Darmika Hutabarat, Knowledge Management and Communications Specialist, FHI 360
Caroline Francis, Technical Director, FHI 360
Saskia Mariska, Senior Technical Officer, FHI 360
Nadia Khafia, Technical Officer, FHI 360
Andrea Surette, Knowledge Management Technical Advisor, FHI 360

Older, unvaccinated adults are more likely to get severe illness or die from COVID-19. Indeed, the COVID-19 pandemic has taken a heavy toll on older adults in Indonesia—patients over the age of 60 comprise more than half of COVID-related intensive care unit admissions and suffer from the lowest recovery rate and highest mortality rate.1 Evidence shows that being fully vaccinated significantly reduces the risk of COVID-related hospitalization and death and is one of the most powerful tools we have against the pandemic.

Since COVID-19 vaccines were introduced in Indonesia, vaccination rates among older adults have lagged behind the rest of the eligible population. In September 2021, national vaccination coverage for first and second dose among this population was 15% and 10% respectively, compared to coverage among general population of 45% for the first dose and 25% for the second dose. The elderly population in Indonesia faces several challenges in reaching vaccination sites, particularly when vaccination events are held during normal working hours, as many rely on their adult children for transportation. In addition, older adults may not be aware of vaccination events happening in their communities.

To overcome these challenges, the Meeting Targets and Maintaining Epidemic Control (EpiC) project rolled out several approaches to increase vaccination coverage among older adults in DKI Jakarta, West Java, Banten Province, Central Java, and the Special Region of Yogyakarta.

An elderly woman receives a COVID-19 vaccine at a community-based vaccination event at a mosque in Garut Regency, West Java Province. Photo by EpiC Indonesia.

EpiC partnered with district health offices and health facilities to identify older adults in each community. EpiC’s partners then worked with local leaders to inform the elderly community members and their families about the time and location of vaccination services. To overcome transportation barriers, EpiC provided cars to pick up elderly community members and transport them from their homes to the nearest fixed vaccination site. In addition, EpiC brought vaccination opportunities closer to communities. After enlisting private sector health care workers as volunteer mobile vaccination teams, EpiC rolled out door-to-door home vaccination campaigns and vaccination services for housebound elderly community members.

In addition to these targeted approaches, EpiC has reached elderly adults with the COVID-19 vaccine through fixed site immunization services at health facilities, mass vaccination events, mobile teams, and community-based outreach sites. Through all of these approaches, EpiC has reached over 158,000 adults over the age of 60 in Indonesia with a COVID-19 vaccine or booster shot since August 2021.

EpiC deployed mobile vaccination teams to reach elderly adults in their homes. Photo by EpiC Indonesia.

References:

1Rehatta NM, Chandra S, Sari D, et al. Comorbidities and COVID-19 status influence the survival rate of geriatric patients in intensive care units: a prospective cohort study from the Indonesian Society of Anaesthesiology and Intensive Therapy. BMC Geriatr. 2002 June 25; 22(523). https://doi.org/10.1186/s12877-022-03227-9.