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FAQ - All about Hepatitis B
Q1. Is the Hepatitis B vaccine safe?
The Hepatitis B vaccine has been shown to be very safe. It has been available since 1982. The vaccine is made using recombinant DNA technology, and does not contain any live components of the hepatitis B virus.
Q2. Are there any side effects for Hepatitis B?
The most common side effects are pain at the injection site and mild to moderate fever. Serious side effects reported after receiving hepatitis B vaccine are very uncommon.

There is no confirmed scientific evidence that the vaccine causes long term or chronic illnesses. There is no risk of hepatitis B infection from the vaccine.
Q3. Would an asthmatic person have any problems with the Hepatitis B vaccination?
There should not be any problems with an asthmatic person receiving the Hepatitis B vaccination.
Q4. Can a person who has or has just recovered from flu/sore throat/cough/fever receive the Hepatitis B immunisation?
If a person is feeling unwell, he/she should check with a doctor before taking the immunisation.
Q5. Can a person who has eczema be safely immunised with the Hepatitis B vaccine?
A person who has mild to moderate eczema should not have any problems receiving the vaccination. If a person has severe eczema, he/she should check with his/her doctor for advice.

For the Hepatitis B immunisation programme in schools, a child with mild eczema should be able to receive the vaccination in school. A child with severe eczema will be referred to the Student Health Centre at Health Promotion Board for the vaccination.
FAQ - All about Laws & Regulations in Immunisation
Q1. Is there a penalty for not vaccinating my child against Measles?
Vaccination against Measles is the requirement of the law. To quote the Infectious Disease (Diphtheria and Measles vaccination) Regulations of the Infectious Diseases Act:

"The parent or guardian of every child born in Singapore shall take or cause the child to be taken to a medical practitioner to be vaccinated against measles when the child is between one year and two years of age....

If the child is born outside Singapore, but the parent or guardian cannot produce any documentary evidence to show that the child has either previously contracted measles or has been vaccinated against measles, the parent or guardian of the child shall take or cause the child to be taken to a medical practitioner to be vaccinated against measles within 12 months after the arrival of the child in Singapore."

This is the responsibility of the parent or guardian.

Under the Infectious Diseases Act and the Infectious Diseases (Diphtheria and Measles Vaccination) Regulations, it is compulsory for parents and guardians to have their child vaccinated against measles. The penalty for non-compliance is a fine of up to $500 for the first offence and up to $1,000 for the second or subsequent offence.

Our strategy is to work with parents to have every child vaccinated on time.
Q2. Is there a penalty for not vaccinating my child against Diphtheria?
Vaccination against Diphtheria is the requirement of the law. To quote the Infectious Disease (Diphtheria and Measles vaccination) Regulations of the Infectious Diseases Act:

"Primary diphtheria vaccination
The parent or guardian of every child in Singapore shall ensure that the child completes a course of primary diphtheria vaccination -
(a) within 12 months of the birth of the child; or
(b) within 12 months after the arrival of the child in Singapore, if the parent or guardian cannot produce any evidence to show that the child has already been so vaccinated....

Booster diphtheria vaccination
In the case of every child residing in Singapore who has received primary diphtheria vaccination, booster diphtheria vaccination consisting of one injection shall be compulsory -
(a) 12 months after the primary diphtheria vaccination; and
(b) within 12 months after the child has attained the age of 6 years,
except that paragraph (b) shall not apply if the child has already received the first booster diphtheria vaccination within a period of not more than two years before attaining the age of 6 years."

This is the responsibility of the parent or guardian.

Under the Infectious Diseases Act and the Infectious Diseases (Diphtheria and Measles Vaccination) Regulations, it is compulsory for parents and guardians to have their child vaccinated against Diphtheria. The penalty for non-compliance is a fine of up to $500 for the first offence and up to $1,000 for the second or subsequent offence.

Our strategy is to work with parents to have every child vaccinated on time.
Q3. How does the NIR get vaccination records?
Under the Infectious Disease Act, doctors are required to notify the NIR of vaccinations given.
Q4. When was the law changed for Small pox vaccination?
Small pox was compulsory by law for all children before the age of 1 year until 1981.
Q5. Is there a governing body for immunisation in Singapore?
Yes. The National Childhood Immunisation Programme has been implemented based on recommendations of the Expert Committee on Immunisation, comprising of Ministry of Health senior officials, consultant paediatricians and experts in communicable disease.

This national committee meets regularly to monitor and review the childhood immunisation programme in Singapore. The committee also follows closely recommendations from World Health Organisation (WHO).

The reason why Singapore is now free from most vaccine-preventable diseases is because of the effective and successful vaccination programme in Singapore.
Q6. When was Diphtheria and Measles became compulsory in Singapore?
Diphtheria was made compulsory in 1977. Measles vaccination was introduced from Oct 1976 and made compulsory in August 1985 for children ages 1-2years.
Q7. When was the two-dose MMR vaccination schedule introduced?
In January 1998, the two-dose MMR vaccination schedule was introduced with the second dose given to primary school leavers (11+ years old).
Q8. When was measles, mumps, rubella (MMR) vaccine introduced?
The monovalent measles vaccine was replaced by the trivalent measles, mumps, rubella (MMR) vaccine in January 1990.
FAQ - All about Measles, Mumps & Rubella (MMR)
Q1. Are there reasons why some children cannot receive their MMR vaccination?
If a child is allergic to the MMR vaccine, or has a suppressed immune system due to leukaemia, taking oral steroids for a prolonged period, or has moderate to severe illness then the child is not suitable for MMR vaccine. If in doubt, the parents should consult their doctor.

However if a previously healthy child has a fever such as from a cold, when the child recovers, the child will be able to take the MMR vaccine. If the parents are not sure, they should consult a doctor.
Q2. What is the implication if a child misses his MMR vaccination?
For adequate herd immunity, 95% is required. Herd immunity refers to the immunity of a group or community (the herd). The resistance of a community to the invasion and spread of an infectious agent is based upon the resistance to infection of a high proportion of individual members of the community.

If the infectious agent is not able to find a susceptible person in the community to infect, then an epidemic would die out. Mass vaccination can result in herd immunity.

In theory, if the MMR vaccination coverage is below 95%, there is always a risk of outbreaks of the diseases concerned. This means that children without the vaccine protection will be susceptible to being infected with the diseases.

If a parent forgets or is too busy to get his child immunised against MMR, the child could potentially fall ill with measles, mumps or rubella. And if the child falls ill, (the parents might miss work), and the child may suffer the risk of complications of the illness that may have long term consequences.

Further, the parents are putting other susceptible children at risk if those children are exposed to their child with infection. These children may be too young to be vaccinated or not able to be vaccinated for medical reasons. When many child are not vaccinated, it is easy for the disease to be introduced into the community.
Q3. Should parents be concerned at all about the MMR vaccine?
Vaccines, like any medicine, may have some side effects. These side effects are mild. The benefits of vaccination greatly outweigh the slight risk.

A decision not to immunise a child also involves risk. It is a decision to put the child and others who come into contact with him or her at risk of contracting measles.
Q4. Is there a relationship between MMR vaccine and autism?
Regarding MMR and autism, the key messages to note are:

* MMR vaccine protects children against dangerous, even deadly diseases.
* Carefully performed scientific studies have found no relationship between MMR vaccine and autism.

Health authories, including the Expert Committee on Immunisation of Singapore, WHO, Centre for Disease Control of USA continue to recommend two doses of MMR vaccine for all children.

For more information, please visit the following websites:
1) www.cdc.gov/nip/vacsafe/concerns/autism/autism-mmr.htm
2) http://www.rainbowpediatrics.net/faq/18.html
3) www.immunize.org/who
Q5. I received a letter from my child's school informing me to bring my child for Measles, Mumps and Rubella (MMR) vaccination. When I refer to the health booklet, it was given. What should I do?
We are updating our records for all children. Our system shows that there is no record of the vaccination for your child.

We seek your assistance in helping us update your child's immunisation records.

To update the record, please send us a copy of your child's health booklet page "Immunisation Record of Child (0 - 6 years) or other supporting document (s) if the vaccination was given overseas. Please indicate your child's Singapore Birth Certificate number, FIN or Passport number on the documents.

You may wish to send the documents by
- e-mail : hpb_nir@hpb.gov.sg or
- post : National Immunisation Registry , Level 5,
ááááááááááá3 Second Hospital Avenue, Singapore 168937

If your child has not received the stated vaccination, please bring him/her together with the identification documents and health booklet to a doctor for vaccination.
FAQ - Certificate
Q1. My child have yet to receive a certificate from the clinic. Can I request for one?
Yes, you can request for the certificate from the clinic where the vaccinations were done.

Should you require the certificate earlier, do contact the clinic and request for one.
Q2. MOE website states that parents can print the immunisation records from NIR website. How do I do this?
Parents can print their children's Immunisation Summary Records by clicking on the "Print Immunisation History" button that is in the website. You will need your singpass and password to access NIR website.
Q3. Do I receive a Certificate of Vaccination when my child have completed all the vaccinations?
Yes. Upon completion of all the immunisations, your doctor should issue the Certificate of Vaccination.

This certificate may be requested by child care centres or schools, many of whom require proof that your child is up to date with immunisations before enrolment.
Q4. I've lost the certificate of vaccination. How can I get a replacement?
Your doctor should be able to re-issue the certificate.
FAQ - General
Q1. How can I access my child's records?
To access your child's records, you would need your SingPass and password.

SingPass is the common password used to transact with different Government online services.



Eligibility for SingPass:

- Singapore Citizen and Permanent Resident

- Employment Pass and Personalised Employment Pass holders

- EntrePass holders

- S-Pass holders

- Dependant Pass holders (of EP, PEP, EntrePass and S-Pass holders)

- Selected Work Permit Holders



You can get your SingPass at the Counters in CPF Board Offices or request your SingPass to be posted to you by using the Online Application service (http://www.singpass.gov.sg). Please keep your SingPass confidential.
Q2. What is the age range that NIR keeps records for?
The NIR maintains the vaccination records for children from birth to 18 years of age. Records for children born on or after 1 Jan 1996 are available online.
Q3. How do the National Immunisation Registry gets my child's records?
Your child will automatically be added to the Registry when they receive their first vaccination.
Q4. Why use SingPass?
SingPass protects your privacy by giving you your personal online identity and password to authenticate your online access.
Q5. Why is it important to follow the recommended immunisation schedule?
Babies are born with some natural immunity which they get from their mother and through breastfeeding. This gradually wears off as the baby's own immune system starts to develop.

Routine childhood immunisations schedule helps provide a child with protective antibodies when the mother's antibodies have gone.

It is important to follow the immunisation schedule as delaying immunisation can leave a baby unprotected. It also increases adverse reactions to some vaccines, such as pertussis.
Q6. I am traveling to overseas and would like to know what vaccinations are needed?
You can call the Travel & Health Vaccination Centre in TTSH. The telephone number is 6357 2222.
Q7. Is there anyone who should not receive immunisation?
Those who have a history of allergy should check with their doctor before getting immunised.
Q8. Do I need to bring my child's health booklet when I bring my child for vaccination?
When your child is vaccinated, the details will be entered into your child's Personal Health Booklet (provided at birth).

It is important to remember to take this document along with you at the time of vaccination.

This record may be requested by child care centres or schools, many of whom require proof that your child is up to date with immunisations before enrolment.
FAQ - Myths
Q1. Myth : Vaccines cause many harmful side effects, and even death and may cause long-term effects.
Most vaccine adverse events are minor and temporary, such as a sore arm or mild fever. These can often be controlled by taking panadol before or after vaccination. More serious adverse events occur rarely.

The benefits of vaccination greatly outweigh the slight risk. A child is far more likely to be seriously injured by one of these diseases than by any vaccine.
Q2. Myth : Giving a child more than one vaccine at a time increases the risk of harmful side effects and can overload the immune system.
Studies have been conducted to examine the effects of giving various combinations of vaccines simultaneously, and it has been shown that the recommended vaccines are as effective in combination as they are individually, and that such combinations carry no greater risk for adverse side effects.

Two practical factors favor giving a child several vaccinations during the same visit. First, immunising children as early as possible provides protection during the vulnerable early months of life.

Second, giving several vaccinations at the same time will mean fewer office visits for vaccinations, which saves parents both time and money and may be less traumatic for the child.
Q3. Myth : Vaccination is no longer necessary because most diseases have been eliminated by better hygiene and sanitation.
Improved socioeconomic conditions have undoubtedly had an indirect impact on disease.

Better nutrition, the development of antibiotics and other treatments, have increased survival rates among the sick; less crowded living conditions have reduced disease transmission; and lower birth rates have decreased the number of susceptible household contacts.

However, vaccinations have been proven to have a significant impact on disease control. Without vaccination, individuals remain susceptible to the infectious agents causing these diseases.
Q4. Myth : Vaccine-preventable diseases have been virtually eliminated, so there is no need for my child to be vaccinated.
It's true that vaccination has enabled us to reduce most vaccine-preventable diseases to very low levels in Singapore. However, some of them are still quite common in other parts of the world.

Travelers can unknowingly bring these diseases into Singapore, and if we were not protected by vaccinations these diseases could quickly spread throughout the population, causing epidemics here.

We should be vaccinated, then, for two reasons. The first is to protect ourselves. Even if we think our chances of getting any of these diseases are small, the diseases still exist and can still infect anyone who is not protected.

The second reason to get vaccinated is to protect those around us. There is a small number of people who cannot be vaccinated (for reasons such as severe allergies to vaccine components), and a small percentage of people don't respond to vaccines. These people are susceptible to disease, and their only hope of protection is that people around them are immune and cannot pass disease along to them.

A successful vaccination program, like a successful society, depends on the cooperation of every individual to ensure the good of all.
FAQ - Retrieval of Immunisation Records
Q1. Would it be possible for me to retrieve my immunisation records if I am above 21 years old?
School Health Service only started computerising the medical and immunisation records in 1990. Available records are kept until the child reaches the age of 21 years after which the data will be archived.

To retrieve the records, please write to:
Youth Health Division
Health Promotion Board
3 Second Hospital Avenue
Singapore 168937
Attention: Director, Youth Health Division

or email: hpb_shc@hpb.gov.sg
FAQ - Update Record
Q1. My family is currently living overseas. My child's vaccinations are done in that country. Do I need to update his records?
You can update the National Immunisation Registry when you are back in Singapore.

You can fax a copy of the immunisation records together with a copy of the child's birth certificate or NRIC or FIN or Passport number, parent┐s NRIC or FIN or passport number to (65) 64381015, e-mail: hpb_nir@hpb.gov.sg or post to:

National Immunisation Registry
Health Promotion Board
3 Second Hospital Avenue
Singapore 168937
Q2. My family has just moved to Singapore. How do I update my child┐s overseas record in Singapore?
Please submit a copy of the immunisation records together with a copy of the child's birth certificate or NRIC or FIN or Passport number, parent┐s NRIC or FIN or passport number by fax to (65) 64381015, e-mail: hpb_nir@hpb.gov.sg or post to:

National Immunisation Registry
Health Promotion Board
3 Second Hospital Avenue
Singapore 168937
Q3. How can I update my child's vaccination record?
Please submit a copy of the certificate of vaccination, or the health booklet (immunisation record page) together with a copy of the child's birth certificate or NRIC or FIN or Passport number, parent's NRIC or FIN or passport number to NIR at hpb_nir@hpb.gov.sg or fax: 64381015
Q4. Why are some of my child's vaccinations not updated, e.g., Prevenar?
The Registry will receive vaccination records from clinics under the National Childhood Immunisation Schedule.

Should you like the optional vaccines to be updated, you can either forward a copy of the your child's vaccination records in the health booklet or request your doctor to notify NIR.

You can fax the document to (65) 64381015, e-mail: hpb_nir@hpb.gov.sg or post to:

National Immunisation Registry
Health Promotion Board
3 Second Hospital Avenue
Singapore 168937
Q5. My child's vaccinations were all done overseas. How do I continue my child's vaccination in Singapore?
Please consult your doctor for the next dose that needs to be given to your child.

If you are planning to bring your child to the polyclinics, you will have to first update your child's records in NIR. After the records are updated, please make an appointment with the respective polyclinic before you bring your child down for vaccination.
Q6. I've received a letter asking me to update my child's vaccination record. Could you please call my GP to get the information?
Yes. Please inform the NIR of your doctor's particulars together with your child's birth certificate number.
Q7. I received a reminder letter asking me to send my child for a vaccination; however the vaccination has already been given. What should I do?
The reminder letter may have been sent before the notification record was received.

Please inform the NIR of the details to update the registry. Supporting documents should be included for verification.
FAQ - Vaccines and Vaccination
Q1. Why is immunisation important?
Vaccines have been developed to protect people against diseases that can cause serious illness.

While improvements in sanitation and hygiene have played an important part in controlling the spread of infectious diseases, vaccination had been critical for the control of these diseases.

Without vaccination, individuals remain susceptible to the infectious agents causing these diseases.
Q2. When was BCG vaccination introduced in Singapore?
BCG vaccination was started in mid 1950s as part of the childhood immunisation programme.
Q3. When did BCG revaccination by School Health Service discontinued?
As of 1st July 2001, BCG revaccination by School Health Service was discontinued.
Q4. What is the difference in 6in1 (Hexa), 5in1 and 4in1?
6in1 includes the following vaccines:
DTPa + HiB + IPV + HEPB
Diphtheria, Tetanus, Pertusiss,
Haemophilus influenza type B,
Inactivated Polio Vaccine and Hepatitis B.

5in1 includes:
DTPa + HiB + IPV
Diphtheria, Tetanus, Pertusiss,
Haemophilus influenza type B, and
Inactivated Polio Vaccine.

4in1 includes:
DTPa + HiB
Diphtheria, Tetanus, Pertusiss,
Haemophilus influenza type B

If you need more information, do consult your doctor.
Q5. Are Pneumococcal & Rotavirus vaccination required?
Pneumococcal & Rotavirus vaccination are not compulsory in Singapore.
Do consult your doctor should you require more information.
Q6. Are Permanent Residents (PR) required to pay for the free vaccinations in the polyclinics?
Yes, PRs have to pay at a discount for the free vaccinations offered to citizens.

Do consult the polyclinics regarding the cost.
Q7. What type of vaccinations are given free to Singapore Citizens by the Polyclinics?
1. DTPa - 3in1 (Diphtheria + Tetanus + Acelluar Pertusiss)
2. MMR (Measles, Mumps & Rubella)
3. BCG (Tuberculosis)

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