Petition to the Singapore Ministry of Health: Make Shingles Vaccination Affordable and Accessible for Singapore’s Seniors

Shingles is a painful and often debilitating condition caused by the reactivation of the chickenpox virus. It primarily affects individuals aged 50 and above. For many, it is not merely a passing illness—shingles can lead to severe complications such as post-herpetic neuralgia (PHN), a condition marked by burning, stabbing, or aching pain that can persist for months or even years after the initial rash has healed.

The Shingrix vaccine is highly effective, providing up to 97% protection against shingles and its complications in healthy adults. However, in Singapore, the vaccine is not part of the National Adult Immunisation Schedule (NAIS), making it ineligible for payment via MediSave. With costs ranging from $720 to $950 for the required two doses, many seniors are unable to afford this critical preventive measure.

Why Action is Urgently Needed

1. Preventing Suffering and Unnecessary Medical Costs

Shingles significantly affects the quality of life for seniors and is often misdiagnosed due to its symptoms mimicking other conditions. This misdiagnosis delays treatment, prolongs suffering, and incurs avoidable medical costs.

Our family has personally experienced this. Our grandmother was initially misdiagnosed and had to visit multiple doctors for consultations and re-evaluations before receiving the correct diagnosis. Over a year later, she continues to suffer from debilitating nerve pain caused by shingles, despite the rash having healed.

Her story is not unique. A recent case in the media highlighted a patient who visited several clinics before shingles was identified, incurring significant expenses from repeated consultations and diagnostic tests. Early prevention through vaccination could eliminate these unnecessary costs while sparing individuals from needless pain and anxiety.

https://www.straitstimes.com/singapore/i-wanted-to-bang-my-head-how-a-delayed-shingles-diagnosis-caused-much-suffering 

2. Reducing Healthcare Costs

Treating shingles and its complications is costly for individuals and the healthcare system. By making the Shingrix vaccine more accessible, we can prevent such cases, reducing long-term medical expenses and alleviating the strain on Singapore’s healthcare system.

3. Eliminating the Risk of Recurrences
Shingles isn't necessarily a one-time illness—studies indicate that recurrence rates range from approximately 1% to 9.6%, depending on factors such as age, immune system strength, and underlying health conditions. While the probability of recurrence is relatively low, the potential consequences can be severe, including intense physical pain and emotional distress. Long-term complications, such as PHN, further emphasize the need for preventive measures. Vaccination remains the most effective strategy to significantly reduce both the likelihood of shingles and its recurrence

4. Addressing the “Wait-and-See” Mentality

Many seniors are hesitant to spend on preventive measures, adopting a "wait-and-see" approach due to high upfront costs. This often results in worsened outcomes when shingles strikes. Allowing MediSave to cover the Shingrix vaccine would reduce financial barriers and encourage more seniors to take proactive steps, significantly decreasing the prevalence of shingles.

5. Learning from Global Examples

Progressive policies in other countries show how Singapore could enhance vaccine accessibility:

• Japan: Shingrix is covered under its National Health Insurance for those aged 50 and above, ensuring affordability.
• United States: The vaccine is included in Medicare Part D, making it accessible to seniors and reducing long-term healthcare costs.
• Canada (Ontario): Seniors aged 65–70 are fully subsidized under the Ontario Health Insurance Plan (OHIP), targeting the most vulnerable age group.
  Proposed Measures for Singapore

We respectfully urge the Ministry of Health to:

1. Lead bulk negotiation to lower Shingrix Vaccine Costs: Request the MOH to negotiate with pharmaceutical manufacturers for bulk pricing of the Shingrix vaccine, similar to how we did for Covid vaccines.  At average current cost of S$850, a possible lowering to S$500 (as what was reported in media for U.S., Malaysia, etc.) would mean a >40% saving in out-of-pocket costs for individuals and could facilitate its inclusion in national health initiatives.
2. Include the Shingrix Vaccine in NAIS: Allow MediSave to be used for the vaccine’s cost, making it more affordable for seniors.
3. Provide Targeted Subsidies: Implement tiered subsidies under the Community Health Assist Scheme (CHAS) to ensure equitable access across income levels.
4. Promote Public Awareness: Educate the public on shingles, its complications, and the importance of vaccination to encourage proactive healthcare.

Let’s Protect Our Seniors

Preventing shingles is not just about avoiding a rash or blisters—it’s about protecting lives from prolonged suffering and pain. By enabling MediSave use and providing subsidies, we can empower seniors to adopt preventive healthcare practices, reducing the burden on Singapore’s healthcare resources and improving lives.

We sincerely urge the Ministry of Health to act swiftly. Join us in advocating for change to make shingles prevention accessible and affordable for all seniors in Singapore.

 

https://www.straitstimes.com/opinion/forum/forum-shingles-vaccine-too-costly-in-singapore

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