EXPERT COMMITTEE ON COVID-19 VACCINATION RECOMMENDS A SECOND BOOSTER DOSE FOR AGES 60 YEARS AND ABOVE, AND ONE BOOSTER DOSE FOR AGES 5 TO 11 YEARS
The Expert Committee on COVID-19 Vaccination (EC19V) is updating its recommendations to:
a. Recommend a second booster dose in all persons aged 60 to 79 years. With this recommendation, all persons aged 60 years and above are recommended to receive a second booster dose; and
b. Recommend one booster dose in children aged 5 to 11 years. With this recommendation, all persons aged 5 years and above are recommended to receive the first booster dose.
The booster doses should be received around five months after the last vaccine dose.
Updated second booster recommendation in adults aged 60 to 79 years
2. The EC19V recommends that all persons aged 60 years and older who have completed their primary vaccination series and first booster dose, should receive a second mRNA COVID-19 booster vaccine from around five months after their first booster. This is in addition to the following groups of persons who were previously recommended to do so.
a. All persons aged 80 years and older;
b. Medically vulnerable persons at higher risk of severe COVID-19; and
c. Persons living in aged care facilities.
3. The latest local evidence has shown that compared to persons who received two doses of mRNA vaccine, the first booster reduced the risk of severe disease by 94% for those aged 70-79 years and by 97% for those aged 60-69 years, while the second booster reduced it further to 97% and 98% respectively. In other words, a second mRNA booster could reduce the actual number of persons aged 60 years and above who get severe disease by up to 50%. Many health conditions, including diabetes or hypertension, which seem to contribute to the severity of COVID-19, are also more common at around this age; the second booster thus provides added protection against severe disease in persons who have such medical conditions, especially since adverse events associated with a second booster at these age groups have also been mild. It is therefore recommended that all persons aged 60 and above receive a second booster to lower their risk against severe COVID-19.
4. The second booster continues to be offered to those aged 50-59 years who want to take it, under the National Vaccination Programme (NVP).
5. For all persons diagnosed with chronic medical conditions that make them vulnerable to severe disease, the second COVID-19 vaccine booster continues to be recommended1.
Booster vaccination in children aged 5 years to 11 years
6. The EC19V also recommends that children aged 5-11 years, who completed their primary vaccination (consisting of two doses of Pfizer-BioNTech/Comirnaty vaccine), should receive one booster dose of Pfizer-BioNTech/Comirnaty vaccine, starting from five months after the second dose.
7. Children aged 5-11 years were recommended to receive the Pfizer-BioNTech/Comirnaty vaccine for stronger protection against hospitalisation and severe disease from COVID-19. There is now local and international data indicating that antibody levels and vaccine protection against COVID-19 hospitalisation decline with time in this age group, just as it does with adolescents and adults.
8. In this age group, the Pfizer-BioNTech/Comirnaty booster vaccine has been shown to increase antibody levels to more than twice the levels achieved after two primary doses, which helps sustain the level of protection against severe disease.
9. Common side effects in children who received the booster dose were generally mild, similar to those from the first two doses. As of August 2022, more than 1,000,000 booster doses have been safely administered to children aged 5-11 years in the United States of America under the recommendation of the United States Centers for Disease Control and Prevention.
10. The EC19V has assessed that booster vaccination is beneficial for protection against severe COVID-19 in children aged 5-11 years. While children of this age group are at low risk of severe COVID-19 disease, some children have required hospitalisation, and developed life-threatening disease requiring intensive care treatment or severe complications such as MIS-C (Multisystem Inflammatory Syndrome in Children). All children aged 5-11 years who have already had their primary vaccination are therefore recommended to receive a booster dose of the Pfizer-BioNTech/Comirnaty vaccine (10 micrograms) under the National Vaccination Programme.
Ensuring continued vaccination protection against severe disease and hospitalization
11. The EC19V recommends that persons in all age groups who are eligible for primary or booster COVID-19 vaccines, should receive their vaccinations without delay, based on the recommended vaccination intervals. The EC19V does not recommend waiting for newer or variant-specific vaccines. This will ensure that they continue to be protected against severe disease and hospitalisation.
12. The EC19V continues to keep track of further developments on COVID-19 vaccines, including those for children under 5 years of age, and will update its recommendations based on the latest scientific, clinical, and public health evidence.
EXPERT COMMITTEE ON COVID-19 VACCINATION
24 AUGUST 2022
[1] For avoidance of doubt, the second COVID-19 vaccine booster continues to be recommended to medically vulnerable persons, even to those under the age of 60 years. This includes those who have been diagnosed with chronic medical conditions that place them at higher risk of severe COVID-19.