CHILDHOOD VACCINATION SCHEDULE IN SINGAPORE

Vaccinations are undoubtedly one of the great advances of modern medicine.  Through the use of vaccines, many diseases that used to cause widespread disease and death, have largely been prevented, if not eradicated completely.

Vaccines are inactivated or dead viruses/bacteria. When introduced into the body, the person's immune system responds by producing antibodies against the disease-causing organism. This process of developing immunity by taking a vaccine is called immunization.

Children are given a series of vaccinations from birth, according to the country's specific childhood immunization schedule. There are minor variations in the timing and type of vaccinations given in different countries. This article covers the Childhood Immunization Schedule in Singapore. (The Optional Vaccinations will be covered in another article).

MOH Scheduled Vaccinations:

• BCG Vaccine
• Polio Vaccine
• Hepatitis B Vaccine
• MMR Vaccine
• DPT/DT Vaccine
• Pneumococcal Vaccine

Optional Vaccinations: (click here to see optional vaccines)

• Hepatitis A Vaccine
• H1N1 Vaccine
• Hib Vaccine
• Varicella (chickenpox) Vaccine
• Rotavirus Vaccine
• Influenza Vaccine

Notes: Children in Primary 6 in 2008 will still receive the MMR booster, oral Sabin (3rd  booster) and Tdap (3rd booster). Children in Primary 5 (2008 -2011) will receive the MMR booster, oral Sabin (3rd booster) and Tdap (3rd booster). From 2012 onwards, children in Primary 5 will only receive the oral Sabin and Tdap.

From November 1, 2009, Medisave can be used to pay for pneumococcal vaccination of children.

With effect from 1st Dec 2011, following the recommendations by the Expert Committee on Immunization, the new recommendations for MMR vaccinations are as follows: 1st dose at 12 mths of age, and 2nd dose at 15 - 18 mth of age (brought forward from 6-7 years previously).    Read more about the changes to the MMR vaccination.

1. BCG (Bacillus Calmette-Guerin) Vaccine

The BCG Vaccine is one of the first vaccines given to your baby at birth. It protects against tuberculosis (TB), a bacterial infection of the lungs, which is actively present in many Asian populations. In its more serious form, it can infect the brain and bone or may be disseminated throughout the body (miliary TB).

Dose:
Single dose at birth.

Common Side Effects:
Pain and swelling over injection site. Scarring.

2. Hepatitis B Vaccine

The Hepatitis B Vaccine protects against Hepatitis B. Hepatitis B is caused by the Hepatitis B virus and it causes infection with associated inflammation (hepatitis) of the liver. Hepatitis B is endemic in Asia and it is transmitted via exposure to infected blood or body fluids. Common forms of transmission include unprotected sexual contact, blood transfusions and vertical transmission from mother to child during childbirth.

Children are less likely than adults to clear the infection, thus leading to chronic hepatitis B. Lifetime risk of death from liver cirrhosis and liver cancer in chronic hepatitis B has been estimated to be about 40%.

Dose:
3 doses over a course of 6 months.

Common Side Effects:
Minimal.

3. DPT / DT Vaccine

Diphtheria is a potentially life-threatening bacterial infection of the respiratory tract. It usually affects the thoat and nose, but can occasionally cause constriction of the airways leading to breathing problems.

Pertussis is also known is “whopping cough”, so named because of the inspiratory gasp (“whoop”) after a coughing bout. It is caused by the bacteria Bordetella Pertussis, and infections typically start with cold-like symptoms quickly progressing to severe coughing. Severe cases may progress to respiratory arrest.

Tetanus (“locked jaw”) is a disease that affects the nervous system caused by Clostridium tetani, a bacteria commonly found in soil. In this condition, there is muscle spasms of the jaw, neck and other parts of the body.

Dose:
Primary vaccination requires 3 doses, followed by 2 booster doses.

Nowadays, it is often given together with the Polio vaccine in the Infarix 4-in-1, 5-in-1 or 6-in1 vaccines.

Common Side Effects:
Low grade fever, irritability, loss of appetite and swelling over the injection site.

4. Polio Vaccine

Poliomyelitis is caused by infection by the Polio virus. In most people, this virus produces a mild illness which lasts for up to 3 days. However, in some, it progresses to the paralytic form.

Dose:
There are 2 types of polio vaccines (i) the oral polio vaccine (OPV) which contains active viruses, and (ii) the inactivated polio vaccine (IPV) given as an injection. The IPV is nowadays part of the Infarix 4-in-1, 5-in-1 and 6-in-1 vaccines. The Polio vaccine requires 3 primary doses followed by 3 booster doses.

Common Side Effects:
Mild soreness over injection site.

5. MMR Vaccine

The MMR Vaccine protects against Measles, Mumps and Rubella.

Measles is a very contagious viral illness characterized by fever, flu-like symptoms together with a rash.

Mumps is a viral illness which typically causes painful swelling of the parotid salivary gland. Occasionally, complications may arise causing meningitis and infection of the testes.

Rubella, otherwise known as German measles, usually causes a mild viral illness with rash in children, but can cause severe malformations in the fetus if caught during pregnancy.

Dose:
1 Primary dose and 1 Booster dose.

Common Side Effects:
Mild fever and occasional rash.

6. Pneumococcal Conjugate Vaccine

Pneumococcal vaccination was included into the National Childhood Immunization Programme by the  Ministry of Health in 2009.  Pneumococcal disease is a group of illnesses caused by the bacterium Streptococcus pneumoniae, also known as pneumococcus.  Pneumococcal infections can result in: pneumonia, meningitis, otitis media, sinusitis and bacteraemia.

In Singapore, 18 per 100,000 children less than 5 years old are infected with pneumococcal disease each year.  In serious cases, 1 in 4 suffer complications (brain damage, permanent hearing loss, paralysis, mental retardation) and 1 in 16 die.

Dose:
2 primary doses at 3 months and 5 months.  1 booster dose between 1 - 2 years of age.

Common Side Effects:
Fever, irritability, decreased appetite, occasional vomiting and diarrhoea.

The article above is meant to provide general information and does not replace a doctor's consultation. 
Please see your doctor for professional advice.