Adult vaccination rates in Singapore are largely dismal as many believe that they are not necessary. Doctors say that adults still believe that vaccines are only needed for children or those going abroad.

"People tend to think of vaccinations as something for kids, but there are vaccinations that people should be getting regularly," said Adjunct Associate Professor Lim Poh Lian who is also deputy clinical director of the Communicable Disease Centre at Tan Tock Seng Hospital.

Medisave rebate to attract adults

To encourage adults taking vaccines, Senior Minister of State for Health Dr Lam Pin Min said that Singaporeans who fall within the target groups will be able to use up to SGD400 of their Medisave savings to pay for the vaccinations from 1 November at hospitals, polyclinics and private clinics on the Community Health Assist Scheme.

Last weekend, the Ministry of Health (MOH) announced the National Adult Immunisation Schedule (NAIS), which includes a list of seven vaccines that most Singaporeans should take at some point in their adult lives.

According to the National Health Surveillance Survey 2013, between 14% – 20% of people aged 50 and above had taken the flu vaccine, which costs SGD20 – SGD30 whereas only 5% – 8% of people in the same age group had taken the pneumococcal vaccine. Pneumococcal vaccines usually cost between SGD70 – SGD170.

To add to the burden some vaccinations require patients to pay upfront.

“When some patients know they have to pay upfront for a vaccine, there...will be some reluctance,” said Dr Vincent Chua.

Dr Lam hopes the new effort of allowing Singaporeans to use their Medisave savings will encourage more adults to take up vaccinations.

“I would even propose providing the influenza vaccine free to adults and children annually in order to increase the vaccine uptake,” said Associate Prof Hsu.

Medisave can be used to pay for vaccinations recommended by the National Adult Immunisation Schedule (NAIS), among other benefits. Photo credit: MOH, Singapore
Medisave can be used to pay for vaccinations recommended by the National Adult Immunisation Schedule (NAIS), among other benefits. Photo credit: MOH, Singapore

Educating adults about vaccines is top priority

Despite the new efforts in place, doctors say that there is more that needs to be done to encourage adults to get the necessary vaccines.

Most patients may know of influenza jabs, but protection against diphtheria or tetanus “are off the radar”, said general practitioner (GP) Tan Tze Lee. He also added that most people “do not understand the need for vaccinations.”

Doctors suggest that public education is necessary to get people to get vaccinated.

“People think that it would not happen to them, so they will ask why they need to get the vaccination,” said Dr Sunil Kumar Joseph.

Associate Prof Hsu urged for healthcare workers and the Health Promotion Board should work together to increase awareness and acceptance of adult vaccination.

“Some of the groups recommended by the Health Ministry for various vaccines could also be broadened,” he added, “The influenza vaccine should be recommended for all adults unless there are specific contraindications such as allergy to the vaccine, for instance.”

Currently, MOH is recommending the influenza vaccines only to persons aged 65 and above, pregnant women, those whose immune systems are compromised or who are receiving long-term or intermediate care services, among other groups.

An ongoing effort within the medical community

Singapore’s medical community has acknowledged the need to raise public awareness and improve the knowledge of local GPs in using vaccines.

Last year, four organisations – Singapore Medical Association, Society of Infectious Disease (Singapore), College of Physicians Singapore and the College of Family Physicians Singapore – have jointly launched an adult vaccination guide. 

"The book serves as a first step in educating the public on the usefulness of vaccination for disease prevention," asserted Professor Leo Yee Sin, director of the Institute of Infectious Diseases and Epidemiology at Tan Tock Seng Hospital (TTSH).

The guide is not for sale, but an e-copy can be found online, such as on the website of the Institute of Infectious Diseases and Epidemiology. MIMS

Read more:
“7 against 11”: NAIS by MOH to encourage adult vaccinations among Singaporeans
The unending battle of getting the world vaccinated
UN Global Burden of Disease Study: Singapore ranks first in achieving health-related targets