Pneumococcal Disease and Vaccine

22 May 2007

Question No:  228  

Question

Name of the Person: Dr Lam Pin Min, MP for Ang Mo Kio GRC

To ask the Minister for Health (a) if he will provide the incidences, mortality rates and morbidity rates of invasive pneumococcal disease in children over the past 5 years, and (b) what factors will bring about the introduction of pneumococcal vaccination in the National Childhood Immunisation Programme.

Reply

Reply From MOH

As invasive pneumococcal disease (IPD) is not a notifiable disease, we do not have information on its incidence rate. But we do have the hospitalisation data. It has been on a downward trend.  Between 2004 and 2006, the hospitalization rate has declined by almost a third. Last year, there were 55 hospitalisations of children aged 5 years and below due to IPD. IPD is not a major cause of morbidity in Singapore. As a comparison, there were some 20,000 hospitalisations of children below 5 years of age each year.

In terms of mortality, there were 3 deaths from IPD during the past 5 years, giving a mortality rate of less than 1 per 100,000. Over the same period, there were about 700 deaths among children in this age-group.

Our IPD hospitalisation rate of 26 per 100,000 for children under 5 years of age in 2006 is significantly lower than the US’ rate of 97 per 100,000 in 1998/99, before it included pneumococcal vaccination into its childhood immunisation programme. The US has since brought down its rate to 24 per 100,000 in 2003, which is comparable to our rate. The US experience shows that universal pneumococcal vaccination does not eradicate IPD.

Nevertheless, as the vaccine is safe and efficacious, vaccination is a viable option. However, for mass vaccination, its high cost is a major constraint. Currently there is only one manufacturer and it costs up to $480 to vaccinate one child. Compare this to the existing childhood vaccination programme where the most expensive vaccination, for diphtheria, tetanus and whooping cough, which were major causes of childhood morbidity and mortality in the past, costs about $40 per child. 

If and when more competitively priced vaccines become available and significantly alter the cost-benefit ratio of pneumococcal vaccination, we will consider its inclusion in the childhood immunisation programme.