Monday 28 December 2020

COVID-19 vaccination in Singapore to begin on 30 December 2020, starting with healthcare workers; Singapore residents aged 70 and older from February 2021

Government accepts Expert Committee's recommendations on vaccine strategy
By Lim Min Zhang and Rei Kurohi, The Straits Times, 28 Dec 2020

Singapore's Covid-19 vaccination exercise will begin on Wednesday, 30 December, with healthcare workers at the National Centre for Infectious Diseases (NCID), followed by those from other healthcare institutions in the coming weeks.

Seniors aged 70 and above will get vaccinated from February next year, said the Ministry of Health (MOH) in a statement yesterday.

This is in line with recommendations by an expert committee that front-line and healthcare workers, as well as those most vulnerable to severe complications if they contract Covid-19, should be vaccinated first, the ministry said.

The Government has accepted in full the recommendations submitted last Thursday by the Expert Committee on Covid-19 Vaccination on Singapore's overall vaccine strategy, MOH added.

Public healthcare institutions and private hospitals are to arrange for their staff to be vaccinated at their respective premises.

Seniors aged 70 and up will get priority for vaccines as they tend to have worse health outcomes than those aged 60 to 69, MOH said.

Thereafter, MOH will vaccinate other Singaporeans and long-term residents who are eligible.

"Vaccination is not a silver bullet that can end the pandemic immediately, but it is a key enabler to getting us back to a safer state of affairs," the ministry said.

Vaccination will complement other "key enablers" such as testing and contact tracing to mitigate any spread and keep community transmission low, MOH noted, stressing that only vaccines that meet strict standards of safety, quality and effectiveness will be used.

The announcement comes as Singapore moves into the third phase of its reopening today, 28 December, nearly six months after the country exited its circuit breaker period on June 1.

Attractions such as Gardens by the Bay and the Singapore Zoo have geared up for an increase in visitors as capacity limits are raised to 65 per cent of their full operating capacity, up from 50 per cent.

Groups of up to eight people can now gather socially, up from a limit of five, prompting restaurants to make changes to their layouts to accommodate larger groups.

The risk of more imported cases and community spread will increase as Singapore moves into phase three, said MOH. Getting vaccinated "is especially important in the face of reports surfacing globally about more transmissible strains", the ministry added.

Yesterday, the expert committee released its recommendations, including its assessment that the Pfizer-BioNTech vaccine is suitable for use in people aged 16 and above.

Pregnant women and immunocompromised individuals should not get the vaccine until more information is available, it added.

The committee recommended that everyone living in Singapore who is medically eligible should be vaccinated when vaccines become more widely available, although it should remain voluntary.

At any time, about 5 per cent of available vaccine stocks should be reserved for specific groups of people who are critical to keeping the country going, like those working in essential services, it said.

Measures such as mask wearing and social distancing should continue, it added, until more information is available on the vaccines' ability to prevent infections.

The committee's chairman, Associate Professor Benjamin Ong, said that while Singapore currently has a low rate of local transmission of Covid-19, it remains vulnerable to the threat of a surge in cases. It is thus key to vaccinate as much of the population as possible.

"We strongly encourage all persons who are medically eligible to be vaccinated when the vaccine is made available to them," he said.

5% of vaccine stocks to be set aside for those involved in critical work
Expert Committee on COVID-19 Vaccination, whose proposals have been accepted by Govt, also recommends prioritising jabs for public health reasons
By Lim Min Zhang, The Straits Times, 28 Dec 2020

About 5 per cent of available vaccine stocks at any point in time should be set aside for people working in areas critical to Singapore's functioning, said a top-level committee on vaccines yesterday.

Examples include those involved in ensuring the country's water and utilities and other "nationally essential services" are not disrupted.

This was among the key recommendations made by the expert committee on Covid-19 vaccination, which was tasked by the Ministry of Health (MOH) in October to devise a vaccine strategy for Singapore.

MOH yesterday said the Government has accepted the committee's recommendations in full, adding that Singapore's vaccination exercise will begin on Wednesday for workers at the National Centre for Infectious Diseases.

The committee said those involved in critical work should be protected from Covid-19 for "greater societal benefits", although identifying these groups was beyond the remit of the committee and will be left to the Government.

Other groups are being prioritised for vaccination for reasons of public health, and they include the elderly - especially those aged 70 and above who are at greater risk of worse health outcomes if they contract the virus - as well as healthcare workers and those working on the front line of the national Covid-19 response.

In recommending such workers to be prioritised, the committee said there is a duty to protect those who place themselves at higher risk of infection in the course of caring for the population.

Other recommendations by the committee include vaccinating everyone in Singapore who is medically eligible as more vaccines become available, and continuing to practise safe management measures until more people are vaccinated and more data on vaccines' ability to prevent infections becomes available.

In its report to the Government, the committee said that while public health measures have been shown to be effective in containing outbreaks, the "fundamental challenge" is that the vast majority of people here and in the world do not have any immunity to the virus.

"The development and availability of effective Covid-19 vaccines is a critically important milestone, providing the means to fundamentally contain the pandemic, diminish its impact in terms of morbidity and deaths from infection, and eventually allow societies to return to normalcy," the report added.

The ultimate goal of its vaccination strategy against Covid-19, it said, is to achieve as high a level of population coverage as possible.

The committee noted that Singapore currently has a low rate of transmission, but the threat of an outbreak persists as the global pandemic intensifies and the country resumes more activities.

The Republic remains vulnerable to the disease and its spread, with the country's high population density and significant proportion of older people, said the report, adding that there is great value in vaccinating the population widely to pre-emptively protect against the risk of Covid-19.

While the Health Sciences Authority's clinical assessment of the Pfizer-BioNTech vaccine found it to have a high efficacy of 95 per cent, with no significant safety concerns detected so far, continued monitoring for long-term efficacy of the vaccine will be needed to determine the duration of protection, as well as for rare and serious adverse effects, the report said.

As more vaccines become available, the committee will make further recommendations on other groups to be prioritised, such as those who live or work in settings where there is potential for rapid transmission and large outbreaks.

Key recommendations submitted to the Government by the Expert Committee on COVID-19 Vaccination:

• That the groups to be prioritised for vaccination should be people at high risk of being infected, such as healthcare and front-line workers; and people most vulnerable to severe disease and complications if they fall ill with Covid-19, who include the elderly and people with multiple vascular illnesses (affecting the circulatory system).

• That everyone living in Singapore, including citizens, permanent residents and long-term pass holders who are medically eligible should be vaccinated as vaccines become more widely available.

• That around 5 per cent of available vaccine stocks should be set aside at any point in time for groups of people who are critically important to the functioning of Singapore, such as those who ensure supplies of water and utilities are not disrupted.

• That ongoing measures such as safe distancing, mask wearing and good hand hygiene should still be practised until more people are vaccinated and more data on the vaccines' ability to prevent infections becomes available.

The committee on vaccines


Associate Professor Benjamin Ong, senior adviser to the director of medical services at the Ministry of Health (MOH).


• Dr Cheong Wei Yang, deputy secretary (special projects) at MOH;

• Associate Professor Chong Chia Yin, senior consultant, Infectious Disease Service at KK Women's and Children's Hospital;

• Professor Nicholas Gascoigne from the Department of Microbiology and Immunology at the Yong Loo Lin School of Medicine, National University of Singapore;

• Associate Professor Lim Poh Lian, director of the High Level Isolation Unit and senior consultant at the National Centre for Infectious Diseases (NCID);

• Associate Professor David Lye, director of the Infectious Diseases Research and Training Office at NCID;

• Associate Professor Helen Oh, senior consultant at the Department of Infectious Diseases at Changi General Hospital;

• Dr Lisa Ooi, vice-president for healthcare and wellness at the Economic Development Board;

• Dr Anuradha Poonepalli, regulatory consultant, Therapeutic Products Branch, Health Products Regulation Group at the Health Sciences Authority;

• Associate Professor Ren Ee Chee, principal investigator at the Singapore Immunology Network;

• Professor Laurent Renia, executive director and senior principal investigator at the Agency for Science, Technology and Research Infectious Diseases Laboratories;

• Professor Benjamin Seet, deputy group chief executive for education and research at the National Healthcare Group;

• Dr Danny Soon, chief executive for the Consortium for Clinical Research and Innovation Singapore;

• Professor Tan Chorh Chuan, MOH's chief health scientist.

*  Singapore's COVID-19 vaccination drive kicks off with jabs for 40 NCID healthcare workers
Senior staff nurse at NCID receives first COVID-19 vaccine in Singapore
By Yuen Sin, The Straits Times, 31 Dec 2020

Singapore's national Covid-19 vaccination programme kicked off yesterday, with the first Pfizer-BioNTech jabs being administered to 40 healthcare workers at the National Centre for Infectious Diseases (NCID).

This marks an important milestone in the Republic's fight against Covid-19, Health Minister Gan Kim Yong told reporters, noting that vaccination could help accelerate the resumption of economic as well as other community activities and pave the way for the reopening of more borders.

"We want to reassure Singaporeans that our priority over the next few months is to ensure that the vaccines that we use are safe and effective, and that we are able to roll out this programme to the whole population smoothly and in an orderly manner," said Mr Gan, who co-chairs the multi-ministry task force tackling Covid-19.

The vaccination efforts will also be ramped up over the next few weeks and months, said Mr Gan during a visit to the NCID, with healthcare workers in other public healthcare institutions and private hospitals next in line to be inoculated.

Subsequently, front-line workers and seniors will be vaccinated, with the doses being progressively extended to the rest of the population after that. "We aim to complete our coverage by the end of next year," he said.

Mr Gan added he was glad to see that a robust system has been put in place to ensure a smooth roll-out, given the challenges of administering the Pfizer-BioNTech vaccines, which were first delivered to Singapore from Brussels earlier this month.

The process includes keeping the vaccines at minus 70 deg C in storage, and ensuring that they stay at 2 to 8 deg C when they are transferred. They also have to be administered within a specific timeframe.

That is why the roll-out of the vaccine is being done slowly and with caution, rather than "rushing into it and (rolling) out en masse", which could pose a multitude of difficulties and challenges, said Mr Gan.

In a Facebook post yesterday, Prime Minister Lee Hsien Loong hailed the roll-out of the vaccine as a new chapter in Singapore's fight against the pandemic.

"The vaccine is key to living in a Covid-19 world, but it will still be some time before this storm will pass. Meanwhile, let's stay vigilant to keep ourselves and our loved ones healthy and safe," he wrote.

Mr Gan also reminded Singaporeans to stay on their guard against the virus.

Though community cases remain low, "the next outbreak is just one infection away", he said, adding that a high vaccination rate can protect the country from future waves of infection.

Said Mr Gan: "We need to continue to remain vigilant and when the opportunity comes for us, we must step forward to get vaccinated to protect ourselves, protect one another and to keep Singapore safe."

Ms Sarah Lim, 46, a senior staff nurse at the NCID, was the first person in Singapore to receive the vaccine.

"I feel grateful and thankful for being the first to be vaccinated. I would encourage (others) to go for it," she told reporters after receiving the shot.

Today also marks a year since China alerted the world to the outbreak of the coronavirus, which has since infected 82 million people worldwide and claimed the lives of about 1.8 million people. There were 27 new coronavirus cases confirmed in Singapore yesterday, taking the country's total to 58,569.

Singaporeans should get vaccinated against COVID-19 despite low community case numbers: Health Minister Gan Kim Yong
Having a population that is widely inoculated will guard against new waves of infection
By Yuen Sin, The Straits Times, 31 Dec 2020

Singaporeans should protect themselves from Covid-19 by getting vaccinated, even if the number of community cases is low, as the next outbreak could be "just one infection away", said Health Minister Gan Kim Yong yesterday.

Urging citizens not to be complacent that the virus is not widely circulating and to take the vaccine when it becomes available to them, he said: "We must always be prepared that there will be new waves of infection."

Having a population that is extensively inoculated would help the country guard against new waves of infections, Mr Gan said.

"(It will also) allow us to continue to progress towards returning to normalcy in our community and our economy," he said.

At the same time, it would pave the way for Singapore to reopen its travel routes.

"International travel has almost ground to a halt because of... border controls and with vaccination, it will allow many of these travel routes to be reconnected, and to allow Singapore to be reconnected back to the rest of the world," noted Mr Gan, who co-chairs the multi-ministry task force tackling Covid-19.

He was speaking to reporters at the National Centre for Infectious Diseases, where Singapore's Covid-19 vaccination exercise kicked off, with the first Pfizer-BioNTech jabs administered to healthcare workers there. Other healthcare workers will be vaccinated in the coming weeks.

Asked about concerns over the safety of the vaccine, Mr Gan said it has met the requirements of the World Health Organisation, the Health Sciences Authority and other regulatory agencies.

He acknowledged that the long-term effects of the vaccine remain unknown, given that the vaccine has been available only for a few months.

"We are continuing to observe and continuing to monitor the data that is emerging... there are precautions that are put in place, and the vaccines have met all the safety and efficacy requirements for it to be deployed," he added.

Any potential risk of receiving the vaccine also has to be weighed against the potential of a person getting Covid-19 and falling severely ill, he said, noting that an expert committee has recommended that all Singaporeans who are medically eligible should be vaccinated.

Asked if travel restrictions to countries like Malaysia could be relaxed for residents who have been vaccinated, Mr Gan said this depends on multiple factors beyond vaccination alone.

"It also depends on... safe management measures in the destination countries, and whether or not there (are) sufficient safeguards," he said, noting that Singapore has multiple lines of defence against the virus. This includes an aggressive testing strategy as well as extensive contact tracing procedures.

"Vaccination alone will not allow you to just simply open up and forget about all the other safe distancing measures," he said.

"(When) the whole of Singapore is vaccinated (and) you have a significant protection against infection, we'll be able to open up significantly after that."

Mr Gan added that members of the Cabinet, including Prime Minister Lee Hsien Loong and himself, will also get vaccinated.

The schedules for that are currently being worked out, with priority going to healthcare workers, he said. "When my turn comes, I will similarly be among the first to step forward."

COVID-19 vaccination exercise being carried out slowly to ensure safety, says Gan Kim Yong
By Rei Kurohi, The Straits Times, 31 Dec 2020

The process of vaccinating Singaporeans against Covid-19 will take some time as it is challenging and must be carried out safely and carefully, said Health Minister Gan Kim Yong.

During a visit to the National Centre for Infectious Diseases (NCID) yesterday, Mr Gan said he had met the centre's management team to get a better understanding of the challenges they face and how the vaccination exercise can be carried out smoothly.

Healthcare workers at NCID were among the first Singaporeans to receive the Covid-19 vaccine developed by Pfizer and BioNTech yesterday morning.

This came just over a week after the first batch of the vaccines arrived here from Brussels, Belgium, on Monday last week.

Asked why it took a week before the first jabs were administered, Mr Gan said the process of preparing the vaccine and ensuring the right people receive it has been challenging.

He noted that the vaccine must be administered within a short time once it is removed from low-temperature storage.

The vaccine can be stored at minus 70 deg C for up to six months or at 2 to 8 deg C - the temperature of a common refrigerator - for about five days.

"All the processes have to be smoothened and also we need to make sure that there's no mistakes," stressed the minister.

"For example, the person who is receiving the vaccination, the identity has to be verified, whether he has a pre-existing condition, whether he has allergy. All this has to be taken into consideration."

Yesterday, 40 NCID staff members, including clinical, nursing, allied health, ancillary and administration staff, were vaccinated. They will be given a second dose on Jan 20 and the remaining NCID staff will get their jabs progressively.

The National Healthcare Group management and staff will be vaccinated from next month.

Other healthcare workers on the front line are also being rostered for vaccination, with public healthcare institutions and private hospitals arranging for their staff to be vaccinated at their respective premises.

For the general public, Singapore residents aged 70 and older will receive their jabs from February, followed by other Singaporeans and long-term residents who are medically eligible.

Mr Gan noted that during the administration of the first rounds of the vaccine at NCID yesterday, the healthcare workers involved were very cautious and would "check and double-check to make sure that they follow the procedures carefully."

He added that it is better to do it carefully instead of rushing to roll out the vaccine en masse, only to discover unforeseen difficulties and challenges.

"We advise the team to do it carefully, do it slowly. Make sure you smoothen the process and are familiar with the process before you roll out in a big volume. I think doing it this way is safer," said Mr Gan.

40 NCID staff first in Singapore to get Pfizer-BioNTech COVID-19 vaccine
By Clara Chong, The Straits Times, 31 Dec 2020

Dr Kalisvar Marimuthu has been priming his loved ones over the last three months for the Pfizer-BioNTech vaccine, Singapore's first and only approved Covid-19 vaccine.

And yesterday, his anticipation of the momentous event came to fruition when the 43-year-old senior consultant at the National Centre for Infectious Diseases (NCID) rolled up his sleeve as the second Singaporean to receive the jab, at NCID's Day Treatment Centre.

"I'm feeling good and lucky... feeling a bit emotional because the vaccine is potentially a game changer," Dr Kalisvar, who manages suspected and confirmed Covid-19 cases, told reporters after his injection.

"It has been a long journey for us to reach here, it has been tough for all of us... Vaccines have brought pandemics to their knees in the past," he said, adding that he hoped history would repeat itself.

The nation kick-started its national Covid-19 vaccination programme with 40 staff from NCID getting the jab by the end of yesterday, including Professor Leo Yee Sin, the centre's executive director.

Each vaccination process took around three minutes and patients were monitored for 30 minutes afterwards to ensure that they tolerated it well.

The remaining NCID staff will be progressively vaccinated, with the rest of the National Healthcare Group management and staff from next month.

Dr Kalisvar, who read the regulatory reports and attended the town halls at hospitals on the vaccine, is confident of the product, about which he said patients had many questions.

"I think it is only reasonable that they feel concerned," he said. "Because it is such an important vaccine, even small problems may be highlighted a lot in the news.

"As a doctor, it is my job to alleviate some of these concerns that patients have. And these are real concerns."

Transient effects of the vaccination can be alleviated, he said, for instance by taking a Panadol for any pain that might follow the jab.

In fact, pain is something which people should feel as it shows that the body is reacting to the vaccine, he added.

Dr Kalisvar also addressed concerns about reported anaphylaxis reaction to the vaccines.

"It's so rare and I know that anaphylaxis is easily treatable with an injection. I know they're going to monitor me after the vaccination, because usually anaphylaxis happens immediately after the vaccination," he added.

First to get the jab was NCID senior staff nurse Sarah Lim, 46, whose job is to screen suspected Covid-19 cases. She said the injection was like an ant bite.

"I am feeling fine...," she told reporters. "I feel grateful and thankful for being the first to be vaccinated. I would encourage (others) to go for it."

She added in Mandarin: "I wanted to take the injection to protect myself, my loved ones, (my) patients and the public."

The injection was given at 9.24am by senior staff nurse Kho Wei Lian, 26. It was removed from the fridge at NCID at 8.30am - according to a note on the wall - and delivered about 45 minutes later.

The vaccine needs to be at room temperature for 30 minutes before it is diluted. Only a small volume, or just 0.3ml, is injected. The vaccine vial, once opened, must be used within six hours.

Third in line to get vaccinated was senior staff nurse Mohamed Firdaus Mohamed Salleh, 38.

The vaccine will give him confidence when he carries out his duties, said Mr Firdaus who works in the intensive care unit looking after Covid-19 patients.

"This also gives me the assurance that I can go home safely to my kids," said the father of four.

He did not experience any side effects, and commended the efficient and smooth workflow.

The vaccine requires two injections, given 21 days apart. Those who got their shots yesterday will return for a second dose on Jan 20.



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