Mr Pritam Singh (Aljunied): Thank you, Mr Speaker. Sir, I have two supplementary questions. The first pertains to a subject I believe that was covered both by the Minister for Health and the Minister for Education. This concerns the apprehension some parents have over the administration of mRNA vaccines for their children. These parents anecdotally are not anti-vax per se. Some of them may have taken the mRNA vaccine on their own, but the concern is really a visceral one. That is about the long-term effects, the fact that this vaccine is referred for emergency approvals and so forth; even though I think some have been granted FDA approval, Pfizer-BioNTech specifically.
To that extent, will MOH allow such parents to wait until non-mRNA traditional protein-based vaccines are approved for their children’s inoculation, so as to give them more choice and to assuage their concerns?
The second question follows. I understand that one such non-mRNA vaccine company, Novavax, submitted data for approval under Singapore’s Pandemic Special Access Route (PSAR) on 22 November. Director of Medical Services confirmed that few days ago, on 5 January that he was very optimistic Novavax will be authorised as a non-mRNA booster. My question is, if Novavax or any other non-mRNA vaccine maker has submitted data for the authorisation for use for children above the ages of 12, and if so, when can these vaccines be expected to be introduced on the National Vaccination Programme?
Just a very short follow-through on that, with regard to the point made by the Minister for Health on the 270 days that are required, the limit before you take a booster and then to be recognised still as being vaccinated, would there be some flexibility to allow Novavax at least to get on this programme and to allow more individuals to then be considered fully vaccinated?
Mr Ong Ye Kung: Thank you. I can fully appreciate parents’ concern about mRNA vaccine for children, they will be concerned about the long-term effects and whatever side effects there may be. Just a few facts, which is the children vaccine, Pfizer-BioNTech/Comirnaty, has gone through extensive clinical trials. And during the clinical trials, it was proven and shown to be safe and effective.
Specifically, myocarditis, which is what most parents are concerned about in children, it occurred, currently, there is about 8.5 million already vaccinated in the US and the incidence rate is about one in a million. And as Senior Minister of State Janil mentioned, we have to balance this against the downside of getting infection. If you are infected, the chances of myocarditis is 45 in a million and also other effects such as MIS-C, which can make the child really sick. [Please refer to “Clarification by Minister for Health”, Official Report, 10 January 2022, Vol 95, Issue 44, Clarification section.] And we have seen a handful, one or two a week when Delta was at its peak and they are admitted to ICU. Thankfully, all of them recovered.
So, there is good track record of safety and efficacy for the children’s vaccine. On the other hand, for children who are infected with COVID-19, while generally children are more resilient, we have seen cases of myocarditis and MIS-C. So, it is a pandemic crisis. We do have to weigh those costs and benefits.
I do have to add one more fact, which is that for the children vaccine, it is a diluted form. They are not taking the same adult vaccine. Pfizer-BioNTech for example, is one-third the dose of an adult’s.
So, these are the facts and parents will have to make the right decision. As of now, we are quite encouraged that many parents are coming forward and the paediatric vaccination exercise is actually gathering pace and many parents are coming forward to protect their children.
On the question of Novavax, it is being assessed by HSA, I think we need to let the scientists do their work. I think we should consider putting it into our National Vaccination Programme. We have always wanted a good portfolio of mRNA and non-mRNA vaccines. But, as for the timing, I think it may take a while more including for delivery, plus another process for assessing whether it is suitable for children, there is another set of data, another set of trials. So, I do not know how long it would take.
In the meantime, Omicron is upon us, highly transmissible, and we do not want to rule out that even a small percentage of children can get very sick; we might be looking at a significant absolute number. So, I would suggest, as Senior Minister of State Janil has advised, get your child vaccinated with mRNA, given the circumstances. It is not perfect, but I think given the circumstances, cause and benefits, the right thing to do now is to get your child vaccinated as quickly as possible.
Likewise, for the 270 days, I can understand what the Leader of Opposition is suggesting – whether we should wait for Novavax. But again, Omicron is upon us. While I hope we have the luxury of time to wait for a non-mRNA vaccine to be available, but with the impending Omicron wave, I think we should act quickly and therefore, we set the validity period of 270 days.
Ministry of Health
10 January 2022
https://sprs.parl.gov.sg/search/sprs3topic?reportid=oral-answer-2665
Office of the Leader of the Opposition 