The PAP Government will ensure that Singapore has early access to vaccines during future pandemics, as it did during Covid-19.
This is because the PAP plans ahead for a resilient Singapore.
“How the vaccine procurement decisions were made in the early stages of the pandemic is an important story to be told in the House today,” said Minister Ong this Tuesday (Mar 21) when Parliament debated the White Paper on Singapore’s Response to Covid-19.
An abbreviated retelling follows. But do not fear.
“Spoiler alert: This story has a happy ending,” assured Minister Ong.
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Overcoming scarce stocks and incomplete information
Despite our small size, and despite the worldwide shortage, Singapore was the first country in Asia to obtain Covid-19 vaccines, enough for all our people.
But we also paid a price. Here’s what happened.
During the early phase of the pandemic, we set up an inter-agency workgroup chaired by the Head of Civil Service, and comprising senior officials from agencies — PMO (Prime Minister’s Office), MOH (Ministry of Health), A*STAR, EDB (Economic Development Board), HSA (Health Sciences Authority), to develop our vaccine procurement approach.
Once they were formed, they immediately faced two challenges.
First, Covid-19 was a new virus. Although several vaccines were concurrently being developed at that time, nobody knew which one will work. So, which one to buy?
Second, every country was clamouring for vaccines, and there was limited manufacturing capability to meet that demand.
As a small market, we lack negotiating power — always been so. And this would normally push us down the priority queue for delivery. The situation was worsened by supply chain disruptions caused by the pandemic. But time was of essence.
So how to secure assured and early deliveries of vaccines?
On the first question of what to buy, the workgroup recommended a portfolio approach — don’t put all our bets on one vaccine, but buy a selected number of vaccines across different technological platforms. And this includes both mRNA and non-mRNA vaccines.
To identify the most promising candidates, the workgroup was advised by a panel of experts from the research institutes, hospitals and industry.
And since we did not know which vaccine candidate would work, we had to buy several types and if one don’t work: Must make sure the other one has enough volume to cover our population.
So therefore, we needed to over procure, such that the combined volumes of all the vaccine candidates more than cover the population of Singapore.
On the question of how to secure assured and early delivery, we leveraged our relationships with the pharmaceutical companies and entered into advance purchase agreements, with fixed delivery schedules and quantities.
And that made them bite.
Steering through cresting infection waves and variants — while vaccine efficiency waned
Then to ensure quality and safety, all selected vaccine candidates were reviewed by the HSA thoroughly before being authorised for emergency use in Singapore.
Then the Expert Committee on Covid-19 Vaccination, the EC19V, provided a second layer of independent review. And gave recommendations on how to optimise the use of the vaccines.
And the first batch of Pfizer BioNTech vaccines arrived in late 2020. Singapore being the first country in Asia to receive them. We rolled out the national vaccination programme shortly after, from December 2020. Again, one of the first few countries in the world to do so. I think only after UK, US and maybe Israel.
The Moderna vaccine was added to the national vaccination programme in March 2021. and Sinovac Novavax in October 2021 and February 2022, respectively.
While the mRNA vaccines were found to be highly effective in protecting against severe Covid-19 infections, around the middle of 2021, we faced two new concerns.
First, there were early indications that vaccine protection could wane over time, especially amongst the elderly. So boosters would be needed.
We therefore procured additional vaccine doses to administer boosters to the whole population.
Second concern came up: New Covid-19 variants were emerging. There was a real possibility that one or more might break through vaccine protection and cause major new infection waves causing many deaths or many cases of severe illnesses.
Moderna and Pfizer-BioNTech therefore developed the new bivalent vaccines that provide better coverage against the newer virus strains. In September 2022, we took the decision to make a clean switch to these new bivalent vaccines.
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“Looking back today, if we can go back in time, given the uncertainties, the high stakes, what we knew and what we did not know, and challenges we faced, I think we would have done things the same way,” said Minister Ong.
“Because we secured safe and efficacious vaccines, delivered when we needed them most, Singaporeans took them with confidence, even with relief.”
“We built up our population immunity and then achieved DORSCON Green today,” he continued.
That said, Minister Ong also announced six post-pandemic shifts to Singapore’s healthcare system.
These include the early access to vaccines mentioned, more hospital capacity, a restructured Ministry of Health, updated public health laws, the PREPARE Programme for Research in Epidemic Preparedness and Response, and an increased focus on preventive care through Healthier SG.
These are to better prepare Singapore for the next pandemic, which international research shows is inevitable.
And because the PAP Government plans ahead for a resilient Singapore.
