Various Considerations for Vaccines in National Schedule

MOH's Reply

Various Considerations for Vaccines in National Schedule

 We thank Dr Leong Hoe Nam for suggestions on the National Childhood Immunisation Schedule (NCIS) (“Add flu and hepatitis A jabs to National Childhood Immunisation Programme”, 1 Aug 2019).

The National Adult Immunisation Schedule (NAIS) and NCIS were established to provide recommendations on vaccinations to protect against vaccine-preventable diseases that are of significant healthcare burden to Singapore. The schedules aim to raise awareness of important vaccinations and increase the uptake of these vaccines

The Ministry of Health (MOH), in consultation with the national Expert Committee on Immunisation (ECI), regularly reviews available vaccines for inclusion in the national immunisation schedules. In general, the considerations take into account local disease burden, vaccine safety, clinical efficacy and cost effectiveness of the vaccines.

Hepatitis A is transmitted through contaminated food or water and the key to preventing the spread of hepatitis A lies in the safe handling, cooking and consumption of food, and proper hand hygiene to prevent cross-contamination. As Singapore has good hygiene and sanitation, the incidence of hepatitis A in Singapore is low at less than 90 cases annually from 2013 to 2017. Vaccination against hepatitis A is therefore currently not recommended at a national level.

However, persons travelling to countries where hepatitis A is prevalent, or perceive that they may be at higher risk of acquiring hepatitis A, are advised to consult their doctor for advice and obtain the vaccines, if necessary, to protect themselves.

 Beyond the national immunisation schedules, MOH also issues guidelines to medical practitioners on recommended vaccinations for groups which are more susceptible to developing serious complications from vaccine-preventable diseases. One example is the influenza vaccine. MOH has informed medical practitioners to advise their patients on the importance of influenza vaccination for children between six months and five years, persons with certain medical conditions, and those aged 65 years or older. We encourage the public to discuss their vaccination needs and suitability with their doctor.

MOH will continue to regularly review our vaccination policies and inclusion of vaccines into the schedules, in consultation with the ECI.

Vernon Lee
Director, Communicable Diseases Division
Ministry of Health

Forum Letter

The Straits Times,1 August 2019

The Government is clearly adopting a forward approach in health. Instead of disease treatment, we are moving towards disease prevention. For the first time, adult vaccinations will be subsidised, beginning in 2020 (Adult vaccine subsidies, help for vulnerable groups, July 29). And the more we use these vaccinations, the greater protection it extends to the rest of the community.

I look forward to heavily subsidised vaccinations for adults against ailments like influenza, pneumonia, shingles and pertussis. They will significantly reduce the burden of illness (and morbidity) on the elderly.

Going forward, we should consider adding two vaccinations to the National Childhood Immunisation Programme. Children with influenza drive the adult influenza outbreaks. By vaccinating children, we cut down the attacks on the elderly. Sick leave is turned into effective school days, and precious parental leave can be reserved for overdue holidays instead.

Hepatitis A is also prevalent as we are exposed to the virus when we go abroad. By introducing hepatitis A vaccination in the National Childhood Immunisation Programme, we can effectively eradicate the disease, as we have for hepatitis B. Hepatitis A has a grade A rating for disease prevention, that is, there is a high chance of prevention.

 Kudos to the HealthySG Taskforce.

Leong Hoe Nam (Dr)