Mr Dennis Tan Lip Fong asked the Minister for Health (a) what are the potential risks or side effects of taking COVID-19 vaccination for persons (i) between ages 12 and 18 and (ii) ages below 12; (b) whether the Government will consider not mandating vaccination for these groups of persons until more is known about the possible risks or side effects of the vaccination on them; and (c) whether there are plans to offer Sinovac or Sinopharm vaccines for children.

The Senior Minister of State for Health (Dr Janil Puthucheary) (for the Minister for Health): Sir, my response will also be addressing questions on similar topics filed by Ms Hany Soh, Dr Wan Rizal1 and Mr Sharael Taha for 11 January.

MOH commenced COVID-19 vaccinations using the paediatric formulation of Pfizer-BioNTech/Comirnaty vaccine on 27 December 2021, starting with older children and with a plan to progressively expand the programme to include younger children, which has now happened. The take-up so far has been encouraging. As of 7 January, about 123,000 children aged five to 11 have received at least one dose of the vaccine or booked their vaccination appointments.

In 2021, there were 15,540 children below the age of 12 who were infected with COVID-19, of which 3,145 had ever been in a hospital or a COVID facility. Fortunately, as of 8 January 2022, none of these children remain hospitalised. Although fewer children have been seriously ill with COVID-19 compared to adults, there is still a risk of them becoming seriously ill or developing severe COVID-19 complications such as Multisystem Inflammatory Syndrome in Children (MIS-C). Since mid-October 2021, we have observed several serious cases of COVID-19 in children, with some requiring intensive care.

This is why it is important for children aged five to 11 to take up the COVID-19 vaccination. The Pfizer/BioNTech COVID-19 vaccination for children has been assessed by HSA and our own Expert Committee on COVID-19 Vaccination (EC19V) to be safe. The assessment is corroborated with international data.

In the United States of America, where about 8.7 million doses had been administered to children as of 19 December 2021, most of the adverse events reported were not serious and no safety concerns have been raised; 2.4% of the children experienced serious adverse events such as fever, vomiting, myocarditis and seizures. The incidence of myocarditis, which is what many parents are most concerned about, is about one in a million doses. The children reported with myocarditis following vaccination had either recovered or were recovering at the time of the report. Vaccination will allow our children to be protected against the disease and reduce the likelihood of infecting others, including vulnerable or elderly family members. On the other hand, the incidence of myocarditis amongst individuals ages 12 to 17 infected with COVID-19, is about 45 per 100,000 infections. [Please refer to “Clarification by Minister for Health”, Official Report, 10 January 2022, Vol 95, Issue 44, Clarification section.] So, Members can see that the risk is much lower with the immunisation and hence, the benefits is much greater. 

To facilitate the vaccination of younger children, 15 designated paediatric vaccination centres (VCs) located islandwide are being progressively stood up. All 15 VCs will be manned by medical personnel trained in paediatric care and staff experienced in administering vaccinations for children.

To provide greater convenience for parents or guardians with more than one child or ward, from 10 January 2022 all accompanying siblings of a child with an appointment from Mondays to Thursdays can walk in for their vaccination without a prior appointment. MOH has also worked closely with MOE and the Early Childhood Development Agency (ECDA) to organise webinars with parents to address common concerns on the safety and efficacy of the COVID-19 vaccine.

Currently, there are no recommendations for children to receive booster shots. If introduced, MOH will continue to ensure that families with children are able to access vaccination services in a convenient manner.

As of 7 January 2022, MOH has not received any report of serious adverse events or myocarditis from vaccination in children in Singapore since the roll-out of the national vaccination programme to children aged five to 11. We will continue to monitor this closely.

We assure parents that all our designated paediatric VCs are equipped with paediatric monitoring and resuscitation equipment, and the medical personnel are trained to manage any on-site emergencies arising from allergic reactions. Most side effects experienced by children after vaccination have been mild, such as injection site pain, fatigue and fever, and they typically resolve in a few days. Members have asked if children are covered by VIFAP, and the answer is yes, as long as they are Singapore Citizens, Permanent Residents, or long-term pass holders.

At present, only the Pfizer-BioNTech/Comirnaty COVID-19 vaccine is authorised for use in children aged below 18 years. Special exemptions are made for those aged 12 to 17 years who are not medically eligible for the Pfizer-BioNTech/Comirnaty COVID-19 vaccine to receive the Sinovac-CoronaVac vaccine under a dedicated public health programme. MOH will work with the EC19V to review if the dedicated public health programme should be extended to children aged five to 11 who are medically ineligible to complete the Pfizer-BioNTech/Comirnaty COVID-19 vaccine based on further studies on the safety and effectiveness of Sinovac-CoronaVac vaccine.

Amongst those aged 12 to 19, less than 4% remain unvaccinated. As of 6 January 2022, there are 14,097 individuals between the ages of 12 to 19 who are unvaccinated, of which, only 14 are medically – 14, that is one four – 14 are medically ineligible for the Pfizer-BioNTech/Comirnaty COVID-19 vaccine.

 COVID-19 vaccination is an important national effort in our fight against the pandemic. Vaccination for children aged five to 11 will help to protect more members of our society from the risk of developing severe illness from COVID-19 infections and further minimise the risk of community spread. We strongly encourage all parents, all guardians to allow their children, who are medically eligible, to please take up the vaccine when offered to them.

Ministry of Health
10 January 2022

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