The COVID-19 vaccination programme is being progressively rolled out to all Singaporeans and long-term residents. What does it mean for people with autoimmune diseases?
Please note that you are recommended to consult your doctor if you are unsure about taking the vaccine.
The information in this article has been gathered from the Ministry of Health Singapore and Singapore hospitals. Please note that effort has been made to ensure that information is current at the time of publishing, however, there are constant updates on the efficacy and possible side effects of the COVID-19 vaccines as the situation evolves every day.
What the COVID-19 vaccines are
Vaccines work with your body’s natural defenses to protect you from diseases. When you get a vaccine, your immune system is trained to recognise the virus and produces antibodies. These antibodies attack the viruses and stay in our bodies.
Singapore has Advance Purchase Agreements for three vaccines:
Pfizer-BioNTech (messenger RNA (mRNA))
Moderna (messenger RNA (mRNA))
Sinovac (inactivated vaccine technology)
mRNA vaccines contain material from the COVID-19 virus that gives our cells instructions on how to make a harmless protein that is unique to the virus. After our cells make copies of the protein, they destroy the genetic material from the vaccine. Our bodies then recognise that the protein should not be there and build antibodies to fight the virus. Inactivated vaccine technology uses weakened or inactive viral particles to stimulate our body to produce an immune response to the COVID-19 virus.
Some vaccines require multiple doses, given weeks or months apart. This allows us to produce long-lived antibodies and develop memory cells – so that our bodies can rapidly fight the virus should we be exposed to it again.
Sinovac's Covid-19 vaccine is only allowed under the Special Access Route (SAR). However, as the vaccine remains unregistered, it cannot be covered by the Vaccine Injury Financial Assistance Programme (VIFAP). For vaccines to come under the national vaccination programme, it has to go through a rigorous evaluation of its safety and efficacy. From global and local data, both the Pfizer-BioNTech and Moderna vaccines have met these criteria. There are some outstanding data on the Sinovac vaccine to complete the evaluation.
There is no good evidence that one vaccine is more suitable than another, let alone for patients who are on immunosuppressive therapy. It may take many months of further research to determine this.
More information on the approval process for the vaccines in Singapore here.
Why should I get vaccinated?
The higher the number of people vaccinated, the lower the risk of major outbreaks, also protecting those who are not currently recommended for vaccination. These include people who are less than 12 years old and those with severe immuno-compromised conditions.
Vaccination also allows us to resume social activities much more quickly and to further reopen our economy.
Can I get vaccinated if I have an autoimmune disease?
Safety and efficacy data on the COVID-19 vaccines in patients with rheumatological diseases with or without immunosuppressive therapy is limited and evolving.
According to the Rheumatology and Immunology at Singapore General Hospital, patients with rheumatological diseases are encouraged to receive the COVID-19 vaccine. However, if your condition is not controlled, or you are unsure about this, please contact your primary Rheumatologist.
Persons on oral and injection forms of immunosuppressive drugs can be vaccinated (except for rituximab that needs special consideration).
Please speak to your primary Rheumatologist if you have a history of
severe drug reactions (e.g. Stevens-Johnson-Syndrome (SJS), Toxic Epidermal Necrolysis (TEN), Drug Rash with Eosinophilia and Systemic Symptoms (DRESS), Drug-induced Hypersensitivity Syndrome (DiHS))
anaphylaxis to drugs, food, insect stings or unknown trigger and have been prescribed an Epi-Pen (current or in the past)
Persons with multiple allergies (allergy to drugs, food, insect stings or unknown trigger) NOT amounting to anaphylaxis. CAN be vaccinated. Anaphylaxis is a life-threatening allergic reaction with two or more of the following three criteria:
Hives or face/eyelid/lip/throat swelling
Difficulty breathing or
If you have been assessed to be ineligible for the Pfizer-BioNTech or Moderna COVID-19 Vaccines due to medical reasons, you may be able to get vaccinated later if data become available that it is safe to receive the vaccination, or you may be able to get vaccinated with other COVID-19 vaccines.
More general information on who should be getting the vaccine can be found here.
The EC19V has recommended that persons with a history of anaphylaxis or allergic reactions to other drugs, food, insect stings, or unknown trigger (idiopathic) can be vaccinated with the mRNA vaccines. Persons with a history of anaphylaxis or allergic reactions to other vaccines can be referred to an allergist for further evaluation fully subsidised by the government and may be vaccinated, if deemed suitable. MOH accepts the EC19V recommendation and will remove this restriction from 5 June 2021. For more information, please click here.
How do I get the vaccine?
When you receive the notification from the Ministry of Health, register at vaccine.gov.sg or get help at the nearest Community Centre/Club.
On vaccination day, wear short-sleeved, or loose clothes. Bring your NRIC/FIN.
Get your first vaccine dose. Return to the same centre for your second dose.
More information on how to get set up your vaccination appointment can be found here.
What should I expect at the vaccination centres?
You will have to register and get your health assessed by the staff at the vaccination centre. It will be helpful to provide information on your condition and the medications you are on.
You may need to take a seat in the waiting area if there are others ahead of you.
Receive your vaccination.
You will be ushered to rest in the observation area for 30 minutes. If you experience any discomfort, please make it known to the vaccination centre staff.
Get discharged and book your second appointment.
For more information on your vaccination appointments, click here.
[Video] How to get your jab at Singapore's vaccination centres, The Straits Times [Video] How Effective Is The COVID-19 Vaccine? Why The Vaccinated Still Get Infected | Talking Point, CNA Insider
What should I do after getting the vaccine?
Ensure that you are well-hydrated after the vaccine. You may experience common side effects, similar to other vaccines. Most side effects are mild or moderate and usually get better within a few days.
See a doctor if:
The side effects persist or get worse
The fever persists for more than 48 hours (2 days)
In very rare cases, this vaccine can cause a severe allergic reaction. Signs of a severe allergic reaction include:
swelling of your face, throat, eyes or lips
a fast heartbeat
dizziness and weakness
a bad rash all over your body.
If you experience a severe allergic reaction, seek medical attention immediately. Call 995 or go to the nearest A&E immediately.
Click here for more information about the side effects.
Centers for Disease Control and Prevention, World Health Organisation
Rheumatology and Immunology, Singapore General Hospital
Vaccine.gov.sg, Ministry of Health Singapore