Measles control and response measures

Name and Constituency of Member of Parliament
Dr Chia Shi-Lu, 
MP for Tanjong Pagar GRC

Question No. 2792
To ask the Minister for Health in view of the global increase in measles cases reported by the World Health Organisation, what measures are in place to prevent measles outbreaks in Singapore and whether these measures need to be strengthened further. 

Answer

1     Measles is a highly contagious and serious viral disease and vaccination is the most effective protection against the infection. High vaccination coverage at the population level not only protects the individuals but also makes it harder for the disease to spread thereby reducing the risk of large outbreaks. This way, it also provides herd immunity which will also protect those who are unable to receive vaccination such as infants under the age of 12 months and those who are immune-compromised. It is therefore important for countries to maintain a high level of vaccination.

2     In recent years, there has been a global increase in measles outbreaks because of declining vaccination coverage in many countries. This has resulted in a significant increase of non-immune individuals in the community, making it easier for the disease to spread. Being a travel hub, Singapore is also exposed to imported cases. In the first 4 months of 2019, Singapore saw 43 measles cases, nearly 3 times more than the same period in 2018 as a result of increased global outbreaks. These were all sporadic cases or cases with limited spread and there was no community outbreak. We are monitoring the global and local situation closely. We have alerted our doctors to look out for measles cases and notify MOH promptly so that actions can be taken to prevent disease spread.

3    We should also strive to achieve a high level of vaccination in Singapore. Our national immunisation schedule recommends that children should have their first dose of measles vaccine at 12 months of age and the second dose at 15 to 18 months of age. With the exception of those who are unable to be vaccinated due to medical reasons, the measles vaccine is compulsory for local children. Earlier this year, we have also made it compulsory for foreign children applying for long-term passes to be fully vaccinated against measles.

4    We have also put in place measures to facilitate and encourage vaccination. Vaccination is available free to all Singaporean children at polyclinics. HPB sends reminders to parents whose children have yet to complete vaccination by 2 years old. HPB also provides catch-up vaccination in primary and secondary schools for students who still have not completed their vaccination. The measles vaccination coverage among resident children reached 95% for the first dose at 2 years of age and 93% for the second dose at 7 years of age. 

5    Nonetheless, we cannot be complacent. MOH is looking into ways to raise the vaccination coverage further. Some of the measures being considered include sending reminders to parents ahead of vaccination due dates.  This way, we ensure that children are protected as early as possible. We will also look into how we can raise the vaccination rate of children before they enter pre-school and primary school.  To protect the more vulnerable populations like infants and the immuno-compromised, we will study ways to ensure that workers caring for them achieve a high level of vaccination coverage.

6    Even with these measures, we can continue to expect to have sporadic cases of measles due to imported cases. We can expect to see more cases when there is an increase in global outbreaks. I would like to urge parents to bring their children for vaccination when it is due. By working together to improve and maintain a high level of vaccination coverage, we can better protect our population and reduce the risk of large local outbreaks.