Should there be a seasonal flu vaccine programme in Singapore schools?

A school-based flu vaccination programme is most feasible in older children in Singapore

The flu is a common illness in children. Fortunately, a school-based seasonal flu vaccination can be a cost-effective tool to improve the uptake of vaccines in children, and can bring substantial health and economic benefits to the broader community. 

Hence, researchers from NUS, led by Assistant Professor Clarence Tam from the Saw Swee Hock School of Public Health, conducted a qualitative study to assess the acceptability and feasibility of a school-based seasonal flu vaccination programme in Singapore. 

Their results, which showed that such a programme would be both widely-accepted and feasible, were published in the journal Vaccine on 18 December.

Assessing the possibility of a school-based vaccine programme 

The team conducted in-depth interviews with key stakeholders, including healthcare professionals, representatives of relevant ministries, preschool principals and parents to understand their perspectives on a proposed school-based seasonal flu vaccination programme. 

The researchers conducted 40 interviews in total. Interviews were then transcribed verbatim and later analysed for their themes. 

The researchers found that a school-based flu vaccination is most feasible in older children in Singapore. Although preschool-aged children are currently the recommended age group for vaccination, the stakeholders suggested introducing the programme in primary and/or secondary schools, where existing vaccination infrastructure would facilitate delivery. 

They also discovered that extensive, age-appropriate public education and awareness campaigns would increase the acceptability of the programme among stakeholders.

Stakeholders also indicated that an opt-out programme with free or subsidised vaccination would be the most likely to achieve high vaccine coverage and make access to vaccination more equitable. 

Next steps

Currently, an evidence-based rationale to estimate the programme’s impact in Singapore is lacking. But the research conducted by the NUS team showed that the participants were supportive of a free or subsidised school-based the flu vaccination programme in primary and/or secondary schools, although children in this age group are not currently a recommended group for vaccination.