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UMass Chan Affiliations
Department of Emergency MedicineDocument Type
Journal ArticlePublication Date
2021-01-01Keywords
Indonesiameasles vaccination
Community Health and Preventive Medicine
International Public Health
Preventive Medicine
Religion
Virus Diseases
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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.Source
Harapan H, Shields N, Kachoria AG, Shotwell A, Wagner AL. Religion and Measles Vaccination in Indonesia, 1991-2017. Am J Prev Med. 2021 Jan;60(1S1):S44-S52. doi: 10.1016/j.amepre.2020.07.029. Epub 2020 Nov 12. PMID: 33189503. Link to article on publisher's site
DOI
10.1016/j.amepre.2020.07.029Permanent Link to this Item
http://hdl.handle.net/20.500.14038/41657PubMed ID
33189503Related Resources
Rights
© 2020 American Journal of Preventive Medicine. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/)Distribution License
http://creativecommons.org/licenses/by-nc-nd/4.0/ae974a485f413a2113503eed53cd6c53
10.1016/j.amepre.2020.07.029
Scopus Count
Except where otherwise noted, this item's license is described as © 2020 American Journal of Preventive Medicine. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/)