MOH, NCID expert counter claims by doctors on need to halt Covid-19 jabs for schoolboys

Senior infectious diseases specialist David Lye said that the group of doctors had not given the full picture.
Senior infectious diseases specialist David Lye said that the group of doctors had not given the full picture.ST PHOTO: ONG WEE JIN

SINGAPORE - Singapore’s expert committee on Covid-19 vaccination and a senior infectious diseases specialist from the National Centre for Infectious Diseases (NCID) have come out to counter claims by a group of doctors behind an open letter arguing for a halt in the vaccination of young people here.

In a revised statement issued on Monday (June 28), the Ministry of Health (MOH), which oversees the Expert Committee on Covid-19 Vaccination, said that news reports about a child's death in the United States did not state heart failure as a cause, as alleged in the open letter. "The matter is still under investigation by the US authorities," said MOH

In his Facebook post on Monday (June 28), the National Centre for Infectious Diseases' Associate Professor David Lye said the doctors behind the open letter were misleading and misinforming the public.

The open letter - posted on Facebook on Saturday by a doctor, Dr Kho Kwang Po - was addressed to Professor Benjamin Ong, chairman of the expert committee. It came after a 13-year-old American boy died days after he received his second dose of a Covid-19 vaccine in the US.

It had called for a pause in Singapore's vaccination exercise for young people until the US Centres for Disease Control and Prevention (CDC) and organisations elsewhere have produced more robust and convincing data on the case.

The letter was signed by Dr Kho; Dr Wong Wui Min, a cardiologist and heart specialist at W.M. Wong Cardiac and Medical Clinic in Gleneagles Hospital; Dr A.M. Chia; Dr L.W. Ping; and Dr I.W. Yang. It was said to be penned "on behalf of many concerned paediatricians, primary care physicians, specialists, surgeons and GPs".

When contacted by The Straits Times on Monday, Dr Paul Yang, who was the author behind the letter, said he does not intend to retract it.

“The US CDC’s recommendations are suitable for the situation there, given that the virus is spreading rapidly. But Singapore has had the infection under control,” said Dr Yang, a general practitioner. 

He is calling for the second dose to be halted until the CDC’s investigations on the 13-year-old boy have concluded. However, he noted that it is still safe to continue administering the first dose.

Responding to the letter on Monday, MOH said that the letter writers presented a one-sided report on presentations to the Advisory Committee on Immunisation Practices of the CDC. Specifically, they failed to mention that there was available data to indicate that "patients generally recover from symptoms and do well".

The letter writers also failed to mention that subsequent discussions at the same meeting went on to support the vaccination of adolescents because the benefits outweighed the risks, said MOH.

Of the four million children in the US infected with Covid-19 since the beginning of the pandemic, there have been about 380 reported deaths in the 12 to 17 age group. Also, Covid-19 in youth can result in multisystem inflammatory syndrome in children and other prolonged disabilities.

“In the face of a more transmissible Delta variant associated with more severe Covid-19, it is imperative that we protect our children from severe Covid-19 and its complications," said MOH.

"This will have to mean full vaccination of two doses, as studies showed that one dose of the Covid-19 vaccine confers 33 per cent protection against the Delta variant," it added.

Agreeing, Prof Lye said: "There are very few effective treatments for children with Covid-19, unlike for adults. Vaccination is the main protection."

He cited Israel as an example. It had initially not recommended vaccinating children, but is now rushing to do so after schools experienced outbreaks linked to the Delta variant.

Citing a study published in the medical journal BMJ, he noted that the doctors behind the open letter had failed to point out what might happen if the Delta variant "sweeps through our children in massive outbreaks and overwhelms our hospitals".

The peer-reviewed study provided an analysis of 129 studies from 31 countries involving more than 10,000 children. Of these, 22.9 per cent were in intensive care and 3.6 per cent of them died.

Prof Lye added that it is "the same small group of doctors" who were once again "misleading and misinforming the public", noting that three of the doctors were involved in "an infamous letter by the group of 12".

He was referring to an earlier letter published by 12 doctors calling for children to be given the traditional Covid-19 vaccines, such as the Sinovac one, instead of the mRNA ones, which are Pfizer and Moderna. They claimed that it was not known what side effects from these vaccines might surface 10 to 20 years down the road.

Prof Lye also said the doctors who had signed the open letter do not represent the majority of doctors and that they should share their true motivation in repeatedly calling to stop mRNA vaccinations.

He noted that the group of doctors had not given the full picture and they had omitted several important points, such as the risk-benefit conclusion presented by the CDC.

It was concluded that the benefits for vaccination in adolescents and young adults still continue to outweigh the risks, though continued monitoring of the long-term outcomes of myocarditis (inflammation of the heart) after the mRNA vaccines will be important.

The expert committee had on Sunday reiterated that there is a small risk of myocarditis and pericarditis (inflammation of the lining of the heart) associated with mRNA vaccines.

Four of the six cases of myocarditis and pericarditis among people vaccinated here involved men between 18 and 30 years old. All four reported symptoms of heart inflammation within a few days of receiving their second dose of the vaccines and have since recovered.

Thus, the authorities, including the US Food and Drug Administration and CDC, as well as Singapore's Health Sciences Authority and MOH, have highlighted the slight risk, explained the risk benefit and advised counter measures.

These include refraining from strenuous exercise for one week after the second dose and seeing a doctor if one feels unwell.