Covid-19: Fewer seniors up-to-date with vaccinations; 7.5% of unvaccinated seniors infected this year fell seriously ill

SINGAPORE — Despite the benefits of vaccinations among people aged 60 and above, the proportion who are updated with their Covid-19 vaccinations have been declining, and more of those who are unvaccinated are getting seriously ill after infection, compared to those who are vaccinated.

The uptake has fallen from 58 per cent in the beginning of this year to 50 per cent now, Health Minister Ong Ye Kung said in Parliament on Tuesday (May 9). 

At the same time, the Ministry of Health (MOH) has seen a higher proportion of unvaccinated persons aged 60 and above developing severe illnesses and having to be hospitalised after contracting Covid-19, compared to those who had been vaccinated. 

Over the first four months of the year, about 7.5 per cent of those aged 60 and above who were unvaccinated developed severe illnesses and had to be hospitalised. And for those with minimum protection, such as three doses of the Pfizer-BioNTech or Moderna vaccines or Novavax vaccine, or four doses of Sinovac, the rate of severe illnesses was about 4 per cent. 

For those with minimum protection and have kept their vaccination updated, such as having received their last shot less than 12 months ago, the incidence of severe illnesses is even lower, at 3.4 per cent, Mr Ong said.

He added that these incidence rates are "overestimates" because of under-reporting of milder cases of Covid-19. 

He was responding to a question by Member of Parliament (MP) Shawn Huang from Jurong Group Representation Constituency (GRC) on what long-term measures have been taken to ensure that elders have adequate protection against the coronavirus, and whether more Covid-19 vaccinations are required in the long term. 

Mr Ong said of people not staying up to date on their vaccinations: "If this trend continues, our resilience against Covid-19 will weaken over time, making ourselves vulnerable to the virus again."

He said that falling vaccination rate, even among the vulnerable segments of the population, is due to a few reasons.

"There is a common thinking among seniors that, 'I seldom go out of my home and hence, I don’t have to take the vaccinations'. This is not recommended," he added.

"The current Omicron variants are highly infectious, and we no longer impose social restrictions, so even if you do not go out of your home, it can find their way to your home, through visiting family members or anyone you may come into contact with."

Some seniors are also concerned about the risk of side effects if they take more vaccination shots, Mr Ong noted.

He pointed out that "hundreds of millions" of doses of vaccines have been administered globally, and the incidence of severe adverse reactions is very low in Singapore, at about seven in 100,000 doses, and this is even lower at one in 100,000 doses with the latest bivalent formulations for the messenger ribonucleic acid (mRNA) vaccines such as Pfizer-BioNTech and Moderna.

"In other words, the benefits of the Covid-19 vaccines continue to far outweigh the risks, and you should keep your vaccination updated." 

Mr Ong also said that the current infection wave is the first that Singapore has encountered since it lowered its indicator (Dorscon green) for the overall disease situation, and the nation "weathered through it, without imposing any further public health measures". 

"However, we can maintain this public health posture provided that we continue to take our Covid-19 vaccinations." 

Dorscon refers to the Disease Outbreak Response System Condition, which is a colour-coded framework that also provides general guidelines on what needs to be done to prevent and reduce the impact of infections. 

Mr Ong added that Covid-19 did not become a milder disease when Singapore transited to Dorscon Green.

"In fact, it remains a dangerous disease. But our population resilience has strengthened due to vaccinations, boosters and safe recovery from infections. These are the reasons which enabled us to treat it as an endemic disease.

"So it is of critical importance that we continue to take vaccinations based on MOH’s latest recommendations, to keep the level of our resilience high." 

CASES OF MYOCARDITIS FROM VACCINATIONS 'GENERALLY MILD' 

As of April 27 this year, out of more than 17 million Covid-19 vaccine doses administered in Singapore, there were 160 reports of myocarditis and pericarditis, Mr Ong said. 

Myocarditis is an inflammation of the heart muscle while pericarditis is the swelling and irritation of the tissue surrounding the heart. Both are possible side effects of the vaccine.

Of the 160 reports, 32 per cent had initial symptoms reported within one day of vaccination, another 20 per cent reported within two days and another 24 per cent reported within one week.

"The majority of cases of myocarditis from vaccination are generally mild and respond to treatment," he added. 

Myocarditis tends to affect young males who are 12 to 30 years old, he noted.

The incidence of vaccine-related myocarditis in this age group here is "very low" at about one in 100,000 doses and is even lower at 0.1 in 100,000 doses with the latest bivalent mRNA formulations, he said.

Separately, Jurong GRC MP Tan Wu Meng asked for updates on the Vaccine Injury Financial Assistance Programme (Vifap), such as the number of applications for the programme from people with cardiac conditions. 

Mr Ong said that about 340 Vifap applications are cardiology-related, and 81 of the applications were approved and financial assistance have been extended to the applicants.

Myocarditis was picked up as a safety signal and reported in June 2021, and that a look-back at Vifap applications from before June 2021 did not identify anyone with myocarditis.

"At present, the Covid-19 vaccines are not known to be causally associated with any other cardiac conditions other than myocarditis," he added.