1. To facilitate the take up of important vaccinations amongst adults and help individuals make more informed decisions, the Ministry of Health (MOH) has established the National Adult Immunisation Schedule (NAIS) to provide guidance on vaccines that persons aged 18 years and older should adopt to protect themselves against vaccine-preventable diseases.
2. From 1 November 2017, Medisave can be used to pay for recommended vaccinations for the specific target adult population groups under the NAIS.
3. Currently, the National Childhood Immunisation Programme (NCIP) aims to achieve herd immunity among children in the population and reduce the risk of disease outbreaks. With the NAIS, adults who have not been previously vaccinated or who are at risk will be able to make more informed choices on vaccination for personal protection. Together, the NAIS and NCIP provide comprehensive vaccination recommendations for Singaporeans and residents for all ages.
4. Senior Minister of State for Health Dr Lam Pin Min said, “Vaccination provides a person with protection against infectious diseases, and is one of the strategies to reduce the risk of disease outbreaks in the community. While the coverage for vaccinations under the National Childhood Immunisation Programme has been high for most of the vaccines, there is low awareness of the benefits of adult vaccination for personal protection and protection of at-risk family members. With the introduction of the National Adult Immunisation Schedule (NAIS), we hope to encourage Singaporeans to take up the recommendations made in the NAIS, to protect themselves and their loved ones against the relevant infectious diseases.”
Vaccines under NAIS
5. The NAIS will provide the public and healthcare professionals with information on the necessary vaccinations, targeted groups who should be vaccinated and frequency of vaccination. It was developed based on the recommendations of the national Expert Committee on Immunisation (ECI), and comprises seven types of vaccines that protect against 11 diseases, including:
(i) Influenza;
(ii) Pneumococcal (PCV13/PPSV23);
(iii) Human Papillomavirus (HPV2/HPV4);
(iv) Tetanus, Diphtheria and Pertussis (Tdap);
(v) Measles, Mumps and Rubella (MMR);
(vi) Hepatitis B; and
(vii) Varicella.
6. In deriving the recommendations, the ECI had examined the specific adult groups’ vulnerability to vaccine-preventable diseases. Considerations include age, occupation, pre-existing medical conditions, vaccination history, as well as efficacy and cost effectiveness of the vaccines. Individuals are advised to discuss their vaccination needs and suitability to receive the recommended adult vaccines with their doctor.
7. MOH regularly reviews its vaccination policies in consultation with the national Expert Committee on Immunisation (ECI), taking reference from latest international best practice.
Extension of Medisave
8. To enhance vaccination coverage and help Singaporeans pay for the recommended adult vaccines, Singaporeans will be able to use up to $400 of their Medisave per account, under the Medisave400 scheme, for all recommended vaccinations for the target adult population groups in the NAIS. This will take effect from 1 November 2017.
9. Singaporeans can use their Medisave for NAIS vaccinations at Medisave-accredited healthcare institutions, such as hospitals, polyclinics, and CHAS GP clinics. The list of recommended adult vaccinations and FAQ can also be found on https://www.moh.gov.sg/NAIS.
Summary of National Adult Immunisation Schedule (NAIS)
(For persons aged 18 years and older)
Vaccine | 18-26 years | 27-64 years | ≥ 65 years |
Influenza* | 1 dose annually | 1 dose annually | |
Pneumococcal* † | 1 or 2 doses§ | 1 dose each§ | |
Human papillomavirus (HPV)† | 3 doses |
|
|
Tetanus, diphtheria and pertussis (Tdap)¶ | 1 dose for each pregnancy | ||
Measles, mumps and rubella (MMR)† ¶ | 2 doses | ||
Hepatitis B† | 3 doses | ||
Varicella | 2 doses | ||
| Recommended for adults who have not been previously vaccinated or lack evidence of past infection/immunity (Please consult your doctor for more details) |
| Recommended for adults with specific medical conditions and indications (Please consult your doctor for more details) |
* Also recommended for specific groups of children.
† Also included in the National Childhood Immunisation Schedule (NCIS).
§ Refer to next page for more details
¶ Protection against three diseases through one vaccination
National Adult Immunisation Schedule – recommended groups and vaccination schedule
(For persons aged 18 years and older)
Vaccines | Recommended Groups | Schedule |
Influenza* | • Persons aged 65 years or older; • Persons aged 18 years and receiving long-term aspirin therapy; • Persons who have chronic medical conditions such as diabetes mellitus, asthma, and heart disease; • Persons who are immunocompromised; • Persons receiving intermediate and long term care services; • Women at all stages of pregnancy. | 1 dose annually |
Pneumococcal* † § | • Persons aged 65 years or older | 1 dose each¶ |
• Persons aged 18 years and older with chronic illnesses such as chronic lung, heart, kidney or liver diseases and diabetes mellitus; • Persons who are immunocompromised or with other medical conditions.** | 1 or 2 doses††
| |
Human papillomavirus (HPV)† §§ | • Females aged 18 to 26 years | 3 doses (0, 1-2, 6 months) |
Tetanus, diphtheria and pertussis (Tdap) | • Pregnant women (for each pregnancy) | 1 dose per pregnancy (16-32 weeks)¶¶ |
Measles, mumps and rubella (MMR)† | • Adults without evidence of immunity and/or prior disease | 2 doses (0, 4 weeks) |
Hepatitis B† | • Adults without evidence of immunity and/or prior disease | 3 doses (0, 1, 6 months) |
Varicella | • Adults without evidence of immunity and/or prior disease | 2 doses (0, 4-8 weeks) |
Contraindications:
Persons who have had severe allergic reaction after a previous vaccination or allergies to specific vaccine components should not receive the vaccine, and those who are severely immunocompromised or are pregnant should not receive live vaccines such as MMR or varicella vaccines.
* Also recommended for specific groups of children, including those with medical conditions or immunocompromised or with other rare conditions.
† Also included in the National Childhood Immunisation Schedule (NCIS)
§ Pneumococcal vaccines in the NAIS include 13-valent pneumococcal conjugate vaccine (PCV13) and 23-valent pneumococcal polysaccharide vaccine (PPSV23).
¶ One dose each of PCV13 and PPSV23 is recommended for persons aged 65 years and above.
** Other medical conditions include: Persons with cochlear implants or cerebrospinal fluid leaks; persons with anatomic or functional asplenia (including conditions such as homozygous sickle cell disease and coeliac syndrome that may lead to splenic dysfunction).
†† The number of recommended doses and vaccine type depend on medical condition and age. Please consult your doctor for more details.
§§ Also recommended for females aged 9 to 17 years. Two types of HPV vaccines are in the NAIS – bivalent HPV vaccine (HPV2) and quadrivalent HPV (HPV4) vaccine.
¶¶ Tdap can also be considered for pregnant women after 32 weeks of gestation during each pregnancy. Please consult your doctor for more details.
Reference: Ministry of Health
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