Indonesia Covid Vaccine NFCS

Introduction

Indonesia is triple covered - it has a national covid vaccine NFCS, it is a member of the COVAX NFCS and the UNICEF NFCS.

Indonesia introduced a national no-fault compensation for COVID-19 vaccines in 2021 through the enacting of the Minister of Health Regulation Number 10 of 2021, which is the implementing regulation of Presidential Decree Number 99 of 2020 and Presidential Decree Number 14 of 2021.

The scheme appears to be administered by the National Commission on AEFI (Komisi Nasional Kejadian Ikutan Pasca Imunisasi/Komnas KIPI). More specifically, Komnas KIPI carries out causality assessments on potential connections between vaccination and injury, and can receive compensation claims following a finding of causation (see Harryandi, Bratadana and Sandyawan 2021).

The funding for the scheme comes from central government (see Minister of Health Regulation Number 10 of 2021, Article 36).

Vaccines Covered

This NFCS covers COVID-19 vaccines administered in Indonesia.

It is not specified whether the scheme includes both vaccines approved for emergency use and standard approvals.

Injuries Covered

This NFCS covers both temporary and permanent injuries.

Under this NFCS only eligible injuries are covered. Eligible injuries are injuries that necessitate medical care and treatment, injuries that cause disability, and death. For the purposes of compensation, disability can be defined as ‘mild’, ‘moderate’ or ‘severe’, as specified in the Minister of Health Regulation Number 10 of 2021, Article 38.

Charges for making a claim

It is not specified whether there are any charges for making a claim under this scheme.

Claimants

Under this scheme the following categories of individuals are permitted to make a claim:

Vaccinated person or legal representative of a vaccinated person;
Family members of an injured vaccinated person;
Legal heirs of a deceased vaccinated person or legal representative of the legal heirs.

See Minister of Health Regulation Number 10 of 2021, Article 39.

Under this scheme the claimant is allowed to nominate a legal representative to make their claim.

Funding for legal representation is not specifically provided by the scheme.

Losses covered

This scheme pays the following:

Live vaccine recipient	Dependants of vaccine recipient	Estate of a deceased vaccine recipient
Compensation payments are for general categories and are not broken down into economic and non-economic losses.	No compensation is specifically provided for dependants.	Compensation payments are for general categories and are not broken down into economic and non-economic losses.

It is not known whether payments consist of a lump sum payment, periodic payments, or a mixture of periodic payments and a lump sum payment.

According to Harryandi, Bratadana and Sandyawan 2021:

'The disability compensation is awarded based on the severity of the disability which is classified into mild, moderate, and severe. Furthermore, the amount of compensation in each category is not strictly regulated, rather it is determined by the evaluation committees which will be forwarded to the Minister of Finance to be approved.'

(2021, 243)

The Minister of Health Regulation Number 10 of 2021 provides at Article 40 that provisions on compensation amounts should be determined by the Minister of Health subject to approval by the Minister of Finance. However, Harryandi, Bratadana and Sandyawan 2021 state that specific regulation on the amount of compensation available under the Indonesian NFCS has not been created yet: ‘...the Indonesian regulations have not yet arranged the elements of compensation comprehensively’ (248).

Medical services costs following injury are funded through the National Health Insurance mechanism with class III of health services if the vaccinated person is an active participant of the National Health Insurance Program. If the vaccinated person is not an active participant of the National Health Insurance Program, the costs are covered by the state budget (see Minister of Health Regulation Number 10 of 2021, Article 36 and Article 40).

Time limits for claims

The scheme does not seem to specify a time limit between vaccination and the adverse event occurring or any time limits on when a claim can be brought.

Evaluating claims – standard of proof required

Under this NFCS, for a claim to be admissible an etiological assessment and a causality assessment should first be conducted by the Regional Commission on AEFI and the National Commission on AEFI respectively. These assessments are based on the record and report results as well as the investigation carried out by the relevant Health Service Facility or health service offices (see Minister of Health Regulation Number 10 of 2021, Article 36 and Article 40).

The standard of proof required by the Regional and National Commissions on AEFI is not further specified in the Regulation.

Should the findings of the Commissions suggest a causal relationship between vaccination and a specific injury exists, Article 35(3) of the Regulations provide that the ‘National Food and Drug Agency shall conduct sampling and testing in accordance with the provisions of laws and regulations.’

According to Harryandi, Bratadana and Sandyawan 2021, a claim for compensation can be filed with the National Commission on AEFI only if a causal relationship between COVID-19 vaccination and injury has been previously found by the Commission (243).

Appeals and the right to litigate

There is a restricted right to litigate – claimants can start litigation, however the Indonesian Government will take over the legal responsibility of providers of COVID-19 vaccinations, if the provider ‘has conducted the production and distribution process in accordance with the proper methods of drugs manufacture and/or the proper methods of drugs distribution’ (see Regulation Number 10 of 2021, Article 46)

There does not seem to be an appeal or review system to review the decisions of the National Commission on AEFI.

Useful information and links

It is not known whether the scheme produces an annual report including data on claims & financial performance (claim numbers, payments, claim processing timeframes, administrative costs, etc).

Links to legislation:

Minister of Health Regulation Number 10 of 2021 (English translation by SSEK Indonesian Legal Consultants): https://www.iccc.or.id/wp-content/uploads/2021/03/Minister-of-Health-Regulation-No.-10-of-2021-SSEK-Translations.pdf

Presidential Decree Number 99 of 2020: https://peraturan.bpk.go.id/Home/Details/167788/perpres-no-50-tahun-2021

Presidential Decree Number 14 of 2021: https://peraturan.bpk.go.id/Home/Details/161210/perpres-no-14-tahun-2021

Academic literature:

Alexander Harryandi, Made Diyosena Bratadana, Stanislaus Demokrasi Sandyawan (2021). ‘Government Liability to Adverse Event Following COVID-19 Vaccine Immunization in Indonesia The Right Form of Access to Justice?’, in Proceedings of the 2nd International Conference on Law and Human Rights 2021 (ICLHR 2021). DOI: 10.2991/assehr.k.211112.031. Available at: https://www.atlantis-press.com/proceedings/iclhr-21/125963806.