Indonesia faces a measles epidemic after clerics declared jab sinful

Measles vaccination rates plummet in Indonesia after Muslim clerics declare the jab is ‘sinful’ because it contains pork gelatine

  • Caused vaccination rates to plummet from 95% to as low as 8% in some areas
  • Rubella outbreak may cause spike in birth defects if it infects pregnant women
  • Gelatine is added as a stabiliser to vaccines to prevent them degrading  
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Measles and rubella vaccination rates have plummeted in Indonesia after Islamic clerics declared the jab is sinful due to it containing pork gelatine.

Rates in the Southeast Asian country have dropped from the recommended 95 per cent to as low as just eight per cent in some areas.

Health experts fear the world’s largest Muslim country may suffer an outbreak of either disease. Rubella can cause birth defects if pregnant women catch the virus, while one in 15 cases of measles can turn life-threatening. 

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 67million children aged between nine months and 15 years old against both conditions.

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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, scheduled for August or September, 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. 


Rubella, also known as German measles, is a rare illness that causes a red or pink spotty rash.

It usually gets better by itself in around a week.

However, it can be serious if a pregnant woman becomes infected. 

The rash starts behind the ears and spreads to the head, neck and body.

Skin may also feel rough or bumpy.

Other symptoms can include:

  • Aching fingers, wrists or knees
  • Swollen lymph nodes behind the ears 
  • Fever
  • Cough, sneezing and runny nose
  • Headaches
  • Sore throat
  • Sore, red eyes 

Rubella usually gets better just with rest, plenty of fluids and painkillers, if necessary.

The risk of catching it is very rare if a person has had both doses of the MMR vaccine or has had rubella before.

MMR is offered to all children in the UK and gives lifelong protection against measles, mumps and rubella.  

Rubella is very rare in pregnancy but can cause miscarriage or serious birth defects that affect a baby’s brain, heart, sight or hearing. 

The risk is highest if rubella is caught early in pregnancy. 

There is no risk if a woman gets infected 20 weeks into her pregnancy.

Source: NHS Choices 

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 (permissible by Islamic law), 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 immunize 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 vaccinating children against measles or rubella.

Ms Soepardi, who was director of disease surveillance and quarantine at Indonesia’s health ministry until January, 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, which protects against childhood diarrhoea, halal – despite the use of trypsin.

It ruled the enzyme was 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. 

Health experts worry the Muslim country will experience a measles epidemic, with rubella also causing birth defects if pregnant women catch the virus (stock image of measles)


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 

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 currently 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. 


Andrew Wakefield’s discredited autism research has long been blamed for a drop in measles vaccination rates

In 1995, gastroenterologist Andrew Wakefield published a study in The Lancet showing children who had been vaccinated against MMR were more likely to have bowel disease and autism.

He speculated that being injected with a ‘dead’ form of the measles virus via vaccination causes disruption to intestinal tissue, leading to both of the disorders.

After a 1998 paper further confirmed this finding, Wakefield said: ‘The risk of this particular syndrome [what Wakefield termed ‘autistic enterocolitis’] developing is related to the combined vaccine, the MMR, rather than the single vaccines.’

At the time, Wakefield had a patent for single measles, mumps and rubella vaccines, and was therefore accused of having a conflict of interest.

Nonetheless, MMR vaccination rates in the US and the UK plummeted, until, in 2004 the then-editor of The Lancet Dr Richard Horton described Wakefield’s research as ‘fundamentally flawed’, adding he was paid by attorneys seeking lawsuits against vaccine manufacturers.

The Lancet formally retracted Wakefield’s research paper in 2010.

Three months later, the General Medical Council banned Wakefield from practicing medicine in Britain, stating his research had shown a ‘callous disregard’ for children’s health.

On January 6 2011, The British Medical Journal published a report showing that of the 12 children included in Wakefield’s 1995 study, at most two had autistic symptoms post vaccination, rather than the eight he claimed.

At least two of the children also had developmental delays before they were vaccinated, yet Wakefield’s paper claimed they were all ‘previously normal’.

Further findings revealed none of the children had autism, non-specific colitis or symptoms within days of receiving the MMR vaccine, yet the study claimed six of the participants suffered all three.

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