SINGAPORE: The COVID-19 vaccine administered in Singapore is safe relative to other childhood and adult vaccines available here, experts said following reports that four people have had severe allergic reactions after getting their first dose.
"Measures to address the very rare severe adverse events have also been put in place. Therefore those who are eligible should go ahead and be vaccinated when their turn comes," said Associate Professor Hsu Li Yang, vice dean of global health at the Saw Swee Hock School of Public Health at the National University of Singapore.
AdvertisementAdvertisementOut of the more than 155,000 people who received at least one dose of the Pfizer-BioNTech vaccine as of Jan 31, four have had anaphylaxis, Senior Minister of State for Health Janil Puthucheary told Parliament on Monday (Feb 1).
[h=3]READ: 4 out of 155,000 people vaccinated had severe allergic reactions, all have recovered[/h]They developed rashes, breathlessness, lip swelling, throat tightness and giddiness, but the symptoms were "promptly detected and treated" and all have recovered, said Dr Puthucheary. None needed ICU support, he added.
Three of them have a history of allergies, including allergic rhinitis and food allergy such as to shellfish, but none had anaphylaxis before, which would have precluded them from receiving the vaccine.
AdvertisementAdvertisementPublic health experts told CNA that it was not the active component of the vaccine - the mRNA genetic fragment - which caused the anaphylaxis.
To stabilise the fragile mRNA and stop it from being destroyed after injection, it has a coating of lipid nanoparticles attached to polyethylene glycol (PEG).
"Most believe it is this coating that is driving the anaphylactic reactions, possibly the PEG component as we know this happens rarely in other medications containing PEG," said Professor Dale Fisher from the NUS Yong Loo Lin School of Medicine.
RARE EVENT
AdvertisementThe Ministry of Health (MOH) says on its COVID-19 vaccination information page that those with a history of anaphylaxis or severe allergic reactions should not receive the vaccine.
However, a person with a family history but not a personal history of anaphylaxis can be vaccinated. This also applies to people with eczema, allergic rhinitis or well-controlled asthma.
"Although there may be some increased risk of hypersensitivity reactions to the Pfizer-BioNTech COVID-19 vaccine, these conditions are common and there is not enough evidence to contraindicate the vaccine at this time," says the site, which also provides additional information for those with allergies.
MOH's advice also said that people with multiple allergies without anaphylaxis should defer receiving the Pfizer-BioNTech COVID-19 vaccine, as there is some increased risk of anaphylaxis. But if the benefits of getting the vaccine outweigh the risk, then vaccination should be conducted in a healthcare facility with immediate access to anaphylaxis treatment.
[h=3]READ: People who need to travel have to wait turn to be vaccinated for COVID-19: MOH[/h]Overall, a severe allergic reaction to the vaccine is a rare event, experts emphasised.
The rate of anaphylaxis from the COVID-19 vaccine is about 10-fold higher than that from the flu shot, which is just over one per million shots, but it is as safe as most childhood vaccines, said Assoc Prof Hsu.
At 2.7 cases per 100,000 people, which is what has been observed in Singapore so far, that is a rate of 0.003 per cent, said Associate Professor Lim Poh Lian, senior consultant in MOH's Communicable Diseases Division and a member of the Expert Committee on COVID-19 Vaccinations.
[h=3]READ: Worried about anaphylactic reactions and side effects? Experts answer FAQs on COVID-19 vaccination[/h]WEIGHING THE RISKS
In general, most people who develop anaphylaxis to one allergen are not at greater risk of having anaphylaxis to a different allergen, said Assoc Prof Hsu.
"For those with mild allergy to shellfish or other foodstuff, their risk of suffering anaphylaxis from the COVID-19 vaccination is no different from the rest of the eligible population."
And while those with a history of allergic reactions could have a higher risk, this has to be weighed against the risk of contracting COVID-19.
"COVID-19 infection is what we should be worried about not the vaccine," said Prof Fisher.
"It is important to remember that anaphylaxis is easily reversed and preparing to manage such reactions will be intrinsic wherever the vaccine is given in Singapore."
[h=3]READ: All polyclinics to offer COVID-19 vaccination from Feb 1[/h]People who are vaccinated here are monitored for 30 minutes after the injection to ensure that any such adverse reactions are detected and treated.
"Because the vast majority of anaphylactic reactions occur within 15 minutes post-exposure, observing individuals who have received the vaccine for 30 minutes afterwards would ensure that medical treatment can be swiftly provided to those who have severe allergic reactions to the vaccine," said Assoc Prof Hsu.
MOH also provides financial assistance for any serious side effects related to COVID-19 vaccines administered here for Singapore citizens, permanent residents and long-term pass holders.
It provides a one-time payout of up to S$10,000 if a person is hospitalised in a high dependency or intensive care ward but subsequently recovers. For death or permanent severe disability, the payout is S$225,000.
"If people are worried, it is worth a conversation with their doctor. An option could be to wait for a different vaccine that doesn’t have the same components as the mRNA vaccines," said Prof Fisher.
Listen to the behind-the-scenes considerations and discussions going into what might be Singapore’s biggest vaccination programme ever on CNA's Heart of the Matter podcast:
[h=3]BOOKMARK THIS: Our comprehensive coverage of the coronavirus outbreak and its developments[/h]Download our app or subscribe to our Telegram channel for the latest updates on the coronavirus outbreak: https://cna.asia/telegram
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