We Advance | The Revised National Childhood Immunisation Schedule (NCIS) Optimises Childhood Vaccination Adherence

11/29/2024 2:20:00 PM | SHP POP!

The article is contributed/written by

A nurse at SingHealth Polyclinics administering childhood vaccination to safeguard the baby against critical illnesses.

Childhood vaccinations play a critical role in protecting our little ones from severe illnesses, reducing the spread of communicable diseases and minimising national economic and healthcare burdens^2,3. Diseases like tetanus, pertussis, diphtheria, and polio are now largely preventable, thanks to available immunisations that save millions of lives globally each year. ^4,5

Yet, vaccine hesistancy and delayed immunisations can disrupt community immunity and may increase the risk of disease outbreaks. ⁶

How has NCIS helped?

The updated 2020 National Childhood Immunisation Schedule (NCIS) has improved childhood vaccination rates, particularly among children at 18 and 24 months of age.

The National Childhood Immunisation Schedule (NCIS) at a glance.
Learn more about vaccinations here.

The Study

A study¹ was conducted by SingHealth Polyclinics, reviewing the vaccination records of more than 23,000 children aged 2 years old. The study focused on how many children completed their catch-up vaccinations by the time they were 18 months and 24 months old.

The study showed a 5 per cent increase in vaccination rates at 18 months under the new NCIS schedule. The overall vaccination uptake at 24 months was 66 per cent, a 2.6 per cent increase from the old NCIS cohorts.

Here are some key improvements under the revised NCIS:

Reduced Doses and Visits: The number of vaccination dose for children under 2 years old was reduced from 13 to 11 doses, and the number of visits were cut down from 8 to 6.

Greater Convenience: Fewer visits mean less anxiety for parents and children, reduced costs and better catch-up rates.

Why timely vaccinations matter?

Vaccinating children on schedule protects them during their most vulnerable years. By streamlining the immunisation process, the revised NCIS has made it easier for parents to keep up, while also reducing the strain on healthcare services.

Overcoming barriers to vaccination

Vaccine hesistancy is complex and are often driven by fear, misinformation, or logistical challenges and it remains a significant hurdle. Here is how these barriers can be addressed:

Combined vaccines: Time constraints, missed vaccination opportunities, costs, and safety concerns about multiple vaccinations have long been cited as barriers to vaccine uptake^8,13. The introduction of combination vaccines and a simplified NCIS are strategies to help parents to catch up with their child's vaccinations.

Digital tools: Digital decision-support tools can aid parents to increase their vaccine knowledge and reduce hesitancy toward vaccinating their children. In addition, implementing an active surveillance system can provide parents with up-to-date information on vaccine safety and risks, which may further minimise hesitancy.

A stronger community, one vaccine at a time

The NCIS is designed to give every child the best possible protection against serious infections. It is important to adhere to the recommended schedule.

To learn more about the NCIS and the different types of vaccines available, click here.

Together, let's safeguard the health of our children and our community.

References:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10145191/

Belongia, E.A.; Naleway, A.L. Smallpox vaccine: The good, the bad, and the ugly. Clin. Med. Res. 2003, 1, 87–92. [CrossRef]

Childhood Immunisation—Ministry of Health. Available online: https://www.moh.gov.sg/docs/librariesprovider5/resourcesstatistics/reports/childhood-immunisation.pdf (accessed on 3 January 2023).

Vaccines and Immunization. Available online: https://www.who.int/health-topics/vaccines-and-immunization#tab=tab_1 (accessed on 6 January 2023).

Maman, K.; Zöllner, Y.; Greco, D.; Duru, G.; Sendyona, S.; Remy, V. The value of childhood combination vaccines: From beliefs to evidence. Hum. Vaccin. Immunother. 2015, 11, 2132–2141. [CrossRef] [PubMed]

Gust, D.A.; Strine, T.W.; Maurice, E.; Smith, P.; Yusuf, H.;Wilkinson, M.; Battaglia, M.;Wright, R.; Schwartz, B. Underimmunization among children: Effects of vaccine safety concerns on immunization status. Pediatrics 2004, 114, e16–e22. [CrossRef] [PubMed]

Infectious Diseases Act 1976—Singapore Statutes Online. Available online: https://sso.agc.gov.sg:5443/Act/IDA1976 (accessed on 3 January 2023).

Hasnan, S.; Tan, N.C. Multi-domain narrative review of vaccine hesitancy in childhood. Vaccine 2021, 39, 1910–1920. [CrossRef] [PubMed]

Taddio, A.; Chambers, C.; Halperin, S.A.; Ipp, M.; Lockett, D.; Rieder, M.J.; Shah, V. Inadequate pain management during routine childhood immunizations: The nerve of it. Clin.

Ther. 2009, 31, S152–S167. [CrossRef]

Taddio, A.; Ipp, M.; Thivakaran, S.; Jamal, A.; Parikh, C.; Smart, S.; Sovran, J.; Stephens, D.; Katz, J. Survey of the prevalence of immunization non-compliance due to needle fears in children and adults. Vaccine 2012, 30, 4807–4812. [CrossRef]

Dubé, E.; Gagnon, D.; Tuckerman, J.; Kaufman, J.; Danchin, M. Effective Approaches to Combat Vaccine Hesitancy. Pediatr. Infect. Dis. J. 2022, 41, e243.

Griva, K.; Tan, K.Y.K.; Chan, F.H.F.; Periakaruppan, R.; Ong, B.W.L.; Soh, A.S.E.; Chen, M.I. Evaluating Rates and Determinants of COVID-19 Vaccine Hesitancy for Adults and Children in the Singapore Population: Strengthening Our Community's Resilience against Threats from Emerging Infections (SOCRATEs) Cohort. Vaccines 2021, 9, 1415. [CrossRef] [PubMed]

Kaufman, J.; Tuckerman, J.; Bonner, C.; Durrheim, D.N.; Costa, D.; Trevena, L.; Thomas, S.; Danchin, M. Parent-level barriers to uptake of childhood vaccination: A global overview of Systematic Reviews. BMJ Global Health 2021, 6, e006860. [CrossRef]

Article contributed by Dr Tan Ngiap Chuan, Director of Research, SingHealth Polyclinics

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