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SINGAPORE – There are some groups of people who should wait to get a Covid-19 vaccine, including those with a history of severe allergic reactions, an expert panel said on Thursday (December 17).
Severe allergies generally refer to people who, in response to a specific stimulus, such as a bee sting or medication, experience swelling around the mouth, eyes, or face, have difficulty breathing, or experience a severe drop in blood pressure. blood pressure, said associate professor Lim Poh Lian, director of the High Level Isolation Unit at the National Center for Infectious Diseases.
Those who belong to certain groups, such as pregnant women, immunosuppressed people, and those under the age of 16, should also stop receiving the injections, as large-scale clinical trials have not involved such volunteers. This means that there is not yet enough data to assess the safety of a Covid-19 vaccine in these groups of people.
But experts who spoke at a webinar hosted by The Straits Times on Thursday afternoon (December 17) pointed out that except for these groups of people, those who are offered a Covid-19 vaccine should take it, especially now. that Singapore moves to open up its economy. .
Said Professor Lim during the webinar, The AZ of Covid-19 Vaccine: “What we want to do is make sure that the people around them are vaccinated.”
Professor Lim, who is also a member of the Covid-19 vaccination expert committee appointed by the Ministry of Health, added: “So everyone who is eligible should receive the vaccine because we want to protect people who cannot receive (the vaccine) or those who may not benefit as much from the vaccine even if they receive it. “
She was one of three experts who spoke at the webinar, moderated by ST Senior Health Correspondent Salma Khalik.
The other two experts were Professor Ooi Eng Eong, an expert in emerging infectious diseases at the Duke-NUS School of Medicine and co-developer of a Covid-19 vaccine; and Mr. Ashish Pal, Managing Director of Merck Sharp & Dohme Pharmaceutical Company in Singapore and Malaysia.
Who should get vaccinated
Priority will be given to those most at risk, including healthcare workers and front-line personnel, as well as the elderly and vulnerable.
Even those with other illnesses, such as heart problems, should receive one as clinical trials had evaluated its safety in this group.
Professor Ooi said that clinical trials were designed to take into account those who are at risk for severe Covid-19, including those with heart problems, cancer, high blood pressure and diabetes, for example. “So in that sense, what the trial managed to include, we know that the data points toward safety,” he said.
Singapore approved on Monday (December 14) the use of the Covid-19 vaccine by Pfizer and BioNTech, following similar approvals in Britain and the United States.
The first shipment is expected to arrive in Singapore later this month, and mass inoculations are already underway elsewhere.
Free Covid-19 vaccinations will be offered to all Singaporeans and long-term residents currently here, although they will be voluntary.
Who shouldn’t get vaccinated yet
1) Those with severe allergies
The Singapore Health Sciences Authority had warned that people with a history of anaphylaxis or rapid onset of severe allergic reactions should not receive the vaccine, as a precaution.
Such reactions have been observed elsewhere. For example, The New York Times reported that two health care workers in Alaska developed reactions after receiving the Pfizer-BioNTech vaccine this week.
The first worker who had no history of allergies had an anaphylactic reaction and experienced a rash on his face and torso, shortness of breath, and an elevated heart rate. She was hospitalized.
The second worker experienced eye swelling, dizziness and an itchy throat, although the hospital said the reaction was not considered anaphylaxis. He was back to normal within an hour and was released.
Both workers had experienced reactions within 10 minutes of vaccination.
This reaction is not unique to the coronavirus vaccine, Professor Lim said.
“All medications can potentially cause allergies, or even anaphylaxis, which is the most serious form of hypersensitivity, (and) can occur immediately,” he said during the webinar.
For example, such reactions are known to occur when penicillin is administered.
“But we do not stop using penicillin. We just have to know what can happen and be prepared for it, to handle the patient safely. So the same will happen with the vaccine (Covid-19),” he said. said.
Professor Lim explained that the expert committee investigating Covid-19 vaccines for Singapore had analyzed information from abroad before recommending that people with severe anaphylactic reactions may want to postpone Covid-19 vaccination.
“That is perfectly valid because we are trying to be safe. But when we administer the vaccine, even someone with no (history of developing a) reaction could have a reaction, and we are going to put those safety (measures) in place,” she said.
2) Pregnant women and children
Determining whether a vaccine is safe for certain groups of people should be based on data from vaccine studies.
And since no studies have been done to evaluate how the Pfizer-BioNTech Covid-19 vaccine might affect fertility or young children, experts advise pregnant women and women younger than 16 to wait for more data before getting vaccinated.
Professor Ooi said: “Studies to show that vaccines can be used safely in people who are planning a pregnancy or who are already pregnant have not been completed. But that does not mean that it is not safe, that it will cause sterility. No means that at all. “
Also, women who fall into this category will likely not be in the first groups to be offered a Covid-19 vaccine in Singapore.
Said Professor Lim: “It’s in my DNA to be kind of a kiasu (very cautious). So until the data comes in, we’ll probably say wait until we get more data, because we want to do this in the safest way possible. . “
However, based on her past experiences with vaccines, such as those for hepatitis A, hepatitis B or tetanus, Professor Lim said that she does not believe that this vaccine causes any fertility problems.
Professor Ooi pointed out that the goal is also to be able to vaccinate children, who can interact with their grandparents, a group considered more vulnerable to the coronavirus.
But he added: “The trials have naturally focused on the most vulnerable population first. But the plan, of course, would eventually be to cover the rest of the population that is not currently covered by the (late-stage) trial.”
3) Immunosuppressed people
Professor Lim noted that being immunosuppressed, or having a weakened immune system, is a condition that falls on a spectrum.
“So, for example, someone with leukemia, which is a type of blood cancer, would clearly be immunosuppressed,” he noted. Anyone who has undergone an organ transplant would also be considered as such.
However, many questions remain, he said.
“If they were treated for leukemia, say, a year ago, are they still immunocompromised? Well, it’s probably a specter as they recover from chemotherapy.”
Professor Lim said that to answer these questions, more data is needed for each specific group of patients.
“So, actually, I would have to look at the data on dialysis patients, kidney transplants, leukemias … So I think we’ll have to wait for that data to come in. We are certainly as interested as all of us. someone else asking us questions. So we’ll get the information as quickly as possible. “
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