The Covid-19 vaccination program for 18 year old and above is enthusiastically ongoing in Jakarta. Unlike the elderly vaccination program, this time, the Jakarta Provincial Government also provides the AstraZeneca vaccine to meet the vaccine needs in the capital. Almost similar to the Sinovac story, the first appearance of Astrazeneca in Indonesia also caused various questions and doubts. Fortunately, Jakarta Smart City had opportunities to talk to dr. Adam Prabata, who is currently studying for his Doctoral Degree in Medical Science at Kobe University, Japan. Let’s see how dr. Adam Prabata answers the following questions about the AstraZeneca vaccine!
Why is the efficacy of AstraZeneca from WHO and the Indonesian Ministry of Health different? Which one should be used as a reference?
dr. Adam:
"We all need to know, efficacy and effectiveness are two different things. Effectiveness means the ability of the vaccine itself in the real world, while the efficacy is in the context of research, clinical trials. The efficacy of AstraZeneca from WHO is 63.09% while from the Ministry of Health is 76%. Why is it different? That's because the retrieved database is also different. There is a lot of research related to AstraZeneca. WHO took a study that the interval between the injection of the first dose and the second dose is 4 to 6 weeks. Meanwhile, the Ministry of Health used the most recent data, which has a 12-week interval for the injection”.
Then, what about the effectiveness of AstraZeneca?
dr. Adam:
“In the UK’s recent study, 12 June 2021, the effectiveness of the AstraZeneca vaccine after the second dose is 79% in reducing the risk of asymptomatic Covid-19 infection and 92% in reducing the risk of symptomatic Covid-19 infection, with a 12-week interval between the first and the second dose of injection.”
Why is the interval between the first and second dose of AstraZeneca different from Sinovac? If so, does the antibody formation process from AstraZeneca take longer?
dr. Adam:
“The best efficacy of the AstraZeneca vaccine is formed with a longer interval between the first and second dose injection, which is 12 weeks. Beside, the antibody formation process from AstraZeneca vaccine tends to take longer (when compared to Sinovac and Sinopharm vaccines)”.
Antibody from both Sinovac and Sinopharm are formed after 28 days from the first injection. Meanwhile, antibody from AstraZeneca is formed after 42 days from the first injection.
(Image from dr. Adam Prabata)
Is it true AstraZeneca is more recommended for young people?
dr. Adam:
“There is no statement that AstraZeneca is more recommended for young people. In the UK, AstraZeneca is used by people aged 40 years and above. In several other countries in Europe, the AstraZeneca vaccine is used by people aged 50 years old, 60 years old, and above. Each country has various considerations, the point is on the benefit and risk of using the vaccine. So if the benefit far outweighs the risk, based on this consideration, the vaccine is good to use.”
Is it true that AstraZeneca contains pig trypsin? What is the main ingredient of the AstraZeneca vaccine?
dr. Adam:
“AstraZeneca vaccine doesn’t contain ingredients of animal origin. However, in the manufacturing process it comes into contact with the trypsin enzyme derived from the pig pancreas.”
In this case, the Indonesian Council of Cleric (MUI) has issued a Mubah Fatwa for the use of the AstraZeneca vaccine that you can see here.
(Image from Instagram @adamprabata)
Is it true that AstraZeneca can trigger blood clots? Based on the news, in Europe there were cases of blood clots which were dominated by young women after being vaccinated using AstraZeneca.
dr. Adams:
"Yes, it’s true. In the UK, there is a relatively very small risk of blood clots in young women, between 1:100,000 to 3.6:1,000,000 in people using the AstraZeneca vaccine.”
Are there criteria for people who can’t be vaccinated using AstraZeneca?
dr. Adams:
“So far, people who aren't allowed to use the AstraZeneca vaccine and causing contraindications are those who have a history of HITT (Heparin Induced Thrombocytopenia and Thrombosis) so that blood clots appear due to Heparin treatment. However, this case is quite rare.”
Then what about people who have a history of heart disease and blood clots?
dr. Adam:
“If you have a history of heart disease and blood clots, consult your doctor first. If there are no problems, then the AstraZeneca vaccine can be used. Also, the Indonesian Cardiology Association doesn’t prohibit the use of the AstraZeneca vaccine to patients with cardiovascular disease with stable condition. The risk of blood clots from the vaccine is very small (3,6 cases per one million people vaccinated), but the effectiveness is very good.”
Is it true that the side effects of AstraZeneca are more severe than Sinovac?
dr. Adam:
"Yes, it’s true. Generally, there are 2 types of side effects after the vaccine, local and systemic. Local side effects occur at the injection site such as redness, swelling, and pain. While systemic side effects occur throughout the body such as fever, aches, fatigue, drowsiness, etc. The side effects of AstraZeneca differ from other vaccines because of the risk of blood clots. This happens because of a substance from the vaccine that triggers blood clots. We don’t know exactly what type of substance can trigger blood clots. But so far, the side effects of blood clots have been in the types of vaccines that use adenoviruses such as AstraZeneca and Johnson & Johnson.”
Can people with autoimmunity be vaccinated using AstraZeneca?
dr. Adam:
"Based on research including AstraZeneca, in general, AstraZeneca is well tolerated by autoimmune patients."
Based on the recommendation of the Indonesian Association of Internal Medicine Specialists (PAPDI), March 18, 2021, autoimmune patients can get a vaccine if their condition is declared stable by the doctor.
Why are there cases of death after being vaccinated using AstraZeneca?
dr. Adam:
"Died after the vaccine is not the same as died from the vaccine. Not necessarily people who died after the vaccine is the same as died from the vaccine. If anyone died after the vaccine, it should be investigated. So, has anyone died from the side effects of the AstraZeneca vaccine? Yes, so far it’s because of a blood clot.”
Can AstraZeneca fight against the new variant of Covid-19?
dr. Adam:
"For now, the most common Covid-19 variant in Indonesia is the Delta variant, some time ago there was also the Alpha variant. AstraZeneca (according to the WHO statement) has been proven to be effective against the two Covid-19 variants."
From the information provided by dr. Adam about AstraZeneca, the vaccine does have risks. However, these risks are not comparable to the many benefits that we gain with the vaccine. So for those of you who are 18 years old and above, register yourself for vaccination through the JAKI application which can be downloaded via Google Play Store or App Store. Don't forget to stay healthy and apply health protocols wherever you are.
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