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Ministry of Health
Parliamentary QA

Covid Reinfection Severity

29 November 2022

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NOTICE PAPER NO. 1549

NOTICE OF QUESTION FOR ORAL ANSWER

FOR THE SITTING OF PARLIAMENT ON OR AFTER 29 NOVEMBER 2022


Name and Constituency of Member of Parliament

Mr Yip Hon Weng

MP for Yio Chu Kang


Question No. 3882


To ask the Minister for Health in light of the US research paper suggesting that COVID-19 reinfection is more dangerous (a) what is the mortality rate and serious complication rate of those in Singapore catching COVID-19 for a second or third time vis-a-vis a first-time infection; and (b) how does vaccination alter the mortality and severe illness rate in both groups.

 

Answer

The Member has referred to a US research paper[1], which according to media reports, found that second COVID-19 infections are more severe compared to first infections. 

The media reports have not been clear or accurate.  The paper cited by the Member does not compare the severity between first-time infections and reinfections. Instead, it compares the outcomes of those who had a first COVID-19 infection, versus those with two or more infections.  And therefore not surprisingly, the study found it is more likely for persons to develop adverse health outcomes after two or more episodes of COVID-19 infection, compared to people who had only one infection episode. Put simply, getting sick twice is worse than getting sick once, but getting sick for the second time is not worse than getting sick the first time.

In fact, from September to mid-November 2022, the mortality rate of reinfection cases in Singapore was 4 per 100,000 cases, lower than that for first-time infection cases at 35 per 100,000 cases. The rate of severe illness – those requiring oxygen supplementation, intensive care or death – was also lower for reinfections at 232 per 100,000 cases, compared to first-time infections at 282 per 100,000 cases.

Our data also shows that achieving minimum vaccination protection – three doses of mRNA or four doses of Sinovac – lowers the risk of severe illness, whether it is a first or subsequent infection.


[1] Bowe, B., Xie, Y. & Al-Aly, Z. Acute and postacute sequelae associated with SARS-CoV-2 reinfection. Nat Med 28, 2398–2405 (2022). https://doi.org/10.1038/s41591-022-02051-3.