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Singapore to press on 'more urgently' with COVID-19 vaccine booster shots amid Omicron variant concerns

SINGAPORE: Singapore will have to press on “more urgently” with its COVID-19 booster vaccination programme to enhance protection against infection and severe disease, amid concerns about the Omicron variant, the Ministry of Health (MOH) said on Tuesday (Dec 14).

Preliminary data overseas shows that vaccinated individuals who have received a booster shot have “significant protection” against infection by the Omicron variant, MOH said.

Even if those who got boosters were infected, they had significant protection against developing severe disease that required hospital treatment.

Singapore has detected 16 cases of the Omicron variant so far, comprising 14 imported cases and two local cases, MOH said. All are fully vaccinated, with no symptoms or mild symptoms, MOH added.

Thirteen cases are recovering in isolation wards at the National Centre for Infectious Diseases and three cases have been discharged, MOH said. So far, all cases have had "minimal interactions in the community" prior to being isolated.

“We have not detected linked cases in the community," said the Health Ministry.

"Active contact tracing is being conducted to ringfence close contacts of these cases and reduce onward transmission once infection with the Omicron variant is suspected, through the detection of S-gene target failure in their test results. This includes quarantine at designated facilities."

The National Public Health Laboratory (NPHL) subsequently confirms infection with the Omicron variant through genomic sequencing of the test samples. 

While no transmission of the variant in the community has been detected so far, Singapore must be prepared for this scenario, said co-chair of the COVID-19 multi-ministry task force Gan Kim Yong at a press conference on Tuesday. 

“It is only a matter of time before this happens, given the experience of other countries. This may then lead to another surge in cases because of the highly infectious nature of the Omicron variant,” he said. 

Finance Minister Lawrence Wong, who is also co-chair of the task force, added that new clusters of Omicron variant could emerge within the "next few weeks or within the coming months". The Omicron wave could potentially be bigger than what Singapore experienced with the Delta variant.

"If Omicron results in milder cases, we will be okay. But if Omicron's severity is similar to what we have seen with the Delta variant, then we will be in a much more challenging position," he said. 

NEED FOR BOOSTERS

The Omicron variant has been detected in more than 60 countries, Mr Gan said. 

MOH said that current observations from affected countries and regions suggest that the Omicron variant is at least as transmissible as currently circulating variants, including the Delta variant.

“Global observations continue to suggest that most infections with the Omicron variant are either asymptomatic or with mild symptoms, although it is still unclear whether the Omicron variant causes overall less severe disease than other strains,” MOH said.

Preliminary real-world studies suggest some degree of "immune evasion" could result in an increased risk of breakthrough infections among the recovered and vaccinated, MOH said.

“Hence, boosters are required to increase one’s immunity and mitigate any effects of immune evasion. We will continue to monitor closely and evaluate the situation as more data emerges,” the ministry said.

Vaccinations and boosters are the best protection against an “unknown and likely highly transmissible COVID-19 variant like the Omicron variant”, MOH said. 

The Health Ministry announced last week it would extend vaccination to children aged five to 11. The vaccine booster programme will also be expanded to include those aged 18 to 29.

Health Minister Ong Ye Kung said at the press conference that by the end of January 2022, about 54 per cent of Singapore's total population is expected to be covered with boosters, adding that more vaccination centres will be set up.

Explaining the need for boosters, he cited a recent study in the United Kingdom that revealed some “important insights”.

After two Pfizer-BioNTech vaccine doses, effectiveness against Omicron infection dropped from about 90 per cent one month after the second dose, to about 50 per cent after three months, and then 35 per cent four months and beyond, he said.

“This erosion of protection is quite fast,” he added.

Two weeks after a booster dose, effectiveness against Omicron infection shot back up to 75 per cent, which is “encouraging”, Mr Ong said.

“It means boosters work and this is protection against symptomatic infection,” he said, adding that protection against severe illness is likely to be much higher.

"That is why vaccination will continue to be central to our response."

Taking the emergence of new variants into consideration, Singapore must treat primary vaccination against COVID-19 "as a three-dose regime" with policies geared towards that, Mr Ong said.

"We will therefore have to set a validity period for full vaccination status. This means that, after two doses of mRNA vaccines and three doses of Sinovac, Sinopharm vaccines, our full vaccination status will last a limited period."

Mr Ong said MOH is consulting the Expert Committee on COVID-19 Vaccination to determine what this duration should be.

"This is a clear signal that we all need to take our boosters, because with waning protection, full vaccination status cannot last perpetually.

"So take our boosters, and our full vaccination status will be extended, and we will be able to access various amenities under our (vaccination-differentiated safe management measures) framework," he added. 

The Health Minister said that details of the new policy will be announced at the end of the year or early next year, adding that the vaccination status of those who have not yet been offered a booster dose will not lapse. Those not eligible for boosters will also retain their fully vaccinated status.

MOH said that local and international data indicate that there is a lower risk of serious allergic reactions such as anaphylaxis from booster vaccination doses of mRNA vaccines.

“In view of this, we will streamline the process for administering booster vaccination doses of mRNA vaccines, by reducing the post-vaccination observation time from 30 minutes to 15 minutes,” MOH said. 

SHORTENING OF EXEMPTION PERIOD AFTER RECOVERY

From Jan 1 next year, people who are not fully vaccinated and who have recovered from COVID-19 will only be given a 180-day exemption after infection to enter settings where vaccination-differentiated safe management measures are implemented, MOH said. 

This is reduced from the current exemption period of 270 days. The exemption period will be calculated from the day of the first positive polymerase chain reaction (PCR) test obtained in Singapore. 

“The adjustment is made due to concerns over the transmissibility and heightened reinfection risk of the Omicron variant, and quicker waning of protection acquired through past infections,” MOH said.

"These recovered persons who are not fully vaccinated should seek to complete their primary series vaccination regime promptly."

Non-vaccinated people who have recovered from COVID-19 before Jan 1, 2022, will also have their exemption period reduced from 270 days to 180 days.

For those who will already exceed the 180-day period as of Jan 1, 2022, they will be granted an additional one-month grace period until the end of January to complete their primary series vaccination regimen.

Recovered people only need one dose of an mRNA COVID-19 vaccine or two doses of the Sinovac vaccine under the national vaccination programme to complete their primary series vaccination regime by Jan 17 next year, MOH said.

This will allow an interval of 14 days from the completion of the regimen to be considered fully vaccinated. 

"During the grace period from the date when they have exceeded the 180-day period, these individuals can produce their discharge memo for entry into VDS settings," said MOH.

Mr Wong said that with the daily number of cases coming down in the past few weeks, there was a "sense of hope" that things would improve soon.

"Unfortunately, the pandemic is not ending soon. In some ways, this is perhaps the calm before the next storm," he added.

"So, we do have to brace ourselves for the Omicron wave. We have dealt with such waves before and we can do it again."

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Source: CNA/ja(mi)

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