The Progress of our COVID-19 Vaccination Programme and Adverse Events

Name and Constituency of Member of Parliament

Dr Lim Wee Kiak

MP for Sembawang GRC

Question No. 518

To ask the Minister for Health (a) what is the progress of the COVID-19 vaccination programme since it was launched; (b) among those who took the vaccination so far, how many have suffered side effects; (c) where will the vaccination sites be located for the wider population; and (d) whether the accessibility of these sites will be considered, particularly for the elderly and those with mobility problems.

Name and Constituency of Member of Parliament

Ms Joan Pereira

MP for Tanjong Pagar GRC

Question No. 526

To ask the Minister for Health whether the Government will consider allowing citizens who need to visit an ill family member who is overseas, to take their COVID-19 vaccination before it is their turn to do so.

Name and Constituency of Member of Parliament

Mr Desmond Choo

MP for Tampines GRC

Question No. 529

To ask the Minister for Health (a) to date, what is the progress of the national COVID-19 vaccination programme; (b) what are the types of side effects observed; and (c) how many instances of severe side effects are there requiring emergency care.

Name and Constituency of Member of Parliament

Mr Yip Hon Weng

MP for Yio Chu Kang

Question No. 537

To ask the Minister for Health with regard to the COVID-19 vaccination exercise (a) whether residents can be given the option to go for early vaccination if they have good reasons to travel abroad and at short notice, such as for studies, business, or on compassionate grounds; (b) whether these travellers can be allowed special dispensation to travel to COVID-19 hotspots identified by the Ministry; and (c) if so, what is the process for this category of travellers to apply for the vaccination.

Name and Constituency of Member of Parliament

Mr Darryl David

MP for Ang Mo Kio GRC

Question No. 546

To ask the Minister for Health whether the Government can provide an update as to how the COVID-19 vaccination programme is progressing especially with regard to any adverse reactions to the vaccinations so far and how such cases, if any, have been managed.

Name and Constituency of Member of Parliament

Mr Murali Pillai

MP for Bukit Batok

Question No. 548

To ask the Minister for Health in relation to the COVID-19 vaccination programme for seniors aged 70 and above that commenced in late January 2021, whether steps will be taken to proactively identify and help seniors who may find it difficult to make bookings for injections or have mobility issues to receive injections.

Name and Constituency of Member of Parliament

Mr Ang Wei Neng

MP for West Coast GRC

Question No. 573

To ask the Minister for Health (a) what are the numbers and kinds of COVID-19 vaccines that Singapore has ordered and what are their delivery schedules; (b) how many vaccination centres will be set up in the next six months and what is the capacity of the vaccination centres; and (c) how many people have received the COVID-19 vaccination as of end-January 2021 and how many of them have shown symptoms of side effects, if any.

Name and Constituency of Member of Parliament

Ms Hazel Poa

Non-Constituency MP

Question No. 577

To ask the Minister for Health whether a vaccination advisory service can be provided to members of the public to seek clarifications about their suitability for COVID-19 vaccination in view of their particular medical conditions such as allergies and past reactions to vaccines.

Name and Constituency of Member of Parliament

Mr Gerald Giam Yean Song

MP for Aljunied GRC

Question No. 598

To ask the Minister for Health (a) what are the vaccination groups for the purpose of scheduling COVID-19 vaccinations; (b) how many persons are there in each group; (c) what is the order of priority for these groups for vaccinations; and (d) whether Singaporeans who are scheduled to travel overseas for studies or essential business can be prioritised for vaccinations.

Name and Constituency of Member of Parliament

Ms Jessica Tan Soon Neo

MP for East Coast GRC

Question No. 603

To ask the Minister for Health (a) how will the general public be notified of the COVID-19 vaccination schedule and where they have to go for their vaccinations; (b) whether there will be an option for Singaporeans who need to travel to request to have their vaccinations earlier; and (c) what is the progress of the vaccination programme and learnings so far.

Name and Constituency of Member of Parliament

Mr Dennis Tan Lip Fong,

MP for Hougang

Question No. 611

To ask the Minister for Health in light of the reported deaths of elderly persons in Norway after taking the Pfizer vaccine (a) whether the Government will be consulting with the Expert Committee on COVID-19 Vaccination to review the vaccination strategy in Singapore, particularly for the elderly; and (b) whether any additional precautions will be taken and, if so, what are they.

Name and Constituency of Member of Parliament

Ms Sharael Taha

MP for Pasir Ris-Punggol GRC

Question No. 620

To ask the Minister for Health (a) whether Singaporeans who are required to work or study overseas can opt-in for early COVID-19 vaccination; and (b) if so, what is the process to apply for the early vaccination.

Answer

The safety and wellbeing of Singaporeans remain our top priorities for the vaccination programme. Only vaccines that meet strict standards of safety, quality and effectiveness will be used for our population.

For our vaccine programme to be successful, education and outreach play a crucial role. Singaporeans need to understand why vaccination is important in the fight against COVID-19, and be confident that the vaccines we are using are safe and effective. We must also communicate clearly when and how they can get vaccinated.

The Ministry of Health (MOH) has made available general information as well as detailed advisories through multiple channels.

The MOH website provides information on the groups currently deemed contraindicated or not, as recommended by the Expert Committee on COVID-19 Vaccination (EC19V), to take the COVID-19 vaccine. For example, pregnant women, children below 16 years of age, or those with a history of anaphylaxis or severe allergies such as eye, mouth, or facial swelling, difficulty in breathing and/or a fall in blood pressure, are not recommended at this stage. Persons who are unwell or have had fever in the last 24 hours are also advised to postpone their vaccination until they have recovered.

Members of the public may call the MOH COVID-19 hotline for assistance if they have medical queries. They may also consult their own regular family doctor. All our medical practitioners have been provided with the detailed clinical definitions of indications and contraindications to vaccination, including, for example, what is considered a history of anaphylaxis or severe allergies, or the definition of “a severely immunocompromised person”. They will be able to advise any individual on vaccine-related queries, including evaluating their specific individual suitability for vaccinations.

Every individual will go through a screening process at the vaccination site before being vaccinated. Each person will have to declare their relevant medical conditions based on the vaccination screening form provided. A final check on the individual’s suitability and fitness for vaccination will be assessed by a trained healthcare personnel at our vaccination centres and polyclinics. These personnel will have on-site access to an individual’s salient medical history in the National Electronic Health Records if necessary, before the individual is allowed to be vaccinated.

Progress of Vaccination Programme

We have made good progress in our vaccination programme. As of 31 January 2021, yesterday, more than 155,000 individuals have received their first dose of the vaccine.

More vaccination centres will be set up over the next few weeks to ensure that everyone can conveniently receive their vaccinations. The vaccination centres will be located in high population catchment areas as well as along public transport routes for greater accessibility. In total, we are planning to set up around 40 vaccination centres, with each vaccination centre planned for an estimated capacity of about 2,000 vaccinations per day on average.

Besides the vaccination centres, the polyclinics and selected Public Health Preparedness Clinics (PHPCs) will also serve as vaccination sites. Currently vaccinations are performed at 9 polyclinics and around 20 PHPCs. From 1 February 2021, today, all 20 polyclinics across Singapore will also begin offering COVID-19 vaccinations. Our polyclinics and PHPCs are wheelchair accessible. To reach out to seniors with more serious mobility issues we have set up mobile vaccination teams.

Vaccinations for Seniors

We have begun vaccinations for seniors in the community. All seniors will receive personalised letters inviting them to make an appointment for their vaccinations. They will also be able to make appointments online, or they can also visit selected Community Centres near to them to book an appointment in-person.

Community volunteers from the People’s Association and our Silver Generation Ambassadors will be conducting house visits to answer queries and help our seniors to book an appointment if necessary. We are grateful for the support and participation of the community in this important national effort.

The Ministry, the Health Sciences Authority and the Expert Committee on COVID-19 Vaccination, have been monitoring international reports on vaccine-related adverse events and deaths in elderly recipients. The Norwegian health authorities and the World Health Organisation’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, the Ministry 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.

Adverse Events

As with other vaccines, people who receive the COVID-19 vaccine may experience injection site pain and swelling, fever, headache, fatigue, and body aches. These mild symptoms generally resolve within a few days.

Among those who have received the vaccine, there were four reported cases of anaphylaxis, which is the rapid onset of severe allergic reactions. The individuals, in their 20s and 30s, developed multiple symptoms such as rash, breathlessness, lip swelling, throat tightness and giddiness. Three of the individuals had a history of allergies, including allergic rhinitis and food allergy such as to shellfish, but none had a history of anaphylaxis which would have precluded them from receiving the vaccine in the first place.

Anaphylaxis can be controlled when detected and treated in a timely manner. As all vaccinated persons in Singapore are closely monitored, the symptoms in these four individuals were promptly detected and treated. All have recovered from the episode. One was under observation for a few hours while the others were discharged from the hospital after a day’s observation or treatment. None needed ICU support.

The incidence rate of anaphylaxis locally is about 2.6 per 100,000 doses administered. The incidence rates reported abroad is around 1 to 2 per 100,000 doses administered, after these countries have administered millions of vaccine doses. Variations in the incidence rate are to be expected initially when the numbers vaccinated in Singapore to-date are relatively small as compared to other countries.

Currently, the benefits of getting vaccinated to protect oneself from the effects of severe COVID-19 disease and its complications far outweigh the risk of any potential adverse events known to be associated with vaccination. We will continue to closely monitor the safety of the vaccine and ensure the vaccines used in Singapore are safe for our population groups.

Vaccine Supply

We seek everyone’s patience and support, as we progressively roll out the vaccinations to the whole population in tandem with the shipments of the vaccines. We have signed advance purchase agreements with Pfizer-BioNTech, Moderna and Sinovac, and are in discussions with a few other pharmaceutical companies. Due to commercial sensitivities and confidentiality undertakings in our advance purchase agreements, we cannot disclose the specific quantity of the vaccines ordered or the delivery schedules.

While there will be some delays to the shipments of the Pfizer-BioNTech vaccines due to the upgrading of Pfizer’s manufacturing plant, we will continue to monitor our supplies closely to meet our target of vaccinating all Singaporeans and long-term residents in Singapore by the end of 2021.

Given the present, short-term limited supply of COVID-19 vaccines globally, there is a need to prioritise the vaccinations at this point in time. We have prioritised healthcare workers and COVID-19 frontline personnel whose work requires them to be in constant contact with individuals who may be infected. These personnel include swabbers hired by Health Promotion Board, staff working at Government Quarantine Facilities, Community Care Facilities, and dedicated Stay-Home Notice facilities. Seniors are at higher risk of severe or fatal illness if infected, and hence they are also given priority for vaccination. We have also vaccinated essential workers, such as those in our security services, and our aviation and maritime workers, who have a higher risk of exposure to infected individuals in the course of their work. We must keep our essential services going.

We understand the anxiety of some Singaporeans who wish to travel overseas for personal reasons and would like to get vaccinated early. At this point when vaccine supplies are limited, we do need to prioritise our healthcare and frontline workers, and seniors, for vaccination. We are therefore unable to provide vaccines at this time to Singaporeans outside of these groups and seek their understanding. When there is greater certainty in our vaccine supply, we will consider allowing these individuals to receive early vaccination. We will announce further details at that time. Further details on the vaccination rollout to the rest of Singaporeans and long-term residents will be announced later on.