Balm of Gilead

By James Ong

The day following my second letter of appeal, Dr. Hariharan Subramony sent me a reply on behalf of the Minister for Health.  Reproduced below is the full content of the letter:

Dear Mr Ong

We refer to your email to Mr Khaw Boon Wan, Minister for Health, dated 19 Nov in which you raised various points on vaccine safety. We thank you for your feedback, and would like to provide the following information.

The National Childhood Immunisation Programme is a recommended schedule of vaccinations for infants and young children aimed at preventing dangerous diseases which may result in significant morbidity or mortality. These diseases include diptheria, measles, mumps, rubella, pertussis, tetanus, poliomyelitis, hepatitis B, tuberculosis and pneumococcal disease. The safety and efficacy of a vaccine is reviewed by MOH’s Expert Committee on Immunisation before a decision is made to include that vaccine in the NCIP.

With respect to this statement in your email : “…….there has been no response from your Ministry regarding the concerns raised about the decision to make pneumococcal vaccination compulsory for all children under the age of five”,

we would like to clarify that of the vaccinations included in the NCIP, only 2 (measles and diptheria) are compulsory. The remaining vaccinations, including pneumococcal conjugate vaccine (PCV), are recommended, but are not compulsory by law.

Possible side-effects after PCV vaccination include reactions at the injection site (eg pain, redness, swelling) and fever. These are generally self-limiting. So far, no serious reactions have been causally linked to this vaccine. In Holland, authorities have banned a batch of Prevnar following the deaths of 3 babies who received Prevnar. However, a definite link between the use of Prevnar and the deaths has not been established, and other batches of Prevnar continue to be used in Holland. In Singapore, adverse reactions to vaccines are monitored by the Health Sciences Authority (HSA). If there is any evidence to suggest that a vaccine is unsafe, HSA and MOH will provide appropriate guidance.

Invasive pneumococcal disease is a serious disease. Between 2000 and 2008, there were a total of 157 deaths from invasive pneumococcal disease in Singapore, of whom 5 were under the age of 5 years. Neurologic sequelae may occur among those who survive. Vaccination against pneumococcal aims to minimise the mortality and morbidity associated with the disease. Nonetheless, no vaccine can be guaranteed to be 100% effective or to be totally free of side-effects. The decision whether or not to vaccinate a child with PCV should be made in consultation with a medical practitioner, and an understanding of the risks associated with the disease, and the potential risk of vaccine-related adverse reactions.

Regards

In Dr. Hariharan’s own words, no vaccine can be guaranteed to be 100% effective or to be totally free of side effects.  Parents beware!  What came as a real surprise to me and I am sure, to many parents as well, is that only two vaccines are compulsory by law – measles and diphtheria.  You will get fined if you do not vaccinate your child with these two vaccines.  The fine can be as high as $10,000 and could carry jail sentences as well.  The rest of the ten vaccines are only recommended.  I wonder how many parents are aware of this.  Isn’t it true that children are routinely vaccinated with all the prescribed vaccines according to schedule?  I doubt parents are ever told their rights and asked if they would like to postpone or refuse any vaccines for their children.  So I wrote another letter, this time addressed directly to Dr. Hariharan.  This will be in the next post.