Hey folks, welcome to our first special edition Nuiceletter where we dive into the shenanigans surrounding “Vaksin Nusantara”, an initiative by former Health Minister Terawan Agus Putranto whose Covid-19 response was, shall we say, extremely lacking and dismissive.
So what is Nusantara vaccine?
According to the disgraced former minister, the Nusantara vaccine uses a person’s dendritic cells, a key coordinator of our immune system. The way it works (or supposed to work) is: a patient’s blood sample is drawn, the dendritic cells are then isolated and the cells are “introduced” to the SARS-CoV2 virus before they are injected back to the patient.
The scientists behind this have claimed that because it involves the patient’s own dendritic cells it has little to no chance of rejection or side effects. They also claimed that patients only need to be inoculated once and they’re immune for life. Cloudest also claimed that unlike other vaccines, Nusantara can be suitable for patients with comorbid conditions.
These claims are disputed. We’ll get to that later.
The same method is being tested as immunotherapy measures to treat a variety of tumors with limited success. Although scientists believe more studies are needed for it to be used as cancer treatment, that didn’t stop Terawan to believe that the method can also work as Covid-19 vaccines.
Apparently, the use of dendritic cells to fight the coronavirus has long been studied by a California-based company called Aivita Biomedical. IDN Times wrote that one of Terawan’s besties brought the research to Terawan’s attention back when his cloudest-ness was still minister. This bae is especially close with Aivita’s CEO, IDN Times discovered.
Before he became minister, Terawan had been a fanboy of unconventional and scientifically dubious and questionable treatments. Which might be the reason why it wasn’t long before Terawan became a fanboy of this dendritic cell-based vaccine “theory”, even when all the pharmaceutical companies out there were like: “we’ll stick to the conventional method of producing vaccines. KTHXBY.”
On Dec 18, 2020 his cloudiness signed a ministerial decree on the formation of a dendritic cell-based Covid-19 vaccine research team. In other words, he told his staff at the ministry’s research and development facility to like: “Yo! Research the hell out of this shitz! This da bomb right here.” So yeah, the early stage of Nusantara vaccine was funded by taxpayers’ money.
Why is it controversial?
Epidemiologists have been criticizing the Nusantara vaccine project. For one, we shouldn’t be calling them “vaccines” in the first place, because they are more of a treatment method instead of weakened or killed forms of a microbe, its toxins, or one of its surface proteins (the very definition of a vaccine).
It’s also impractical and not something which is easily mass produced and distributed like ordinary vaccines, since each patient is injected with their own dendritic cells which have been incubated with the virus in a lab. To inoculate millions, we need to train thousands of lab technicians and workers on how to draw a patient’s blood, isolate the dendritic cells, incubate them, and reinject them back to the specific patient where they originate from. Not every corner of this vast archipelago has labs suited for these types of work.
As we have mentioned, epidemiologists disputed claims by the people behind Vaksin Nusantara that their method is safe. Many things can go wrong between the time a patient’s blood is drawn and the time the same patient is injected with the incubated dendritic cells. Since the “vaccines” are crafted individually and not created en masse in the manufacturing floor: quality, effectiveness, efficacy, and safety might differ greatly.
But what got epidemiologists upset AF, is the secrecy surrounding the whole project. Potential vaccines should first be tested in animals to evaluate its safety and potential to prevent diseases in a process known as a pre-clinical trial. Results of Vaksin Nusantara’s pre-clinical trial was never made public, and on March 10 – when the Food and Drug Supervisory Agency (BPOM) testified in front of members of parliament – we finally know why: there was no pre-clinical trial.
His cloudest-ness argued there was no need for his team to conduct their own pre-clinical trial because that’s already been done by Aivita. While that’s technically true, the trial was conducted in January 2020 and the report wasn’t received until late February of this year, more than one year later. Talk about sus.
Despite the absence of a proper pre-clinical trial, the Vaksin Nusantara team went ahead and did a phase 1 clinical trial anyway with the involvement of 31 subjects. However, the BPOM discovered that the subjects already have COVID-19 antibodies prior to the trial, which means that at some point they have contracted the virus. BPOM said this is against protocol and invalidated the whole trial.
That’s not the only problem. One month after the subjects were inoculated, the treatment failed to provide the patients adequate protection against COVID-19, the BPOM concluded. The agency said that they wished to speak with the Vaksin Nusantara team to address these issues saying that unless they do so, BPOM cannot allow them to go to phase 2.
Eject! Eject!
The whole project was so messy some institutions tried to distance themselves from it. UGM's faculty of medicine and public health said they are trying to get their name off the list of parties developing Vaksin Nusantara.
UGM said that way back when they were informally asked to be on the team and they agreed to help. But since then, UGM said they were... shall we say... ghosted by the team. They said they were kept in the dark the whole time adding that they were never asked to do anything, never reviewed any papers, never asked to give opinions, nothing. In fact, the faculty's vice dean said, they only found out that their name was on the list of parties developing Vaksin Nusantara from the media.
Even the government is distancing itself from the project. The Ministry for Research and Technology said Vaksin Nusantara is not a part of the Vaksin Merah Putih program, a bid by a consortium of universities and research institutes to develop Indonesia’s own vaccine.
Research Minister Bambang Brodjonegoro said they tried to get Vaksin Nusantara on board, invited them to present their theories and asked them to submit their research papers but they were also ghosted. He said he wasn’t even aware that Vaksin Nusantara was already being tested.
When Commission IX (Health and Manpower Commission) of the DPR called the Health Ministry and the BPOM to discuss about the pandemic and the vaccines on March 10, Deputy Health Minister Dante Saksono who attended on the Ministry’s behalf initially avoided talking in depth about Vaksin Nusantara until some members of the commission pressured him to bring it up. Seems that the Deputy Minister never intended to talk about Vaksin Nusantara in the first place. The hearing ended up lasting nine hours with quite animated responses from members of the Commission.
One particular member, Saleh Partaonan Daulay (PAN, N. Sumatra) was so incensed that he called for the newly arrived AstraZeneca vaccine to be thrown out because he claimed it received more favorable treatment than Vaksin Nusantara. Well, he sort of got his wish because the AstraZeneca vaccine apparently is under a cloud of doubt currently due to unexpected side effects affecting several recipients across Europe and Asia. BPOM and the Health Ministry issued an order to delay the use of the British vaccine in Indonesia until a full evaluation is completed.
What now?
Well, the drama isn’t over yet since BPOM is adamant on evaluating Vaksin Nusantara much more deeply, forcing a longer delay for phase 2 and 3 trials, if it ever gets to that stage. President Joko Widodo said that proper steps need to be taken to ensure that the results of the trials are scientifically accountable to ensure the use is safe and effective.
In the meantime, Indonesia’s vaccination drive is chugging along with the Sinovac vaccine. Still below the target of 500,000 vaccinations per day for first time vaccinations but collectively it’s getting there, almost 400,000 in total today and almost 5 million since the start of the drive on 13 February.
That's all we know so far on Vaksin Nusantara but judging from the wide political support from the Parliament, this won't be the last time we hear about this. That's it for our first special report. Let us know if we missed anything and what subjects or topics you’d like us to cover in future editions of the report.
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Thanks for reading. See ya!