Table Of Contents

• Introduction
• The Importance of Childhood Vaccinations
• Singapore’s National Childhood Immunisation Schedule
  • Birth to 12 Months
  • 12 Months to 6 Years
  • Primary School (7-12 Years)
  • Secondary School (13-17 Years)
• Optional but Recommended Vaccines
• Understanding Vaccine Subsidies and Financing
• Common Vaccine Side Effects and Management
• Keeping Track of Vaccination Records
• What to Do About Missed Vaccinations
• Frequently Asked Questions
• Conclusion

The Importance of Childhood Vaccinations

Vaccines work by stimulating the body’s immune system to recognize and fight specific infectious agents, effectively teaching the immune system to defend against future infections. In Singapore, the National Childhood Immunisation Programme (NCIP) was established to protect children against preventable diseases that once caused significant childhood mortality and morbidity.

The benefits of following the recommended vaccination schedule extend beyond individual protection. When a high percentage of the population is immunized against a disease, it creates what health experts call “herd immunity” or “community protection.” This significantly reduces the risk of outbreaks and protects vulnerable individuals who cannot receive certain vaccines due to age, allergies, or compromised immune systems.

Singapore maintains one of the world’s most comprehensive immunization programs, with coverage rates consistently above 95% for most childhood vaccines. This high vaccination rate has eliminated diseases like polio and diphtheria that were once common childhood illnesses in Singapore.

Singapore’s National Childhood Immunisation Schedule

The National Childhood Immunisation Schedule in Singapore is regularly reviewed and updated by the Ministry of Health based on the latest scientific evidence and disease prevalence. The 2025 schedule continues to provide comprehensive protection against preventable diseases while incorporating several updates from previous years.

Under the Infectious Diseases Act, vaccinations against diphtheria and measles are mandatory for all children living in Singapore. Parents or guardians who fail to vaccinate their children against these diseases without valid medical reasons may face penalties. While other vaccines on the schedule are not legally required, they are strongly recommended by health authorities.

Let’s examine the age-specific vaccination requirements in detail:

Birth to 12 Months

The first year of life is a critical period for establishing immunity against several serious diseases:

At Birth:

• BCG (Bacillus Calmette-Guérin): Protects against tuberculosis
• Hepatitis B (1st dose): First of a three-dose series that protects against hepatitis B infection

At 2 Months:

• 6-in-1 vaccine (DTaP-IPV-Hib-HepB): Combines protection against diphtheria, tetanus, pertussis (whooping cough), polio, Haemophilus influenzae type b (Hib), and hepatitis B (2nd dose)
• PCV (Pneumococcal Conjugate Vaccine): Protects against pneumococcal bacteria, which can cause pneumonia, meningitis, and blood infections

At 4 Months:

• 6-in-1 vaccine (DTaP-IPV-Hib-HepB): Second dose
• PCV: Second dose

At 6 Months:

• 6-in-1 vaccine (DTaP-IPV-Hib-HepB): Third dose

For premature babies or those with specific health conditions, your pediatrician may recommend a slightly adjusted schedule. Always consult with your healthcare provider if you have concerns about your child’s specific vaccination needs.

12 Months to 6 Years

As children grow through toddlerhood and into preschool age, they continue to build immunity with additional vaccines and boosters:

At 12 Months:

• MMR (Measles, Mumps, Rubella): First dose of this combined vaccine
• PCV: Third dose

At 15-18 Months:

• MMRV (Measles, Mumps, Rubella, Varicella): This combination vaccine provides additional protection against chickenpox while boosting immunity to measles, mumps, and rubella

At 18 Months:

• DTaP-IPV-Hib: Fourth dose of the combined vaccine (without the hepatitis B component)

At 4-6 Years (Pre-School):

• DTaP-IPV: Fifth dose, a booster shot that reinforces protection against diphtheria, tetanus, pertussis, and polio
• MMR: Second dose (if MMRV was not given at 15-18 months)

The 2025 schedule emphasizes the importance of the MMRV vaccine at 15-18 months, which combines protection against measles, mumps, rubella, and varicella (chickenpox). This combination reduces the number of injections a child needs while providing comprehensive protection.

Primary School (7-12 Years)

As children enter primary school, their vaccination schedule focuses primarily on boosters to maintain immunity levels established in early childhood:

At 10-11 Years (Primary 5):

• Tdap (Tetanus, reduced-diphtheria, and acellular pertussis): Booster shot

The School Health Service conducts vaccination programs in primary schools, making it convenient for children to receive their scheduled immunizations without parents needing to make separate clinic appointments. Parents will receive consent forms and information about these school-based vaccinations before they are administered.

If your child missed any earlier vaccinations, the primary school years are also a good time to catch up. Speak with your child’s healthcare provider about a catch-up schedule.

Secondary School (13-17 Years)

Adolescent vaccinations focus on maintaining immunity and adding protection against additional diseases:

At 13-17 Years:

• HPV (Human Papillomavirus): A two-dose series administered 6-12 months apart. This vaccine protects against several types of HPV that can cause cervical cancer and other cancers. Historically offered only to girls, the 2025 schedule continues the recommendation that boys also receive this vaccination for broader protection and community immunity.

The HPV vaccination program is offered through schools, but it can also be obtained at polyclinics and CHAS GP clinics with subsidies. Secondary school-aged children who missed earlier vaccinations can also receive catch-up doses during this time.

Optional but Recommended Vaccines

Beyond the mandatory and nationally scheduled vaccines, several additional immunizations are recommended by healthcare professionals in Singapore. While these are not required by law, they provide important protection against other diseases:

Influenza (Flu) Vaccine: Recommended annually for all children 6 months and older. This is especially important for children with chronic health conditions such as asthma or diabetes.

Hepatitis A Vaccine: A two-dose series that protects against hepatitis A virus, which can cause liver disease. This vaccine is particularly recommended for families who travel frequently or plan to visit areas where hepatitis A is common.

Rotavirus Vaccine: An oral vaccine given to infants to protect against rotavirus, a common cause of severe diarrhea in young children. This is typically administered in 2-3 doses before 8 months of age.

Meningococcal Vaccine: Protects against meningococcal bacteria, which can cause meningitis and blood infections. This is recommended for children and adolescents with certain medical conditions and those traveling to areas where meningococcal disease is common.

Japanese Encephalitis Vaccine: Recommended for children who will be traveling to rural areas in countries where Japanese encephalitis is endemic.

The decision to give these optional vaccines should be discussed with your child’s pediatrician, who can provide recommendations based on your child’s specific health status, travel plans, and risk factors.

Understanding Vaccine Subsidies and Financing

Singapore offers substantial subsidies for childhood vaccinations to ensure that financial constraints don’t prevent children from receiving necessary protection against diseases:

Mandatory Vaccines: All Singaporean children can receive the nationally recommended vaccines at highly subsidized rates at polyclinics and CHAS (Community Health Assist Scheme) GP clinics.

MediSave: Parents can use MediSave to pay for their children’s vaccinations under the National Childhood Immunisation Schedule. Up to S$600 can be withdrawn from the child’s or parents’ MediSave account for this purpose, with a limit of S$600 per account per year.

Enhanced Subsidies for 2025: The government has enhanced subsidies for several vaccines, including:

• The 6-in-1 vaccine (DTaP-IPV-Hib-HepB)
• The pneumococcal conjugate vaccine (PCV)
• The human papillomavirus (HPV) vaccine

CHAS Subsidies: Families with CHAS cards can receive additional subsidies when their children receive vaccinations at participating CHAS GP clinics. The subsidy amount varies depending on the type of CHAS card (Blue, Orange, or Green).

For the most current subsidy information, parents should check the Ministry of Health website or inquire at polyclinics and CHAS GP clinics. Remember that while there are costs associated with vaccinations, these are significantly lower than the potential costs of treating vaccine-preventable diseases.

For families experiencing financial difficulties, additional assistance programs may be available through social service agencies. Don’t hesitate to discuss financial concerns with healthcare providers, as ensuring children receive necessary vaccinations is a public health priority.

Common Vaccine Side Effects and Management

While vaccines are generally safe and serious side effects are rare, many children experience mild reactions. Understanding these common side effects and how to manage them can help parents feel more confident about the vaccination process:

Common Mild Side Effects:

• Pain, redness, or swelling at the injection site
• Mild fever (below 38°C or 100.4°F)
• Irritability or fussiness
• Decreased appetite
• Drowsiness

Managing Vaccination Discomfort:

1. For pain or swelling at the injection site, apply a clean, cool washcloth.
2. For fever, ensure your child drinks plenty of fluids. Fever-reducing medications like paracetamol (Panadol) can be given according to your doctor’s instructions.
3. Cuddle and comfort your child, as extra attention may help soothe them.
4. For babies, nursing or bottle feeding immediately after vaccination can be comforting.

When to Call the Doctor:

• Fever above 40°C (104°F)
• Seizures or convulsions
• Excessive crying or irritability (crying for more than 3 hours)
• Unusual drowsiness or unresponsiveness
• Severe swelling or redness extending beyond the injection site
• Any symptoms that concern you as a parent

While rare, severe allergic reactions (anaphylaxis) can occur. These typically happen within minutes to hours after vaccination and require immediate medical attention. Signs include difficulty breathing, hoarseness or wheezing, hives, paleness, weakness, fast heartbeat, or dizziness.

Healthcare providers typically ask parents to wait at the clinic for 15-30 minutes after vaccination to monitor for any immediate reactions. This waiting period is an important safety measure, especially for first-time vaccinations.

Keeping Track of Vaccination Records

Maintaining organized records of your child’s vaccinations is important for several reasons:

Health Records Access: In Singapore, parents can access their children’s vaccination records through the HealthHub portal or mobile app. This digital system maintains a comprehensive record of all vaccinations administered at polyclinics, participating GP clinics, and school-based health services.

Importance of Record-Keeping:

• School enrollment: Many schools require vaccination records before enrollment
• Travel: Certain countries require proof of specific vaccinations for entry
• Future healthcare: Accurate vaccination history helps healthcare providers make informed decisions
• Avoiding unnecessary re-vaccination: Documentation prevents the need for repeat doses

If you’ve recently moved to Singapore, bring any previous vaccination records to your child’s first healthcare appointment. Your healthcare provider can help determine which vaccinations your child has already received and which ones are still needed according to Singapore’s schedule.

For children born outside Singapore who may have followed a different vaccination schedule, healthcare providers can develop a personalized catch-up schedule to ensure they receive all recommended immunizations.

What to Do About Missed Vaccinations

Life gets busy, and sometimes vaccinations may be delayed or missed entirely. The good news is that it’s never too late to catch up:

Catch-Up Vaccination Principles:

• There’s no need to restart a vaccination series if previous doses were given
• Additional doses can be given to complete the series, regardless of how much time has passed
• Multiple vaccines can usually be administered during the same visit to catch up more quickly

Creating a Catch-Up Schedule:

If your child has missed several vaccinations, consult with a healthcare provider who can create a personalized catch-up schedule. This schedule will prioritize vaccines based on:

• Your child’s age
• Previously received vaccines
• Risk of exposure to specific diseases
• The presence of any risk factors or health conditions

For school-aged children who have missed earlier vaccinations, the School Health Service works with parents to develop catch-up plans. This may include additional vaccination sessions at school or referrals to polyclinics for the required immunizations.

Remember that catching up on missed vaccinations is important at any age. Even if your child is older than the typical age for certain vaccines, they can still benefit from the protection these immunizations provide.

Frequently Asked Questions

Q: Can my child receive vaccinations if they have a cold or mild illness?
A: In most cases, a mild illness with a low-grade fever is not a reason to postpone vaccination. However, if your child has a moderate or severe illness, with or without fever, it’s best to wait until they recover before getting vaccines. Always consult with your healthcare provider about your child’s specific situation.

Q: Can multiple vaccines be given during the same visit?
A: Yes, receiving multiple vaccines during a single visit is safe and effective. The immune system can handle multiple vaccines at once, and this approach reduces the number of clinic visits needed. The vaccines in the National Childhood Immunisation Schedule are specifically timed to provide optimal protection.

Q: What if my child has allergies?
A: Before vaccination, inform your healthcare provider about any allergies your child has, particularly to previous vaccines, vaccine components, or foods like eggs (which are used in some vaccine production). Alternative formulations or precautions may be recommended based on specific allergies.

Q: Do vaccines cause autism?
A: Multiple large scientific studies have found no link between vaccines and autism. The original study that suggested this connection has been retracted due to serious procedural and ethical flaws.

Q: What if we’re planning to travel abroad?
A: If you’re planning international travel, consult with a healthcare provider at least 4-6 weeks before departure. Depending on your destination, additional vaccines or an accelerated schedule might be recommended. Some countries require proof of certain vaccinations for entry.

Q: Where can I get more information about vaccines?
A: Reliable sources of information include your child’s healthcare provider, polyclinic, the Ministry of Health website, and the HealthHub portal. These sources provide evidence-based information about vaccines, their benefits, and potential risks.

Conclusion

Navigating your child’s vaccination schedule is an important responsibility that contributes significantly to their long-term health and wellbeing. Singapore’s comprehensive National Childhood Immunisation Programme offers protection against numerous preventable diseases, with the 2025 schedule incorporating the latest evidence-based recommendations.

By following the recommended schedule, taking advantage of available subsidies, and staying informed about your child’s vaccination needs, you’re providing them with essential protection against serious diseases. Remember that vaccination is not just an individual choice—it contributes to community immunity that protects vulnerable members of society who cannot be vaccinated.

If you have questions or concerns about your child’s vaccinations, don’t hesitate to discuss them with your healthcare provider. They can provide personalized advice based on your child’s specific health needs and circumstances.

Keeping up with your child’s immunizations is one of the most important steps you can take to ensure they grow up healthy and protected against preventable diseases. The small discomfort of vaccinations is far outweighed by the significant protection they provide throughout childhood and beyond.

Staying informed about Singapore’s vaccination requirements and recommendations is an essential part of responsible parenting. With the updated 2025 National Childhood Immunisation Schedule, you now have a comprehensive framework to ensure your child receives timely protection against preventable diseases.

Remember that immunizations not only protect your child but also contribute to broader public health by preventing the spread of contagious diseases. By following the recommended schedule and keeping accurate records, you’re making an important investment in your child’s health that will benefit them throughout their life.

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