SINGAPORE: With COVID-19 vaccinations in Singapore to be voluntary, efforts may be needed to encourage those people who are reluctant to take the jab to go ahead and do so, said medical experts CNA spoke to.
Clear information about the available vaccines, including their benefits and any disadvantages, could help persuade some people that getting the shot is in their best interests as well as those of the wider community, they added.
The Ministry of Health (MOH) has said that while COVID-19 vaccination will be voluntary, it strongly encourages everyone who is medically eligible to get vaccinated when it is offered.
“While there is certainly a segment of Singapore’s population that shuns vaccination, the extent of anti-vaccination sentiments in Singapore is considerably lesser than in Europe or in North America,” said Professor Teo Yik Ying, dean of the National University of Singapore’s Saw Swee Hock School of Public Health.
The spread of anti-vaccination misinformation - including unfounded claims linking the vaccine against measles, mumps and rubella to an increased risk of autism in children - has been blamed for an increase in measles cases in recent years across many countries, such as the United States and Samoa.
Singaporeans are generally well-informed about the benefits and potential side-effects of vaccines, said Prof Teo, with the Health Ministry using school-based programmes and various forms of mass media to communicate the importance of vaccination.
“Because we have a smaller fraction of people with deep-seated prejudice or dogma against vaccines, the hesitancy that people may face when it comes to the COVID-19 vaccine is more an issue of misinformation or lack of information,” he said.
READ: Could COVID-19 weaken 'anti-vaxxers'?
“This is good news, in the sense that the population can be provided with transparent, clear and truthful communication about COVID-19 vaccines, the benefits and disadvantages, what we currently know about the vaccines and what are the questions that remained unanswered.”
“Such clear and frank communication will actually help to improve the reception towards the COVID-19 vaccine,” said Prof Teo.
Any hesitancy in getting vaccinated could point to a need for further investment in public education and communication, he noted.
Professor Paul Tambyah, president of the Asia-Pacific Society of Clinical Microbiology and Infection, said there is no scientific data on the prevalence of anti-vaccination sentiment in Singapore.
The country has a history of taking a “cautious and scientific” approach to vaccination, he said, pointing to the Health Sciences Authority’s stand on dengue vaccination, where the vaccine is only given to people when the benefits outweigh the risk.
“If anything, the cautious approach from both the public and regulators will help ensure that accurate data on the side effects of vaccination are communicated and people can choose for themselves about the vaccination based on their own risk assessments,” he said.
SAFETY NOT COMPROMISED IN VACCINE DEVELOPMENT
Earlier this month, Prime Minister Lee Hsien Loong announced that vaccination against COVID-19 would be free for all Singapore citizens and long-term residents, with the country receiving its first batch of Pfizer-BioNTech vaccines last week.
This comes less than a year after the COVID-19 pandemic first spread.
In comparison, it took more than two decades to develop an effective vaccine for polio.
However, this apparent speed does not indicate that the development of COVID-19 vaccines was rushed or that safety was compromised, said Prof Teo.
“The reason why the COVID-19 vaccines can be designed, developed and tested so quickly, is because of the sheer number of research laboratories that have been repurposed to research on the COVID-19 vaccine, as well as parallelising the different phases of the clinical trials,” he said.
Prof Tambyah noted that the vaccines that have thus far been approved or are close to approval, are based on the spike protein - the part of the virus that allows it to enter the body - similar to that of the SARS spike protein characterised between 2003 and 2004 by researchers in Singapore and elsewhere.
“They studied the structure of the protein as well as how the human body’s immune system responded to the protein. So, this vaccine actually took about 17 years to develop,” he notes.
READ: From shortlisting promising candidates to negotiations: How Singapore procured its first COVID-19 vaccine shipment
While there have been reports of allergic reactions among those who have received the COVID-19 vaccine, these are rare, noted Prof Tambyah.
“What are more common are fever, fatigue and muscle pains. These are relatively common especially after the second vaccine dose,” he said.
“It is important for people to be prepared for these so they know what to expect and are not taken by surprise. The best analogy is with childhood vaccines where often the babies are cranky for a day on the day they get their shots.”
“A very small number of people have reported anaphylactic responses, and this is exactly why there are very clear recommendations that people with prior history of adverse responses to certain medications and food - and the emphasis here is on adverse responses, not just mild reactions - should not take the COVID-19 vaccine until further notice,” said Prof Teo.
“Given that tens of thousands of people are involved in the clinical trials, the risk is estimated to be around 1 in 10,000 or rarer, for some of these more serious side effects. This is really a very small risk, when viewed from an individual’s perspective,” he added.
HOW MANY NEED TO BE VACCINATED?
Nobody knows for sure what percentage of Singapore’s population will need to be vaccinated to ensure the country’s safety, said Prof Tambyah.
“One indication is from the closed communities such as the Diamond Princess or the dormitories in Singapore where about half of the population was infected either symptomatically or asymptomatically,” he said.
The Diamond Princess is a cruise ship which saw hundreds of people infected on board in the early stages of the pandemic.
“The big difference is that Singapore is one of the world’s major travel and trade hubs so we would need half of the world’s population to be immune rather than just half of the population of Singapore – and that is assuming that data from the dorms and Diamond Princess can be extrapolated to the general population,” he adds.
“Based on the current understanding of the infectivity of the SARS-CoV-2 virus, we are looking at a target of at least 80 per cent of the population to be vaccinated against COVID-19,” said Prof Teo.
“Clearly if the reports of the mutated variant from the United Kingdom are verified, and that strain is much more infectious, we may even need to look at revising the target to be higher, say to 90 per cent or more.”
“Clear, informative and transparent” communication is needed to increase vaccination uptake, Prof Teo said.
“Having a number of platforms for people to post questions about the vaccines to certified experts, as well as understanding the social and behavioural sciences of why some people are reluctant to take up the vaccines, can also help to sharpen and improve the way information about the vaccine is communicated to the public,” he added.
“I think that if the rates fall dramatically in countries such as the US and UK post vaccine roll out, the rates of vaccination will rise here too,” said Prof Tambyah.
Singapore is “not unfamiliar with vaccination during an epidemic”, he added, pointing to the country’s vaccination programmes put into place in the mid-20th century.
“The experience with the Sabin vaccine during the polio epidemics of the 1950s shows that if a vaccine works, Singaporeans will take it!” he said.