Across the globe, countries struggle to find effective ways to fight the Wuhan coronavirus (COVID-19) and maintain their economies. For a country like Indonesia, the situation is dire enough that the country is volunteering to act as a testing ground for a Chinese coronavirus vaccine.
With over 257,000 cases and around 9,900 deaths, according to data from Johns Hopkins University, Indonesia’s coronavirus outbreak is the second-worst in Southeast Asia after the Philippines. Its daily case count has been breaking records every week since the last week of August.
In an attempt to keep this outbreak from growing any further, the country is now looking to be a guinea pig for the coronavirus vaccine candidate developed by China’s Sinovac Biotech.
Taking a risk with Sinovac’s vaccine
Testing in Indonesia began back in August in Bandung, the capital of West Java province.
The last stage of one of the world’s fastest-moving trials for a COVID-19 vaccine involved two dozen volunteers, and it took place in a small community clinic. The participants were given an experimental shot from Sinovac.
Abinubli Tariswafi Mawarid, one of the volunteers, is a 27-year-old microbiologist. He’s disappointed with how the country is dealing with the pandemic, and he wants to help others suffering because of coronavirus.
“I believe the vaccine is the magic bullet to solve this pandemic. This is the most appropriate solution,” added Mawarid.
Unlike America, which is wary of Big Pharma’s plans to develop a vaccine and gain more profits, Indonesia is one of a handful of countries that are eagerly awaiting a vaccine.
The Indonesian government has estimated that the coronavirus pandemic will push 4.9 million people into poverty, which can significantly affect its population of at least 270 million. Indonesia's current situation reflects the outsize expectations motivating companies to quickly develop a vaccine worldwide, along with the many obstacles of the hurried search for a miracle cure.
Is Sinovac the key to ending coronavirus in Indonesia?
Bandung, a resort area in Indonesia with a population of over two million, is the location of clinical trials run by state-owned pharmaceutical company PT Bio Farma. The trials have been covered by local news outlets, and a more than a few of the 1,620 volunteers in the Sinovac trial who come from Bandung and nearby towns have been interviewed on local media.
Bandung’s police chief received a shot, but no one knows if he was given the trial vaccine or a placebo. Ridwan Kamil, West Java’s governor, also volunteered for the Sinovac trials, even posting about the event on Instagram.
The Padjadjaran University’s research team for the Sinovac’s COVID-19 vaccine clinical trials reported that 248 participants, including Kamil, were given the vaccine.
Bio Farma has partnered with regulators to expedite the approval of CoronaVac, Sinovac’s vaccine. The company announced that it will manufacture at least 10 million to 20 million doses even before it gets the g0-signal to ensure that the shot is readily available.
Iin Susanti, head of planning and business strategy for Bio Farma, shared that broader distribution will only begin after Indonesian regulators give emergency approval.
President Joko Widodo revealed that the Indonesian government aims for authorization for CoronaVac as early as January next year. The first batches of the vaccine will go to health workers.
Balance speed with caution, experts warn
The Indonesian government is pushing for the vaccine because coronavirus has already infected 29 million globally. However, it remains to be seen when exactly the vaccine will be available for public use.
Health experts are also worried about safety risks, particularly if “speed isn’t balanced with caution.” Since CoronaVac is still being tested, no one can say for sure if it will be 100 percent effective.
In Britain, AstraZeneca paused testing of its experimental vaccine, earlier touted as “one of the world’s most promising,” after a volunteer became sick. Despite proving that rushing testing isn’t without its dangers, the company has already restarted trials in the U.K. after regulators deemed it was safe to do so.
Global delays have devastating consequences for countries hoping for a vaccine. Indonesia’s large informal workforce risks starvation during lockdowns. The country’s economy also contracted by 5.32 percent in the second quarter compared to the previous year – the worst it’s ever been since the Asian financial crisis in the late 1990s.
Infections also skyrocketed after the government briefly loosened social distancing rules. Many are worried that Jakarta, the capital of Indonesia, is running out of hospital beds.
Jakarta has limited the use of public transport, and nonessential industries required employees to work from home. (Related: Indonesia’s government botched its coronavirus response; residents are now paying the price.)
On Sept. 1, Jokowi told a group of foreign journalists at his palace that the physical distancing protocol will continue in Indonesia, but he added that a vaccine “is the answer to end this pandemic.”
Jokowi also acknowledged the uncertainties, concluding that it remained to be seen if the protective effects of any vaccine will last.
The race for a vaccine continues
CoronaVac, which is manufactured using an inactivated version of coronavirus, is competing with other global biotech firms such as Moderna in America.
Jokowi’s administration has also assigned local research institutes and universities with developing the country’s own vaccine or “the red-white vaccine,” named after the colors of Indonesia’s flag, by mid-2021. PT Kalbe Farma, Indonesia’s biggest pharmaceutical company, has partnered with South Korean biotech firm Genexine to begin Phase II clinical trials in November and to determine a drug’s effectiveness and short-term risks.
Ensuring that testing balances safety with speed is advised by health experts, but it doesn’t look like companies are listening to them.
Vaccine development usually takes at least 10 years, but COVID-19 has fast-forwarded the process drugmakers go through into less than one year. Scientists are worried that this isn’t enough time to fully understand the potential risks linked with any vaccine.
In America, President Donald Trump’s Operation Warp Speed program is pushing for a vaccine as early as October. The U.S. Food and Drug Administration (FDA) has placed safeguards to guarantee that safety and efficacy criteria aren’t overlooked while companies rush to produce a vaccine.
While vaccine developers have promised to follow all protocol and avoid shortcuts to ensure safety, this isn’t something you should count on when Big Pharma is eyeing profits.
Findings from late-stage trials like the one Bio Farma is running in Indonesia can prove how effectively a vaccine can protect people against COVID-19. Bio Farma promised that it won’t cut any corners, while Sinovac has reported that the shot had no safety issues in Phase I and II trials.
Lives are on the line
William Haseltine, a pioneering AIDS researcher, emphasized the importance of coronavirus vaccine safety because a single adverse event during a study with tens of thousands of volunteers could result in hundreds of thousands getting sick or dying once regulators approve vaccines for public use.
Haseltine, who also chairs Access Health International, a New York-based think tank, added that the timeline suggested by vaccine developers worldwide means “you cannot do a yearlong safety trial, so you are not going—under any circumstances—to know the long-term effect of these vaccines.”
Jeremy Lim, an adjunct professor at Saw Swee Hock School of Public Health in Singapore, believes that a COVID-19 vaccine will likely only produce partial immunity in some individuals. Shots could also be contraindicated for others because of “unacceptable side effects.”
Timely distribution is another hurdle in the race for a coronavirus vaccine. Indonesia sits on the world’s largest archipelago, with a distance of roughly that between New York and Alaska. This means that a vaccine like CoronaVac, which needs to be stored at 2 C to 8 C (35.6 F to 46.4F) to work effectively, must be safely transported across the country’s 6,000 inhabited islands.
Takeshi Kasai, regional director for the Western Pacific at the World Health Organization, doesn’t think it’s wise to place all hopes on a vaccine, which might also have many negative side effects. Even if a vaccine is, by some miracle, safe and effective, “the production capacity would not really meet the demand coming from the entire world,” said Kasai.
Instead of waiting for a vaccine, Kasai concluded that it’s more effective to continue to practice social distancing and wear facemasks in public during the pandemic.
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