Private COVID-19 Vaccination Drive Courts Controversy in Indonesia

With factory workers at risk of exposure to COVID-19 and the government’s vaccination campaign criticized as sluggish, Indonesian employers have taken the initiative to launch and pay for inoculation drives.

About 11,000 companies in Southeast Asia’s most populous country have sought to buy doses of vaccine from the government for inoculating staff and their families under the so-called gotong royong (burden-sharing) scheme, according to the Indonesian Chamber of Commerce. 

“With gotong royong vaccinations, we want to speed up the vaccination program so that herd immunity can be achieved sooner rather than later,” Siti Nadia Tarmizi, a health ministry official and spokeswoman for the coronavirus vaccination drive, told BenarNews. 

The initiative, expected to start next month, is ahead of similar programs being established by neighbors Thailand and the Philippines.

The Indonesian government is backing the initiative even though epidemiological experts warned that a private drive could divert limited stocks of vaccines from people who need them most, namely the elderly and other vulnerable people.

In December, Indonesian President Joko “Jokowi” Widodo said coronavirus vaccinations would be free for everyone. His announcement was an about-face amid public criticism after the government had announced that jabs would be given at no cost to only 30 percent of the population deemed vulnerable.

Since the government’s free vaccination program kicked off in January, nearly 5.2 million Indonesians have received shots using the vaccine developed by China’s Sinovac Biotech, according to the Health Ministry.

Indonesia aims to vaccinate 181.5 million of its 270 million people by March 2022, but the target is a tall order at the current rate, according to experts. 

The government wants private companies to start their programs in April but details, including costs, have not been finalized, officials said.

Siti said companies would pay for the vaccines, so there would be no cost to workers or their families, and private clinics and hospitals would administer the shots instead of public health facilities.

“This program will not interfere with the government’s one that is ongoing because the vaccines used will be different from the ones we are currently using,” she said.

Indonesia’s pharmaceutical holding company Bio Farma, tasked by the government to acquire vaccines, said it expected to receive more than 20 million doses of vaccines to be used in the private inoculation drive as early as later this month.

At least 15 million doses will be supplied by the Chinese state-owned firm Sinopharm, while the remainder will come from Moderna, a Massachusetts-based biotechnological company, said Bio Farma director Honesti Basyir.

But some experts questioned the move.

“We are in a pandemic situation, a national disaster. This means that the government is obliged to provide a pandemic control strategy by providing vaccines to groups with the highest risk, not groups with money,” said Dicky Budiman, an Indonesian epidemiologist at Australia’s Griffith University.

The private scheme “will raise the issue of inequality and questions about the quality of vaccines,” he said. “The private companies have agreed to use their own money, but it is not only about how much the cost they are willing to pay, it is about equity and accessibility.”

Budiman accused the government of putting the economy before people’s health.

“During the first year, Indonesia tried to strike a balance between the economy and health, however this strategy didn’t work because we couldn’t control the transmission of the virus,” he said.

“In the second year, Indonesia is focusing more on the economy than health. I think they care more about the economy,” he said.

Indonesia, the world’s fourth most populous country, has the highest COVID-19 caseload in East Asia. As of Monday, the nation had recorded nearly 1.466 million cases, with nearly 40,000 deaths linked to the global pandemic.

Millions are expected to be vaccinated under the private scheme, said Anindya Bakrie, a deputy chairman of the Indonesian Chamber of Commerce.

“Within companies, 3.5 million have been registered. We are confident there will be more,” Anindya told Antara, the Indonesian state news agency.

“We are collecting the data, which will be verified by the government,” he said, describing the program as “a smart way” to distribute vaccines.

A coalition of activists and health experts, meanwhile, warned that the private program was prone to abuse.

“Apart from opening up unequal access and unequal distribution of vaccines, this program also has the potential to miss the target,” said Yeyen Yenuarizki, a spokeswoman for the coalition.

Allowing companies to vaccinate employees and their families violates the government’s commitment to vaccinations based on risk such as age or comorbidities, she said.

The scheme is also prone to corruption and conflicts of interest, she said.

Similar programs

Other countries in Southeast Asia are seeking to establish private COVID-19 vaccination programs.

While Indonesia expects to receive 20 million doses for private distribution, Thailand will procure an additional 100,000 doses of the Sinovac COVID-19 vaccine to be used and paid for by businesses during the first phase of its private sector scheme, Reuters news service reported last week.

Meanwhile, the Philippine Department of Health and the National Task Force against COVID-19 issued a news release on Monday reiterating that private sector companies may procure vaccines as long as they entered into three-way agreements with the government and the manufacturer.

The news release noted three reasons for such agreements: manufacturers require that the government cover indemnification before any deal can be made; that the government should shoulder costs of adverse effects; and that vaccines are provided only under Emergency Use Authorization and cannot be sold commercially.

Indonesia has so far received about 40 million doses of vaccines, all but 1.1 million from Sinovac. On Friday, the Food and Drug Control Agency (BPOM) gave the go-ahead to use those 1.1 million doses developed by AstraZeneca after a delay over concerns in Europe about blood clots linked to the vaccine.

“The benefits of the AstraZeneca vaccine outweighs the risk, so we can start to use it,” the BPOM said in a statement on its website.

Other vaccines ordered by the government for its subsidized program include those produced by U.S. firms Novavax and Pfizer. 

And in another development on Friday, the Indonesian Council of Ulema, the country’s semi-official authority on Islam, said the AstraZeneca vaccine was haram, or forbidden, because it contained porcine trypsin, yet it was permissible for Muslims to take the vaccine because of the emergency situation.

“There are not enough halal vaccines to support our goal to achieve herd immunity,” said Asrorun Naim Sholeh, the head of the council’s fatwa commission.

“Muslims have an obligation to participate in the government’s COVID-19 vaccination program,” he said.

In response, AstraZeneca said the vaccine does not contain any ingredients derived from pork, according to media reports.