COVID vaccination guidelines eased for pregnant, breastfeeding women, cancer patients

SINGAPORE — COVID-19 vaccination guidelines in Singapore have been eased for pregnant women, breastfeeding women, cancer patients currently receiving treatment, and persons who have previously suffered severe skin allergy reactions to medications.

The Expert Committee on COVID-19 Vaccination (EC19V) has been monitoring evidence and developments around the world and has revised its guidelines accordingly, the multi-ministry taskforce (MTF) on the pandemic said at a virtual press briefing on Monday (31 May).

There was no evidence to suggest that the Pfizer-BioNTech or Moderna COVID-19 vaccines may cause harm to pregnant women or their babies, the MTF stated.

However, the committee noted that the amount of data collected on the population segment was still much smaller compared to data on the general population.

It advised pregnant women to discuss the risks and benefits with their doctors to make an informed decision on the vaccination. Pregnant women will be able to register and book a vaccination appointment from 4 June, if they are part of the population group eligible for vaccination.

Similarly, the two vaccines have been deemed to be safe for breastfeeding women and there is no need to stop breastfeeding while receiving the jabs, the EC19V said.

Cancer patients on active cancer treatment remain at an increased risk of complications from COVID-19 but there was no evidence of any safety signals or increased rates of adverse events from mRNA-based COVID-19 vaccines, noted the authorities.

Director of medical services Kenneth Mak noted that MOH had previously exercised "considerable caution" and advised that these patients complete their treatment before getting vaccinated. "At this time, we prefer for these patients to be vaccinated in a hospital setting where they can be better monitored for their health status. And we will review later whether these conditions can be revised."

Persons with Severe Cutaneous Adverse Reactions (SCAR), or sever skin allergy reactions to medications, can also receive both vaccines, even though they were previously not recommended to do so. SCAR includes Stevens-Johnson Syndrome, Toxic Epidermal Necrolysis, Drug Rash with Eosinophilia and Systemic Symptoms, and Drug-induced Hypersensitivity Syndrome.

"These are very severe reactions that occur as a result of taking various types of medications," explained Prof Mak. "And if you have previously had such a severe allergic reaction to medications like antibiotics, you will now be eligible to receive your COVID-19 vaccination."

The EC19V is also reviewing safety data on persons with a history of anaphylaxis, to allow more to be safely vaccinated, it added. The committee said it intends to complete the review in the next two weeks, and will set out guidelines allowing certain persons who have had previous history of anaphylaxis to be vaccinated using mRNA vaccines safely.

Prof Mak said, "We hope that these adjustments to our guidance will offer vaccination opportunities for more people and allow them to benefit from the enhanced immune protection that vaccination offers."

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