The National​ Adult Immunisation Schedule (NAIS)1 provides nationally recommended vaccinations that persons aged 18 years or older should adopt to protect themselves against vaccine-preventable diseases. ​​TC_14.png​​


Certain adults are at increased risk of complications or susceptible to vaccine preventable diseases if they have not previously received the vaccination and are in contact with individuals who have the infection. Vaccinations recommended under the NAIS aim to prevent such infections among susceptible individuals and reduce com​plications, morbidity and mortality2.

The NAIS was developed based on international best practice and the recommendations of the Expert Committee on Immunisation (ECI). Considerations include: 

  • Local disease burden;

  • Age, occupation, pre-existing medical conditions, vaccination history; 

  • Vaccine safety, efficacy and cost effectiveness of the vaccines in preventing infections among susceptible individuals and reducing complications, morbidity and mortality.

The NAIS is summarised in Table 1 below1Government subsidies are available for NAIS vaccinations – see Financing section. 

Table 1: National Adult Immunisation Schedule 

​​​​Vaccine​
​18-26 years
​27-64 years
​≥ 65 years
​​​Influenza (INF)​
​​1 dose annually or per season 
​1 dose annually or per sea​son​
​​Pneumococcal conjugate (PCV1​3)
​​​​​​1

​​​​​dose
​​Pneumococcal polysaccharide (PPSV23)​
​1 or 2 doses
(depending on indication)​
​​1 dose
​​Tetanus, reduced diphtheria and acellular pertussis (Tdap)
​​​1 dose during ea​ch pregnancy
​​

​​Human papillomavirus (HPV2 or HPV4)
3 doses
(Females)​​

​​Hepatitis B (HepB)
​​​3 doses
​​Measles, mumps and rubella (MMR) (live)
​​​2 doses​​
​​Varicella (VAR) (live)
​2 doses​​​​


​​Re​commended for adults who meet age requirement
​​
​Recommended for adults with specific medical condition or indication

​​Recommended ​for adults who have ​not been previously vaccinated, or lack evid​ence of past infection or immunity

Other Vaccinations

For the use of other vaccinations not part of NAIS (e.g. yellow fever for travel to endemic areas, meningococcal for Haj), please refer to the Package Insert (PI), available on the Register of Therapeutic Products (under E-services, Infosearch) on the HSA website. There is no need to report to the National Immunisation Registry for these. 

Administering Vaccinations

Healthcare providers should ensure the following during the administration of any vaccine:

  • The vaccine is being given to the correct patient,

  • The vaccine is given at the appropriate time, i.e. appropriate age and interval,

  • The correct vaccine and diluent are given to the patient,

  • The appropriate dose has been measured,

  • The vaccine is being administered via the correct route and technique e.g. subcutaneously vs intramuscularly,

  • The vaccine is administered at the correct site e.g. deltoid vs anterolateral thigh, and

  • The vaccination details should be documented in NIR and clinic's EMR accurately with the type of vaccine, diluent, dose, batch, expiry, date and time administered, route and consent.

After the administration of vaccines, patients should be observed for any immediate post-vaccination adverse effects. Patients should also be advised to monitor for possible side effects of the vaccine once they have been discharged.


The following data fields should be documented in your case notes as part of good clinical practice for all patients enrolled to your practice.

Submission of data fields marked with asterisks* is required for subsidy claims and Healthier SG payments. These are aligned to data being submitted for NAIS claims.

  1. Singapore Drug Dictionary (SDD) code*
  2. Date of Vaccination
  3. Due date of next dose ​​

^ Refers to claim code for MOH Healthcare Claims Portal submission.​​


Free Vaccinations under Healthier SG

For Singapore Citizens (SCs) enrolled in Healthier SG and medically eligible for NAIS vaccinations, these vaccinations will be provided free of charge. Healthier SG GPs therefore do not need to collect payments from Singaporeans enrolled to their clinics. Instead, Healthier SG GPs should claim for the full remuneration using the same process and to the same bank account as for payments made under the Vaccination and Child Development Screening scheme4. <Placeholder for MOH circular on financing details.>

Enrolled SCs will only be able to enjoy the waiver of co-payment when receiving the vaccination at their own enrolled provider. If the SC receives the NAIS vaccination at another provider that they are not enrolled to, prevailing subsidies and co-payment will apply.​

Details on GP remuneration for providing NAIS vaccinations to eligible SCs can be found in the prevailing CHAS agreement. Details on the GP annual service fee can be found in the HSG Cluster-GP LOA.