JAKARTA (The Straits Times/ANN): A steep rise in measles cases in Indonesia has highlighted the country’s ongoing struggle to boost immunisation rates amid growing vaccine hesitancy that has persisted since the Covid-19 pandemic.
The measles outbreak is so worrying that doctors on social media have taken to advising parents not to let their infants be held or kissed by too many people, especially in the lead-up to Eid-al Fitr, where large family gatherings are the norm.
The disease’s most common symptoms include fever, rash and cough, and can result in more serious, sometimes even life-threatening, complications such as pneumonia and encephalitis, especially for the unvaccinated.
In Indonesia, most measles cases are children – 80 per cent of cases in 2025 were those aged nine and below. Infants and toddlers under five years old, who face the highest risk from the disease, made up 53 per cent of the cases.
Homemaker Amanda Larasati, 22, received similar advice from her six-month-old daughter’s paediatrician during an appointment on March 10.
“The doctor said that she shouldn’t meet too many people, and if they do hold her, they should make sure to wash their hands. And if it’s not pressing, we should avoid going out,” she said.
With 10,744 confirmed cases in the last six months of 2025, Indonesia now has the second-highest incidence of measles in the world, behind only Yemen, based on World Health Organisation (WHO) data.
The data also shows that the number of measles cases more than doubled from 7,191 in 2024 to 17,204 in 2025.
In 2026, 10,453 suspected cases were recorded as at March 3.
The sharp uptick in the incidence of measles has been blamed on lower immunisation rates of children, who are recommended to receive the first dose at nine months and the second dose at 18 months.
Vaccine access remains patchy across Indonesia, as health facilities are unevenly distributed and health workers are limited, especially in remote parts of the archipelago.
Vaccine hesitancy compounds the problem, pulling down immunisation rates even in areas where vaccines are readily available.
Measles vaccination rates in Indonesia, like in much of the rest of the world, plummeted during the Covid-19 pandemic.
A concentrated post-pandemic immunisation drive by the Health Ministry succeeded in pushing the rate to 92 per cent in 2022, but this has hovered at around 82 per cent since 2023 – below the pre-pandemic level of 88 per cent in 2019.
At a hospital in Bekasi, in West Java, paediatrician Mega Septiana said she has treated at least 20 measles patients since the start of 2026.
“In normal conditions, you should only see maybe one or two measles cases a month. But now I’m seeing at least one or two cases a week,” she told The Straits Times. “The rise has been quite drastic.”
Dr Mega estimated that around 80 per cent of her measles patients were unvaccinated. Some of them were infants who were not yet able to be vaccinated. Others missed vaccinations due to scheduling issues or forgetfulness.
But around half of the unvaccinated children, she said, had parents who harboured doubts about vaccines.
“Some of them have very strong negative opinions about vaccines. They think that vaccines are just being promoted for profit. Some of them also believe that vaccines can cause disability or death,” she added.
Anti-vax views on the rise
Dr Dicky Budiman, an Indonesian epidemiologist at Griffith University in Australia, said WHO had already identified vaccine hesitancy as a global health security threat in 2019, even before the pandemic.
“It worsened during the pandemic because of a lot of misinformation, disinformation and conspiracy theories,” he told ST.
Before the pandemic, vaccine hesitancy in Indonesia was largely attributed to religious considerations.
In 2018, for example, local Islamic leaders in Riau and South Sulawesi urged the government to stop its immunisation programme over concerns that the measles-rubella vaccine was not halal as it contained trace amounts of pig-derived material.
This prompted the Indonesian Ulama Council, the country’s top Islamic body, to issue a fatwa, or religious ruling, declaring the measles-rubella vaccine to be mubah (permitted for use), given the public health necessity and lack of halal alternatives.
But since the Covid-19 pandemic, there has been an increasing prevalence of anti-vaccine views based on pseudoscience and global conspiracy theories, much of it spread by so-called “holistic health” influencers.
One such influencer, Ms Rizki Novianti, better known by her nickname Bude Wellness (“Wellness Auntie”) drew controversy in February when she got into a debate with several medical professionals on social media.
Ms Rizki, who has more than 220,000 followers on Instagram, where she promotes a “low-toxin lifestyle”, was asked by a follower whether it was all right if they had been vaccinated. She replied via an Instagram story that “making a mistake once is understandable, but repeating it again makes it a habit”, implying that getting vaccinated was a mistake.
The post was criticised by many, including Dr Yassin Bintang, an obstetrician and gynaecologist with a large online following.
“If you don’t get vaccinated, that’s not wellness, but illness,” he posted on social media platform Threads.
But Ms Rizki doubled down on her stance, saying that health workers like Dr Yassin were “playing God” and “being judgemental”.
Doctors call for more government intervention
Dr Dicky said views like Ms Rizki’s were not new, and that the Indonesian government should take more steps to counter such misinformation.
“They should involve more local figures, including religious and cultural leaders,” he said, adding that information about vaccines should be more localised.
“In Australia, for example, immunisation pamphlets are translated into different languages for immigrant communities. I’ve never seen such information translated to regional languages in Indonesia,” he said.
Dr Tri Yunis Miko Wahyono, an epidemiologist at the University of Indonesia, agreed, saying: “Anti-vaccine sentiment will have different causes in every province, every regency,” he told ST. “So vaccine promotion has to be tailored accordingly.”
Dr Yurdhina Meilissa, chief primary healthcare officer at the Center for Indonesia’s Strategic Development Initiatives (CISDI), said the government should also improve surveillance and data collection, especially ahead of the Eid holiday.
A project to improve immunisation rates in Bekasi and Depok, in West Java, is among the initiatives run by CISDI, a non-governmental organisation that focuses on public health policy.
Dr Yurdhina has found that low vaccination rates are often caused as much by supply problems as by low demand.
“Sometimes there’s a delay in inputting data, and as a result, the Health Ministry will be late in resupplying a particular health centre. Once that happens, parents will be disappointed, and it’s hard to get them to come back at a rescheduled date,” she said.
“It’s important to handle issues like this, especially at a time when people are going to interact a lot and there’s a risk that diseases will spread faster.”
For its part, the Health Ministry has said that vaccine stocks in every province will suffice for at least the next two months, and that it will accelerate its Outbreak Response Immunisation programme in regions with the highest measles rates ahead of the holiday.
“We encourage parents to immediately check their child’s immunisation status and complete it if it’s incomplete,” the ministry’s acting director-general for disease control, Dr Andi Saguni, said in a statement on March 6. “Immunisation is the most effective protection against measles.” -- The Straits Times/ANN
