Subsidies helpful, but public education also needed to improve adult vaccination rates: Experts

Subsidies helpful, but public education also needed to improve adult vaccination rates: Experts

vaccination file photo
File photo of a woman preparing a measles vaccine. (Photo: AFP/Schneyder Mendoza)

SINGAPORE: Invasive pneumococcal disease (IPD) kills one in every four to five senior adults who catch the disease, said Associate Professor Helen Oh, senior consultant for infectious diseases at Changi General Hospital. Yet according to figures from the Ministry of Health (MOH) only 12 per cent of adults aged 65 to 74 in Singapore have been vaccinated against it.

With the take-up rate for the influenza vaccine equally low at 14 per cent, experts find the numbers worrying given that it can be more difficult for seniors to fight off infections as their immune systems weaken.

To improve the take-up rates, a multi-agency task force proposed on Sunday (Jul 28) that vaccination subsidies be given to Singaporean adults and Permanent Residents to protect themselves against vaccine-preventable diseases.

In an addendum on the recommendations, MOH said the subsidies are expected to be rolled out before the end of 2020. It aims to have more than 50 per cent of adults vaccinated against diseases under the National Adult Immunisation Schedule (NAIS) within five years.

Aside from pneumococcal diseases and influenza, NAIS includes vaccines against chickenpox, hepatitis B, tetanus, measles and human papillomavirus (HPV). 

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While cost is a potential reason for the low take-up, other factors like convenience and public awareness are key, said Prof Oh. 

“Public education is crucial to dispel any misinformation or misconception that vaccine-preventable diseases are not serious. The public may also have a lack of confidence in the effectiveness of vaccines, such as the influenza vaccine,” she added. 

Mdm Shum Yeong Yun, 62, has never been vaccinated. And since her general practitioner (GP) never brought up the issue, she concluded that she did not need them.

“If I knew more or maybe if there was more information about it, we might think it’s better to protect ourselves and maybe we would consider taking it. There’s not enough information to make me think it’s necessary to take it,” she said.

Ms Ng Geok Wah, 69, said while her doctor had advised her to take the pneumococcal vaccine last year, she decided against doing so because she was “not worried” about the risks. 

“If it was compulsory I would have taken it. If you make it more convenient for people to take the vaccination, more people will go,” she added. 

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Ms Tan Puay Hua, 58, who last got vaccinated when she was pregnant decades ago, said she “has concerns” about vaccines, even though she is not against them. 

“I think we need more information about vaccinations. We need to know how it protects us, for how long, how effective it is and what are the risks involved. 

“Maybe if there’s a chart at my GP, and my doctor recommends it, I would take the jab.”

Assistant Professor Clarence Tam from the NUS Saw Swee Hock School of Public Health acknowledged that vaccinations need to be “a more prominent aspect of discussions” between patients and doctors. 

Research shows that patients consider healthcare professionals to be the most trustworthy sources of vaccine information, and that people who are recommended vaccines by their doctors are much more likely to be vaccinated, he said. 

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“But we also need ways to help doctors have these discussions with patients. Doctors generally have very limited consultation times with patients and there is limited time to talk about vaccinations. 

“Raising awareness among the public and encouraging individuals to consult their doctors about vaccination is equally important.”


These would also help dispel misconceptions about vaccines that individuals like Ms Tan have.

“Taking a flu jab every year, introducing different strains of the virus to your body every year doesn’t sound good,” she said. 

Debunking the myth that patients can get the flu after receiving the vaccine, Asst Prof Tam said: “The flu jab has no live components so it cannot cause the flu. 

“People may experience some soreness and mild fever after being vaccinated, but these are just signs that their immune system is responding to the vaccine, which is what we expect.”


Prof Paul Tambyah, president of the Asia Pacific Society of Clinical Microbiology and Infection said Singaporeans do not think about the flu as a major public health problem as Singapore does not have a well-defined flu season. 

“This is different from temperate countries where people know that when the winter comes, there is a risk of flu and thus go looking for their flu shots. With flu occurring all year round in Singapore, people think that they don’t need influenza vaccination unless they travel.”

“The concept of vaccinations should be viewed as a preventive measure akin to exercise, healthy diet and medical risk reduction,” said Prof Oh.

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Asst Prof Tam said high levels of vaccination in the population helps to prevent disease in those who have been vaccinated, and also reduces the risk for others who cannot be vaccinated for medical reasons. 

“When vaccination levels in the population are low, this increases the chances that people will be infected and pass on the infection to others, resulting in disease epidemics,” he added.

Source: CNA/hw