Getting vaccinations for your child in Singapore

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In order to encourage more Singaporean adults to be protected from preventable diseases, the Ministry of Health of Singapore (MOH) established the National Childhood Immunisation Programme (NCIP) which reminds parents to be more proactive when it comes to immunisation for their children. Parents are strongly encouraged to have their children vaccinated against all the diseases stated in the NCIP according to the recommended age bracket. Vaccination protects not just the individual but the community as a whole, creating a herd immunity that is unfavourable for the spread of diseases.[1]

National Childhood Immunisation Programme (NCIP)

The NCIP covers a variety of diseases that children are susceptible to, including vaccinations against Diphtheria and Measles, which are compulsory by law.[2] While the rest of the vaccinations are not mandated and require parental consent, children are required to be immunised against certain diseases before they can register for primary school education. These include BCG, Pertussis, Poliomyelitis, Mumps, Rubella and Hepatitis B.

It should be noted that Influenza vaccinations are not suitable for infants below 6 months, so in order to provide newborns with maximum protection, mothers are encouraged to receive the Influenza vaccination during the course of her pregnancy.[3]

Immunisation table[4]

Age Vaccine Disease
Birth
  • BCG
  • HepB dose 1
  • Tuberculosis
  • Hepatitis B
3 Months
  • DTaP dose 1
  • IPV dose 1
  • Hib dose 1
  • PCV dose 1
  • Diphtheria, Pertussis & Tetanus
  • Poliomyelitis
  • Haemophilus influenza type B
  • Pneumococcal Disease
4 Months
  • DTaP dose 2
  • IPV dose 2
  • Hib dose 2
  • Diphtheria, Pertussis & Tetanus
  • Poliomyelitis
  • Haemophilus influenza type B
5 Months
  • HepB dose 3
  • DTaP dose 3
  • IPV dose 3
  • Hib dose 3
  • PCV dose 2
  • Hepatitis B
  • Diphtheria, Pertussis & Tetanus
  • Poliomyelitis
  • Haemophilus influenza type B
  • Pneumococcal Disease
5 - 6 Months
  • HepB dose 3
  • Hepatitis B
12 Months
  • MMR dose 1
  • PCV booster
  • Measles, Mumps & Rubella
  • Pneumococcal Disease
15 - 18 Months
  • MMR dose 2
  • Measles, Mumps & Rubella
18 Months
  • DTaP booster 1
  • IPV booster 1
  • Hib booster 1
  • MMR dose 2
  • Diphtheria, Pertussis & Tetanus
  • Poliomyelitis
  • Haemophilus influenza type B
  • Measles, Mumps & Rubella
10 - 11 Years
  • Tdap booster 2
  • OPV booster 2
  • Tetanus toxoid, reduced diphtheria toxoid and acellular pertussis
  • Poliomyelitis
9 - 26 Years
  • HPV (3 doses)
  • Human Papillomavirus

Parents are reminded to bring along their child’s past immunisation records during each appointment. In the case where the child falls behind the immunisation schedule, he or she can still catch up with the missing shots without having to start the whole schedule again.[5] Parents can view their child's immunisation records through the National Immunisation Registry’s (NIR) website using their SingPass password (NIR portal).[6]

Common preventable diseases

Tuberculosis

Tuberculosis is a serious infectious disease that usually attacks the lungs. The bacteria that cause the disease are spread through tiny droplets released into the air via coughs and sneezes.[7]

Human Papillomavirus (HPV)

HPV is the major cause of cervical cancer as it is transmitted through sexual contact and causes infection to the cervix and genitals. In most cases, the virus can be cleared by the body’s own immune system. However, in some cases, a persistent infection may develop into cervical cancer. Starting from 2019, the Singapore government will be offering free HPV vaccinations for Secondary 1 girls as the recommended age of vaccination is between 9 to 26 years old.[8] The HPV vaccine is highly recommended by healthcare professionals and parental consent has to be given before the vaccine can be administered.

Pertussis

Commonly known as the “whooping cough”, Pertussis is a very contagious disease that infects infants and children. It can lead to pneumonia and lung infection.[9] All Singaporeans are vaccinated against Diphtheria, Tetanus, and Pertussis (DTaP) during infancy, as required by the law.[10]

Tetanus

This is an untreatable disease developed from wounds that have been infected by a bacterium commonly found in soil, dust and animal faeces. Tetanus will lead to severe spasms, blockage of the pulmonary artery or even death.[11] All Singaporeans are vaccinated against Diphtheria, Tetanus, and Pertussis (DTaP) during infancy, as required by the law.[12]

Diphtheria

Diphtheria is a contagious and life-threatening bacterial infection that mainly affects the throat. However, in more serious cases, it may lead to the blockage of the breathing passage or even damage the heart and nerves. All Singaporeans are vaccinated against Diphtheria, Tetanus, and Pertussis (DTaP) during infancy, as required by the law.[13]

Side effects of vaccinations

Vaccination is generally a very safe procedure provided that the child does not have any serious allergies or other underlying health issues. That being said, parents are reminded to inform the doctor about the child’s health condition before the procedure.

Side effects such as mild fever, rash or sore arm may occur after the injection. BCG vaccination will result in a small raised bump and scarring at the injection site. While there used to be a common belief that the MMR vaccination may increase chances of autism, this myth has been debunked by doctors around the world as there is no proven association of vaccines with Autism Spectrum Disorder (ASD).[14] However, like all other medications, some children may develop severe reactions but such cases are rare. Parents should seek medical help if the child develops a high fever, severe rash or swelling, fits or breathing difficulties.[15]

Costs of vaccinations

All recommended vaccinations under the NCIP (except PCV and HPV) are fully subsidised and provided free of charge at all polyclinics for children who are Singapore citizens. The average cost of a PCV vaccine is S$150 while the cost of HPV vaccines ranges from S$285 to S$744, depending on the type of vaccine and choice of clinic.[16][17]

Baby Bonus

Parents can also pay for vaccinations using their child’s baby bonus cash gift and the savings in his or her Child Development Account (CDA) at any Baby-Bonus-approved healthcare institutions. The Baby Bonus and CDA can also be used to finance siblings’ vaccinations.[18]

Medisave

Singaporeans are allowed to withdraw up to S$400 from their Medisave account yearly under the Medisave400 scheme. All recommended vaccinations under the NCIP would be routinely offered to parents who bring their children for immunisation or whenever opportunities arise as a standard of care.[19]

References / Citations

  1. Chong, Siow Ann. “Herd immunity and how health choices affect those around you”. The Straits Times. April 29, 2017. Accessed on 5 April 2019. Retrieved from: https://www.straitstimes.com/opinion/herd-immunity-and-how-health-choices-affect-those-around-you
  2. Ministry of Health. "CHAPTER 7: CHILDHOOD IMMUNISATION". Ministry of Health. Accessed on 27 June 2019. Retrieved from: https://www.moh.gov.sg/docs/librariesprovider5/resources-statistics/reports/childhood-immunisation.pdf
  3. Unantenne, Nalika. “Myths and facts about vaccinations”. theAsianparent Singapore. Accessed on 5 April 2019. Retrieved from: https://sg.theasianparent.com/myths-and-facts-about-vaccinations
  4. “Immunisation Chart Based On Age”. Baby Bonus. Accessed on 8 April 2019. Retrieved from: https://www.babybonus.msf.gov.sg/parentingresources/web/Young-Children/YoungChildrenWell-Being/Vaccinations/Young_Children_Immunisation_Chart?_adf.ctrl-state=pq6tu5c4b_4&_afrLoop=2526659664618541&_afrWindowMode=0&_afrWindowId=null#%40%3F_afrWindowId%3Dnull%26_afrLoop%3D2526659664618541%26_afrWindowMode%3D0%26_adf.ctrl-state%3D941brkclp_4
  5. “Vaccinations”. SingHealth. February 21, 2019. Accessed on 8 April 2019. Retrieved from: https://www.singhealth.com.sg/patient-care/conditions-treatments/vaccinations-childhood-illnesses
  6. “Immunisation Chart Based On Age”. Baby Bonus. Accessed on 8 April 2019. Retrieved from: https://www.babybonus.msf.gov.sg/parentingresources/web/Young-Children/YoungChildrenWell-Being/Vaccinations/Young_Children_Immunisation_Chart?_adf.ctrl-state=pq6tu5c4b_4&_afrLoop=2526659664618541&_afrWindowMode=0&_afrWindowId=null#%40%3F_afrWindowId%3Dnull%26_afrLoop%3D2526659664618541%26_afrWindowMode%3D0%26_adf.ctrl-state%3D941brkclp_4
  7. “Tuberculosis”. Mayo Clinic. January 30, 2019. Accessed on 8 April 2019. Retrieved from: https://www.mayoclinic.org/diseases-conditions/tuberculosis/symptoms-causes/syc-20351250
  8. Elangovan, Navene. “Free HPV vaccination: Doctors hail move, but mixed views among parents and teens.” Today. March 7, 2019. Accessed on 8 April 2019. Retrieved from: https://www.todayonline.com/singapore/free-hpv-vaccination-doctors-hail-move-mixed-views-among-parents-and-teens
  9. “Healthy Start For Your Baby”. Health Promotion Board. July, 2016. Accessed on 8 April 2019. Retrieved from: https://www.healthhub.sg/sites/assets/Assets/PDFs/HPB/Healthy%20Start%20For%20Your%20Baby/Healthy-start-for-your-baby.pdf
  10. “National Childhood Immunisation Schedule”. Health Promotion Board. August 26, 2016. Accessed on 3 April 2019. Retrieved from: https://www.nir.hpb.gov.sg/nirp/eservices/immunisationSchedule
  11. “Tetanus”. Mayo Clinic. February 22, 2019. Accessed on 3 April 2019. Retrieved from: https://www.mayoclinic.org/diseases-conditions/tetanus/symptoms-causes/syc-20351625
  12. “National Childhood Immunisation Schedule”. Health Promotion Board. August 26, 2016. Accessed on 3 April 2019. Retrieved from: https://www.nir.hpb.gov.sg/nirp/eservices/immunisationSchedule
  13. “National Childhood Immunisation Schedule”. Health Promotion Board. August 26, 2016. Accessed on 3 April 2019. Retrieved from: https://www.nir.hpb.gov.sg/nirp/eservices/immunisationSchedule
  14. Unantenne, Nalika. “Myths and facts about vaccinations”. theAsianparent Singapore. Accessed on 5 April 2019. Retrieved from: https://sg.theasianparent.com/myths-and-facts-about-vaccinations
  15. Jaya. “Vaccination schedule in Singapore for babies and children. theAsianparent Singapore. Accessed on 8 April 2019. Retrieved from: https://sg.theasianparent.com/vaccination-schedule-in-singapore
  16. “HPV Vaccine Singapore - Cost Guide to Getting Vaccinated Against Cervical Cancer”. Money Smart. March 21, 2019. Accessed on 5 April 2019. Retrieved from:  https://blog.moneysmart.sg/healthcare/hpv-vaccine-singapore/
  17. “How much do vaccines cost in Singapore?”. UEX. May 9, 2018. Accessed on 3 April 2019. Retrieved from: https://uexglobal.com/2018/05/09/costs-vaccinations-singapore/
  18. “Healthy Start For Your Baby”. Health Promotion Board. July, 2016. Accessed on 8 April 2019. Retrieved from: https://www.healthhub.sg/sites/assets/Assets/PDFs/HPB/Healthy%20Start%20For%20Your%20Baby/Healthy-start-for-your-baby.pdf
  19. “Healthy Start For Your Baby”. Health Promotion Board. July, 2016. Accessed on 8 April 2019. Retrieved from: https://www.healthhub.sg/sites/assets/Assets/PDFs/HPB/Healthy%20Start%20For%20Your%20Baby/Healthy-start-for-your-baby.pdf