1. For 2023, the Expert Committee on COVID-19 Vaccination (EC19V) is recommending that the following groups receive one booster dose of COVID-19 vaccine at one year after their last booster dose:
(a) ages 60 years and above,
(b) medically vulnerable persons aged 12 years and above, or,
(c) residents living in aged care facilities.
Other persons aged 12 years and above may also do so if they choose.
Additional Booster Dose Enhances Protection, Especially in Higher Risk Individuals
2. The EC19V has reviewed the approach for vaccination, as the COVID-19 situation in Singapore reaches a more stable state. Periodic COVID-19 vaccination such as annual doses may be needed.
3. Based on the current local and international epidemiological trends, as well as our updated understanding of COVID-19, the EC19V is updating its COVID-19 vaccination recommendations for the calendar year 2023.
4. There is currently a high level of hybrid immunity in our population, resulting from high vaccination coverage as well as a large proportion of our population having recovered from COVID-19 infection. Hence, protection against severe disease in boosted individuals is likely to be at a high level.
5. Nevertheless, new variants of COVID-19 are continuing to emerge. The current protection against infection by COVID-19 will wane over time. Therefore ensuring protection against COVID-19 through vaccine booster doses remains important, especially for the groups at highest risk for COVID-19 complications.
6. Individuals in older age groups, and patients who are immunocompromised and/or with chronic diseases (see Annex) are particularly vulnerable to any changes in the COVID-19 situation given their underlying susceptibility to develop severe disease, as well as COVID-19 destabilising their other medical conditions. Hence enhancing protection for these groups is recommended.
7. Studies have shown that a booster dose, especially with updated bivalent vaccines, enhances protection against Omicron variants. The safety profile of additional booster doses, as well as the updated bivalent vaccines, is comparable to that of previous doses.
8. Since persons at higher risk for severe COVID-19 will derive the greatest benefit from an additional booster dose, these groups are recommended to receive a dose in 2023 around 12 months after their last dose. Younger healthy persons may receive an additional booster around 12 months after their last dose, if they would like to do so.
Higher Risk Individuals Recommended an Additional Booster Dose in 2023
9. Based on the considerations outlined above, EC19V recommends that the following persons receive in 2023, one booster dose of COVID-19 vaccine at an interval of one year after their last booster dose:
a. ages 60 years and above,
b. medically vulnerable persons (see Annex) aged 12 years and above, or,
c. residents living in aged care facilities.
The updated bivalent vaccines are recommended for this. Other persons 12 years and above may also receive one booster dose at the same interval, if they choose to.
10. Persons aged 5 years and above continue to be recommended to achieve at least Minimum Protection (such as three doses of the mRNA vaccines) and should proceed to get vaccinated as soon as possible, if they have not done so.
11. Children aged 6 months to 4 years also continue to be recommended to complete their primary vaccination series by completing two doses of Moderna/SpikeVax or three doses of Pfizer-BioNTech/Comirnaty at an interval of eight weeks apart.
Conclusion
12. The updated recommendations take into consideration the current COVID-19 situation and the level of protection in our population. If or when a new COVID-19 variant emerges, and is assessed to pose a significant threat, there may be a need for the population at large to receive boosters at that time to ensure better protection. EC19V will provide recommendations for such a response, if required.
13. The EC19V continues to keep track of further developments on COVID-19 vaccines and the evolving global and local pandemic situation, and may update its recommendations periodically as needed.
EXPERT COMMITTEE ON COVID-19 VACCINATION
9 February 2023