As parents, the medical needs of our children are often our number one concern. For expat parents newly arrived, the question of obtaining vaccination for children in Indonesia is one that often comes up. Thankfully, this article will explain when and how to get them. Further, we will also mention some unique issues specific to Indonesia.
Mandatory Vaccination for Children in Indonesia
Routine childhood vaccination in Indonesia follows the recommendation of Ikatan Dokter Anak Indonesia (IDAI – Indonesian Pediatric Society). While the IDAI recommends vaccinating against 16 different diseases, only 5 are mandatory. The mandatory vaccinations are available for free to all national health insurance (BPJS) participants. Note that expats on KITAS and KITAP visas are eligible for BPJS.
The mandatory vaccinations are:
- Tuberculosis (TB) – The BCG vaccine is given before 3 months of age. Many western countries have stopped giving this vaccine due to low rates of TB in those countries. If you are moving to Indonesia, this may be one of the vaccines your child will need to catch up on. Consult with your pediatrician to see if your child needs a tuberculin sensitivity test (Mantoux test) before getting the BCG vaccine.
- Hepatitis B – If you give birth in Indonesia, then the first dose of this vaccine will be given within 12 hours of birth at the hospital. Then 3 more doses (see chart). If the mother is HBsAg positive, the baby will receive HB immunoglobulin as well.
- Polio – The first dose is usually given during a baby’s first medical exam, a few days after birth. Then again at 2, 3 and 4 months.
- DTP – Diphtheria, Tetanus, Pertussis, given at 6 weeks, with follow up doses at 2, 4 and 6 months. Then additional boosters at 12 years of age.
- Measles – Known as Campak in Indonesian. Your child may receive the first dose at 9 months of age. A second dose at 18 months is not needed if MMR vaccine was administered earlier.
Recommended Vaccination for Children in Indonesia
Unfortunately, you have to pay out of pocket for the non-mandatory vaccines. Prices vary by type, brand, and also region. Expect to pay between Rp 200,000 to Rp 1,000,000 per visit, depending on number and type of vaccinations needed at the time.
Besides the mandatory vaccinations, the IDAI recommends the following:
- Haemophilus influenzae type B (Hib)
- Pneumococcal conjugate vaccine (PCV)
- Hepatitis A
- Varicella (Chicken Pox)
- Human papillomavirus (HPV)
- Japanese Encephalitis
Complete Vaccination Schedule
Please see the below chart for complete schedule
Notes on Chart: Green indicates optimal time, yellow indicates catch-up time, blue indicates boosters and pink is for endemic areas only. a) Monovalent Rotavirus vaccine does not require 3rd dose. b) If given to children between 10 and 13 years, 2 doses are enough.
Note on Dengue vaccination: On December 7, 2017 IDAI has released a statement to postpone Dengue vaccination while further study is conducted. Please consult with your pediatrician on the most recent recommendation on this vaccine.
Where to get Vaccination for Children in Indonesia
If you participate in BPJS, then your local primary care facility (FasKes 1) will give the vaccination. Or they will refer you to a facility that will. For non-mandatory vaccines, or if you do not wish to use BPJS, you should contact your pediatrician. If you give birth in Indonesia, the hospital will usually give the first doses. They usually will also give you a book to record future vaccinations. Keep it for your future reference.
It is normally better to get the vaccines at your pediatrician’s private office, rather than at a hospital. The hospitals will usually charge more, even for the same doctor.
Your pediatrician may set aside a specific day of the week for vaccinations. Check before making an appointment what days they vaccinate, so as to not waste a trip.
Other venues for vaccination
In special circumstances, the government may have mass immunization campaigns. For example, during the Diphtheria outbreak of 2017. In such cases, the Ministry of Health my visit schools and health care facilities to give vaccinations for free. If your children are missing the particular vaccination, this would be a good time to get them up-to-date.
Some local provincial governments or lower level local governments may have special programs tailored for their area. For example, in 2018 Bali is a pilot project for Japanese Encephalitis vaccination, and kids 9 months to 15 years of age can be immunized for free.
The rates of vaccination for children in Indonesia is poor. This includes the mandatory ones. Consequently this means that herd immunity is low. It is therefore very important to make sure you keep your children’s vaccinations up to date.
Certain vaccines may be out of stock for long periods of time due to various reason. It is best to not delay vaccinating while stocks are available. You may also want to discuss alternatives with your pediatrician.
In 2016, a large scandal involving fake vaccines and at least 14 hospitals came to light. If you have any concerns, your pediatrician can review with you the authenticity of their supply. They should be able to produce the original packaging, lot and batch number.
This article, while written with the utmost care, was not written by a medical professional. Please consult a pediatrician for your children’s medical needs, including vaccinations.