The Ministry of Health (MOH) has introduced a vaccination schedule, the National Adult Immunisation Schedule (NAIS) for Singaporean adults aged 18 and above. This is to encourage adult preventive care towards possible disease outbreaks in the community. Depending on their age and health, Singaporean adults can also use up to SGD400 annually for the vaccinations, with the Medisave400 scheme.

The NAIS was formed based on recommendations by the Expert Committee on Immunisation, comprising officials from MOH, government agencies, and doctors. It includes lists detailing who should be vaccinated and when, including immunisation for diseases such as the flu and hepatitis B.

Commencing 1 November, MOH hopes that NAIS will "provide guidance on vaccinations that persons aged 18 years and older should adopt to protect themselves against vaccine-preventable diseases".

NAIS lists 7 vaccines to protect against 11 diseases

The NAIS has listed seven vaccines that protect against 11 diseases, including influenza, human papillomavirus (HPV2/HPV4), pneumococcal (PCV13/PPSV23), tetanus, diphtheria and pertussis (Tdap), measles, mumps and rubella (MMR), hepatitis B and varicella.

Summary of National Adult Immunisation Schedule (NAIS) for persons aged 18 years and older. Source: MOH Singapore
Summary of National Adult Immunisation Schedule (NAIS) for persons aged 18 years and older. Source: MOH Singapore

For those who are eligible, they can be vaccinated at Medisave-accredited healthcare institutions, such as hospitals, polyclinics, and the GP clinics under Community Health Assist Scheme (CHAS).

According to health experts in Singapore, allowing people to use their Medisave accounts would make vaccinations more affordable, besides being able to increase the health standards among the public. In any case, vaccines remain as one of the most cost-effective ways to prevent infectious diseases. 

Annual vaccinations against influenza are encouraged among adults aged 65 and above. Similarly, vaccinations against HPV are also recommended for all women aged between 18 and 26, to help in reducing risk of cervical cancer.

According to Senior Minister of State for Health and Transport Dr Lam Pin Min, for those aged 65 and above, 56 out of every 100,000 hospital cases involve pneumococcal disease, which can cause pneumonia. This risk can be reduced by vaccination, which costs between SGD70 and SGD170.

NAIS for Singaporean adults aged 18 and above – recommended groups and vaccination schedule. Source: MOH Singapore
NAIS for Singaporean adults aged 18 and above – recommended groups and vaccination schedule. Source: MOH Singapore

MOH advised Singaporean adults to discuss their vaccination needs with their doctor, as factors like age, occupation, pre-existing medical conditions, vaccination history, as well as the efficacy and cost-effectiveness of the vaccines will be taken into consideration.

Dr Chia Shi-Lu, chairman of the Government Parliamentary Committee for Health, also commented that, "whether someone needs these vaccinations, such decisions should be made in consultation with their doctors."

NAIS to boost awareness of adult vaccination

Citing the National Health Surveillance Survey in 2013, an MOH spokesperson stated that vaccination coverage is low among Singaporean adults. The survey found that only 14% – 20% of Singaporeans above the age of 50 have had an influenza vaccination.

In addition, there has also been a lack of awareness among older Singaporeans of the benefits of adult vaccination, remarked Dr Lam, in a speech announcing NAIS, at the Singapore Prevention and Cardiac Rehabilitation Symposium on 21 October.

"While the coverage for vaccinations under the National Childhood Immunisation Programme (NCIP) has been high for most of the vaccines, there is low awareness of the benefits of adult vaccination for personal protection and protection of at-risk family members.

The similar scheme for children – the National Childhood Immunisation Programme – has been effective over years, yet the benefits of adult vaccination are not highly aware among adults, highlighted Dr Lam. Vaccines for children below the age of 11 had been introduced since mid-1950s, covering vaccination against tuberculosis, hepatitis B, diphtheria, pertussis and tetanus (DPT), poliomyelitis, MMR, pneumococcal, and HPV. "If a sufficiently large proportion of the population is vaccinated, there is a corresponding herd immunity that results in some protection for the rest that are not," said Associate Professor Hsu Li Yang of the Saw Swee Hock School of Public Health at the National University of Singapore. MIMS

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Sources:
http://www.straitstimes.com/singapore/moh-introduces-immunisation-schedule-for-adults?login=true
http://www.todayonline.com/singapore/moh-introduces-new-list-recommended-vaccine-jabs-adults
http://www.channelnewsasia.com/news/singapore/adults-can-soon-use-medisave-to-pay-for-vaccines-recommended-by-9331506
http://www.ibtimes.sg/singapore-health-ministry-new-immunisation-scheme-medisave-adults-positive-expert-old-age-healthcare-18453