Maintaining Trust Through Immunisation

A schoolchild’s immunisation consent form, brought home to parents, often appears to be just an annual routine. Yet behind that simple sheet of paper lies a crucial decision that determines the health of a generation. When parents sign the consent, they are not merely permitting their child to receive a vaccine; they are helping to build a shared protective fortress to ensure infectious diseases do not find space to thrive again. In Indonesia, the School Children’s Immunisation Month (BIAS) is a vital instrument for ensuring this protection is maintained. The programme not only supplements individual immunity but also preserves herd immunity to keep various vaccine-preventable diseases (PD3I) under control. This challenge has become increasingly relevant as various countries face a resurgence of disease cases that have long been preventable through vaccines. The decline in immunisation coverage following the pandemic, increased public mobility, and the relentless flow of disinformation have made these threats real once more. It is within this context that the Surabaya City Government’s move to collaborate with the Indonesian Ulema Council (MUI), the Ministry of Religious Affairs, the education sector, health workers, and community leaders to ensure the success of BIAS 2026 is noteworthy. This approach demonstrates that the issue of immunisation is no longer solely a medical matter, but also a matter of public trust. Surabaya is targeting a BIAS 2026 coverage rate of 90 percent, an increase from the approximately 85 percent achieved in 2025. While this target appears to be a mere statistic, behind that five percent increase are thousands of children expected to gain protection from dangerous diseases such as measles, rubella, diphtheria, tetanus, and Human Papilloma Virus (HPV) infection. This data was presented by the Surabaya City Government during a cross-sectoral coordination meeting ahead of the BIAS 2026 implementation. For years, Indonesia has built one of the world’s largest immunisation programmes. Various diseases that were once a scourge have been significantly suppressed. However, this success does not mean the threat has disappeared. Reports from the World Health Organization (WHO) and UNICEF in recent years show that millions of children globally missed or were delayed in receiving routine immunisations after the COVID-19 pandemic. This situation increases the risk of measles outbreaks and other preventable diseases re-emerging. Indonesia is not entirely free from these challenges. The Ministry of Health has repeatedly warned that a decline in immunisation coverage could trigger extraordinary events (KLB) in several regions if not promptly restored. This is where Surabya is taking a different approach. The city government is not only strengthening health services but also building social communication through religious leaders, school principals, Islamic boarding school administrators, health cadres, and sub-district officials. This step stems from the reality that immunisation refusal today is more often triggered by doubt than by limited access to services. Some parents are still influenced by incorrect information regarding the safety or halal status of vaccines. This phenomenon shows that the digital era not only facilitates the spread of information but also accelerates the spread of doubt. A social media post not based on scientific evidence can reach thousands of people in minutes, while explanations from health workers often take much longer to rebuild trust. Therefore, Surabaya’s decision to involve the MUI and the Ministry of Religious Affairs holds strategic significance. The public health approach becomes more complete when scientific messaging goes hand in hand with religious and social approaches. The MUI Fatwa Number 4 of 2016, which states that vaccines in the government immunisation programme are halal, serves as an important foundation for addressing lingering doubts.