Measles is set to spike in Indonesia after Islamic clerics declared the MR vaccine is sinful due to it containing pork gelatine.
This has caused vaccination rates against measles and rubella in the Southeast Asian country to plummet from the recommended 95 per cent to as low as just eight per cent.
Health experts worry the world’s largest Muslim country will experience a disease epidemic, with rubella also causing birth defects if pregnant women catch the virus.
Gelatine is added as a stabiliser to many vaccines and medicines to prevent them degrading during transportation.
Measles is set to spike in Indonesia after Islamic clerics declared the MR vaccine sinful due to it containing pork gelatine. This has caused vaccination rates against measles and rubella to plummet from the recommended 95 per cent to as low as just eight per cent (stock)
Until recently, Indonesia had one of the highest rates of measles in the world, according to the World Health Organization.
Although it produced its own jab against the infection as part of its childhood vaccination scheme, administration of the vaccine was patchy.
The Southeast Asian country switched to a combined MR jab last year as part of the WHO-led plan to eliminate measles and rubella globally by 2020.
Indonesia’s ministry of health aimed to play ‘catch-up’ by vaccinating 67 million children aged between nine months and 15 years old against the conditions.
The campaign started on the island of Java, where 95 per cent vaccine coverage was achieved, which caused rubella rates to drop by more than 90 per cent.
But the roll-out to the rest of the country was put on hold when the Islamic body Indonesian Ulama Council stated it had not certified the jab as halal.
Parents were immediately put off, with just six out of 38 students at a primary school in the province of North Sumatra receiving the MR jab.
Some parents even gathered outside the school to ensure their youngsters were not vaccinated, with some claiming their children had to miss out on the jab due to them being ‘ill’ at home.
WHAT ARE THE SYMPTOMS OF MEASLES DURING PREGNANCY? AND IS IT SERIOUS?
Measles is a highly contagious virus that spreads via contact with an infected person.
If a pregnant woman who has not been vaccinated becomes infected, she is at greater risk of suffering a miscarriage, stillbirth or premature labour.
Infected pregnant women suffer the same symptoms as other measles patients.
These include fever, cold, cough and rashes, which are characterised by red spots and bumps on the skin.
Pregnant women showing symptoms of measles, or those who have been in contact with an infected person, should contact their GP or midwife immediately.
They will then undergo a blood test to determine if they are immune to measles.
If not, they may require an injection to boost their immune-cell counts, which should help to reduce their measles symptoms and the impact of the infection on their babies.
With parents being put off, Indonesia’s health ministry lobbied for the Indonesian Ulama Council to rule ‘fatwa’ on the vaccine, which would declare it as halal, last August.
Instead, the council declared it haram, or sinful, due to the jab containing gelatin from pigs’ skin as a stabiliser.
The vaccine also has the pig protein trypsin, which prevents the components of the jab from sticking to its glass container while it is being manufactured.
The Indonesian Ulama Council stressed it was not blocking the vaccination campaign, with parents having the choice to vaccinate their children if they wish.
A message put out by the body at a public consultation on September 18 read: ‘Trusted experts have explained the dangers posed by not being immunized.’
But the damage was already done with just 68 per cent of children being vaccinated on islands surrounding Java to date, according to the health ministry.
And in Aceh, which is ruled by Islamic law, vaccination rates are just eight per cent.
A spokesperson for the WHO’s office in the capital Jakarta stated vaccination rates are poor in many countries.
Although the fatwa ‘has caused some confusion at local levels, it is in fact clear in its directive and ultimately supportive’ of vaccination, a spokesperson said.
The WHO remains positive about its plans to immunise 95 per cent of children in Indonesia and has extended the deadline to December.
Elizabeth Jane Soepardi, an independent public health expert, told Science ‘we can’t play’ with the MR vaccine.
Ms Soepardi, who was director of disease surveillance and quarantine at Indonesia’s health ministry, warned low vaccination rates ‘could mean a boomerang for us’.
There is no certified halal alternative to the MR vaccine.
However, many Muslim clerics argue pork products in jabs are chemically purified, which makes them acceptable under Islamic law.
And in 2013, the Islamic Religious Council of Singapore declared a rotavirus vaccine halal despite the use of trypsin.
It ruled the enzyme had been made pure by dilution and the addition of other pure compounds.
Jewish groups have previously said the use of gelatine in medicines does not violate their religious beliefs because it is not ingested.
But if parents still refuse to vaccinate their children, manufacturing a halal jab may be the only option, according to Art Reingold, an epidemiologist at the University of California, Berkeley.
Cow gelatine has been suggested as an alternative, however, studies proving its safety and effectiveness may take up to 10 years.
In response to the development of halal vaccines, the WHO said: ‘WHO works with regulatory authorities and manufacturers to ensure vaccines have the highest standards of safety and efficacy.
‘We don’t assess vaccines on other criteria.’
This comes after vegetarians claimed last month that the use of pork gelatine in vaccines and medicines is putting people off using them.
Lynne Elliot, chief executive of the Vegetarian Society, said it was ‘disappointing’ so many still contain animal ingredients.
MMR vaccination rates are also poor in the UK, which has been blamed on the disgraced gastroenterologist Andrew Wakefield’s discredited claims that the jab causes autism and bowel disease.
Only 91.9 per cent of children were vaccinated against measles between 2015 and 2016 compared to 94.2 per cent in 2014/2015 and 94.3 per cent in 2013/2014, according to NHS immunisation statistics.
WHAT IS MEASLES, WHAT ARE THE SYMPTOMS AND HOW CAN YOU CATCH IT?
Measles is a highly contagious viral infection that spreads easily from an injected person by coughing, sneezing or even just breathing.
Symptoms develop between six and 19 days after infection, and include a runny nose, cough, sore eyes, a fever and a rash.
The rash appears as red and blotchy marks on the hairline that travel down over several days, turning brown and eventually fading.
Some children complain of disliking bright lights or develop white spots with red backgrounds on their tongue.
In one in 15 cases, measles can cause life-threatening complications including pneumonia, convulsions and encephalitis.
Dr Ava Easton, chief executive of the Encephalitis Society told MailOnline: ‘Measles can be very serious.
‘[It] can cause encephalitis which is inflammation of the brain.
‘Encephalitis can result in death or disability.’
Treatment focuses on staying hydrated, resting and taking painkillers, if necessary.
Measles can be prevented by receiving two vaccinations, the first at 13 months old and the second at three years and four months to five years old.
Source: Great Ormond Street Hospital