Fighting infection outbreaks while respecting religious dietary laws The challenge of balance

Indonesia’s regional authorities on Madura Island are grappling with a deadly measles outbreak that has persisted for nine months. More than 2,600 people have been infected this year, with 20 fatalities reported, but health officials face a delicate challenge: many parents are hesitant to vaccinate their children over concerns that the vaccine may violate halal dietary laws.

Pork-derived gelatin, commonly used as a stabiliser to keep vaccines safe and effective during storage and transport, creates a dilemma for religious communities that consider pigs ritually unclean. Many Islamic scholars argue that vaccines containing gelatin stabilisers are permissible under religious law, similar to other medical products containing pig-derived ingredients, under specific conditions, according to ABC News.

Religious authorities in Indonesia, the world’s largest Muslim-majority country, ruled in 2018 that vaccines containing pig gelatin are haram, or forbidden, but advised Muslims to use them “for the benefit of society” until alternatives are available, said Ahmad Syamsuri, head of Disease Control and Prevention at the Sumenep Health Office.

The regional government’s latest initiative, launched in August, aims to provide more than 78,000 vaccines to children in the area. Vaccines are distributed through local clinics, delivered directly to residents’ homes, and brought to schools.

Officials hope the campaign will prevent future infections and deaths, but convincing wary parents remains a major challenge. This outbreak is not unprecedented as Indonesia experienced a major measles outbreak in 2018.

Measles vaccination coverage in Indonesia fell short of national targets in 2023, according to Ministry of Health data. Measles-rubella vaccinations reached 86.6% of the target in 2023, dropping to 82.3% in 2024.

This trend mirrors a global pattern. The World Health Organization reported that last year 84% of children received their first dose of the measles vaccine, while only 76% received both doses. Experts note that vaccination rates must reach 95% to prevent outbreaks and establish what is known as "herd immunity." WHO also reported that 60 countries experienced major measles outbreaks last year all across the globe.

By Nazrin Sadigova