Harapan Harapan1, Noelle Shields2, Aparna G Kachoria3, Abigail Shotwell2, Abram L Wagner4. 1. Medical Research Unit, School of Medicine, Universitas Syiah Kuala, Banda Aceh, Indonesia. 2. Department of Epidemiology, University of Michigan, Ann Arbor, Michigan. 3. Research and Evaluation Department, University of Massachusetts Medical School, Worcester, Massachusetts. 4. Department of Epidemiology, University of Michigan, Ann Arbor, Michigan. Electronic address: awag@umich.edu.
Abstract
INTRODUCTION: Some Muslim religious councils in Indonesia have ruled that measles vaccines contain haram (i.e., forbidden materials). This study evaluates the changes in measles vaccination coverage between 1991 and 2017 and compares vaccination coverage between Muslims and non-Muslims in Indonesia. METHODS: A total of 7 cross-sectional in-person surveys of mothers in 1991-2017 in Indonesia were analyzed in 2019. Participants were asked about religion in 1991-2007, and 100 data sets of religion were imputed for 2012 and 2017. In this multiple imputation analysis, binomial regression models output prevalence differences adjusted for wealth, education, child's sex, and mother's age. A quadratic term for year (year X year) and an interaction term between year and religion evaluated changes in vaccination over time by religion. RESULTS: The 7 data sets included 23,106 children aged 12-23 months, with the proportion of those who were Muslims ranging between 85% and 89% across the survey years. Between 1991 and 2017, measles vaccination coverage increased from 57% to 79% among non-Muslims and from 59% to 79% among Muslims. In the multivariable regression model, measles vaccination coverage increased by 1.6% each year (with a quadratic term of -0.05%, indicating some leveling over time). At baseline in 1991, non-Muslims had a vaccination coverage of 6.2% higher than that of Muslims, but this disparity decreased by -0.2% each year. CONCLUSIONS: Measles vaccination increased in both Muslims and non-Muslims in Indonesia but has stagnated in recent years. Because of increased attention among Muslim groups on haram materials in vaccines since 2017, future studies should continue to examine the relationship between religion and vaccine uptake in Indonesia. SUPPLEMENT INFORMATION: This article is part of a supplement entitled Global Vaccination Equity, which is sponsored by the Global Institute for Vaccine Equity at the University of Michigan School of Public Health.
INTRODUCTION: Some Muslim religious councils in Indonesia have ruled that measles vaccines contain haram (i.e., forbidden materials). This study evaluates the changes in measles vaccination coverage between 1991 and 2017 and compares vaccination coverage between Muslims and non-Muslims in Indonesia. METHODS: A total of 7 cross-sectional in-person surveys of mothers in 1991-2017 in Indonesia were analyzed in 2019. Participants were asked about religion in 1991-2007, and 100 data sets of religion were imputed for 2012 and 2017. In this multiple imputation analysis, binomial regression models output prevalence differences adjusted for wealth, education, child's sex, and mother's age. A quadratic term for year (year X year) and an interaction term between year and religion evaluated changes in vaccination over time by religion. RESULTS: The 7 data sets included 23,106 children aged 12-23 months, with the proportion of those who were Muslims ranging between 85% and 89% across the survey years. Between 1991 and 2017, measles vaccination coverage increased from 57% to 79% among non-Muslims and from 59% to 79% among Muslims. In the multivariable regression model, measles vaccination coverage increased by 1.6% each year (with a quadratic term of -0.05%, indicating some leveling over time). At baseline in 1991, non-Muslims had a vaccination coverage of 6.2% higher than that of Muslims, but this disparity decreased by -0.2% each year. CONCLUSIONS: Measles vaccination increased in both Muslims and non-Muslims in Indonesia but has stagnated in recent years. Because of increased attention among Muslim groups on haram materials in vaccines since 2017, future studies should continue to examine the relationship between religion and vaccine uptake in Indonesia. SUPPLEMENT INFORMATION: This article is part of a supplement entitled Global Vaccination Equity, which is sponsored by the Global Institute for Vaccine Equity at the University of Michigan School of Public Health.
Authors: Kristin VanderEnde; Marta Gacic-Dobo; Mamadou S Diallo; Laura M Conklin; Aaron S Wallace Journal: MMWR Morb Mortal Wkly Rep Date: 2018-11-16 Impact factor: 17.586
Authors: Harapan Harapan; Samsul Anwar; Amanda Yufika; Khan Sharun; Mahir Gachabayov; Marhami Fahriani; Milda Husnah; Rawan Raad; Rashed Ya Abdalla; Rashed Y Adam; Namareg Me Khiri; Mohajer Ih Ismaeil; Asma Y Ismail; Wajdi Kacem; Nesrine Bh Dahman; Zeineb Teyeb; Khaoula Aloui; Montacer Hafsi; Manel Ferjani; Dalia A Deeb; Dina Emad; Kirellos Said Abbas; Fatma A Monib; Farah S Sami; R Subramaniam; Suhrud Panchawagh; Sunil Anandu; Md Ariful Haque; Lirane Ed Ferreto; María Fc Briones; Rocío Bi Morales; Sebastián Al Díaz; José To Aburto; Jorge Et Rojas; Emmanuel O Balogun; Seyi S Enitan; Akele R Yomi; Abiodun Durosinmi; Eyiuche D Ezigbo; Esther N Adejumo; Elham Babadi; Edris Kakemam; Najma I Malik; Irfan Ullah; Dott F Rosiello; Talha B Emran; Guilherme W Wendt; Morteza Arab-Zozani; Abram L Wagner; Mudatsir Mudatsir Journal: Pathog Glob Health Date: 2021-12-20 Impact factor: 3.735