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Unvaccinated foreign travellers may be denied entry to Singapore under proposed changes to the law

SINGAPORE — Foreign travellers who are not vaccinated against serious infectious diseases may be denied entry into Singapore, as the Ministry of Health (MOH) steps up defences against the importation of diseases such as yellow fever.

Unvaccinated foreign travellers may be denied entry to Singapore under proposed changes to the law

The proposed changes come as infectious diseases such as avian influenza, Ebola, and Middle East Respiratory Syndrome are becoming "serious public health threats globally", the MOH said.

SINGAPORE — Foreign travellers who are not vaccinated against serious infectious diseases may be denied entry into Singapore, as the Ministry of Health (MOH) steps up defences against the importation of diseases such as yellow fever.

Under proposed changes to the Infectious Diseases Act – which opens for public consultation on Wednesday (June 27) – the authorities will have “discretionary powers” to return unvaccinated non-citizens to their places of embarkation without first offering them vaccination, isolation or surveillance.

Currently, only those who refuse to comply with vaccination, isolation or surveillance may be returned to their place of embarkation.

The proposed change is in line with international practice and discretionary powers will be used “judiciously” in scenarios where it is impractical to offer vaccination, isolation or surveillance, the MOH said.

“Unwell travellers arriving in Singapore will not be turned away, and will continue to receive medical attention as needed,” it said.

Infectious diseases such as bird flu, Ebola, and Middle East Respiratory Syndrome (Mers) have become serious public health threats globally. The government needs to protect the community here against new and emerging infectious diseases, both locally and overseas, the ministry said.

Currently, the law only requires people entering Singapore to be vaccinated against specific infectious diseases in line with the International Health Regulations (2005), an agreement among 196 countries including all World Health Organisation member states. For now, yellow fever – a mosquito-borne disease found mainly in Africa and Latin America that can be fatal – is the only infectious disease which travellers to Singapore must be vaccinated against.

A vaccine costs up to S$200 here and is the best protection against yellow fever.

Only travellers arriving from countries with risk of yellow fever transmission are required to be vaccinated against the disease when entering Singapore, the MOH told TODAY. Since 2016, there have been about 100 of such unvaccinated travellers. They are usually placed on phone surveillance for monitoring of health status and symptoms.

Experts welcomed the proposal. The risk of a yellow fever epidemic is at its highest in over 70 years, said Dr Duane Gubler, emeritus professor at Duke-NUS Medical School’s emerging infectious diseases programme. Yellow fever, which is transmitted by the same mosquito that transmits dengue, Zika and chikungunya, can cause “devastating epidemics with high mortality”, he said.

But with the list of diseases to be covered under the proposed amendment still undefined, some experts wondered if more diseases would be added.

Herd immunity – or the protection on the population afforded by vaccination – fails and a disease re-emerges if the proportion of the unvaccinated population becomes excessive, said Professor Ooi Eng Eong of Duke-NUS’ emerging infectious diseases programme.

“Preventing the proportion of non-immune individuals from exceeding this threshold that makes Singapore vulnerable to disease re-emergence and epidemics is thus sensible,” he said.

If diseases such as measles or diphtheria – which Singapore children are vaccinated against – are added to the list, migrant workers could be affected as many were not vaccinated during childhood, said Dr Leong Hoe Nam of Rophi Clinic. This will affect the cost of hiring such workers.

 

MORE FREEDOM FOR LOWER-RISK INDIVIDUALS

Other changes proposed by the MOH will allow for greater calibration of risk and result in fewer restrictions on those of lower risk.

Lower-risk contacts of an infectious case under surveillance will not need to make a trip to a specific location for an examination, and may be monitored via phone calls, text messages or video-conferencing.

They may also be allowed to visit certain places instead of being on strict home quarantine. And instead of a blanket stop-work order, they may be allowed to perform certain work-related activities, subject to conditions.

But high-risk individuals who willfully violate legal orders will have their movement restricted even more. The MOH will be able to stop them from breaking isolation and from leaving Singapore. Instead of arresting them, the MOH will have the power to use physical means to place them back in isolation and restrict their movement.

The MOH could get the power to get local mobile operators and air, sea and land transport operators, among others, to disseminate health advisories to people visiting, or who have visited, overseas areas affected by an infectious disease of public health concern.

The public consultation paper will be posted on www.reach.gov.sg and the MOH’s website.

Feedback can be sent to ida_public_consult [at] moh.gov.sg until 6pm on Aug 7.

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