MOH updates COVID-19 vaccination guidelines; those with multiple allergies without anaphylaxis can now receive jabs

SINGAPORE: The Ministry of Health (MOH) has eased its COVID-19 vaccination recommendations for certain groups of people, including those with multiple allergies that are not anaphylactic in nature.

The ministry had previously advised those with a history of multiple allergies to defer receiving mRNA-based vaccines. 

New evidence has shown that these individuals can be vaccinated as long as they have no life-threatening signs or symptoms suggestive of anaphylaxis, MOH said in its guidelines on vaccination that were updated on Saturday (Mar 13).

"It is the severity of the allergy, and not the number of allergies that determines if a person can be vaccinated," MOH said.

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Both Pfizer-BioNTech and Moderna vaccines - the only two to be approved in Singapore to date - are mRNA-based COVID-19 vaccines.

Anaphylaxis is a severe life-threatening reaction with two or more of the following three criteria: 

- Hives or face/eyelid/lip/throat swelling

- Difficulty breathing

- Dizziness

Anyone with a history of having been prescribed an Epi-Pen suggests an anaphylaxis risk, and should not be vaccinated at this time, MOH said. 

A person with a family, but not a personal history of anaphylaxis can proceed with the vaccination.

Those with histories of an allergic reaction to other vaccines may be allergic to specific vaccine components which may be present in a COVID-19 shot. 

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CANCER PATIENTS

MOH also updated its guidelines for those who can receive COVID-19 shots to include people who have active cancer, as long as they have not received chemotherapy, radiotherapy or immunotherapy in the last three months and do not plan to undergo these treatments in the next two months.

Additionally, people in remission can be vaccinated, as can those on active cancer hormonal therapy.

Women who are breastfeeding can undergo vaccination, but they can consider suspending breastfeeding for five to seven days after receiving the vaccine, MOH added.

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People who have recovered from COVID-19 - and have not completed their vaccination - may receive a single dose of vaccine, in line with the revised guidelines.

"This applies to recovered persons who are unvaccinated and recovered persons who had received one dose of vaccine before being infected," said MOH.

"There is evidence shown that a single dose of vaccine can further boost the immunity against COVID-19 in persons who have recovered from a COVID-19 infection."

Those who are allergic to either mRNA vaccine and are unable to receive their second dose "may have suitable alternatives in future", said MOH.

Anyone who thinks that they might be severely immunocompromised and unsuitable to receive an mRNA-based vaccine should discuss the matter with their doctor.

Individuals will also be assessed at vaccination sites for their suitability to receive the vaccine, said MOH. 

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Singapore is still awaiting the approval of a third vaccine for use, the single-shot vaccine developed by China's Sinovac Biotech.

Unlike the two already approved here, the Sinovac vaccine uses inactivated vaccine technology, which utilises virus particles that have been killed to stimulate our bodies to produce an immune response. This vaccine is similar to the flu vaccine. 

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