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Singapore is among one of a few countries that have started giving booster shots to elderly and the immunocompromised. US FDA has recommended Pfizer booster for people aged at least 65 and those at high risk of severe illness.


Is it necessary for me?


It helps reduce the risk of severe illness in the elderly.

Studies show that immunity against coronavirus goes down after the initial shot. Data from Pfizer showed that an additional dose can reduce rates of infection by 11 times and severe illness by 20 times in the elderly. These are hence the first group for consideration for booster shots.


A drop in antibody levels isn’t necessarily a bad thing.

There is always an expected drop in antibody levels after a vaccine is given. Blood full of antibodies would make it sluggish. The quantity of these antibodies is not as important as their quality – whether they can protect the body from illness. Measuring this with certainty is not as clear.


Real world evidence looking at actual infection rates may be better in understanding immunity levels. It does seem that one will more likely suffer more severe effects of the illness if the vaccination was done a longer time ago.


Will extra shots help and are they safe?

Evidence does show that booster shots elicit a stronger immune response. However, as the initial doses are already keeping most of the population well, the benefits of an additional jab may only be marginal for the large majority.


Boosters will provide significant benefit to immunocompromised individuals. Those who are immunocompromised might have difficulties producing satisfactorily high levels of antibodies even after being fully vaccinated. Booster shots will help to bring the level of antibodies up further, though it may remain lower than those who are healthier.


This then strengthens the case for the elderly and those with comorbidities (people with two or more medical conditions) to get the booster shot.


What are the risks involved?

- Not too different from before for common adverse events like fever or local injection site pain, with a small proportion having more serious issues like blood clots and inflammation

- Immune exhaustion: Each additional shot brings the risk that the immune system learns to tolerate the virus rather than recognize it as a threat and seek to eliminate it


What’s the conclusion?

Vaccine booster shots are currently good for some (namely elderly and immunocompromised) but not necessarily for others at this point.


Eligible Singaporeans, Permanent Residents and Long-Term Pass holders aged 50 years old* and above who have received a notification from MOH can get their vaccination done at our clinic free.


*Updated 24 Sep 2021 based on ADDENDUM TO CIRCULAR 119/2021 - FURTHER BOOSTER VACCINATION RECOMMENDATIONS


Getting your Pfizer BioNTech Vaccine at Intemedical Clinic

Before your visit - Book your appointment through https://www.vaccine.gov.sg/ and select Intemedical Clinic (Kovan) - Both doses must be taken at the same centre - Appointment times are between 1pm - 9.30pm

At your visit - Bring proof of your identification (Eg. NIRC/Passport) - Set aside about 1 hour for the visit including 30 minutes of observation time

After your vaccination - Rest and hydrate. Take medications for symptomatic relief for common side effects such as pain over the injection site or fever. If your fever lasts more than 2 days, consult a doctor. - Avoid alcohol for 2 days. Avoid vigorous exercise for 1 week.


Source: https://www.straitstimes.com/world/the-science-behind-covid-19-vaccine-boosters-do-we-really-need-an-extra-shot

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What is Ivermectin?

It is a drug that has been used for the treatment of parasitic worm infections, which has become quite uncommon in a clean country like Singapore. It has gained interest and attention recently with many groups professing its use in the treatment of COVID-19, despite the lack of scientific evidence showing clear benefits.


Why did people get the idea that it can treat COVID?

The idea started in 2020 when Australian researches showed that the medicine could kill the virus in the laboratory setting. But this brings us to the next point.


Ivermectin works in the lab but not necessarily in humans

Though studies have shown that Ivermectin works in vitro (i.e in laboratory on cells) where high concentrations of the drug can be used, this may not necessarily work in humans. For one, the amount of drug needed to have an effect on the virus was much higher than the amount approved for human use and could even be fatal. Lab tests in a petri dish also don’t account for the various systems and complexities in the human body. It has never been used as prophylaxis before.

Ivermectin is approved for use in the treatment of parasitic worm infections. The dosages required are usually for treatment and are short term. What proponents of ‘Ivermectin for COVID-19’ are suggesting is using the drug for prophylaxis – giving the drug to prevent COVID-19. Given the uncertain duration of the pandemic, there is greater uncertainty on how long individuals might have to take a prophylactic drug.


It may give people false hopes and prevent them from seeing a doctor early.

One possible mindset people taking Ivermectin for prophylaxis may adopt is that they may become immune to the effects of the virus or opt against vaccination instead. These individuals run the risk of developing serious illness or even passing the virus on to others.



Patients are advised to not self-medicate with ivermectin and to consult their doctor for proper treatment of COVID-19. If you have any fever or flu like symptoms, you can visit the Intemedical Clinic for consultation at subsidised rates ($10 inclusive of consultation, medication and swab if necessary)4



How to make an appointment with Intemedical Kovan?


Appointment Portal: https://forms.gle/HyGy59i9mYx4sEi96

(most direct and fuss-free)


WhatsApp: 8879 9404

(available during clinic opening hours, 8am to 12am)


Mobile: 8879 9404

(messaging preferred)


Landline: 6243 3036

(please be aware that the phone might be engaged due to high call volume)



Source:


https://www.todayonline.com/singapore/ivermectin-not-approved-treatment-covid-19-consumers-strongly-advised-not-self-medicate

https://www.washingtonpost.com/lifestyle/2021/09/10/ivermectin-covid-humans/

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Children (aged 12 and below) have accounted for 0.6% of all local infection cases in Singapore, with 367 cases as of 15 Sep 2021. So far none of them developed severe illness requiring oxygen supplementation or ICU.


With COVID-19 cases recently increasing as we move towards and endemic stage, as well as the fact that children below 12 are currently not eligible for vaccination – should we be worried?



Most symptomatic children with COVID-19 recover within a week.


This is according to one of the largest studies done in the UK so far. Those that suffer from long lasting symptoms is low. The most common symptoms were headache (62%) and fatigue (55%).

The reason why children may be less likely to have “long COVID” may be due to their more robust innate immune response.


Will children (aged 12 and below) need to be vaccinated in the future?


Health Minister Ong Ye Kung has said that Vaccines for children below 12 could start early next year after trials and regulatory approvals are complete.


Here are some reasons why this may be needed:


1. Children can pass on the virus to vulnerable adults

Currently unvaccinated children form a big potential pool of COVID-19 spread which could in turn spread to households with vulnerable adults


2. There are immunocompromised children that may be at risk of severe illness from COVID-19

These include children with underlying medical conditions such as genetic neurological metabolic conditions - some degree of medical complexity - congenital heart disease, obesity, diabetes, asthma, chronic lung disease, sickle cell disease or immunosuppression.

3. Though a very low proportion of children infected with COVID-19 experience severe illness, this number could increase if there are rising cases amongst children



If your child has any upper respiratory tract symptoms (cough, runny nose, sore throat, fever etc.), you may walk in or arrange an appointment at our clinic for a consultation under the Flu Subsidized Scheme ($10).


Appointment Portal: https://forms.gle/HyGy59i9mYx4sEi96 (most direct and fuss-free)

WhatsApp: 8879 9404

(available during clinic opening hours, 8am to 12am)

Mobile: 8879 9404

(text messaging preferred)

Landline: 6243 3036

(please be aware that the phone might be engaged due to high call volume)


Source: https://www.channelnewsasia.com/singapore/367-children-singapore-infected-covid-19-including-172-delta-variant-2175691

https://specialty.mims.com/topic/covid-19-days-fewer-in-children--experts-explain-why?topic-grouper=news


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