COVID-19 VACCINATION IN SINGAPORE
Ever since Singapore kicked off its national vaccination programme for COVID-19, more than 4 million Singaporeans and long-term residents have been fully vaccinated, with more than 8 million doses administered as of 8 September 2021. While vaccination is strongly encouraged in Singapore, it remains voluntary. In total, 81 percent of Singapore’s population has completed their full regimen or received two doses of COVID-19 vaccines, and 83 percent has received at least one dose. According to the Ministry of Health (MOH), vaccination is free for all Singaporeans and long-term residents who are currently in Singapore, with enough vaccines available so that all eligible Singaporeans can get vaccinated.
However, despite the availability of COVID-19 vaccines in Singapore, and leaving aside those who cannot take the vaccine for medical reasons, deciding to get vaccinated may not be a straightforward decision for some. There remains a proportion of the population who may be wary and hesitant about getting their shots, and others who refuse to get vaccinated altogether.
According to a survey conducted by the Institute of Policy Studies (IPS), 67 percent of Singaporeans were willing to take the COVID-19 vaccine if it were offered to them, with 13 percent saying they were unwilling. The rest were neutral on the issue. About half the respondents have concerns about the safety and potential side effects of the vaccine, as well as its efficacy.
Vaccination opposition and hesitancy is not a new phenomenon and has been documented for other types of vaccinations. In recent months, opposition to vaccinations has been discussed more frequently with anti-vaxxers coming together to discuss their thoughts and opinions on online forums and social media. Anti-vaxxers refer to those who disagree with the use of vaccines for a variety of reasons. They believe that vaccines are unsafe and infringe on their human rights, and typically deny the existence or validity of the science supporting their use in the general population. The popularity of these opinions is hard to measure and not many are willing to share their views, however, the Karyawan team managed to speak to three individuals who shared their anti-vaccine sentiments and the reasons behind their vaccine hesitancy.
UNDERSTANDING OPPOSITION TO VACCINATIONS
Shila (not her real name), 34, and a single other of one teenager does not mind when people label her as a conspiracy theorist or an anti-vaxxer. According to her, she had not always been opposed to vaccination, having dutifully received flu jabs and other types of vaccines in the past. However, when COVID-19 vaccines made the news last year, she started to read up more about vaccines, and the more she read up, the more opposed she became to them. According to Shila, her opposition to vaccines comes mainly from a mistrust of the pharmaceutical companies and her fear of the possible side effects.
“I do believe in conspiracy theories. I have been doing research on pharmaceutical (companies) over the internet. There are pharmaceutical companies that were also involved in the development of the vaccine that have faced lawsuits involving some of their drugs. I also believe that the pharmaceutical industry is profit-driven and that they are only interested in selling their products regardless of the possible side effects that will affect consumers. They even come out with so many supplements that is not necessary. And like most of these unnecessary supplements, I feel that vaccines are just a synthetic loaded gun aimed at our immune system,” Shila said.
According to Shila, the fear of complications and possible side effects of the vaccine also play a part in her vaccination hesitancy.
“Another thing that’s stopping me from taking the vaccine are the bad side effects that may come with the second dose. Everybody is different. What if I die? I understand that there is an insurance in case anything happens, but I don’t need to be insured. I just don’t want to die from the vaccination. You don’t know what medical problem you have. What worries me most is that you can still get the virus even if you are vaccinated. The vaccine doesn’t promise to protect you,” Shila added.
Shila shared that, as a parent, she prefers natural or homeopathic treatments instead.
“I am more inclined to natural healings and sunnah healing. I would resort to clinical medications only if I’m really sick. That being said, I am not taking the pandemic lightly. I practise preventive behaviour and I stay away from people as much as I can. Yes, I worry about the pandemic, but I feel that the COVID-19 vaccines were created super fast, so I don’t trust the system at this point of time,” Shila explained.
We also spoke to Shah (not his real name), 32, who is working as a mechanical engineer in a construction firm. He shares the same sentiment when it comes to the rapid development of the vaccine. According to him, the COVID-19 vaccine went through an unprecedentedly rapid process and his concern is that the vaccines were rushed and may not have been properly assessed so their safety is in question.
“I have mixed feelings about the vaccination to be honest. I am skeptical about it for numerous reasons. One that really made me decide not to go for the vaccination was medical experts saying that it is impossible for a vaccine for a pathogen of this deadly calibre to be produced within a short range of time. I feel that the vaccines produced were rushed and there was not enough time for tests to be carried out before releasing them to the world. There are no known long-term side effects in records,” Shah explained.
Indeed, the vaccines were developed in record time. Vaccine development is a long and complex process, often lasting 10 to 15 years and involving a combination of public and private involvement. However, researchers claimed that they were not starting from scratch when they learned about SARS-CoV-2, the virus that causes COVID-19, so there were necessary experimental experience and groundwork to develop the vaccine for COVID-19.
Ifah (not her real name), a 28-year-old teacher, shared that more time should be given to monitor the efficacy of the vaccination.
“I feel that the vaccination must be made entirely voluntary or optional. Your freedom should not be associated with your vaccination status. In fact, I feel that we are used as guinea pigs for research and there is always a risk factor when measuring effectiveness. Personally, I don’t mind being vaccinated if there is substantial research on its effectiveness. However, there are news that reported Pfizer is not as effective, and a third booster is called for, which means that research is still ongoing,” Ifah said.
VACCINATION-DIFFERENTIATED MEASURES: DISCRIMINATING OR ENCOURAGING?
The rollout of vaccines in Singapore has given hope to many Singaporeans of a return to some form of normality with some of the COVID-19 restriction measures being eased for those who have been vaccinated including for dining in and socialising in bigger groups. Fully vaccinated individuals will also be able to take part in other higher-risk activities where masks are removed. With moves made to nudge and encourage people to get the COVID-19 vaccine, incentives have also expanded into the retail, and food and beverage sectors, with a growing array of freebies and discounts extended to those who have gotten their jabs.
However, our interviewees felt that the differentiated safe management measures were discriminatory towards those who have not been vaccinated. They felt that the COVID-19 vaccine has become a source of division. Our interviewees also argue that the differentiated measures run contrary to earlier declarations that vaccination will not be made mandatory.
“They say that vaccination was not mandatory, but most establishments require us to be vaccinated. Because of this, I am indirectly restricted from my personal activities and freedom. The government is saying that it is not mandatory because they do not want to be liable for any health complications, but their regulations are indirectly pointed towards compulsory vaccination. I don’t like to be forced,” Ifah said.
“Currently, it seems that the government has divided the citizens into two categories: vaccinated and unvaccinated. Those who are vaccinated tend to be able to go about their new normal routines such as dining out or attending activities, while those who choose not to, be it for personal or medical reasons, are not able to do so. This has caused a divide and created social awkwardness,” Shah said.
Shila, who is currently unemployed, shared that her vaccination status has also restricted her job application experience.
“Even now when applying for a job, they will ask for my vaccination status. I didn’t get the jobs I applied for because of my vaccination status,” Shila shared.
When asked about their source of information when it comes to vaccination, our interviewees shared that they often refer to online sources and social media. According to them, one need not have to work hard to find information about anti-vaccination. For them, official narratives from the mainstream media obscure the truth, while alternative viewpoints from YouTube commentators deserve to be heard. Indeed, according to sociologist Tan Ern Ser from the National University of Singapore, those who have no access to, are unable to comprehend or do not trust official information may be less accepting of vaccination.
Shila also added that she also has a few friends and a community, with whom she discusses information about the vaccine.
“I have a few friends who have the same mindset as me. I also know a community which opted out of vaccination. They even suggest going for cupping to remove the vaccination if we end up being made to take the vaccine. In fact, I also know people who don’t believe in COVID-19,” Shila shared.
As shared by our interviewees, the anti-vaccine sentiment is associated with conspiracy-thinking and protection of individual freedom. The central dogma of the anti-vaccine ideology is that the vaccines were developed too fast to confirm their efficacy and safety. However, according to our interviewees, they are not against those who are for vaccination and respect everyone’s decision and perspectives on vaccination. They hoped that their opinions will be respected too, and not set them apart from the rest of the society.
“I think that it’s a personal choice and it is clearly said that vaccination is voluntary. I think it is misleading when they said it is not compulsory but at the same time, the unvaccinated are marginalised. People get scared of me when they know I am not vaccinated. COVID-19 is just confusing in all aspects at the moment, so why can’t we have the time to research more about it? Why pressure us when there is no concrete evidence? If I really have to be vaccinated, I want to take my time to do it,” Shila said.
“My body belongs to me, and I should be allowed to decide what I want. I don’t owe anyone a living. I am liable for whatever I want to do. Just because I am in a country, which is practising certain vaccination regulations, does not mean I can indirectly be forced to vaccinate, which makes me unable to live my life normally,” Ifah shared.
“I would like for them to know that vaccination is a personal choice. One should not be discriminated in any way if they choose not to be vaccinated. Those who choose not to be vaccinated should not have their rights taken away from them and be able to continue living normally like everyone else,” Shah said.
Whether they are committed to an anti-scientific cause, or simply undecided about whether to be vaccinated, these choices are often the result of many complicating factors that need to be addressed sensitively, especially if we hope to reach population-level immunity. There is no easy solution, but health authorities can continue to provide easy-to-digest, accurate information to recognise and address the major concerns among those who are hesitant towards vaccination. ⬛
1 Ministry of Health. Update on local COVID-19 situation. 2021, September 9. Retrieved from: https://www.moh.gov.sg/news-highlights/details/update-on-local-covid-19-situation_9_September_2021
2 Ministry of Health. COVID-19 Vaccination. Accessed 2021, September 7 at: https://www.moh.gov.sg/covid-19/vaccination
3 Tan, A. Covid-19 vaccines will be free for S’poreans; vaccination recommended but voluntary for adults. The Straits Times. 2021, February 10. Retrieved from: https://www.straitstimes.com/singapore/health/covid-19-vaccines-will-be-free-for-sporeans-vaccination-recommended-but-voluntary
4 Ong, J. 67% of S’poreans willing to take Covid-19 vaccine, 20% neutral; younger ones more likely to be concerned: IPS study. The Straits Times. 2021, April 26. Retrieved from: https://www.straitstimes.com/singapore/health/67-per-cent-willing-to-take-vaccine-20-per-cent-neutral-younger-sporeans-more
5 Kandola, A. What is an anti-vaxxer? Medical News Today. 2020, November 4. Retrieved from: https://www.medicalnewstoday.com/articles/anti-vaxxer
6 The College of Physicians of Philadelphia. Vaccine Development, Testing, and Regulation. Accessed 2021, September 1 at: https://www.historyofvaccines.org/content/articles/vaccine-development-testing-and-regulation
7 Solis-Moreira, J. How did we develop a COVID-19 vaccine so quickly? Medical News Today. 2020, December 15. Retrieved from: https://www.medicalnewstoday.com/articles/how-did-we-develop-a-covid-19-vaccine-so-quickly#Other-coronaviruses
8 Lee, V. Vaccination perks. The Straits Times. 2021, August 1. Retrieved from: https://www.straitstimes.com/life/vaccination-perks
9 Gan, E. Understanding why some people are not taking Covid-19 vaccines and how to gain their confidence. TODAY. 2021, June 12. Retrieved from: https://www.todayonline.com/singapore/understanding-why-some-people-are-not-taking-covid-19-vaccines-and-how-gain-their
Nabilah Mohammad is a Senior Research Analyst at the Centre for Research on Islamic and Malay Affairs (RIMA). She holds a Bachelor of Science in Psychology and a Specialist Diploma in Statistics and Data Mining.