Ministry of Health declares shingles vaccine not cost-effective for subsidies

In November 2024, the Ministry of Health (MOH) in Singapore announced its decision not to subsidise the shingles vaccine, Shingrix, following a parliamentary inquiry. The vaccine, which consists of two doses taken two to six months apart, is priced between $720 to $950, including taxes and consultation fees. This high cost was cited as the primary reason for MOH's stance against public funding for the vaccine, which is produced by the British pharmaceutical company GSK. Despite the vaccine's strong protection rate of over 90% against shingles, particularly for those who have not had the condition before, MOH indicated that its effectiveness may diminish in older populations and those with weakened immune systems. It was highlighted that shingles is a painful illness leading to various complications, most notably postherpetic neuralgia, affecting up to one in five patients. This complicates the public health considerations of providing broad access to the vaccine under the National Adult Immunisation Schedule. Shingles is associated with lasting nerve pain and can also cause serious complications like pneumonia, encephalitis, and hearing loss, especially in older adults, who have a higher risk of developing these issues. As shingles can recur, the importance of vaccination becomes paramount as a preventative measure. The MOH's refusal to provide subsidies raises concerns about accessibility for vulnerable seniors, as some lawmakers, including Mr. Christopher de Souza from Holland-Bukit Timah GRC, had pressed for governmental support to include the vaccine in the immunisation schedule for adults. While the shingles vaccine remains uncategorised for subsidies, the MOH still covers other vaccinations for seniors, such as the annual influenza vaccine and the pneumococcal vaccine, which aims to guard against pneumonia, meningitis, and blood infections. This prioritisation reflects the government's strategy in addressing public health while managing budgetary constraints linked to wider immunisation funding. The decision against subsidising Shingrix fuels a broader dialogue about vaccine accessibility and cost-effectiveness in Singapore's health policy. In summary, the discourse surrounding the shingles vaccine subsidies encapsulates a pivotal public health challenge balancing efficacy, cost, and accessibility for vulnerable populations. These decisions may influence future proposals for vaccinations, prompting health authorities to re-evaluate parameters for assessing the cost-effectiveness of other vaccines.