Singapore to offer COVID-19 vaccine booster shots to seniors, some immunocompromised people

SINGAPORE: Singapore will offer COVID-19 vaccine booster shots to people who are moderately to severely immunocompromised, as well as people aged 60 and above, and residents of aged care facilities.

The Ministry of Health (MOH) and the Expert Committee on COVID-19 Vaccination have evaluated the need for booster shots, said co-chair of the COVID-19 multi-ministry task force Gan Kim Yong on Friday (Sep 3).

Having reviewed the available evidence and scrutinised the safety and efficacy of booster doses administered globally, the committee has recommended, and MOH has agreed, to start a booster programme for these groups of people.

Seniors are at risk of severe COVID-19 infection and may develop a lower immune response from their two-dose vaccination regimen, said MOH. This is coupled with the expected decline of their immunity over time, as many were vaccinated earlier, added the Health Ministry.

They should receive a booster dose of an mRNA vaccine about six to nine months after having completed their primary course of vaccination regimen.

This is to "ensure higher levels of protection from infection and continued high levels of protection against severe disease, and reduce the possibility of spikes in infections and more people falling severely ill", said MOH.

About six months have passed since the first batch of seniors aged 60 and above completed their second doses in March under the national vaccination programme.

They will be eligible for the third dose within this month, said MOH, adding that more details on the implementation of the booster shot will be announced later.

Immunocompromised persons have a "blunted immune response" to vaccination, and are also at a higher risk of severe illness from COVID-19, said the Health Ministry.

"These individuals are recommended to receive a third dose of the same mRNA vaccine two months after their second dose as part of their primary course of vaccination to ensure that they start off with an adequate protective immune response to vaccination," said MOH.

Health Minister Ong Ye Kung said that immunocompromised individuals will be contacted by their doctors.

Mr Ong added that with new variants, there have been more breakthrough infections despite vaccinations, and that the strength of protection decreases as antibodies wane over time.

"In Singapore, our data shows that the ability of vaccination to prevent any COVID-19 infection is around 40 per cent. Second observation is, despite this, vaccines continue to be very effective in protecting against severe illnesses and deaths, should you be infected," said Mr Ong.

This is because even when the antibodies wane, memory cells in the body have learnt how to produce new antibodies the next time they meet the coronavirus.

The percentage of vaccinated people infected with COVID-19 who get very sick or die is 1.3 per cent compared to 9.2 per cent for unvaccinated people, he said.

A booster programme will pre-empt a very sharp rise in breakthrough infections which can still lead, in absolute terms, to many deaths or cases of severe illness, said Mr Ong.

"This is especially relevant to the elderly and to other higher-risk groups," he said.

A number of countries have started or are planning to give their population booster shots, including Israel, United Kingdom, Germany and France.

The US Food and Drug Administration has also approved a third dose for immunocompromised individuals and is considering the recommendation for seniors.

Mr Ong said that 81 per cent of Singapore's population has completed the full vaccination regimen.

The expert committee will continue to review the evidence and data for other groups. One area it will pay specific attention to is the rare but more severe adverse reactions to vaccines that occur mostly in the younger age group.

Another area of study will be whether using a different brand of vaccine for the booster shot will be more effective than using the same vaccine as the first two doses.

"Many parents have asked me about vaccination for children. I believe this will happen, but it may take some time because clinical trials are ongoing for those aged below 12 years," said Mr Ong.

MOH expects vaccination for children to start early next year after the studies are completed and regulatory approval processes are carried out, he added.

A pilot for a home recovery scheme will also be starting. Mr Ong said that in the coming weeks, about 50 COVID-19 cases are expected to be allowed to recover at home.

The pilot will aim to smoothen operations before the programme is expanded.

"If you find that you have a neighbour infected and recovering from home, you cannot meet him, because he will be isolated in his room. But please, give him your full understanding and full moral support," said Mr Ong.