Pendidikan / Pelatihan
1992 Dokter Spesialis Anak FKUI
1997 Kursus Epidemiologi dan Surveilans, Kumamoto, Tokyo
2003 Magister Sains Psikologi Perkembangan, FPsiUI
2005 Pelatihan Vaksinologi WHO di Jakarta dan Kinabalu
2015 Doktor Ilmu Kesehatan Anak FKUI
Jabatan
2005 - skrg Anggota Satgas Imunisasi IDAI
2008 - skrg Anggota Tim Uji Klinik Vaksin Dengue, Pentabio, Flubio, Typhoid FKUI
2009 - skrg Anggota ITAGI (Komite Penasihat Ahli Imunisasi Nasional)
2018 - skrg Gurubesar Ilmu Kesehatan Anak FKUI
2020 - skrg Anggota Tim Advokasi Vaksinasi COVID PB IDI
2021 - skrg Anggota DSMB beberapa uji klinik vaksin COVID
Soedjatmiko
Anggota Satgas Imunisasi IDAI
Eyang MIKO, SOEDJATMIKO, Juli 2022
Topik bahasan
• Update bahaya COVID dan pencegahannya
• Awas Campak Rubella,
• Pencegahan Difteri, Pertusis, Tetanus, Polio
• Imunisasi Rutin, BIAS, COVID, BIAN
• Booster anak Pra Sekolah, Usia Sekolah, Remaja menurut WHO, IDAI Kemenkes
Sumber :
❑ ANAK umur < 6 thn : meninggal karena COVID relatif sedikit (0,6 %)
• sakit COVID relatif sedikit (3,1%),
❑ LANSIA : MENINGGAL 47,5 %, cakupan vaksinasi booster 26,25% (< 70%)
• Antibodi lansia cepat menurun, booster mutlak perlu segera
• Vaksinasi 2x risiko meninggal 11x, dibanding vaksinasi 3x
❑ DEWASA (non lansia) meninggal 35,5%, cakupan booster rendah : 26,5 % (<70%)
❑ PRIORITAS PROGRAM VAKSINASI COVID:
• BOOSTER (vaksinasi ke 3) LANSIA dan DEWASA agar mencapai > 70 %
• Vaksinasi ke 2 anak umur 6 - 17 thn → mendukung PTM
WHO : Masker tidak menyebabkan kekurangan Oksigen, masker tidak menyebabkan CO2 menumpuk.
• Imunisasi Rutin dilengkapi (BIAN : Campak Rubella, OPV 4x, IPV 1x, DPT-Hib-HepB 4x)
Salam Eyang MIKO SOEDJATMIKO
EYANG MIKO, SOEDJATMIKO, JULI 2022
AWAS !!!
Penyakit menular lain
juga mengancam
Anak, Cucu, Adik,
Pasien kita
2021
Sumber :
Kemenkes RI 2022
: Campak (C)
115 Kasus campak konfirmasi laboratorium terdapat di 35 Kab/Kota di 14 Provinsi
: Rubela (R)
81 Kasus rubela konfirmasi laboratorium terdapat di 37 Kab/Kota di 14 Provinsi
Eyang MIKO, SOEDJATMIKO, Juli 2022 Dots are randomly placed within province
PENYAKIT CAMPAK PENYAKIT RUBELLA
CAMPAK → janin dalam kandungan ibu
→ bayi, balita, anak sekolah RUBELLA
2012-2017
2012 – 2018
Di RS tipe A :
35 < 15 yr ≥ 15 yr
< 15 yr ≥ 15 yr 50
2021 : 84 % (N=207) 2021 : 16% (N=38)
2021 : 74% (N=89) 2021: 26% (N=32) 2020 : 80 % (N=121) 2020 : 19 % (N=29)
30 2020 : 80 % (N=251) 2020 : 15 % (N=48)
40
Kasus positif CAMPAK Kasus positif RUBELA
25
paling banyak pada paling banyak pada
Kasus
Kelompok usia < 15 tahun Kelompok usia < 15 tahun
Kasus
20 30
2020 2020
15 2021 2021
20
10 4%
1%
10 0%
5
0%
0 0
10
12
14
16
18
20
22
24
26
28
30
32
34
36
38
40
0
2
4
6
8
Unknown
10
12
14
16
18
20
22
24
26
28
30
32
34
36
38
40
4
Unknown
0
2
6
8
Sumber ;
Kemenkes RI
Eyang MIKO, SOEDJATMIKO, Juli 2022
Kasus DIFTERI Tahun 2021 - 2022
96 Kab/Kota di 23 Provinsi terdampak difteri
2021 (N=235)
2022
(N=34)
: Difteri konfirmasi lab
: Difteri klinis
23 Kab/Kota di 10 Provinsi terdampak difteri
10
27%
6%
> 60
2
1
3
4
5
6
7
8
9
13
24
35
46
57
<1
10
11
12
14
15
16
17
18
19
20
21
22
23
25
26
27
28
29
30
31
32
33
34
36
37
38
39
40
41
42
43
44
45
47
48
49
50
51
52
53
54
55
56
58
59
60
Unknown
Sumber : Usia
• DIF-3 Monthly Report
• Data PHEOC
• kemenkes Eyang MIKO, SOEDJATMIKO, Juli 2022
Distribusi Kasus DIFTERI per Kelompok Umur
2019
1 – 4 thn 2 3
1 – 4 thn
19 – 40 thn
19 – 40 thn
5 – 9 thn
15-18 thn 5 – 9 thn
10 – 14 thn
4 1
Sunarno S, Sofiah SN, Amalia N, Hartoyo Y, Rizki A, et al. (2022) Laboratory and epidemiology data of pertussis cases and close contacts: A 5-year case-based surveillance of pertussis in
Indonesia, 2016–2020. PLOS ONE 17(4): e0266033. https://doi.org/10.1371/journal.pone.0266033
https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0266033
Table 2. Proportion of clinical and confirmed cases of PERTUSSIS and close contacts by age, sex, and year of sample collection.
Sunarno S, Sofiah SN, Amalia N, Hartoyo Y, Rizki A, et al. (2022) Laboratory and epidemiology data of pertussis cases and close contacts: A 5-year case-based surveillance of pertussis in
Indonesia, 2016–2020. PLOS ONE 17(4): e0266033. https://doi.org/10.1371/journal.pone.0266033
https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0266033
Rubela (MR)
Rubela (MR)
Sumatera Selatan
- Musi Banyuasin (1 kasus)
- Ogan Komering Ilir (1 kasus)
- Ogan Komering Ulu Timur (1 kasus)
Jawa Timur Sulawesi Selatan
- Situbondo (1 kasus) - Bulukumba (2 kasus) Kalimatan Utara
- Kota Tarakan (1 kasus)
Source: 2022
Surveillance: Monthly TN Report as of 17 Feb 2022 1 case
: 1 kematian
: 1 kasus TN
*Dots are randomly placed within provinces
Status Imunisasi Ibu Kasus TETANUS NEONATORUM
Indonesia, 2021
Status Imunisasi Ibu Kasus TN Status Imunisasi Ibu Kasus Kematian TN
82%
89%
TT2+ TT1 Tidak Imunisasi Tidak Jelas TT2+ TT1 Tidak Imunisasi Tidak Jelas
Jadwal booster ?
• Sebelum masuk SD ?
• SD kelas 1 ?
• SD kelas 2 ?
• SD kelas 5 ?
• Remaja ?
**
* SP DTaP-IPV – PRP-T can be used as a toddler booster in countries that have not implemented an hexavalent vaccine in this age group
** Pending local approval of indication & official national recommendation
Eyang MIKO, SOEDJATMIKO, Juli 2022
[1] Sanofi Pasteur. Tetraxim CCDS. V.13.0. 2019 [2] Sanofi Pasteur. Pentaxim CCDS. V.11.0. 2011 [3] Sanofi Pasteur. Hexaxim CCDS. V.8.0. 2018 [4] Sanofi Pasteur. Adacel CCDS. V.17.0. 2018 [5] Sanofi Pasteur. Adacel Polio CCDS. V.12.0. 2018
DTaP-IPV as a School-Entry Booster
Is highly % seroprotection and anti GMC titer for DTP
Immune responses 2 month after DTaP-IPV (n=123) as a school-entry booster at 4-6 years in children primed
with Pentavalen DTaP-IPV-Hib at 2-4-6 & 18-19 months (n=161) (3+1 Primary Series) (Thailand, 2009-10) [1,2]
Seroprotection rate GMC
95,0 100 100 99,2 100 96,3 97,6
100 10 100 15 100 500 100 93,1 92,6 500
7,81
% Seroconversion
% Seroconversion
% Seroprotection
% Seroprotection
80 8 80 400 80 400
(0.1 IU/mL) 356
(0.1 IU/mL)
(4-fold rise)
(4-fold rise)
9,99
60,2 10 307
60 6 60 300 60 272 300
7,72
[1] Chotpitayasunondh. S Asian J Trop Med Health, 2012;43(2) [2] Pancharoen. S Asian J Trop Med Pub Health, 2012;43(3) [3] Langue. Vaccine, 2004;22(11-12) [4] Mallet. Vaccine, 2004;22(11-12)
Eyang MIKO, SOEDJATMIKO, Juli 2022
SPID.TETRA.19.09.0066(09.2019)
DTaP-IPV as a School-Entry Booster
Is highly % seroconvertion and anti GMC titer for Polio virus
Immune responses 2 month after DTaP-IPV(n=123) as a school-entry booster at 4-6 years in children primed
with Pentavalen DTaP-IPV-Hib at 2-4-6 & 18-19 months (n=161) (3+1 Primary Series) (Thailand, 2009-10) [1,2]
% Seroprotection
% Seroprotection
% Seroprotection
(1/dil 5)
(1/dil 5)
(1/dil 5)
4621
60 60 60
3013 4000 4000 3837 4000
3430
40 3000 40 3000 40 3000
0 0 0 0 0 0
Post-Toddler
Pentax Pre- Post-Boost
Pre-boost Post- Post-Toddler
Pentax Pre- Post-Boost
Pre-boost Post- Post-Toddler
Pentax Pre- Post-Boost
Pre-boost Post-
Booster Tetraxim Booster Tetraxim Booster Tetraxim
(Pentaxim) Booster (Pentaxim) Booster (Pentaxim) Booster
[1] Chotpitayasunondh. S Asian J Trop Med Health, 2012;43(2) [2] Pancharoen. S Asian J Trop Med Pub Health, 2012;43(3) [3] Langue. Vaccine, 2004;22(11-12) [4] Mallet. Vaccine, 2004;22(11-12)
Eyang MIKO, SOEDJATMIKO, Juli 2022
SPID.TETRA.19.09.0066(09.2019)
Mengatasi KERAGUAN
IMUNISASI
Oleh TENAGA KESEHATAN
• Dokter Spesialis Anak
• Dokter umur / Layanan primer
• Perawat / Bidan
Source: The BeSD (Behavior & Social Driver) expert working group. Based on: Brewer NT, Chapman GB, Rothman AJ, Leask J, and Kempe A
(2017). Increasing vaccination: Putting psychological science into action. Psychological Science for the Public Interest. 18(3): 149-207
Eyang MIKO, SOEDJATMIKO, Juli 2022
INDONESIA : survei penerimaan vaksinasi rutin & COVID, 2018 - 2022
Kalau tidak divaksin apa dampaknya ? Tidak kebal, mudah sakit berat, cacat, meninggal
**
* SP DTaP-IPV – PRP-T can be used as a toddler booster in countries that have not implemented an hexavalent vaccine in this age group
** Pending local approval of indication & official national recommendation
Eyang MIKO, SOEDJATMIKO, Juli 2022
[1] Sanofi Pasteur. Tetraxim CCDS. V.13.0. 2019 [2] Sanofi Pasteur. Pentaxim CCDS. V.11.0. 2011 [3] Sanofi Pasteur. Hexaxim CCDS. V.8.0. 2018 [4] Sanofi Pasteur. Adacel CCDS. V.17.0. 2018 [5] Sanofi Pasteur. Adacel Polio CCDS. V.12.0. 2018