Singapore to administer third vaccine shot to people with severely impaired immune system, expert committee looking into booster strategy

A third vaccine shot will be administered for people who are severely immunocompromised at the time of their first two doses of the vaccine. ― Reuters pic
A third vaccine shot will be administered for people who are severely immunocompromised at the time of their first two doses of the vaccine. ― Reuters pic

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SINGAPORE, Aug 20 — A third vaccine shot will be administered for people who are severely immunocompromised at the time of their first two doses of the vaccine, Health Minister Ong Ye Kung said on Thursday (Aug 19).

These include those who are receiving cancer treatment, transplant patients, other patients on immunosuppressive therapy and end-stage kidney disease patients on dialysis.

The minister said that because of their medical conditions, the bodies of these individuals “cannot produce as many antibodies or activate the necessary mechanisms to fight the coronavirus”.

“Hence, a third dose of vaccine is necessary for them,” he said during a press conference by the multi-ministry task force dealing with the Covid-19 pandemic.

Ong said that the expert committee on Covid-19 vaccination advising the Government will be putting out its recommendations for this group “shortly”.

He also said that the committee has been reviewing and monitoring domestic and overseas data on vaccine boosters and is developing recommendations for Singapore’s booster strategy for the general population.

It is very likely that Singapore will have to start on a vaccine booster exercise and the committee is monitoring the situation in other countries that have already embarked on a similar move.

For instance, Israel has already started administering booster shots for seniors and vulnerable persons, and France, Germany and the United Kingdom have announced that they will be starting theirs in September.

He also said the United States’ Centers for Disease Control and Prevention has recommended booster shots after eight months from the second dose of receiving a vaccine.

“These countries started vaccinations earlier than us, and we therefore now have the advantage of observing them and learning from their experiences,” Ong said.

There are two key things the expert committee needs to monitor, he added.

The first is the incidence of adverse reactions and whether it is lower or higher than the first and second dose of vaccines that a person receives. If it is higher, then solutions will be needed to mitigate or remove the risks.

The second thing to study is whether Singaporeans should go for the same vaccine or different vaccine when it is time for a booster shot.

Describing this as a homologous or heterologous strategy — that is, using the same or different types of vaccines to complete a regimen — he said that there is scientific basis to suggest a heterologous strategy (using different vaccines) may confer stronger protection.

“The United Kingdom is implementing such a strategy and we will be monitoring the outcome closely,” he said.

Ong also said that Singapore has “quite a sizable group of people” who took the first shot of messenger ribonucleic acid (mRNA) vaccines and found that they were allergic to it and had to complete their vaccination with a traditional inactivated-virus vaccine such as Sinovac.

The expert committee will be closely monitoring their immune response.

On the nationwide vaccination programme, Ong said that it is signficant that 77 per cent of the population have been fully vaccinated against Covid-19, and 82 per cent have received at least one shot of the vaccine.

The overall vaccination numbers have fallen to around 20,000 a day — a quarter of what he described as Singapore’s peak which was 80,000 a day.

With that, Singapore will be reducing the number of its vaccination centres, but it will “still need to keep a good number” operating for three reasons, said Ong.

Aside from allowing those who have yet to get vaccinated to do so, it will also provide a place to administer booster shots or to inoculate children below the age of 12. 

Vaccination for this group of children will only commence after the safety and efficacy aspects of this plan have been studied, though Ong said it “should start sometime in early 2022”. 

Responding to a question from the media on how quickly booster shots for the general population will be introduced, Ong said to give the expert committee “some time to answer” the two areas that it needs to monitor.

Associate Professor Kenneth Mak, director of medical services at the Ministry of Health (MOH), said that the expert committee is in the midst of finalising its recommendations and that there are many facets to consider.

“We want to ask ourselves whether booster vaccinations are required for the general population, or whether we should prioritise a sub-group of people who have an increased risk of getting infections, even after vaccination,” he said. 

“So that’s an issue that the expert committee is currently deliberating and we expect their recommendations to come out soon.”

The committee is composed of 14 members from the medical fraternity and is chaired by Associate Professor Benjamin Ong, who is the senior adviser to Assoc Prof Mak. Assof Prof Ong is also the senior vice-president for health education and resources at the National University of Singapore. — TODAY

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