| Q1 | [Updated 18 Feb] Which vaccines are approved for use in Singapore?
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| | The Health Sciences Authority (HSA) has assessed that the Pfizer-BioNTech and Moderna COVID-19 Vaccines meet safety and efficacy standards. HSA has authorised their use locally under the Pandemic Special Access Route (PSAR) which facilitates early access to vaccines and medicines during a pandemic, such as COVID-19.
This is supported by the Expert Committee on COVID-19 Vaccination which has also reviewed the clinical data on Pfizer BioNTech and Moderna COVID-19 vaccines*. Only vaccines deemed suitable for use in target population subgroups, and where overall benefits outweigh the known risks, are recommended for use by the expert committee.
* Links to Press Releases (27 Dec 2020 and 3 Feb 2021): 1. Expert Committee Submits Recommendations on Singapore’s COVID-19 Strategy 2. Government Accepts Recommendations of Expert Committee on COVID-19 Vaccination
3. HSA Grants Interim Authorisation for Moderna COVID-19 Vaccine in Singapore
4. Second COVID-19 Vaccine Authorised for Use in Singapore |
| Q2 | Vaccines for COVID-19 have been approved for use in a shortened timeframe compared to other vaccines or drugs. How can we be sure that scientific rigour has not been compromised? |
| | An accelerated development timeline for vaccines against COVID-19 was possible given the following: a. Significant investment and dedication of resources from vaccine manufacturers to the ramping up of vaccine production; moreover, the mRNA technology platform had already been in development for many years prior to the COVID-19 pandemic. b. Strong global partnerships between many different partners including international organisations, governments, researchers and manufacturers; c. Given the pandemic situation, recruitment for and conduct of the randomised controlled trials to identify the differences in disease risk between those given vaccines and placebo, are able to be conducted more quickly than in the absence of a pandemic. d. Many trials have performed their trial phases concurrently, allowing for sufficient data to be produced in a shorter time. Safety, scientific or ethical integrity have not been compromised, and no short-cuts have been made, but the unique circumstances and factors described above have allowed accelerated development.
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| Q3 | [Updated 18 Feb] How effective is the vaccine? How long does the protection last? |
| | Based on Phase 3 trial data from Pfizer-BioNTech and Moderna, the efficacy of the vaccines in preventing symptomatic COVID-19 disease, after completion of the vaccine regimen, is about 95%. The vaccines continue to be effective for at least two months with no signs of waning protection. MOH will continue to monitor and review further data on the duration of immunity.
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| Q4 | [Updated 18 Feb] If it is a single dose, what will the efficacy be? |
| | Two doses of the Pfizer-BioNTech and Moderna COVID-19 vaccines are required to achieve optimal protection against COVID-19. Persons should complete two doses of either the the Pfizer-BioNTech and Moderna vaccines, based on the respective vaccination schedules.
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| Q5 | [Updated 18 Feb] Can vaccinated persons get infected with COVID-19? Are they less able to transmit the disease? |
| | The Pfizer-BioNTech and Moderna COVID-19 vaccines were shown to be about 95% effective in preventing symptomatic disease. That means that some vaccinated persons may still be vulnerable to infection.
We are awaiting further data on whether vaccination will completely prevent onward transmission of infection. Based on experience with vaccination for other diseases, there is likely to be some increase in protection against onward transmission, even if it is not 100% protection. Most vaccines that protect from viral illnesses also prevent transmission of the virus by those that are vaccinated. |
| Q6 | [Updated 18 Feb] Who should not get the COVID-19 vaccines?
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| | The COVID-19 vaccines are not recommended for (1) pregnant women, (2) severely immunocompromised persons, and (3) children under the age of 16 years for Pfizer-BioNTech COVID-19 vaccine and children under the age of 18 years for Moderna COVID-19 vaccine for now, until more efficacy and safety data become available for these subgroups.
It is also not advisable for those with a history of anaphylaxis or severe allergic reactions to receive COVID-19 vaccine. Severe allergic reactions include eye, mouth, or facial swelling, difficulty in breathing and/or a fall in blood pressure. Anyone who develops anaphylaxis to the first dose of COVID-19 vaccine should not receive the second dose.
For lactating women, EC19V’s recommendation is that they can get vaccinated but are recommended to abstain from breastfeeding for 5 to 7 days post-vaccination.
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| Q7 | [Updated 18 Feb] Which groups are at risk for anaphylaxis and should not be vaccinated?
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| | Persons who had history of an allergic reaction to a previous dose of the Pfizer-BioNTech COVID-19 Vaccine or Moderna COVID-19 vaccine or any of its components SHOULD NOT be vaccinated with the vaccine(s).
Persons with a history of anaphylaxis which include severe angioedema, bronchospasm and/or hypotension, to other drugs, vaccines, food, insect stings, or unknown trigger (idiopathic) also SHOULD NOT receive this vaccine because of severe allergic reactions reported with this vaccine in other countries in individuals with a history of anaphylaxis or a severe allergic reaction.
A history of having been prescribed an Epi-Pen suggests anaphylaxis risk and such persons SHOULD NOT receive the Pfizer-BioNTech COVID-19 or Moderna COVID-19 Vaccine at this time
Severe drug reactions which are not type 1 hypersensitivity reactions include:
a) Stevens-Johnsons Syndrome (SJS)
b) Toxic Epidermal Necrolysis (TEN)
c) Drug Rash with Eosinophilia and Systemic Symptoms (DRESS)
d) Drug-induced Hypersensitivity Syndrome (DiHS)
Nevertheless, persons with any of the above severe drug reactions SHOULD NOT receive the Pfizer-BioNTech COVID-19 Vaccine at this time until more information is available over the next few months.
Persons for whom the Pfizer-BioNTech COVID-19 Vaccine or Moderna COVID-19 vaccine is contraindicated at this time may be able to get vaccinated later if data become available that it is safe to vaccinate them, or they may be able to get vaccinated with other COVID-19 vaccines.
Persons with atopy (such as eczema, allergic rhinitis or well-controlled asthma) can be vaccinated. Although there may be some increased risk of hypersensitivity reactions to the Pfizer-BioNTech COVID-19 or Moderna COVID-19 Vaccine, these conditions are common and there is not enough evidence to contraindicate the vaccine at this time.
A person with a family history (but NOT a personal history) of anaphylaxis CAN be vaccinated.
NSAID-induced angioedema is generally not considered an allergic (type 1 hypersensitivity) reaction. Nevertheless, persons with a history of NSAID-induced angioedema may be at some increased risk of anaphylaxis from the Pfizer COVID-19 vaccine and are advised to defer at this time. However, if the clinical risk/benefit strongly favours vaccination (i.e. significant risk of exposure or of severe disease compared to the general population and patient accepts the possible risk of anaphylaxis), then vaccination can be provided but treatment for anaphylaxis should be readily available. All vaccination providers are required to be equipped and be able to manage anaphylaxis
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| Q8 | [Added 30 Jan] Can persons with prior COVID-19 infection be vaccinated?
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| | Currently available data do not indicate any safety concerns or risks of vaccination in those with prior COVID-19 infection. However, persons with prior COVID-19 infection are likely to be protected for at least the first 3 months after infection, and probably longer. Priority would therefore be given to vaccinate those with no COVID-19 immunity. Persons with prior COVID-19 infection can be vaccinated but are advised to postpone COVID-19 vaccination until after the COVID-19 naïve community have received their vaccinations.
No routine testing by PCR or serology is required before getting COVID-19 vaccination to determine eligibility for vaccination.
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| Q9 | [Added 30 Jan] Can a woman who is breastfeeding receive the Pfizer-BioNTech COVID-19 Vaccine?
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| | Women who are breastfeeding can be vaccinated. Out of an abundance of caution, women can consider suspending breastfeeding for 5-7 days after receiving the vaccine. If a woman feels she is unable to suspend breastfeeding and still wishes to get vaccinated, she can be vaccinated.
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| Q10 | [Added 30 Jan] How soon after vaccination can a woman try to conceive? Can a woman be vaccinated if she is pregnant? If she received the first dose of vaccine and then became pregnant, can she get the second dose?
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| | Women who are planning a pregnancy are advised to consider deferring conception for 1 month after completing the second dose, out of an abundance of caution. This does not apply to male vaccine recipients.
There is currently not enough evidence to advise on the use of COVID-19 vaccines during pregnancy. It is recommended that pregnant women defer vaccination until more data become available. They may receive the COVID-19 vaccine after delivery.
Women who become pregnant after the first dose and before the second dose should not receive the second dose of vaccine, but should postpone it until after delivery.
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| Q11 | [Updated 18 Feb] Is COVID-19 vaccination safe for those with chronic illness such as hypertension, high cholesterol and diabetes?
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| | The study population for Pfizer-BioNTech’s and Moderna's phase 3 trials included persons with medical comorbidities, who were at risk of serious, life-threatening disease and death from COVID-19 infection, and there were no safety concerns reported in this group. Persons with chronic illnesses are recommended to receive the vaccine for personal protection as well as protecting their loved ones.
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| Q12 | [Added 4 Feb] Can I receive another (non-COVID-19) vaccine at the same time as COVID-19 vaccine? How long do I have to wait before getting other vaccines?
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| | There is no data on administering COVID-19 vaccine at the same time as other non-COVID-19 vaccines. A minimum interval of 14 days is recommended before or after any other vaccines i.e. other vaccines should not be administered 14 days or less before the first dose; or 14 days or less after the second dose of a COVID-19 vaccine.
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| Q13 | [Added 18 Feb] Can I donate blood after receiving the COVID-19 vaccine? |
| | The Health Sciences Authority (HSA) and the blood bank has implemented a new blood donation eligibility guideline for donors who received a COVID-19 vaccine.
The deferral period may vary depending on the type of vaccine received or if you developed symptoms after receiving the vaccine. Please click here for more information.
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| Q14 | [Added 18 Feb] In light of the reported deaths of elderly persons in Norway after taking the Pfizer vaccine, will the Government be reviewing the vaccination strategy in Singapore, and whether any additional precautions will be taken?
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| | MOH, the Health Sciences Authority (HSA) and the Expert Committee on the COVID-19 Vaccination (EC19V) have been monitoring international reports on vaccine-related adverse events and deaths in elderly recipients. The Norwegian health authorities and the World Health Organization’s Global Advisory Committee on Vaccine Safety have found no evidence that the Pfizer-BioNTech vaccine contributes to an increased risk of death in the elderly.
Thus, we continue to offer COVID-19 vaccination for our seniors. It is important and vital to vaccinate and protect seniors, as COVID-19 infection in the elderly has been observed to result in severe, or fatal illness. Nevertheless, MOH has reiterated to vaccination providers that doctors should review the medical history of seniors carefully to confirm that they are indeed suitable for vaccination, and that they should be monitored closely in the immediate period after a vaccination.
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