SINGAPORE: The COVID-19 vaccine given in Singapore is safe compared to other childhood and adult vaccines available here, experts said after reports that four people have had a severe allergic reaction after for them to get the first dose.
“Measures have also been put in place to deal with very rare adverse events. So those who are eligible should go ahead and get the vaccine when the opportunity arises,” said Professional Professor Hsu Li Yang, global dean of health at the Saw Swee Hock School of Public Health at the National University of Singapore.
Of the more than 155,000 people who received at least one dose of the Pfizer-BioNTech vaccine as of January 31, four have had anaphylaxis, State Minister for Health Janil Puthucheary told Parliament on Monday (February 1 ).
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They developed rashes, shortness of breath, lip swelling, sore throat and giddiness, but the symptoms were “quickly detected and treated” and have all been overcome, Dr. Puthucheary said. None of them needed ICU support, he said.
Three of them have a history of allergies, including allergic rhinitis and food allergies such as shellfish, but none have previously had anaphylaxis, which would have prevented them from getting the vaccine.
Public health experts told CNA that the anaphylaxis was not caused by the active component of the vaccine – the genetic fragment mRNA.
To stabilize the fragile mRNA and prevent it from being destroyed after injection, a coating of lipid nanoparticles is bound to polyethylene glycol (PEG).
“Most people think that this coating drives the anaphylactic reactions, perhaps the PEG part because we know that this rarely happens in other medicines that contain PEG, ”said Professor Dale Fisher from NUS Yong Loo Lin School of Medicine.
RARE EVENT
The Ministry of Health (MOH) says on their COVID-19 vaccine factsheet that those with a history of anaphylaxis or a severe allergic reaction should not get the vaccine.
However, someone with a family history but no personal history of anaphylaxis can get the vaccine. This also applies to people with eczema, allergic rhinitis or well-controlled asthma.
“If they had an allergy to shellfish such as moderate rash or itch, the risk of anaphylaxis from the Pfizer-BioNTech COVID-19 vaccine is very low and probably similar to others without allergies at all,” said the Associate Professor Lim Poh Lian, director of the High Level Remote Unit at the National Center for Infectious Diseases.
“In fact, if they were allergic to shellfish as anaphylaxis, they would not be allowed to get the vaccine based on the current advice from MOH.”
MOH advice also stated that people with multiple allergies without anaphylaxis should delay receiving the Pfizer-BioNTech COVID-19 vaccine, as there is an increased risk of anaphylaxis. But if the benefits of getting the vaccine outweigh the risks, the vaccine should be made in a health care facility with immediate access to anaphylaxis treatment.
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Overall, a severe allergic reaction to the vaccine is a rare occurrence, experts stressed.
The rate of anaphylaxis from the COVID-19 vaccine is about 10-fold higher than that of the flu picture, which is just over one million beats, but is as safe as most childhood vaccines , said Assoc Prof Hsu.
At 2.7 cases per 100,000 people, which is what has been seen in Singapore so far, that is a rate of 0.003 per cent. This means that 99.997 percent of people received the vaccine without anaphylaxis, said Assoc Prof Lim, who is a member of the Expert Committee on COVID-19 vaccination.
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Millions of doses of Pfizer-BioNTech vaccine have already been given worldwide, said Associate Professor Josip Car, director of the Center for Population Health Sciences at Chian Lee Kong School of Medicine at Nanyang University of Technology .
From the first nearly two million doses given in the U.S., approximately 11 cases of allergic reactions involving anaphylaxis per million doses have been reported. Of those, 71 percent occurred within 15 minutes of vaccination, and no deaths from anaphylaxis were reported, he said.
INCLUDING THE RULES
Assoc Prof Lim said answering a questionnaire before the vaccine, scratches for people is not recommended for COVID-19 vaccine. They include children under the age of 16, pregnant women, and those with severe immunizations.
It also scrapes for those who have had previous anaphylaxis in response to other things.
“But there is always the first time when anaphylaxis occurs, so these people will have no history to show that they are at higher risk,” she said.
Although those with a history of allergic reactions may be at higher risk, this must be measured against the risk of contracting COVID-19.
“COVID-19 infection is something we should be concerned about not the vaccine,” Dr. Fisher said.
“It is important to remember that anaphylaxis is easily reversible and preparation for the management of such reactions will be sexual wherever the vaccine is given in Singapore.”
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People receiving the vaccine will be monitored here for 30 minutes after the injection to make sure that such side effects are detected and treated.
“Because most anaphylactic reactions occur within 15 minutes of exposure, by monitoring individuals who have been vaccinated for 30 minutes after that they will ensure that medical treatment is promptly given to those who have a severe allergic reaction to the vaccine, “said Assoc Professor Hsu.
MOH also provides financial support for any adverse effects associated with COVID-19 vaccines administered here for Singapore citizens, permanent residents and long-term passport holders.
It offers a one-time payment of up to S $ 10,000 if a person is hospitalized in a high dependency or intensive care ward but subsequently recovers. For death or severe permanent disability, the payment is S $ 225,000.
“If people are worried, it’s worth talking to their doctor. There may be an option to wait for a different vaccine that doesn’t have the same components as the mRNA vaccines,” said Dr. Fisher.
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