GROUPS ELIGIBLE FOR SECOND BOOSTER AND DOSING INTERVAL FOR COVID-19 PRIMARY VACCINATION SERIES

1.  The Expert Committee on COVID-19 Vaccination (EC19V) has made the following updates to the vaccination recommendations:

a.   All persons aged 50 years and older may now be offered the second booster;

b.    Persons aged 18 years and above who are medically vulnerable to severe COVID-19 are no longer require a doctor’s referral to receive the second booster; and

c.     The recommended interval between the first two doses of a primary vaccination series will now be extended to eight weeks, but the minimum allowable interval remains unchanged especially for persons who need to achieve protection more quickly due to their risk of exposure or susceptibility to severe disease.

Updates on COVID-19 Second Booster Vaccination

2.  The EC19V had previously recommended for the following groups of persons to receive a second COVID-19 booster around five months after their first booster:

a.    All persons aged 80 years and above;

b.    Persons living in aged care facilities; and

c.     Medically vulnerable persons at higher risk of severe COVID-19.

3.  These groups are most at risk of severe disease. Vaccine protection against severe disease from three doses is also lower in persons aged 80 years and older, and a second booster is important to achieve a high level of protection. As such, the EC19V strongly urges persons in these recommended groups to receive the second booster vaccination as soon as they are eligible.

4.  Data has shown that the risk of severe COVID-19 can increase in persons aged 50 years and older. As such, the second booster can now be offered to all persons aged 50 years and older to further increase their protection. This is an update from the previous position of the second booster being offered to all persons aged 60 years and older. All persons aged 80 years and older are strongly recommended to get their second booster, as previously recommended. The second booster should be given around five months after the first booster. 

5.  To facilitate uptake of the second booster, EC19V further recommends that persons aged 18 years and older, who have health conditions that make them medically vulnerable to severe COVID-19, can receive the second booster without the need for a physician’s referral. They can self-declare their health condition to be eligible for the second booster (please refer to the Annex for the list of health conditions). This is an update from the previous arrangement where such persons were required to provide a doctor’s referral to receive the second booster. The list of health conditions in the Annex covers medical conditions of concern, but is not exhaustive. Persons with medical conditions not listed in the Annex, or who are not sure if they are included in the listed groups should consult their doctor.  They may then proceed to receive the second booster based on their doctor’s advice if the doctor provides an appropriate referral.

Extending the Recommended Primary Vaccination Series Dosing Interval

6.  The recommended dosing intervals between the first two doses of a COVID-19 primary vaccination series had been set at 21 to 28 days depending on the vaccine used. This was based on the vaccination protocols used in their respective vaccine trials, and also due to a need to expedite protection against COVID-19 for a vaccine-naive population during the acute phase of the COVID-19 pandemic.

7.  There is now more evidence that an extended interval between the first two doses of the primary vaccination series may confer better immune response and vaccine effectiveness. EC19V is thus now recommending for the dosing interval to be extended to eight weeks between the first two doses of the primary vaccination series for all COVID-19 vaccines^[1] available under the National Vaccination Programme, for those who have yet to be vaccinated with their primary vaccination series.

8. Individuals, particularly those who are at risk of exposure to COVID-19 or more susceptible to severe disease, may still receive the doses earlier than the eight-week interval but not less than the previously established minimum intervals^[2].

9. All eligible individuals are strongly encouraged to complete the COVID-19 primary vaccination series and booster vaccinations recommended for them, if they have not done so already.

EXPERT COMMITTEE ON COVID-19 VACCINATION

10 JUNE 2022

[1] Vaccines available under the National Vaccination Programme are: Pfizer-BionTech/Comirnaty, Moderna/Spikevax, Novavax/Nuvaxovid and Sinovac-Coronavac.

[2]The minimum intervals that the first two doses of the vaccines should be taken are: 21 days for Pfizer-BioNTech/Comirnaty and Novavax/Nuvaxovid, 28 days for Moderna/Spikevax and Sinovac-CoronaVac.