Vaccinations: A Singaporean’s rite of passage

Vaccinations: A Singaporean’s rite of passage
Photo Credit: AsiaOne

Photo Credit: AsiaOne

Every child studying in Singapore would recollect how it feels to queue for probably the scariest thing ever, vaccine injections from the attending school health nurse. (Unless, of course you are the one person in class that has a fetish for injections). This ritual, known collectively as the National Childhood Immunisation Programme (NCIP), first initiated in the 1950s with the BCG vaccination that significantly reduced the chances of getting Tuberculosis. Along with the now discontinued use of the smallpox vaccine, you may not remember getting the injections, but you may have the scar to prove it.

Photo Credit: Quora

Photo Credit: Quora

The small scar is a normal outcome of the Tuberculosis vaccine as a small red blister may appear in one to six weeks after the injection is given. This blister may turn into a weeping sore which may take up to three months to heal and in some cases, leaving a scar behind. I do not recommend using sticking plasters during the healing process and instead covering the site with gauze. This allows air to get in and help with the healing process.

- Dr Farhad Fakhrudin Vasanwala, Sengkang Health’s Head of Family Medicine

But is it worth the scarring? You bet! Vaccines train the body’s immune system to fight off diseases by giving it the opportunity to fight a weakened form of the disease. Your immune system then learns how to create antibodies to combat these diseases. Therefore, when you encounter such a disease in the future, even if it’s years later, your body will know how to fend off these horrible diseases.

The NCIP protects us against 11 vaccine-preventable diseases, and 12 if you are a female aged nine to 26.

Most of these vaccines are administered to us within two years of our lives, ensuring that we enjoy the benefits without remembering the cries of pain. However, many of us may never forget the childhood experience of the dreaded vaccination queues that’s part of the Primary School experience, during which children were given compulsory boosters via injections and a weird tasting liquid.

In the past, the BCG vaccination required a booster to be taken at age 12 (Primary 6) to maintain the immunity for Tuberculosis. This booster, known as the “red hot needle”, and only students from the 1989 batch and prior had to go through this. (Ask your parents about their experiences) Another big change was in 2011, when the NCIP was updated and saw the end of the Primary 1 ritual of the NCIP due to a change in the recommended timing in which vaccinations are administered.

While the removal of the “red hot needle” would be much welcomed to anyone looking forward to their next vaccination, some would still prefer it to be totally pain free. There are some innovative new ways such as the microneedle patch that might replace injections, but not anytime soon said Dr Farhad.

Photo Credit: Kevin Lim/The Straits Times

Photo Credit: Kevin Lim/The Straits Times

Microneedle patch is still very new. More field studies needs to be done before it can be recommended by the World Health Organisations and other reputable agencies.

In fact, while some advances in vaccine technology have been made, some aspects are largely unchanged. For instance, the currently used BCG technology has been basically same for the past 80 years plus, using attenuated Mycobacterium bovis strains passaged over 13 years. Due to its variable efficacy of the vaccine, studies are ongoing on developing recombinant BCG vaccines to ensure more predictable immune response. But it is still in clinical trials and not mainstream yet. In the meantime, the most reliable proven method is the best to go.

- Dr Farhad Fakhrudin Vasanwala, Sengkang Health’s Head of Family Medicine

If you have a new-born child or you are trying to mentally prepare yourself for an upcoming vaccination, here’s what you need to know. Yes, vaccines occasionally cause reactions, such as a sore arm or mild fever. Usually that’s like a free “MC” ticket for school kids, but for parents, there is no need to worry. These side-effects are usually mild and the benefit of having your child go through the NCIP is a wiser path of “better safe than sorry”. However, in the case of any serious reactions, see your doctor as soon as possible.

Photo Credit: Singaporedoc

Photo Credit: Singaporedoc

Parents researching on vaccinations also need not worry about your child, getting those fancy MMR, 5-1 and 6-1 vaccinations. The simultaneous administration of vaccines does not increase the rate of adverse reactions or reduce its effectiveness. Inactivated vaccines* can be given on the same day or any other day with other inactivated vaccines. However, different live vaccines should be taken four weeks apart as taking vaccines between those periods will negatively affect the immune system’s response to the diseases from the vaccines.


Information of inactivated vaccines are inferred by the Centers for Disease Control and Prevention, Altanta, USA. Sengkang Health is neither related to the Centers for Disease Control and Prevention nor is it responsible for any of the information presented by them.

This series is made possible through our collaboration with Sengkang Health, a SingHealth institution that aims to build a community compact for a healthier Northeast. We have worked with the doctors of Sengkang Health in creating this health series. Let us know if you want to see more similar content in the comment section below and check out the other articles of this 6-part series.