Policy on Influenza Vaccination among Indonesia Pilgrim. Workshop on Health and Economic Impact of Influenza Inter-Continental, Bali 5-7 June 2012

Transcription

1 Policy on Influenza Vaccination among Indonesia Pilgrim Workshop on Health and Economic Impact of Influenza Inter-Continental, Bali 5-7 June 2012

2 Immunization goals Provide immunity to certain diseases, in this case the prevention of infectious disease meningococcal meningitis and seasonal influenza Especially for seasonal influenza vaccine is recommended especially in high risk groups such as parents who have underlying chronic disease

3 Vaccine use Mandatory / compulsory on meningococcal polysaccharide conjugated quadrivalent A,C,W 135, Y Recommendation on seasonal influenza

4 Policy on Meningococcal Meningitis Vaccination among Indonesia Pilgrims 1. Meningococcal meningitis (MM) disease rate hasn't been available to date, but there are reports on MM cases among Indonesian Hajj Pilgrims returning from Saudi Arabia. 2. Indonesia is a largest number of people (Hajj Pilgrims, Umrah, Indonesian Migrant Workers-TKI) who are routinely travelling to endemic areas for longer periods of time. 3. Saudi Arabia Kingdom has issued official mandatory regulation that everybody should have authentic evidence proving that they have been vaccinated against MM, in order to obtain entry visa to Saudi Arabia.

5 Requirements of vaccine Have authorization from NRA Have Halal certificate from MUI (Moslem Ulama Council) Procedures for vaccine storage based on Immunization National Guideline (temperature 2-8 C) Managing AEFI surveillance for vaccine safety

6 Characteristics Year Total Hajj pilgrims Reguler (Gov) Private (ONH +) Age group < > % 28% 32% 25% % 28.6% 31.3% 23.9% Sources: Siskohatkes Puskes Haji

7 PROPORTION HAJJ PILGRIMS ACCORDING TO RISK FACTORS , ,000 87, , ,346 99,997 80,000 60,000 40,000 20, Risti non Risti Sources: Siskohatkes Puskes Haji

8 Indonesia Death of Hajj pilgrims in Saudi Arabia According to Risk Factors In 2010 and 2011 Indonesian Hajj pilgrims of high risk and no risk factors who dies in Saudi Arabia High Risk No Risk 347 Year Hajj Pilgrim Death % Hajj Pilgrim Death % ,40% ,06% ,44% ,05% Sumber data dari Siskohatkes Risti Non Risti Indonesian Hajj pilgrims died on the most common high risk factors. Indonesian Hajj pilgrims who passed away at high risk of high total risk in the future Hajj in 2011 increased from the year 2010 as many as 101 people Sources: Siskohatkes Puskes Haji

9 DISTRIBUTION OF THE FIVE MOST DIAGNOSIS OUTPATIENT VISITS IN 2011 No Daker Mekkah Daker Madinah Kloter Sektor BPHI Kloter BPHI 1 Common Cold Common Cold Essential Primary Hypertention 2 Influenza due to certain identified influenza viruses 3 Essential Primary Hypertention 4 Mylagia, Neuralgia and Neuritis, Back Pain Acute Laryngitis and Tracheitis Non/Insulin Dm, Ulcus Gangren Essential Primary Hypertention Depresi Other diseases of stomach and duodenum Diabetes Mellitus, Ulcus Gangren Common Cold Essential Primary Hypertensi Mylagia, Neuralgia and Neuritis, unspesified, Back Pain Influenza due to certain identified influenza viruses ISPA Diabetes Melitus Hypertensi GEA Sources: Siskohatkes Puskes Haji

10 TOTAL OUTPATIENT VISITS IN 2011 No Disease Total 1 common cold 203,550 2 pharingitis acute 71,007 3 bronchitis acute 8,790 4 laringitis acute dan tracheitis 6,911 5 Others 256,745 Total outpatient visits 547,003 Sources: Siskohatkes Puskes Haji

11 PERCENTAGE OF OUTPATIENT VISITS IN % 45.00% 40.00% 35.00% 30.00% 25.00% 20.00% 15.00% 10.00% 5.00% 0.00% 37.21% common cold Sources: Siskohatkes Puskes Haji 12.98% pharingitis acute 1.61% 1.26% bronchitis acute laringitis acute dan tracheitis 46.94% lain-lain

12 CASE INCIDENT INFLUENZA Case Influenza H1N1 (pandemic) Indonesia hajj pilgrims in Saudi Arabia Case Suspect Cases 14 persons 6 persons None Confirmed Cases 6 persons - None Deaths 1 persons 3 persons None Sources: Siskohatkes Puskes Haji

13 Health systems and Influenza Influenza seasonal vaccination is not the government policy (??) has been prepared by the government in this case the Ministry of Health Indonesia, as in meningitis vaccination must be halal certificate from the MUI (Moslem Ulama Council) when allocated to the pilgrims. In this set up funds to purchase influenza vaccine for Indonesian pilgrims. For the next year waiting for the policy of the Minister of Health Indonesia Regional Consultation on Implementation of the PIP Framework

14 Health systems and Influenza A certain risk group such as Hajj and laboratory workers in NIC were administered with the seasonal flu vaccine every year. Experience in year 2009 for seasonal influenza vaccine (outbreak influenza in Mexico) - All the pilgrims who went to Saudi Arabia - Medical officer Hajj Pilgrims (TKHI)

15 Immunization procedures Meningitis and seasonal influenza vaccines can be administered concurrently in different site one on right arm, the other on the left arm.

16 Publishing ICV and mechanism Sistem Security Printing Dokumen ber Barcode Content of ICV : name, address, gender, type of vaccine, batch number, administration date, doctor s name Issuance of visas by the Embassy of Saudi Arabia must have ICV

17 Launching by MoH On Meningococcal Meningitis Conjugated Quadrivalent A,C,W 135 Y Immunization at Health Center (Padang, West Sumatra), 2010 Indonesia MoH

18 Thank you