Jakarta. Indonesia saw a surge in measles cases in 2022, as the number of new infections rose by a whopping thirty-twofold last year compared to 2021 levels.

The Health Ministry recently reported that Indonesia had logged 3,341 measles cases across 31 provinces throughout 2022. 

“Indonesia saw 32 times the number of measles cases in 2021, during which we had 132 cases,” Prima Yosephine, the ministry’s acting director for immunization at the Health Ministry, told a virtual press conference on Friday.

The government attributed the rising infections to the sluggish immunization campaign amid the Covid-19 pandemic, as the country turned its attention to keeping coronavirus at bay. About 58 percent of the confirmed measles cases in 2022 have had no prior immunization.

Indonesia last year conducted a nationwide immunization catch-up campaign (BIAN). 

Data show Indonesia only reached 72.7 percent rubella measles immunization coverage, comprising about 26.5 million children across the archipelago, last year, far below the 95 percent target. The vaccination coverage, however, managed to top 98 percent in the highly populous Java and Bali. But the number was significantly lower in regions outside Java and Bali, standing precisely at only 63.9 percent.

“We were unable to achieve the routine immunization target in 2020-2021, and this led to outbreaks in several regions,” Prima said.

“The measles cases did not increase that much in 2021 because the routine immunization coverage was pretty high in 2018-2019,” she added.

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About 34 cities/districts in 12 provinces, including Bogor and Bekasi, in 2022 declared an “extraordinary occurrence”, a status which refers to when a region has at least two cases of lab-confirmed measles that are epidemiologically-related. Jakarta did not announce an extraordinary occurrence status. 

Prima said that it was up to the sub-national government to decide on the status for the virus. The Health Ministry will only declare an extraordinary occurrence if the country is seeing a massive nationwide outbreak.

The government confirmed that 6 people died from suspected cases of measles in 2022. They, however, died before taking the lab tests.

“So their status remained as ‘suspected cases’, but they had symptoms such as fever and rash,” Prima said. 

Data showed that measles cases peaked on the 25th week in 2022 or some time around June. At the time, Indonesia was dealing with the highly contagious Omicron coronavirus subvariant. 

Prima said that there was no correlation between the Omicron wave and the spike in measles cases. 

In addition to the immunization gap, higher mobility during the 2022 Eid holidays could drive the dramatic rise in measles cases, according to Prima.

Indonesia aims to eliminate the spread of rubella measles by 2023, although the recent surge might lead to a setback in its plans. Prima, however, said that the measles outbreak would be far more controllable this year compared to 2022.

“So far in 2023, we have seen suspected measles cases in West Nusa Tenggara, West Sumatra, North Maluku, and Papua. But there are only a few suspected cases, and they have not undergone lab tests,” Prima said, although she did not disclose the exact number.

Measles is highly contagious. The virus spreads to others through droplets from sneezing, coughing, and talking. Symptoms include a skin rash, cough, runny nose, and fever.

“Immunization is the most effective prevention against measles,” Prima told reporters.

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