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Pentingnya Vaksinasi Pada
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Laman Media Sosial (Instagram) Pusat Kesehatan Haji Kemkes

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“Dr. Muhammad Al-Abdel Ali, spokesman of the

ministry, said that an increase in influenza cases
was observed during the current season.

He said that its spread is stronger than the

reported cases in the past two years and there are
many people admitted into intensive care units
and the flu may lead to deaths.”

“Ministry stated that seasonal

influenza causes many
complications, the most serious of
which are pneumonia, bronchitis,
ear infection, blood poisoning and
death.”
https://www.saudigazette.com.sa/article/627853/SAUDI-ARABIA/Flu-spread-stro
nger-than-past-two-years-and-can-lead-to-deaths-MoH-warns
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Influenza harus dipertimbangkan pada pasien dengan gangguan saluran nafas berat yang
dirawat di ICU.
Musim dan Ko-infeksi adalah dua faktor penting dalam mempertimbangkan influenza sebagai
pathogen penyebab pasien kritis.

Virus influenza A dan B mempengaruhi pasien terhadap infeksi bakteri.

Streptococcus pneumoniae, Haemophilus influenzae, dan Staphylococcus aureus dilaporkan
sebagai penyebab paling umum infeksi bakteri sekunder pada pasien influenza.

Infeksi virus Influenza meningkatkan keparahan infeksi bakteri, termasuk morbiditas dan
mortalitas
Cantan B, et al. Influenza Infections and Emergent Viral Infections in Intensive Care Unit. Semin Respir Crit Care Med. 2019 Aug;40(4):488-497.
Morris DE, et al. Secondary Bacterial Infections Associated with Influenza Pandemics. Front Microbiol. 2017;8:1041. Published 2017 Jun 23. doi:10.3389/fmicb.2017.01041
 Internal

Infeksi Saluran Nafas merupakan Penyebab Utama Pasien

Rawat Inap di Saudi Selama Musim Haji1

Jenis Virus Penyebab2

60% Jemaah yang berkonsultasi di Klinik Primer
Mina datang dengan keluhan Infeksi Saluran
Pernapasan1

57% Rawat
Nafas
Inap didominasi Infeksi Saluran

~56%
Disebabkan Virus
Influenza Rawat Inap di Rumah Sakit Rujukan
20–40% disebabkan Pneumonia

Rawat di ICU disebabkan Infeksi Saluran

55–67% Nafas

Parainfluenza HSV RSV

Influenza A Influenza B
Studi Balkhy et al. pada 500 pasien Jemaah Haji, dengan 1.Travel Med Infect Dis. 2016 March-April; 14(2): 92–109.
estimasi total 24,000 kasus Influenza 2 2. Balkhy et al. Journal of Travel Medicine, Volume 11, Issue 2, 1 March 2004, Pages 82–86
 Internal

Influenza tidak sama dengan Selesma (Common Cold) 1,2

GEJALA Selesma Influenza

(Common Cold)
Demam Jarang Tiba‐tiba, seringkali demam tinggi,
berakhir dalam 3‐4 hari

Sakit kepala Jarang Sering

Nyeri dan pegal Ringan Biasa terjadi, dan seringkali sangat

nyeri

Lemah Jarang, Ringan Sedang sampai berat, bisa sampai

satu bulan

Terbaring di Tempat Jarang, Ringan Sering, bisa sampai 5‐10 hari

Tidur
Pilek Sering kadang‐kadang Kondisi di Arab Saudi dapat
Bersin-bersin Umum kadang‐kadang
memudahkan penyebaran virus
influenza.3
Tenggorokan Sakit Umum kadang‐kadang
Jemaah haji yang berkumpul dalam jumlah besar
Batuk Kadang-kadang, Biasa, bisa menjadi parah seperti di Kaabah dan di Mina, meningkatkan risiko
ringan penyebaran virus.3
Komplikasi yang Sinus atau infeksi Pneumonia, gagal ginjal, gagal hati,
bisa terjadi telinga dapat mengancam jiwa
1. CDC cold vs flu , https://www.cdc.gov/flu/about/qa/coldflu.htm accessed on 3 April 2018
2. WHO Influenza fact sheet 211,http://www.who.int/mediacentre/factsheets/fs211/en/ accessed on 3 April 2018
3.Travel Med Infect Dis. 2016 March-April; 14(2): 92–109.
 Internal

Dampak Influenza tidak sebatas Infeksi Saluran

Pernafasan1,2

Dampak Saluran Pernafasan:

Persespsi Demam, pusing,
Exacerbations:
Influenza penyakit infeksi Nyeri otot, • Pneumonia
saluran pernafasan ringan batuk... ‒ Primary viral • Asthma
Akan sembuh kurang dari ‒ Secondary bacterial • COPD
satu minggu
Dampak Influenza Selain Sistem Pernafasan:
Dampak Aktual Kardiovaskular
Beban kesehatan, Deconditioning Diabetes
ekonomi, dan sosial
• Infark Miokardial Akut • ADL menurun • Kontrol gula darah
dari komplikasi
• Gagal Jantung terganggu
Influenza • Berat badan turun
• Miokarditis • Ulkus Dekubitus • Keto Asidosis
Diabetikum
• Stroke
• VTE Sistem Saraf Penyakit Ginjal

• Kebingungan, delirium Gagal Ginjal Akut

• Guillain-Barre Syndrome Rhabdomyolysis
• Ensefalopati
COPD: chronic obstructive pulmonary disease. 7
ADL: activities of daily living; COPD: chronic obstructive pulmonary disease; MI: myocardial infarction; VTE: venous thromboembolism.
1. Disease Burden of Influenza (FAQ). 2. Factsheet about seasonal influenza.
 Internal

Virus Influenza dapat ditularkan melalui droplet atau aerosol

melalui berbagai cara:1,2

Resiko infeksi meningkat dengan padatnya

orang yang berkumpul (3)

• Satu penumpang bergejala menyebarkan penyakit

ke 72% penumpang lain dalam pesawat komersil(4)
• Kejadian Luar Biasa infeksi influenza A pada kapal
pesiar menyerang 48% penumpang setelah 2 hari
terpapar (5)

Berbicara
1- CDC. Influenza Fact Sheet. Key facts about the flu: how to prevent the flu and what to do if you get sick Available at http://www.cdc.gov/flu/key facts.htm accessed on March 2007 2- Nature volume 595, pages205–213 (2021)
3- Aymard M. influenza : epidemiology, etiology, physiopathology, diagnosis, treatment and prevention. VAC.Pdt. INFO N°2, Feb 1995:47-70 4-Goldmann DA. Transmission of viral respiratory infections in the home. Pediatr Infect Dis J, 2000;19 (10):S97-102 5-
CDC. Outbreak of influenza A infection among travelers – Alaska and the Yukon territory, May-June 1999. MMWR July 02, 1999;48 (25):545-546,555
 Internal

Departemen Kesehatan Kerajaan Arab Saudi CDC merekomendasikan Pejalan International

merekomendasikan semua pengunjung/peserta untuk mendapatkan Vaksinasi Influenza
Umrah, Haji, atau Pekerja di area Haji untuk Musiman setidaknya 2 minggu sebelum
perjalanan
mendapatkan Vaksinasi Influenza Musiman

Health-Regulations-En.pdf (moh.gov.sa)
Influenza Prevention: Information for Travelers | CDC
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Vaksinasi Influenza Direkomendasikan oleh

Organisasi Internasional dan Indonesia
Indonesian Society of CDC dan WHO merekomendasikan
Centers for Disease European Internal Medicine (PAPDI) pemberian Vaksinasi Influenza pada:
WHO Control and Prevention Union countries

Anak 6 Bulan - 5 Tahun

Ibu Hamil

Indonesian Society of ≥ Lansia 65 Tahun

Pediatrics (IDAI)
Pasien Dewasa dengan
Penyakit Penyerta
(Diabetes, Hipertensi,
HIV/AIDS, Asma, Penyakit
Jantung / Paru-paru

Pelaku Perjalanan
Luar Negeri

Tenaga Kesehatan
1
1. http://www.who.int/wer/2012/wer8747.pdf?ua=1 4. http://ecdc.europa.eu/en/publications/Publications/Seasonal-influenza-vaccination-antiviral-use-europe.pdf
0
2,http://www.idf.org/sites/default/files/LTT-Influenza%20and%20diabetes_final.pdf 5 http://apps.who.int/immunization_monitoring/globalsummary/schedules
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Manfaat Vaksinasi Influenza:
mengurangi resiko rawat inap karena influenza berat

2023 Southern Hemisphere

seasonal influenza vaccine
mengurangi risiko
hospitalisasi yang
berhubungan dengan
influenza sebesar 52%.

Interim VE estimates indicate a significant

reduction in hospitalization associated with
the predominant influenza A(H1N1)pdm09
virus among young children and older adults.

Fowlkes AL, Nogareda F, Regan A, et al. Interim Effectiveness Estimates of 2023 Southern Hemisphere Influenza Vaccines in Preventing Influenza-Associated Hospitalizations — REVELAC–i Network, March–
July 2023. MMWR Morb Mortal Wkly Rep 2023;72:1010–1015. DOI: http://dx.doi.org/10.15585/mmwr.mm7237e1
 Internal

Available Influenza Vaccines in Indonesia:

Why Quadrivalent and Why Split Virion?

Influenza Influenza Type of Remarks Trivalent Influenza Vaccine

Vaccine Strain Vaccine
Category Coverage
Protect against
Trivalent 2 Influenza A
Influenza Split Virion strains [H1N1,
Vaccine H3N2] and 1
Influenza B lineage
Inactivated Protect against
Influenza Quadrivalent Split Virion Influenza 2
Vaccine Influenza Influenza A strains
Vaccine Subunit [H1N1, H3N2] and Quadrivalent Influenza Vaccine
2 Influenza B
lineages
 Internal

Why Quadrivalent? :
Extended Protection of QIV vs TIV

Current Influenza B Epidemiology strongly supports

the need for additional Influenza B Lineage coverage
1,2

Cross protection among Influenza B Lineages is very

limited1

Quadrivalent Influenza Vaccine provides extended

coverage that covers both co-circulating Influenza B
lineages 1,2

Ambrose C, Levin MJ, The rationale for quadrivalent influenza vaccinesHum Vacc & Immunother 2012: 8(1) 81‐88
1. Barr IG, et al, The Coming Era of Quadrivalent Human Influenza VaccinesDrugs 2012; 72(17)1‐9
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Respon Imun Vaksin Influenza Kuadrivalen superior

terhadap strain Influenza B yang tidak diproteksi TIV
3.50

3.00

2.50

GMTR
2.00

1.50

1.00

0.50

0.00
18-60 years >60 years 18-60 years >60 years
B/Victoria B/Yamagata

§ QIV vs Investigational TIV (B/Yamagata) ‡ QIV vs Licensed TIV (B/Victoria)

QIV elicited a superior immune response against B strains not contained in TIV,
in adults (18–60 years) and in the elderly (over 60 years)

(Superiority was demonstrated as the lower limit of the two-sided 95% CI of the ratio of day 21 GMTs was >1 for each B strain in each age group based on PPAS analysis)
All vaccines were inactivated, split-virion preparations containing 15 g hemagglutinin per strain in a total volume of 0.5 mL. The QIV (batch S4361) contained the A/California/07/2009 (H1N1), A/Victoria/210/2009 (H3N2), B/Brisbane/60/2008 (Victoria
lineage), and B/Florida/04/2006 (Yamagata lineage) strains. The B/Florida strain was selected for inclusion in QIV as it was the Yamagata lineage strain most recently included in TIV (2008/2009 formulation) prior to this study.

QIV: Quadrivalent Influenza Vaccine; TIV: Trivalent Influenza Vaccine

Reference: 1. Pépin S, et al. Vaccine 2013;31(47):5572

MAT-GLB-2201239 V1 – 05/2022 14
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Rekomendasi komposisi strain influenza virus untuk Vaksin

Influenza Northern Hemisphere 2023-2024

For Quadrivalent vaccines for use in the

2023-2024 northern hemisphere influenza
season, the WHO recommends the
following:
Egg-based vaccines
• an A/Victoria/4897/2022 (H1N1)pdm09-
like virus;
• an A/Darwin/9/2021 (H3N2)-like virus;
and
• a B/Austria/1359417/2021 (B/Victoria
lineage)-like virus.
• a B/Phuket/3073/2013 (B/Yamagata
lineage)-like virus.
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Mengapa Split Virion Influenza Vaccine?: Komponen Antigen

Subunit vaccines hanya mengandung

antigen permukaan dari virus influenza:
HA dan NA.

Platform Subunit dikembangkan sejak

1970an.

Whole Cell Virus: Split Virion mengandung partikel

Imunogenisitas: Baik inaktif virus Influenza (Termasuk
•Reaktogenisitas: Tinggi antigen permukaan HA&NA, dan
Internal Protein).
Platform Whole Cell
dikembangkan Internal Protein penting dalam
sejak 1940an.
merangsang Imun Respons Seluler.

Platform Split Virion dikembangkan sejak

1960an.
Vaccines 2021, 9(9), 1032; https://doi.org/10.3390/vaccines9091032
Kim YH, Hong KJ, Kim H, Nam JH. Influenza vaccines: Past, present, and future. Rev Med Virol. 2022;32(1):e2243. doi:10.1002/rmv.2243
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Mengapa Split Virion Influenza Vaccine?: Komponen Antigen

Parameter Split Virion Influenza Vaccine Subunit Influenza Vaccine

Komponen Surface Antigen + Internal Protein Surface Antigen
Respon Imun Seluler (Co MD, et al 2009) Respon Interferon-γ ELISpot lebih tinggi secara signifikan pada
Split vaccine dibanding subunit vaccine.
Respon Imun Humoral (Talbot et al. 2015) Efektifitas yang lebih baik secara klinis didapatkan pada split-
(Immunogenicity) virion vaksin pada pasien lansia
Safety (YH Zhang, et al. 2022) Tidak didapatkan perbedaan signifikan antara vaksin
subunit dan split-virion terkait profil keamanan

(S Squarcione et al. 2003).

Reaktogenisitas kedua jenis vaksin dapat ditoleransi dengan baik.

Frekuensi reaksi lokal lebih rendah pada grup yang menerima Vaxigrip®.

Nyeri pada lokasi suntik terjadi dalam kurun waktu 30 menit sampai 3 hari setelah
vaksinasi lebih sedikit didapatkan (P = 0.005) pada grup Vaxigrip®.