R

epeated outbreaks of epidemical diseases in a number of regions across the country have led to numerous deaths. At the height of a diphtheria outbreak in Padang, West Sumatra, in 2015, at least five children lost their lives. A diphtheria epidemic in East Java killed nine children in 2009, 21 in 2010 and another 11 in 2011, which eventually prompted the central government to declare the outbreak in the province an “extraordinary occurrence,” and take emergency measures aimed at reducing fatalities, if not eliminating the disease.

As our special report on page 12 today reveals, these figures are more than enough to generate criticism on how preventable diseases like diphtheria are still deadly despite the vaccination program, which has been in place since 1956, and the government’s continuous campaigns against the illnesses. Another contributing factor to the failure to prevent outbreaks is the poor distribution system of vaccines, particularly in remote areas.

The repeated outbreaks, however, cannot be solely blamed on the government as many in the communities where the epidemics occurred had rejected immunization. Indonesia has been struggling to reach 100 percent coverage to create immunity in the entire population, with actual basic vaccination figures having persistently dropped since 2012.

Resistance to immunization by anti-vaxxers is also evident in the government’s newly launched measles and rubella vaccination program. The strongest opposition is seen in East Java, which sadly includes hundreds of schools in the province.

Another region highly vulnerable to rubella and measles outbreaks is Yogyakarta, where resistance to immunization is gaining traction. West Sumatra is another province where the vaccination rate is below 80 percent. In 2013, the coverage even dipped to 35 percent there.

Basically, there are two categories of anti-vaxxers in Indonesia. The first are those who base their argument on the belief that the vaccines contain an enzyme derived from pork, which is haram (strictly prohibited for consumption under Islamic law). The second are “naturalists” who believe that immunity is something the human body can build naturally with a healthy lifestyle.

These anti-vaxxers are apparently the most difficult element of society for the government and relevant parties to convince of the importance of immunization.

Unless people can be convinced about the substances in the vaccines and about the need for immediate medication for infected persons, resistance will not subside and the death toll will increase.