Staying nimble against Covid-19 instead of setting trigger points like case numbers

Eight MPs posed additional questions about vaccinations and vaccination-differentiated safe management measures (VDS) for children in Parliament on Monday (Jan 10). Here are the edited excerpts of key exchanges:

Mr Pritam Singh, Leader of the Opposition (Aljunied GRC):

To what extent will the Ministry of Health (MOH) allow parents to wait until non-mRNA vaccines are approved for their children's inoculation to give them more choice and to assuage their concerns (about long-term effects)?

One such non-mRNA vaccine company, Novavax, submitted data for approvals to Singapore's Pandemic Special Access Route (PSAR) on Nov 22.

Has Novavax or any other non-mRNA vaccine maker submitted data for the authorisation for use for children above the age of 12, and if so when can these vaccines be expected to be introduced in the national vaccination programme?

Minister for Health Ong Ye Kung:

The Pfizer-BioNTech (Comirnaty) vaccine has gone through extensive clinical trials, and during the clinical trials it was shown to be safe and effective. Specifically for myocarditis, which is what most parents are concerned about in children, there are about 8.5 million already vaccinated in the US and the incidence rate is about one in a million in the US.

You have to balance this against the downside of getting infection. If infected, chances of myocarditis is 450 in a million and there are also other effects such as multisystem inflammatory syndrome (MIS-C) which can make the child really sick.

On the question of Novavax - it is being assessed by the Health Sciences Authority. I think we need to let the scientists do their work. And I think we should consider putting it into our national vaccination programme.

In the meantime, Omicron is upon us, it is highly transmissible. We do not want to rule out that even if a small percentage of children get very sick, we might be looking at a significant number.

So I would suggest get your child vaccinated with an mRNA vaccine given the circumstances. I think it is the right thing to do now.

Mr Yip Hon Weng (Yio Chu Kang):

Some young children may have undetected medical conditions and especially allergies if their parents do not send them for non-mandatory medical reviews.

As such, I wish to ask whether MOH will advise all young children to undergo a medical review before going ahead with the Covid-19 vaccination.

This is similar to how some adults with underlying medical conditions are advised to get clearance from the doctor in the early stages of the vaccination drive.

Senior Minister of State for Health Janil Puthucheary:

We took that approach in the early stages of the adult vaccination drive because at that time, the amount of data that we had was less and the amount of experience that we had was less and now we know a lot more about both the disease, as well as the vaccination, including in children.

So the approach for children is not so different from adults. If they have an underlying condition, and there's a list, the doctor will know about it. But if the child is otherwise healthy, then the recommendation is to proceed with vaccination.

The issue of allergies is slightly different in that for any drug, you can't necessarily tell whether an allergy will happen or not happen, on the basis of prior underlying conditions. Hence, the team at the site of the vaccinations is trained to detect and deal with rare allergies that do happen.

So the short answer to the member's question whether all children have to go for medical review prior to Covid-19 vaccination is no.

Ms Foo Mee Har (West Coast GRC):

Boosters are shown to increase protection against infection and severe illness, including Omicron, substantially. Is MOH contemplating the imposition of booster jab as a requirement for vaccinated travel lane travellers beyond the current requirement of two jabs only?

Mr Ong:

We do know that two doses doesn't last forever. The European Union has already implemented a guideline that is similar to us - nine months validity or 270 days.

So I think the world will converge towards some form of validity I believe, and naturally this will become a requirement in due course - that is my conjecture.

Mr Louis Chua (Sengkang GRC):

Given what we know about Covid-19 today over the last one to two years worth of experience, may I ask if the Government will consider publishing the key quantitative and qualitative metrics and thresholds before decisions are made to actually change the safe management measures?

And I do understand the need to be nimble, but having a decision-making framework and matrix published would actually help businesses and consumers have greater confidence and clarity.

Mr Ong:

We don't want to be too rigid in setting parameters, trigger points. There's so many twists and turns in this pandemic.

We would rather be a bit more nimble and to be able to adapt, but we take the member's point.

We want to strike a balance, preserve the healthcare capacity, and at the same time allow people to live life as normally as possible, businesses to be able to operate, and be able to survive.

And each time we make a decision we do explain, show all the data - hospitalisation, ICU and so forth - to give a full rationale, with numbers, on why we decided that.

So I hope over time, people begin to understand what are our key considerations even though we may not be able to pinpoint trigger points.

Ultimately, it's not about the numbers that cause all this uncertainty. It's the fact that we're in the middle of a pandemic.

We were not entirely ready in the first year in terms of our resilience. Last year 2021 we are much better, and I do believe 2022 will be even better.

Hopefully this year, we can ride through waves with a much more liberal posture, that's how we keep on improving.

Non-Constituency MP Leong Mun Wai:

I received feedback from residents that some teachers have already practised VDS measures in schools. So can the Education Minister confirm that if teachers are practising that or any officers in the schools are practising that, that is against government policy at the moment?

Education Minister Chan Chun Sing:

Can I seek a clarification from Mr Leong for further information on which schools and what VDS measures have which teachers have been practising?

Mr Leong:

The resident who have feedbacked to me are on my WhatsApp messages. Can I refer to the messages and then I give a reply later? Thank you.

Mr Chan:

I would really appreciate if Mr Leong can give me the information of which teacher in which school has practised what VDS measures so that we can take the feedback seriously and then look into the necessary follow up if possible.

At this point in time, we have no plans on applying any VDS in our schools. We want as far as possible for our students to be able to participate in the core curriculum, in the school activities.

For certain selected activities that may be deemed of a higher risk, we may consider applying specific measures for them. For example, students participating in the playing of wind instruments or the choir, or students participating in sports activities that may require close physical contact.

I also caveated my explanation by saying that, of course, we will look at the overall national posture for us to adjust our policies accordingly.