Evaluation Effectiveness of the Moderna Booster Vaccine on Health

Workers in Indonesia

Inggrya Aliyy Fatma Pradevi and Diana Laila Ramatillah

Faculty Pharmacy, Universitas 17 August 1945 Jakarta, Indonesia

Keywords: Moderna, Booster, Health Workers in Indonesia.

Abstract: This study was conducted to evaluate the effectiveness of the moderna booster vaccine in health workers in

Indonesia. This study used a mixed method and prospective crossectional studies, for all health workers in

Indonesia who have been vaccinated with the third dose of the Moderna vaccine or booster with the

convenience sampling method. The purpose of this study was to find out whether there was a relationship

between the sociodemography of health workers who received the moderna booster vaccine after 6 months

with the incidence of covid-19 and the use of vitamins after vaccination. It was found that the moderna booster

vaccine has an effectiveness of 97.2%. Other factors that influence the side effects and effectiveness of the

vaccine are genders, BMI, and vitamins with a p-value of each variable <0.05. The conclusion is that there

is a relationship between the genders, BMI, and the consumption of vitamins with the effectiveness of the

vaccine.

1 INTRODUCTION

The outbreak that emerged in late 2019 brought a new

disease that is Coronavirus 2019 (COVID-19), the

disease was first discovered in the city of Wuhan, the

capital of Hubei province. In addition to causing

thousands of deaths in China, the virus began to

become a pandemic that spread rapidly to 213

countries, or territories around the world (Ramatillah

and Isnaini 2021). Coronavirus disease 2019

(COVID-19) is caused by severe acute respiratory

syndrome coronavirus 2 (SARS-CoV-2) that attacks

the lower respiratory tract (Lee et al. 2020). So far

the World Health Organization has reported more

than 6 million cases of COVID-19 with more than

150 thousand deaths in Indonesia as of June 1 , 2022

(WHO Coronavirus (COVID-19) Dashboard | WHO

Coronavirus (COVID-19) Dashboard With

Vaccination Data n.d.).

Health workers (HW) are those who handle any

work in the health care environment, being at the

forefront of the risk of infection because SARS-

CoV-2 is easily transmitted through the air, direct

contact with contaminated surfaces, exposure in the

workplace, and inadequate use of personal protective

equipment (PPE) (Soebandrio et al. 2021). Some

studies in some countries state that, risk factors

among health workers are lack of PPE, exposure to

infected patients, overwork, poor infection control,

and pre-existing conditions (Adelina and

Dwijayanti 2021).

The Ministry of Health of the Republic of

Indonesia stated that, technically, the Moderna

vaccine has a high efficacy rate and is proven to be

able to significantly suppress the transmission of

COVID-19 in the United States so that the vaccine

A third dose of Moderna is given to health workers

as a booster in order to optimally protect them

(Sekretariat Kabinet Republik Indonesia | Gov’t to

Provide Moderna’s Vaccines for Public, Health

Workers n.d.).

The Moderna COVID-19 vaccine is a vaccine

developed by Moderna and the Vaccine Research

Center at the National Institute of Allergy and

Infectious Diseases (NIAID), within the National

Institutes of Health (NIH) (Baden et al. 2021). This

vaccine is based on messenger RNA (mRNA) which

will later provide instructions to the

host cell to produce the S antigen protein unique

to SARS-CoV-2 so that the body can store immune

information that is generated in immune cell

memory (Moderna mRNA-1273, COVID-19 vaccine

n.d.).

According to research by medxiv on the

Effectiveness of a third dose of BNT162b2 or

156

Pradevi, I. and Ramatillah, D.

Evaluation Effectiveness of the Moderna Booster Vaccine on Health Workers in Indonesia.

DOI: 10.5220/0011977700003582

In Proceedings of the 3rd International Seminar and Call for Paper (ISCP) UTA â

Z45 Jakarta (ISCP UTA’45 Jakarta 2022), pages 156-164

ISBN: 978-989-758-654-5; ISSN: 2828-853X

 2023 by SCITEPRESS – Science and Technology Publications, Lda. Under CC license (CC BY-NC-ND 4.0)

mRNA-1273 vaccine for preventing post-vaccination

COVID-19 infection: an observational study. The

third dose of mRNA-1273 was 46.6% effective in

preventing SARS-CoV-2 infection and 50.0% in

preventing COVID-19 hospitalization. The study

also showed a reduction in post-vaccination infection

in people who received a third dose of the vaccine 6

months after completing the main series of mRNA-

1273 (Sharma, Oda, and Holodniy 2021).

In an observational studyof the third dose of

mRNA was mild (i.e., fatigue, lymphadenopathy,

nausea, and diarrhea) and there was no increase in

which was significant in the EHR reporting of severe

side effects after the third dose compared to after the

second dose (Niesen et al. 2022).

Although data relating to efficacy and side effects

regarding the moderna booster vaccine already exists.

Further clinical research is needed on Effectiveness

Evaluation among Indonesians especially for health

workers by looking at various other aspects such as

sociodemographies that allow there is a link with the

efficacy and side effects of this vaccine.

1.1 Covid-19

SARS-CoV-2 is the novel coronavirus responsible for

the 2019 Coronavirus Pandemic (COVID-19)

disease. Coronavirus disease 2019 (COVID-19) is

caused by the severity of the coronavirus acute

respiratory syndrome (SARS-CoV-2). It has been

declared a new pandemic by the World Health

Organization (WHO) on March 11, 2020. The causes

of COVID-19 are pneumonia and acute respiratory

distress syndrome (ARDS). Other COVID-19

complications may include acute liver, heart, and

kidney injuries, as well as secondary infections and

inflammatory responses. The absence of protective

immunity to the virus and this virus is then able to

escape from the innate immune response. The innate

immune sensing mechanism serves as the first line

of defense antivirals, which is an important aspect of

immunity to viruses (Umar et al. 2021).

SARS-CoV-2, SARS-CoV and MERS-CoV

have a similar structure and phylogenetics, and

consist of four main structural proteins: spike (S),

envelope (E) glycoprotein, nucleocapsid (N),

membrane protein (M), 16 proteins nonstructural, and

5-8 accessory proteins (Moncunill et al. 2022).

1.2 Symptoms of Covid-19

The average incubation period for COVID 19 is 5.2

days, symptoms usually begin with non-specific

syndromes such as fever, dry cough, and malaise.

There are several systems that may be involved such

as the respiratory system (cough, shortness of breath,

sore throat, rhinorrhea, hemoptysis, chest pain),

gastrointestinal (diarrhea, nausea, vomiting),

musculoskeletal system (muscle pain), nervous

system (headache and confusion). More common

signs and symptoms are fever (83% -98%), cough

(76% -82%), and shortness of breath (31-55%). There

are about 15% of cases of fever, cough, and shortness

of breath. No conjunctival injections were reported

in the first series, with some cases under the age of

18. Post-onset symptoms are mild, with the average

time for first hospital admission being 7 days.

However, the disease develops into shortness of

breath on the 8th day, acute respiratory distress

syndrome (ARDS) on the 9th day, and the use of

mechanical ventilation on the 10.5th day occurs in

about 39% of patients (Wu, Chen, and Chan 2020).

However, the clinical condition can quickly

develop into severe pneumonia and eventually,

death, especially in patients who have comorbidities,

such as obesity, type 2 diabetes and cardiovascular

disease (Teotônio et al. 2021).

1.3 Vaccine

The covid-19 vaccine has four types, including

mRNA vaccines were developed by Pfizer-BioNTech

and Moderna. RNA and DNA vaccines are cutting-

edge approaches that use genetic engineering of RNA

or DNA to produce proteins that themselves trigger

an immune response safely. Viral vector vaccines

(adenoviruses) developed by Astra-Zeneca, Johnson

& Johnson, Reithera and Sputnik. Viral vector

vaccines use genetically engineered viruses and do

not cause disease but produce coronavirus proteins to

safely trigger an immune response. An inactivated

viral vaccine was developed by Sinovac. Attenuated

or attenuated viral vaccines use attenuated or

attenuated forms of the virus to obtain an immune

response without causing disease. A protein subunit

vaccine developed by Novavax. Protein-based

vaccines use harmless protein fragments, or protein

shells, that mimic Covid-19 to safely produce an

immune response (Mascellino et al. 2021).

Moderna vaccine also has been one of the

preferred vaccines as it has a higher efficacy which is

94-95% vaccine efficacy that was tested in less than

a year, recommended for 18 y old people and has been

proven to have benefits in preventing SARS-CoV-2

(Article, Araminda, and Ramatillah 2022).

The mRNA-1273 vaccine is administered as a

sterile liquid for injection at a concentration of 0.5 mg

per milliliter. Normal saline is used as a diluent to

Evaluation Effectiveness of the Moderna Booster Vaccine on Health Workers in Indonesia

157

prepare the administered dose (Jackson et al. 2020).

To date, 11.8 billion doses have been distributed and

more than 60% of the population has been vaccinated.

2 MATERIALS AND METHODS

2.1 Design

This study used a mixed method and prospective

crossectional studies, The sampling time is March-

June 2022. The data collection technique carried out

in this study is convenience sampling. Sampling

takes all the items that make up the research inclusion

criteria. The inclusion in this study is all health

workers in Indonesia who received the third dose of

vaccine or booster and are still actively working (not

retired). The exclusion of this study is all health

workers in Indonesia who suffer from cancer, HIV /

AIDS, TB, autoimun.

2.2 Participants

Participants in this study were health workers in

Indonesia that have been conducting a booster dose

of vaccination with the vaccine Moderna. The total of

participants in the study were 323 respondents.

2.3 Instruments

This study used questionnaires distributed through

social media, such as WhatsApp, Twitter, Facebook,

Instagram, and Telegram. The questionnaires

consisting of questions about the identity, efficacy of

the Moderna booster vaccine after the vaccinations,

the short and long term and monitoring the efficacy

of the vaccine for 6 months after being vaccinated.

2.4 Statistical Analysis

The collected results were analyzed using SPSS

application version 25. Fisher, Chi-square, Mann-

Whitney, and Kruskal Wallis tests were then

performed to find the relationship between risk

factors (gender, comorbidities, age, BMI) to the

effectiveness of the vaccine. The value of p <0.05 is

considered significant.

2.5 Ethical Consent

This research has received ethical approval

from the ethics committee of health research at the

University of 17 August 1945 Jakarta, with approval

letter No.37/KEPK-UTA45JKT/EC/EXP/07/2022.

3 RESULTS AND DISCUSSION

In this study, 323 respondents were found who

worked as health workers with an age range of 21-58

years. All respondents have received a covid-19

vaccination booster dose of moderrna which is an

inclusion of this study.

Based on figure 1, it can be seen that the number of

female respondents is higher with a percentage of

75.85% compared to male respondents with a

percentage of 24.15%.

Figure 1: Gender

Respondents who participated in this study were

spread almost throughout Indonesia. The highest

percentage for respondents' domicile was 90.09% for

Java Island, then Sumatra Island with 5.26%,

Kalimantan Island with 3.72%, Sulawesi Island with

presemtasse 0.62%, and Bali island with the lowest

percentage is 0.31%. In this study, researchers were

unable to get respondents with a domicile on Papua

Island.

The percentage of respondents based on domicile

can be seen in figure 2.

the 323 respondents who participated in this

study, the highest percentage for respondents' jobs

was 61.30% for Nurses, then Pharmacists with a

percentage of 10.84%, General Practitioners with a

ISCP UTA’45 Jakarta 2022 - International Seminar and Call for Paper Universitas 17 Agustus 1945 Jakarta

158

percentage 8.98%, Midwives with 7.43%, Pharmacist

Assistants with a percentage of 5.26%, Dentists and

Specialists with 1.86%, Pharmaceutical Technical

Personnel and Dentist Assistants 0.93%,

Radiographers and Radiology Assistants with the

lowest percentage being 0.31%.

The percentage of respondents by occupation can

be seen in figure 3.

Figure 3: Job

In 323 respondents there was 1 respondent with

asthma-borne disease. The percentage of respondents

with comorbidities can be seen in figure 4.

Figure 4: Comorbidities

3.1 Efefectiveness

The effectiveness of the Moderna booster vaccine in

the 1-3rd month is 98.8% and, in the 4th-6th month is

98.5%.

Based on these data, it can be known that the

effectiveness of the Moderna booster vaccine in a

period of 1-6 months is 97.2%. This can be seen in

figure 5.

Figure 5: Effectivenesses of The Moderna Booster Vaccine

3.1.1 Association between Genders with

Vaccine Effectiveness

It can be seen from the data presented in table 1, it is

known that after the vaccine there were 20 female

respondents who had diarrhea, then in 1-3 months

after vaccination there was 1 respondent with female

gender, and 3 respondents with male gender infected

with covid-19. Then 18 female respondents felt a

state of fatigue easily and another 15 female

respondents felt arm pain. Immunotherapy aimed at

stimulating immune responses, e.g. vaccines, develop

a stronger response in women and may experience

greater efficacy than men (Bischof, Wolfe, and Klein

2020)

3.1.2 Association between Jobs with Vaccine

Effectiveness

From the data figure 6, it can be seen that there are 9

out of 11 workers who are recorded as having a fever,

starting from Pharmaceutical Technical Personnel,

Radiographers, Dental Assistants, Specialist Doctors,

Pharmacists and Assistant Pharmacists, Midwives,

Nurses, and the last one is the General Practitioner.

Then for the Radiographer Assistant and Dentist no

symptoms of fever were found.

In the study conducted by Angle, among health

workers at a center in Tel Aviv, Israel who received

the BNT162b2 vaccine had significantly lower

symptomatic and asymptomatic sars-CoV-2 infection

rates for more than 7 days after the second dose.

Results are limited by observational design (Angel et

al. 2021).

323 323

200

400

Infected by Covid-19

after 1-3 month

Infected by Covid-19

after 4-6 month

EFFECTIVENESSES OF THE

MODERNA BOOSTER

VACCINE

Total Infected by Covid-19

Evaluation Effectiveness of the Moderna Booster Vaccine on Health Workers in Indonesia

159

Table 1: Relationship between Genders with Vaccine Effectiveness.

Variable

Female (n=245) Male (n=78)

p-value

Frequency Percentage Frequency Percentage

After the vaccine

Diarrhea 20 8,16% - - 0,049*

1-3 months

Infected with Covid-19

after vaccination

1 0,41% 3 3,85% 0,045*

4-6 months

Easy fatigue 18 7,35% - - 0,006*

Arm pain 15 6,12% - - 0,026*

Figure 6: Relationship Between Job with Vaccine Effectiveness.

0 102030405060

Pharmacist

Pharmacist Assistant

Pharmaceutical Technical Personnel

Radiographer

Midwife

Dentist Assistant

Nurse

General Practitioner

Medical Specialist

CORRELATION BETWEEN JOB AND VACCINE

EFEFCTIVENESS

Fever

ISCP UTA’45 Jakarta 2022 - International Seminar and Call for Paper Universitas 17 Agustus 1945 Jakarta

160

3.1.3 Association between Jobs with Vitamin

Use after Vaccination

Table 2: Relationship between job and vitamins use after vaccination.

Variable

TTK (n=3) Pharmacist (n=35)

Assistant Pharmacist

(n=17)

p-value

Frequency Percentage Frequency Percentage Frequency Percentage

Vitamin C - - 5 14,29% - - 0,016 #

Vitamin C

&Vitamin D3

- - 1 2,86% - - 0,016 #

Vitamin D - - - - - - 0,016 #

Vitamin B12 2 66,67% 2 5,71% 1 5,88% 0,016 #

Table 3: Relationship between job and vitamins use after vaccination.

Variable

Specialist Doctor (n=6)

General Practitioner

(n=29)

Nurse (n=198)

p-value

Frequency Percentage Frequency Percentage Frequency Percentage

Vitamin C - - - - 30 15,15% 0,016 #

Vitamin C

&Vitamin D3

- - 1 3,45% 2 1,01% 0,016 #

Vitamin D - - - - 1 0,51% 0,016 #

Vitamin B12 1 16,67% 5 17,24% 12 6,06% 0,016 #

#Test Chisquare

From the data presented in the table, it can be seen

that a fairly large percentage of respondents who took

vitamin C, vitamin B12, vitamin C & D3, in all jobs

then with the smallest percentage was vitamin D in

Nurses.

In research conducted by Jaehyun showed that

taking vitamin D supplements at doses recommended

by the Endocrine Society can help reduce the risk of

SARS-CoV-2 infection from severe consequences,

including death (Bae et al. n.d.).

The main reason for severe lung pain in COVID-

19 patients is the immune system that does not

function to kill the virus, but instead injures the

patient, causing oxidative stress as well as radicals

free. Vitamin C can reduce oxidative damage and

neutralize these free radicals in the lungs (Sarowar

Uddin et al. n.d.).

In COVID-19 and post-COVID-19 patients,

symptoms such as vitamin B12 deficiency were

found. Studies testing vitamin B12 supplementation

can be used to alleviate some of the symptoms of

various diseases that are also present in COVID-19.

Thus, vitamin B12 can be used in the additional

treatment of mild to severe COVID-19 symptoms,

due to its analgesic function and role in

neuromuscular disorders (Batista et al. n.d.).

In a study conducted by Igor conducted on

hospitalized COVID-19 patients, one high dose of

vitamin D3, when compared to placebo, vitamin D3

did not significantly reduce the duration of

hospitalization. The findings in this study do not

support the use of vitamin D3 for the treatment of

moderate to severe COVID-19 (Murai et al. 2021).

Evaluation Effectiveness of the Moderna Booster Vaccine on Health Workers in Indonesia

161

Table 4: Relationship between job and vitamins use after vaccination.

Variable

Dentist (n=6) Radiology Assistant (n=3)

p-value

Frequency Percentage Frequency Presentation

Vitamin C 1 16,67% - - 0,016 #

Vitamin C

&Vitamin D3

1 16,67% - - 0,016 #

Vitamin D - - - - 0,016 #

Vitamin B12 - - 1 33,33% 0,016 #

Table 5: Relationship between job and vitamins use after vaccination.

Variable

Dental Assistant

(n=3)

Midwife (n=24) Radiographer (n=1)

p-value

Frequency Percentage Frequency Percentage Frequency Percentage

Vitamin C - - 1 4,17% - - 0,016 #

Vitamin C

&Vitamin D3

- - 1 4,17% - - 0,016 #

Vitamin D - - - - - - 0,016 #

Vitamin B12 1 33,33% 4 16,67% 1 100% 0,016 #

3.1.4 Association between BMI with Vaccine

Effectiveness.

Table 6: Presents the relationship between BMI on vaccine effectiveness

Variab

Underweight (n=31) Normal (n=265) Overweight (n=24) Obesitas (n=3)

valu

Frequen

Percenta

Frequen

Percenta

Frequen

Percenta

Frequen

Presentati

Diarrh

- - 17 6,41% 3 12,5% - -

0,04

9 #

Easy

fatigue

1 3,22% 16 6,03% - - 1 3,33%

0,03

2 #

ISCP UTA’45 Jakarta 2022 - International Seminar and Call for Paper Universitas 17 Agustus 1945 Jakarta

162

#Tes Chisquare

It can be seen in the table presented that respondents

with normal weight experience more get tired easily

than diarrhea, respondents with overweight have

more diarrhea, while respondents with underweight

and obesity, they get tired easily.

In the study conducted by Iguacel, respondents

with overweight and obesity experienced fewer side

effects than respondents with normal weight In fact,

in the relationship between side effects COVID-19

vaccines with gender and age are quite significant,

while the status of body weight or BMI, is not

significant (Iguacel et al. 2021).

In the other study by researchers at the University

of Oxford, people with obesity have more risk and the

cause is unknown. It is the same as seasonal flu

infections. Among people with a low BMI the

reduced effectiveness of COVID-19 vaccines may

cause due to frailty or other conditions associated

with low body weight. Further research is needed to

explore the relationship between BMI and immune

responses (Piernas et al. 2022).

4 CONCLUSIONS

In this study, it was found that the effectiveness of the

vaccine was 97.2% and the variables related to the

effectiveness of the vaccine were gender, BMI, and

vitamins. In the sexes, women get greater side effects

than men but have a greater degree of effectiveness,

for the side effects of the moderna booster vaccine in

this study found in female respondents namely;

diarrhea, fatigue, arm pain, and 1 respondent infected

with covid-19, while in men, 3 respondents infected

with covid-19 were found. On the BMI it was found

that the relationship was insignificant. Meanwhile,

vitamins C, B12, and D were found to be able to help

the body in recovery after being infected with covid-

19.

REFERENCES

Adelina, Mutiara, and Fifi Dwijayanti. 2021. “The Infection

of COVID-19 among Health Care Workers in Dharmais

Cancer Hospital.” Indonesian Journal of Cancer 15(1):

1–3. https://www.indonesianjournalofcancer.or.id/e-

journal/index.php/ijoc/article/view/823 (June 1, 2022).

Angel, Yoel et al. 2021. “Association Between Vaccination

With BNT162b2 and Incidence of Symptomatic and

Asymptomatic SARS-CoV-2 Infections Among Health

Care Workers.” JAMA 325(24): 2457–65.

https://jamanetwork.com/.

Article, Original, Gena Nafta Araminda, and Diana Laila

Ramatillah. 2022. “EVALUATION COMPARISON

BETWEEN ASTRAZENECA AND MODERNA

VACCINE’S SIDE EFFECTS AND EFFICACY

AMONG INDONESIA SOCIETY BASED ON

SOCIODEMOGRAPHY.” International Journal of

Applied Pharmaceutics: 37–43.

https://innovareacademics.in/journals/index.php/ijap/ar

ticle/view/44747 (May 30, 2022).

Baden, Lindsey R. et al. 2021. “Efficacy and Safety of the

MRNA-1273 SARS-CoV-2 Vaccine.” The New

England journal of medicine 384(5): 403–16.

https://pubmed.ncbi.nlm.nih.gov/33378609/ (June 1,

2022).

Bae, Jae Hyun et al. “Association of Vitamin D Status with

COVID-19 and Its Severity Vitamin D and COVID-19:

A Narrative Review Mitogen-Activated Protein Kinase

NF-ΚB Nuclear Factor Kappa-Light-Chain-Enhancer

of Activated B Cells OR Odds Ratio RAAS Renin-

Angiotensin-Aldosteron.” Reviews in Endocrine and

Metabolic Disorders 1: 3.

https://doi.org/10.1007/s11154-021-09705-6.

Batista, Kamila S et al. “The Role of Vitamin B 12 in Viral

Infections: A Comprehensive Review of Its

Relationship with the Muscle-Gut-Brain Axis and

Implications for SARS-CoV-2 Infection.”

https://doi.org/10.1093/nutrit/nuab092.

Bischof, Evelyne, Jeannette Wolfe, and Sabra L Klein.

2020. “The Journal of Clinical Investigation Clinical

Trials for COVID-19 Should Include Sex as a

Variable.” 130. https://doi.org/10.1172/JCI139306.

Iguacel, Isabel et al. 2021. “Association between COVID-

19 Vaccine Side Effects and Body Mass Index in

Spain.” https://doi.org/10.3390/vaccines9111321.

Jackson, Lisa A. et al. 2020. “An MRNA Vaccine against

SARS-CoV-2 — Preliminary Report L.A.” The new

england journal of medicine Original 383(20).

Lee, Ping Ing et al. 2020. “Are Children Less Susceptible

to COVID-19?” Journal of Microbiology, Immunology

and Infection 53(3): 371–72.

Mascellino, Maria Teresa, Federica Di Timoteo,

Massimiliano De Angelis, and Alessandra Oliva. 2021.

“‘Overview of the Main Anti-SARS-CoV-2 Vaccines:

Mechanism of Action, Efficacy and Safety’ [Response

To Letter].” Infection and Drug Resistance 14: 4501–2.

“Moderna MRNA-1273, COVID-19 Vaccine.”

https://www.who.int/publications/m/item/moderna-

covid-19-vaccine-(mrna-1273) (June 1, 2022).

Moncunill, Gemma et al. 2022. “Determinants of Early

Antibody Responses to COVID-19 MRNA Vaccines in

a Cohort of Exposed and Naïve Healthcare Workers.”

eBioMedicine 75.

Murai, Igor H et al. 2021. “Effect of a Single High Dose of

Vitamin D 3 on Hospital Length of Stay in Patients

With Moderate to Severe COVID-19 A Randomized

Clinical Trial Supplemental Content.”

https://jamanetwork.com/.

Niesen, Michiel J M et al. 2022. “Surveillance of Safety of

3 Doses of COVID-19 MRNA Vaccination Using

Electronic Health Records.”

JAMA Network Open 5(4):

e227038–e227038.

Evaluation Effectiveness of the Moderna Booster Vaccine on Health Workers in Indonesia

163

https://jamanetwork.com/journals/jamanetworkopen/fu

llarticle/2791034 (June 1, 2022).

Piernas, C et al. 2022. “Associations of BMI with COVID-

19 Vaccine Uptake, Vaccine Effectiveness, and Risk of

Severe COVID-19 Outcomes after Vaccination in

England: A Population-Based Cohort Study.” THE

LANCET Diabetes & Endocrinology 10: 571–80.

www.thelancet.com/.

Ramatillah, Diana Laila, and Suri Isnaini. 2021. “Treatment

Profiles and Clinical Outcomes of COVID-19 Patients

at Private Hospital in Jakarta.” PLOS ONE 16(4):

e0250147.

https://journals.plos.org/plosone/article?id=10.1371/jo

urnal.pone.0250147 (June 1, 2022).

Sarowar Uddin, Mohammad et al. “The Protective Role of

Vitamin C in the Management of COVID-19: A

Review.” https://doi.org/10.1186/s42506-021-00095-

“Sekretariat Kabinet Republik Indonesia | Gov’t to Provide

Moderna’s Vaccines for Public, Health Workers.”

https://setkab.go.id/en/govt-to-provide-modernas-

vaccines-for-public-health-workers/ (June 1, 2022).

Sharma, Aditya, Gina Oda, and Mark Holodniy. 2021.

“Effectiveness of a Third Dose of BNT162b2 or

MRNA-1273 Vaccine for Preventing Post-Vaccination

COVID-19 Infection: An Observational Study.”

medRxiv: 2021.11.29.21266777.

https://www.medrxiv.org/content/10.1101/2021.11.29.

21266777v1 (June 1, 2022).

Soebandrio, Amin et al. 2021. “COVID-19 Prevalence

among Healthcare Workers in Jakarta and

Neighbouring Areas in Indonesia during Early 2020

Pandemic.” Annals of Medicine 53(1): 1896–1904.

https://www.tandfonline.com/doi/abs/10.1080/078538

90.2021.1975309 (June 1, 2022).

Teotônio, Isabella Márcia Soares Nogueira et al. 2021.

“Clinical and Biochemical Parameters of COVID-19

Patients with Prior or Active Dengue Fever.” Acta

Tropica 214(November 2020): 1–5.

Umar, Abubakar et al. 2021. “Coronavirus Disease 2019 (

COVID-19 ): An Overview of the Immunopathology ,

Serological Diagnosis and Management.” (October

2020): 1–12.

“WHO Coronavirus (COVID-19) Dashboard | WHO

Coronavirus (COVID-19) Dashboard With Vaccination

Data.” https://covid19.who.int/ (June 1, 2022).

Wu, Yi Chi, Ching Sung Chen, and Yu Jiun Chan. 2020.

“The Outbreak of COVID-19: An Overview.” Journal

of the Chinese Medical Association 83(3): 217–20.

https://journals.lww.com/jcma/Fulltext/2020/03000/Th

e_outbreak_of_COVID_19__An_overview.3.aspx

(June 1, 2022).

ISCP UTA’45 Jakarta 2022 - International Seminar and Call for Paper Universitas 17 Agustus 1945 Jakarta

164