Indonesians receive shot as polio spreads

PIDIE, Indonesia — Children in school uniforms and toddlers with their parents lined up Monday for polio vaccinations in the Sigli town square on the northern tip of the Indonesian island of Sumatra, after four children were found infected with the highly contagious disease that was declared eliminated in the country less than a decade ago.

The virus was first detected in October in a 7-year-old boy suffering from partial paralysis in the province of Aceh near Sigli, and since then three other cases have been detected, prompting the mass immunization and information drive.

Officials say that polio immunization rates in the conservative province are well behind the rest of the country, with efforts hampered by widespread disinformation the vaccine is incompatible with religious beliefs, among other things. The government has also been prioritizing covid-19 vaccinations since they became available.

The campaign that started Monday aims to vaccinate some 1.2 million children in the province, said Maxi Rein Rondonuwu, the Health Ministry’s director general for disease control and prevention.

“There is no cure for polio, the only treatment is prevention and the tool for prevention is vaccination,” Rondonuwu said, adding that the child is still able to walk, albeit with a limp.

With some 275 million people, Indonesia is the world’s fourth most populous and the largest Muslim-majority nation.

Aceh is particularly conservative, and is Indonesia’s only province allowed to practice Shariah, which was a concession made by the national government in 2006 to end a war with separatists.

False rumors that the polio vaccine contains pork or alcohol, prohibited according to Muslim beliefs, have proliferated, especially in rural areas, complicating vaccination efforts, said the head of the Aceh Health Office, Hanif, who only goes by one name like many Indonesians.

“We cannot work alone, we need support from all parties, including religious leaders, to that people understand the importance of immunization,” said Hanif.

The World Health Assembly adopted a resolution for the global eradication of polio in 1988 and since then, wild poliovirus cases have decreased by more than 99%, according to the World Health Organization.

It was eliminated in Indonesia in 2014, and is today only still endemic in two countries — Afghanistan and Pakistan.

Polio primarily affects children under the age of 5, according to the WHO. Unvaccinated people of any ages can contract the disease, however, and sporadic cases continue to crop up.

The polio virus is transmitted person-to-person, generally through the “fecal-oral” route, according to the WHO. In Indonesia, authorities have also pointed to unsanitary conditions as a probable cause of the new infections after finding out that some local residents still defecate directly into a river where children are often found playing.

Across Indonesia, polio vaccination coverage has been slipping since the outbreak of COVID-19. Despite the challenges of reaching people in the archipelago nation of five main islands and thousands of smaller ones, 73.4% of Indonesians are now fully vaccinated for covid-19 and 87.5% have at least one shot.

For polio, 86.8% of babies were vaccinated in their first year in 2020 nationwide, which fell to 80.7% in 2021 as the country was forced to focus most of its health facilities and workers on addressing the pandemic.

(AP/Riska Munawarah) A medical worker gives vaccine to a boy during a polio immunization campaign Monday at Sigli Town Square in Pidie, Aceh province, Indonesia.