FAQs on General Vaccine Recommendations

01 Mar 2024

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General Vaccine Recommendations
  • I was infected with COVID-19 before I could complete the recommended doses. Is the COVID-19 infection considered as a dose?
  • I have recovered from COVID-19. How soon can I receive my next vaccination dose?
  • Can I be vaccinated if I am ill on the day of vaccination?
  • Do all vaccine doses need to be of the same brand and vaccine composition?
  • Can I receive other non-COVID-19 vaccines at the same time as the COVID-19 vaccine? How long do I have to wait before getting other vaccines?
  • I have received one or more additional dose(s) as recommended previously. Do I still need to receive another additional dose in 2024?
Who can receive the vaccine
  • Who should not get the mRNA-based COVID-19 vaccines?
  • What is the recommendation for persons who are unable to receive the mRNA vaccines (i.e. Pfizer-BioNTech/Comirnaty or Moderna/Spikevax vaccines)?
  • Who should not get the Sinovac-CoronaVac COVID-19 vaccines?
  • Can individuals with a history of allergies or anaphylaxis to other medications, drugs, food, insect stings, or unknown triggers (idiopathic) take COVID-19 vaccine?
  • Are the vaccines safe for pregnant or breastfeeding women?
Medically Vulnerable and Immunocompromised
  • Who are considered medically vulnerable persons?
  • Immunocompromised persons may not develop good immune responses to vaccination and may need additional doses. Who are immunocompromised persons? What vaccine doses should they receive, and how can they do so?
  • Who are considered severely immunocompromised? Can severely immunocompromised persons receive the mRNA-based vaccine?
  • Can persons with active cancer be vaccinated?
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General Vaccine Recommendations

 I was infected with COVID-19 before I could complete the doses. Is the COVID-19 infection considered as a dose?
 A:

Recovered persons who were unvaccinated, or partially vaccinated before their infection can proceed to complete their two initial vaccine doses. You are recommended to receive remaining vaccine doses from 3 months or more after the date of infection to reduce your risk of reinfection.

Recovered persons who are recommended to receive an additional COVID-19 vaccine dose after your last vaccine dose should do so at the recommended interval thereafter, and at least 28 days after the infection although an interval of three months from the infection is recommended for better effectiveness.

 I have recovered from COVID-19. How soon can I receive my next vaccination dose?
 A:You can walk in to any of the Joint Testing Vaccination Centres (JTVC) or polyclinics 28 days after the infection, if you are due for your vaccination. 

Alternatively, you may book an appointment at a Public Health Preparedness Clinic (PHPC) using this link, or at selected polyclinics through the HealthHub booking system. 

For better effectiveness however, you are recommended to receive your next vaccine dose
three months after the infection or the recommended interval for your next dose, whichever is later.

Can I be vaccinated if I am ill?
 A:If you are unwell, please do not go for your vaccination. You should only do so after you have fully recovered.
 Do all vaccine doses need to be of the same brand?
 A:For Pfizer-BioNTech/Comirnaty, Moderna/Spikevax or Novavax/Nuvaxovid*, your first two doses of vaccine should be of the same brand. Subsequent doses of vaccine can be of different brands, where applicable.

From time to time, the composition of a COVID-19 vaccine may be updated to target more recent virus variants. If you are due for a vaccine dose, you are recommended to receive the updated version of the vaccine. There is no need for your vaccine doses to be of the same composition.

*The Novavax/Nuvaxovid vaccine is currently unavailable under the National Vaccination Programme. Novavax is in the process of filing for regulatory approval for its updated COVID-19 XBB.1.5 vaccine formulation. 

 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?
 A:The vaccines can be administered together with other non-COVID-19 vaccines across all ages.

 I have received one or more additional dose(s) as recommended previously. Do I still need to receive another additional dose in 2024?
A: Regardless of the number and composition (monovalent/bivalent) of previous additional doses received, an additional dose of the updated vaccine around 1 year (and no earlier than 5 months) after the last dose received is:

(a) Recommended for all persons aged 60 years and above, medically vulnerable individuals and residents of aged care facilities;

(b) Encouraged for all individuals aged 6 months and above, in particular, healthcare workers, as well as household members and caregivers of medically vulnerable individuals. 

Immunocompromised persons can be considered to receive the additional dose of COVID-19 vaccine from 5 months after their last dose in consultation with their treating physician for better protection. 

Who can receive the vaccine

 Who should not get the mRNA-based COVID-19 vaccines?
 A: The mRNA-based COVID-19 vaccines, Pfizer-BioNTech/Comirnaty and Moderna/Spikevax, are currently not available for children under the age of 6 months.

Persons with a history of anaphylaxis to mRNA COVID-19 vaccine or its components SHOULD NOT receive the mRNA-based vaccine again. Anaphylaxis is a severe life-threatening reaction with two or more of the following three criteria:

a) Hives or face/eyelid/lip/throat swelling;
b) Difficulty breathing;
c) Dizziness.

Patients with the following high-risk allergic reactions to a previous dose of mRNA COVID-19 vaccine or its components SHOULD NOT be administered the vaccine.
a) Hives or face/eyelid/lip/throat swelling with onset within 4 hours post-vaccination
b) Painful swelling of the inner surfaces of the mouth and/ or large blisters spontaneously occurring at any time after vaccination.

Persons with a history of allergic reactions (including anaphylaxis) to other vaccines CAN receive the mRNA-based vaccine, unless they have a confirmed allergy specific to PEG (which is a component of the mRNA vaccine). Persons who were diagnosed with myocarditis after a dose of mRNA COVID-19 vaccines SHOULD NOT receive the vaccine again.

Persons who cannot get the mRNA vaccines due to the high-risk allergic reactions indicated above, including persons who a confirmed allergy specific to PEG, can choose to receive the Sinovac-CoronaVac vaccine.
 What is the recommendation for persons who are unable to receive the mRNA vaccines (i.e. Pfizer-BioNTech/Comirnaty or Moderna/Spikevax vaccines)?
 A:Persons who are unable to receive the mRNA vaccines can choose to receive the Sinovac-CoronaVac vaccine. 
 Who should not get the Sinovac-CoronaVac COVID-19 vaccines?
 A:Persons who are able to take mRNA vaccines are encouraged to do so, in preference to the Sinovac-CoronaVac vaccine, given the higher efficacy of the mRNA vaccines.

The Sinovac-CoronaVac vaccine is not recommended for persons under the age of 18 years.

Persons with a history of allergic reactions or anaphylaxis to the Sinovac-CoronaVac vaccine, its components, or other inactivated vaccines SHOULD NOT receive Sinovac vaccine again. Anaphylaxis is a severe life-threatening reaction with two or more of the following three criteria:

a) Hives or face/eyelid/lip/throat swelling;
b) Difficulty breathing;
c) Dizziness.
 Can individuals with a history of allergies or anaphylaxis to other medications, drugs, food, insect stings, or unknown triggers (idiopathic) take COVID-19 vaccine?
 A:Individuals with a history of anaphylaxis to other medications, drugs, food, insect stings, or unknown triggers (idiopathic) CAN be vaccinated.

There is no evidence to suggest that individuals with a history of anaphylaxis to non-vaccine related triggers are at higher risk of anaphylaxis to the COVID-19 vaccines.

However, individuals with an allergy to other inactivated vaccines should NOT receive the Sinovac-CoronaVac.
 Are the vaccines safe for pregnant or breastfeeding women?
 A:Pregnant or breastfeeding women can receive the COVID-19 vaccines.

Pfizer-BioNTech/Comirnaty and Moderna/Spikevax Vaccines
Internationally, a large number of pregnant and breastfeeding women have received a COVID-19 vaccination.  The Expert Committee on COVID-19 Vaccination (EC19V) has examined studies done to monitor women who were vaccinated when they were pregnant, and their babies. These studies were done on women at different trimesters of pregnancy and there is no evidence to suggest that the Pfizer-BioNTech/ Comirnaty or Moderna/Spikevax COVID-19 vaccine may cause harm to pregnant women or their babies.

Both Pfizer-BioNTech/Comirnaty and Moderna/Spikevax COVID-19 vaccines are mRNA vaccines. As mRNA vaccines are not live vaccines, they are biologically unlikely to adversely affect breastfed babies. In addition, the breast milk of vaccinated mothers may help to protect their babies from COVID-19 due to antibodies in breast milk. There have also been no vaccine-related side effects reported in the babies who were breastfed by mothers who received the vaccine while breastfeeding.

Sinovac-CoronaVac and Novavax/Nuvaxovid* Vaccine
There is currently limited data in pregnant women. Nevertheless, the Sinovac-CoronaVac vaccines is an inactivated vaccine, while Novavax/Nuvaxovid is a protein subunit vaccine. These vaccines are routinely used in many other vaccines with a documented good safety profile, including in pregnant women.

*The Novavax/Nuvaxovid vaccine is currently unavailable under the National Vaccination Programme. Novavax is in the process of filing for regulatory approval for its updated COVID-19 XBB.1.5 vaccine formulation. 

Medically Vulnerable and Immunocompromised

 Who are considered medically vulnerable persons?
 A: Medically vulnerable persons are individuals who are at increased risk of severe COVID-19 due to significant medical risk factors. These include persons with chronic diseases of the heart, lungs, kidneys, liver and other organ systems. 

A list of specific health conditions that will classify one as medically vulnerable can be found by using this link. If you are unsure, you should consult your doctor.
 Immunocompromised persons may not develop good immune responses to vaccination and may need additional doses. 
• Who are immunocompromised persons?
• What vaccine doses should they receive, and how can they do so?
 A:Immunocompromised persons have significantly impaired immune system which include persons with the following conditions:

a) Transplant patients on medications that suppress the immune system, including solid organ and allogenic stem cell transplants
b) Cancer patients on active treatment with chemotherapy or on other therapies that suppress the immune system
c) Haematological cancers
d) Treatments for non-cancer conditions that suppress the immune system
e) End-stage kidney disease
f) Advanced or untreated HIV

Persons with the above conditions are recommended to receive three initial doses of the mRNA vaccines. This comprises a third vaccine dose two months after the second dose as part of an enhanced three-dose primary series. Thereafter, they should, in 2024, receive an additional dose of the updated vaccine between five months to one year from their last dose. 

Children aged 6 months to 4 years who are immunocompromised are recommended to receive an enhanced primary series comprising three doses of the Moderna/Spikevax vaccine or Pfizer-BioNTech/Comirnaty vaccine. 
 Who are considered severely immunocompromised? Can severely immunocompromised persons receive the mRNA-based vaccine?
 A:

The following are some examples of severely immunocompromised persons, but there may be other examples not on this list.
• Transplant within the past 3 months (solid organ or stem cell)
• Aggressive immunotherapy (e.g. Rituximab) for non-cancer conditions
Severely immunocompromised persons can be vaccinated. However, they are encouraged to discuss their optimal timing for COVID-19 vaccination with their doctor, and would need to obtain a memo from their doctor to be vaccinated.

If in doubt, Individuals will also be assessed by the medical personnel at the vaccination sites for their suitability to receive the vaccination before they are vaccinated.

 Can persons with active cancer be vaccinated?
 A:Cancer Patients Not on Treatment
Persons with active cancer who are NOT on treatment with chemotherapy, radiotherapy or immunotherapy CAN be vaccinated at any available vaccination site. Active cancer not on treatment is defined as:
• Not being on any of the above treatment in the past 3 months AND
• Not having planned treatment of the above in the next 2 months
Persons with a history of cancer, who are in remission, CAN be vaccinated at any available vaccination site.
 
Cancer Patients on Hormonal Treatment
Persons on active cancer hormonal therapy CAN be vaccinated at any available vaccination site.

Cancer Patients on Active Treatment
Persons on active cancer chemotherapy, radiation therapy or immunotherapy can be vaccinated if they have a memo from their treating oncologist/specialist.

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