaccine recipient is at least 6 months after the second dose is injected.
Priority
Giving booster doses of vaccines or vaccines booster in Indonesia has started on January 12, 2022. In giving this vaccine, the elderly or the elderly and people with impaired immunity will be a priority, after health workers who have received a booster dose of vaccine first. In government programs, booster doses of vaccines will be given free of charge.
Booster vaccinations for the elderly can be carried out in all districts or cities. Meanwhile, booster vaccinations for non-elderly vulnerable communities can only be carried out in areas where the first dose target is at least 70 percent of the total population and the first dose for the elderly is at least 60 percent.
Member of the Indonesian Technical Advisory Group on Immunization (ITAGI) Soedjatmiko said that booster dose vaccination needs to be prioritized for the elderly because it takes into account the magnitude of the risk caused by Covid-19 transmission. During the two years that the pandemic occurred in Indonesia, as many as 46 percent of deaths occurred in the elderly.
“Antibodies formed in the elderly from primary immunization are also lower than in young people and decline more quickly. Therefore, the elderly must be prioritized,” he said.
Chairperson of the Indonesian Allergy Immunology Association, Iris Rengganis, said that giving booster doses of vaccines must still pay attention to the possibility of post-immunization follow-up events. Early screening efforts are still needed, especially in the elderly who usually have comorbidities or comorbidities.
COMPASS/TOTOK WIJAYANTO
Medical officers prepare the Pfizer vaccine which will be given to elderly residents who are participating in the third dose injection program or the Covid-19 vaccine booster at the Kramat Jati Health Center, East Jakarta, Wednesday (12/1/2022). In the early stages, the booster vaccine, which is given free of charge to all Indonesians, will be prioritized for the elderly and vulnerable groups.
“For screening, it is no different from primary vaccination. However, it is recommended that the elderly can undergo a medical examination first, such as measuring blood pressure before being vaccinated. Existing comorbidities must also be ensured under control,” he said.
The booster vaccination is not only aimed at protecting against the threat of the Omicron variant, but also the Delta variant which is currently still transmitting in the community.
Soedjatmiko added that booster vaccination is not only aimed at protecting against the threat of the Omicron variant, but also the Delta variant which is currently still transmitting in the community. However, other more important preventive measures must be considered, namely wearing masks, keeping a distance, and washing hands.
Read too Against Omicron’s Onslaught, Antibody “Elite Troops” Need Boost Vaccines
The coverage of primary dose vaccination must also be ensured to be more widespread and even. Protection from vaccination will be more optimal if the entire community has received a complete dose of vaccine.
The Ministry of Health as of January 12, 2022 noted, the total population who had received a complete dose of vaccination was 118.1 million people or 56.7 percent of the total target. Even so, this coverage is not evenly distributed, in fact there are still 21 provinces with coverage of the second dose of vaccination less than 50 percent. The lowest coverage was in the provinces of Papua (20.7 percent), Maluku (26.8 percent), and Aceh (29.2 percent).
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