Since Indonesia announced its first COVID-19 case in March, many parents have faced the dilemma of whether to bring their children in for immunizations.

According to an assessment conducted by the Health Ministry, with the support of UNICEF, between April 20 to 29, the pandemic has led to a decline in the country’s vaccination coverage.

Based on the ministry's online survey, which polled 5,329 out of the 9,993 Puskesmas (healthcare centers) in Indonesia, immunization services had been significantly disrupted by the outbreak, and the government policy of physical distancing was in place in about 84 percent of the reporting facilities.

National immunization program data shows that between January and March, there was a 13 percent decline in measles and rubella vaccinations compared to the same period last year, indicating that thousands of children will be at risk of increased morbidity and mortality from vaccine-preventable diseases (VPDs).

Inadequate understanding of the ministry’s guidance and a perceived high risk of local transmission of COVID-19 in the reported Puskesmas areas were among the reasons mentioned for the disruption.

The report also states that despite their understanding of immunizations, some caregivers are anxious about contracting COVID-19, and their fears have outweighed their willingness to bring their children in for immunization.

On May 22, the Indonesian Pediatricians Association (IDAI) called on parents to continue vaccinating their children despite the outbreak.

Pediatrician Citra Amelinda reiterated that children under the age of two had to follow their immunization schedules. “We need to protect our children from other diseases besides COVID-19,” she said during a virtual press conference on June 4.

In response to the crisis, parents such as Andreas Yosafat Tarigan and Siksta Alia have sought alternatives, including drive-through and in-home vaccination services.

Andreas brought his 9-month-old son to a drive-through immunization in Santo Borromeus Hospital in Bandung, West Java. He told The Jakarta Post that he was satisfied with the service as he didn’t need to enter a crowded area.

“We queued in the car, got out of our car and went directly to the room,” he said, adding that he had made a reservation and paid for the service one day before going to the hospital.

“I prefer drive-through vaccination during the pandemic,” he said.

Read also: UN agencies: 117 million children may miss measles shots due to COVID-19

Siksta used the ProSehat mobile application to reserve in-home vaccinations for her two children. She said the service gave her peace of mind as she did not need to go to the hospital during the pandemic.

“It’s [quite comfortable] for emergencies. But the immunization was not performed by a pediatrician, and there were no weight and head measurement, which is important for children under the age of two,” she added.

Brawijaya Clinic in Kemang, South Jakarta, is one of the healthcare facilities offering drive-through vaccinations. The clinic’s manager, Martina Maharani, told the Post that the service was created because of high demand from patients.

“We understand that patients are afraid of going out and coming to the clinic because there is a risk of contracting the coronavirus,” she said.

The drive-through procedure is quite simple. Patients register on WhatsApp prior to their visit. During the appointment, a doctor in protective health gear (APD) performs the immunization inside the car.

“For child immunizations, the doctor will do a quick review of the patient’s medical history. For other health issues, the patients can use our teleconsult application,” said Martina, adding that the patients could choose between a pediatrician and general practitioner for the service.

In addition to ProSehat, ZAP Clinic is offering in-home vaccinations.

The clinic, known primarily as a beauty specialist before the pandemic, charges a minimum of Rp 1.5 million (US$106) per visit.

To use the service, patients contact the clinic’s call center and consult with the pediatrician. After making an appointment, a medical worker wearing APD will visit their home.

“The entire consultation and administration procedure will be conducted before the appointment,” said ZAP Clinic CEO Fadly Sahab, adding that the service sought to uphold the principle of quick and limited physical interaction. (kes)