Vaccines Aide-mémoire

Product route / dosage
Approved population
Schedule
Financial
  • Influenza

  • Influvac
    • IM / deep SC
    • 6 to 35 months: 0.25 to 0.5 ml
    • All others: 0.5 ml

  • Influvac Tetra
    • IM / deep SC
    • 0.5 ml

  • Fluarix Tetra
    • IM
    • 0.5 ml

  • Vaxigrip Tetra
    • IM / SC
    • 0.5 ml

  • SKYcellflu quadrivalent
    • IM
    • 0.5 ml
    • 3 yo and older
  • 6 months to < 5 years
    • Universal

  • 5 years to < 65 years
    • Chronic heart or lung diseases, including asthma
    • On follow-up or was admitted for chronic metabolic (including DM), renal, neurologic, hepatic, or hematologic disorders, or immunocompromised
    • Aged 18 and below and on long-term aspirin therapy (and therefore at risk of Reye syndrome after influenza infection)
    • Pregnancy at any stage
    • On ILTC services

  • 65 years and older
    • Universal

  • MOH circular: hypertension, dyslipidaemia, and pre-diabetes are NOT part of indications
  • 6 months to < 9 years
    • 2 doses 4 weeks apart if receiving influenza for first time

  • All others
    • 1 dose annually or every season  

  • Influenza seasons
    • Northern hemisphere - October to March
    • Southern hemisphere - April to September
    • See MOH circular for specific strains
  • SVL

  • Trivalent
    • Influvac

  • Quadrivalent
    • Influvac Tetra
    • Fluarix Tetra
    • Vaxigrip Tetra
    • SKYCellflu

  • PCV 10 / 13

  • (Pneumococcal conjugate)

  • PCV10 is only for children up to 5 years old

  • Prevenar 13
    • IM
    • 0.5 ml

  • Synflorix (PCV10)
    • IM
    • 0.5 ml
  • 6 weeks to < 5 years
    • Universal

  • 5 years to < 6 years
    • Chronic pulmonary, cardiovascular, renal, or liver disease  
    • Diabetes mellitus
    • Cochlear implant or CSF leak
    • Anatomic or functional asplenia  
    • Immunocompromised  

  • 6 years to < 65 years
    • Cochlear implant or CSF leak
    • Anatomic or functional asplenia  
    • Immunocompromised  

  • 65 years and older
    • Universal
  • 1-3 doses in lifetime, depending on age when first dose is given and indication

  • NCIS routine schedule
    • 3 doses (at ages 4, 6, and 12 months)
    • “Children who did not receive PCV as per routine schedule are recommended to receive age- or indication-appropriate doses”

  • All others (by age/indication)

  • < 1 year
    • 2 doses, 8 weeks apart
    • 1 booster at 1 year old, at least 8 weeks after D2

  • 1 year to < 2 years
    • 2 doses, 8 weeks apart

  • 2 years to < 5 years
    • Healthy: 1 dose
    • Chronic disease / DM / cochlear implant / CSF leak: 1 dose (MOH) / 2 doses, 8 weeks apart (ACIP)
    • Anatomic or functional asplenia / immunocompromised: 2 doses, 8 weeks apart

  • 5 years to < 6 years
    • Chronic disease / DM / cochlear implant / CSF leak: 1 dose (MOH) / 2 doses, 8 weeks apart (ACIP)
    • Anatomic or functional asplenia / immunocompromised: 2 doses, 8 weeks apart

  • 6 years and older
    • 1 dose regardless of indication
    • No need to repeat if completed in childhood
    • No need to repeat at > 65 years if already done at < 65 years
  • SVL
    • Prevenar 13
    • Synflorix (PCV10) only for children
  • PCV 20

  • (Pneumococcal conjugate)

  • Prevenar 20
    • IM
    • 0.5 ml
  • 18 years to < 65 years
    • Chronic pulmonary, cardiovascular, renal, or liver disease  
    • Diabetes mellitus
    • Cochlear implant or CSF leak
    • Anatomic or functional asplenia  
    • Immunocompromised  

  • 65 years and older
    • Universal
  • 1 dose in lifetime, under NAIS
    • No need to follow with PPSV23
    • Can be used to complete any PCV/PPSV series previously started
    • No recommendation under NCIS yet

  • Interval after previous PCV/PPSV (by age/comorbidities)

  • All aged 65 years or older
    • 1 year if either PCV13 or PPSV23 previously
    • 5 years if BOTH PCV13 and PPSV23 previously

  • 18-64 years with DM or chronic pulmonary, cardiovascular, liver diseases
    • 1 year

  • 18-64 years with CSF leak or cochlear implant
    • 1 year if either PCV13 or PPSV23 previously
    • 5 years if BOTH PCV13 and PPSV23 previously

  • 18-64 years with CKD or immunocompromise
    • 1 year if either PCV13 or PPSV23 previously
    • 5 years if BOTH PCV13 and PPSV23 previously
  • SVL
    • Prevenar 20
  • PPSV 23

  • (Pneumococcal polysaccharide)

  • Pneumovax 23
    • IM / SC
    • 0.5 ml
  • 2 years to < 65 years
    • Chronic pulmonary, cardiovascular, renal, or liver disease  
    • Diabetes mellitus
    • Cochlear implant or CSF leak
    • Anatomic or functional asplenia  
    • Immunocompromised  

  • 65 years and older
    • Universal
  • 1-3 doses in lifetime, depending on age and indication

  • Healthy
    • 1 dose at or after age 65 (1 year after PCV13)
    • To give even if given before age 65 (space apart by 5 years)

  • Chronic pulmonary, cardiovascular, renal, liver disease, or DM
    • 1 dose when age 2 years to < 65 years (8 weeks after PCV13)
    • 1 more dose at or after age 65 (1 year after PCV13 and 5 years after PPSV23)

  • CSF leak, cochlear implant
    • 1 dose when age 2 years to < 65 years (8 weeks after PCV13)
    • 1 more dose at or after age 65 (8 weeks after PCV13, 5 years after PPSV23)

  • Anatomic or functional asplenia, immunocompromised
    • 2 doses, 5 years apart, when age 2 years to < 65 years (8 weeks after PCV13)
    • 1 more dose at or after age 65 (8 weeks after PCV13, 5 years after PPSV23)
  • SVL
    • Pneumovax 23
  • Hepatitis A

  • Havrix
    • IM
    • 1 to 18 yo: 0.5 ml
    • 19 yo and older: 1 ml

  • Vaqta
    • IM
    • 1 to 17 yo: 0.5 ml
    • 18 yo and older: 1 ml

  • Avaxim
    • IM
    • 16 yo and older: 0.5 ml
  • 1 year and older*
    • Travellers
    • Occupational exposure to Hepatitis A (e.g. lab)
    • Underlying liver disease
    • Awaiting or received liver transplant
    • Immunocompromised

  • Rationale: at high risk of complications or exposure

  • * Use Havrix or Vaqta in paediatric population because Avaxim is only approved for 16 yo and above
  • 2 doses
    • 6-12 months apart

  • No need for booster
    • >97% remained positive for anti-HAV after 20 years

  • Twinrix (Hep A+B) can also be used for Hep A vaccination (only for 18 yo and above)
    • 3 doses: 0, 1, 6 months
  • Not on SVL
  • Hepatitis B

  • Engerix-B
    • IM
    • 1 to 19 yo: 0.5 ml
    • 20 yo and older: 1 ml
    • 20 yo and older and on haemodialysis: 2 ml

  • Twinrix
    • IM
    • 18 yo and older: 1 ml
    • Not used for < 18 yo

  • Part of 6-in-1 (NCIS only)
    • Infanrix Hexa
    • Hexaxim
  • From birth
    • Universal

  • NAIS: “for persons without evidence of immunity or prior disease”
  • NCIS

  • Routine schedule
    • 3 doses: at birth (Hep B), 2 months (6-in-1), 6 months (6-in-1)

  • Infants born to HBsAg-positive mothers
    • 3 doses: at birth (Hep B), 1 month (Hep B), 6 months (6-in-1)

  • General population
    • 3 doses: 0, 1, 6 months
    • Recheck Hep B status 1 to 2 months after final dose

  • Haemodialysis
    • 4 doses: 0, 1, 2, 6 months
    • Double dose of Engerix-B (2 ml) each time
    • Recheck Hep B status 1 to 2 months after final dose
    • Check anti-HBS annually: 1 booster dose if anti-HBS < 10 mIU/ml
  • SVL

  • Hep B
    • Engerix-B

  • 6-in-1
    • Infanrix Hexa
    • Hexaxim
  • Human Papilloma Virus

  • (HPV)

  • Cervarix / Gardasil / Gardasil-9
    • IM
    • 0.5 ml

  • Gardasil (HPV4) no longer available in SG
  • 9 years to 45 years
    • Universal
    • Applicable to both males and females

  • PI-approved upper age limits
    • Cervarix (HPV2) — till 25 years
    • Gardasil (HPV4) — till 26 years
    • Gardasil-9 (HPV9) — till 45 years

  • NAIS: “If HPV vaccination [implied as HPV2 and HPV4] is initiated but not completed by age 26 years or earlier, remaining dose(s) may be completed after age 26 years, as early as possible, but up to age 45 years”
  • - MOH Circular (13 July 2020)

  • Protection rates
    • Cervarix (HPV2) — 70%
    • Gardasil (HPV4) — 70% + genital warts
    • Gardasil-9 (HPV9) — 90% + genital warts
  • Number of doses (2 or 3) needed is determined by age when first dose is given  

  • Cervarix (HPV2)

  • 9 to 13 years
    • 2 doses: 0, 6 months

  • 14 to 25 years
    • 3 doses: 0, 1, 6 months

  • Gardasil (HPV4)

  • 9 to 13 years
    • 2 doses: 0, 6 months

  • 14 to 26 years
    • 3 doses: 0, 2, 6 months

  • Gardasil-9 (HPV9)

  • 9 to 14 years
    • 2 doses: 0, 6 months

  • 15 to 45 years
    • 3 doses: 0, 2, 6 months

  • Switching between brands
    • No clear guidance from ACIP/SIDS
    • HPV9 may be used to continue or complete a series started with HPV2 or HPV4
    • Protection against HPV type 16 and 18 unaffected. But efficacy against other strains not studied
  • SVL
    • Cervarix
    • Only subsidised for females
  • MMR

  • (Measles + Mumps + Rubella)

  • M-M-R II (LIVE)
    • IM / SC
    • 0.5 ml

  • Priorix (LIVE)
    • SC
    • 0.5 ml

  • M-M-R II and Priorix can be used interchangeably (ACIP MMWR 2022)
  • 1 year and older
    • Universal

  • FDW working in households with a child < 7 years old without documented proof of immunity:  
    • 2 doses of measles vaccine at least 28 days apart
    • Serological evidence of immunity
    • Laboratory confirmation of past infection
    • Exempted if all children < 7 years old in the household are already fully vaccinated

  • NAIS: “for persons without evidence of immunity or prior disease”

  • Post-exposure prophylaxis
    • To give within 72 hours of exposure to measles if unvaccinated or incompletely vaccinated
    • No evidence if exposure was to mumps or rubella
  • NCIS routine schedule
    • 2 doses (12 months, 15 months)
    • Dose 1: separate MMR and V ^
    • Dose 2: combined MMRV
    • 12-week interval between MMR doses here is to harmonise with minimum interval between varicella doses

  • All others (including NCIS catch-up)
    • 2 doses, 4 weeks apart
    • If 1 dose was already given in childhood, only need 1 more dose
  • SVL
    • M-M-R II
    • Priorix
  • Varicella

  • Varivax (LIVE)
    • SC
    • 0.5 ml

  • Varilrix (LIVE)
    • IM / SC
    • 0.5 ml
  • 1 year and older
    • Universal

  • NAIS: “for persons without evidence of immunity or prior disease”

  • Post-exposure prophylaxis
    • Evidence in unvaccinated children if given within 3-5 days of exposure: reduce incidence and severity of disease
    • No evidence for adults
    • No evidence for giving second dose if one dose has already been given
    • But practically, to give if unvaccinated or incompletely vaccinated
  • NCIS routine schedule
    • 2 doses (12 months, 15 months)
    • Dose 1: separate MMR and V ^
    • Dose 2: combined MMRV
    • 12-week interval between MMR doses here is to harmonise with minimum interval between varicella doses

  • Varicella alone
    • 2 doses
    • 1 to 12 years: 12 weeks apart
    • 13 years and older: 4-8 weeks apart

  • HCP vaccination
    • 2 doses, 4 weeks apart
    • DO NOT check varicella antibody levels after vaccine (most commercially available tests are sensitive enough to detect only infection-induced antibodies, and not vaccine-induced antibodies)
    • If 1 dose given previously (even if distantly), only 1 more dose needed to complete schedule
  • SVL
    • Varivax
    • Varilrix
  • MMR + Varicella

  • (MMRV)

  • ProQuad (LIVE)
    • SC
    • 0.5 ml

  • Priorix-Tetra (LIVE)
    • IM / SC
    • 0.5 ml
  • 1 year to 12 years
    • Universal

  • Not for use from 13 years and older
  • NCIS routine schedule
    • 2 doses (12 months, 15 months)
    • Dose 1: separate MMR and V ^
    • Dose 2: combined MMRV

  • Catch-up vaccination
    • 2 doses (0, 3 months)
    • MMRV can be given as first dose only from age 4 years ^
  • SVL
    • ProQuad
    • Priorix-Tetra
  • Zoster

  • Shingrix
    • IM
    • 0.5 ml

  • Zostavax (LIVE)
    • SC
    • 0.65 ml

  • Zostavax no longer available in SG
  • 18 years and older
    • With immunocompromising conditions  

  • 60 years and older
    • Universal

  • Shingrix
    • Effectiveness against zoster > 90%
    • Effectiveness against PHN 70-100%

  • Zostavax
    • Effectiveness against zoster ~ 50%
    • Effectiveness against PHN ~ 65%

  • Shingrix

  • 2 doses
    • Healthy: 2-6 months apart
    • Immunocompromised: 1-2 months apart

  • Previous Zostavax
    • Full 2 doses, after an interval from Zostavax  

  • Previous zoster
    • Full 2 doses, to give after recovery from acute illness (no specific interval recommended)

  • No varicella before
    • Routine varicella serology testing before vaccination is NOT recommended
    • But if serology is confirmed negative, to give varicella vaccination instead
    • Zoster can arise from live attenuated virus in varicella vaccine, but not enough evidence to recommend zoster vaccination after previous varicella vaccination

  • Zostavax

  • 1 dose
  • SVL
    • Shingrix
    • NOT free for HSG
  • Tetanus

  • Tetavax (TT)
    • IM / Deep SC
    • 0.5 ml

  • Imovax d.T. (Td)
    • IM
    • 0.5 ml
  • 6 weeks and older

  • Formulation used depends on age
    • 6 weeks to 6 years: DTaP (5-in-1 / 6-in-1)
    • 7 years and above: Tdap / Td / TT
    • TT is used only for wound prophylaxis
  • Routine vaccination

  • NCIS schedule
    • Primary series: 3 doses (2, 4, 6 months old)
    • Boosters: 2 doses (18 months, 10-11 years old)
    • Use DTaP (5-in-1 / 6-in-1) for all doses except for 2nd booster (Tdap)

  • 7 years and above
    • Refer to Tdap

  • Post-exposure prophylaxis   

  • Completed primary series (at least 3 doses)
    • Clean, minor wound: 1 dose if last > 10 years ago
    • All other wounds: 1 dose if last > 5 years ago

  • Incomplete / unknown primary series
    • Clean, minor wound: 1 dose now, complete age-appropriate series subsequently
    • All other wounds: give Tetanus immunoglobulin (TIG) concurrently with tetanus vaccine
  • Not on SVL
  • Tdap

  • Boostrix
    • IM
    • 0.5 ml

  • Adacel
    • IM
    • 0.5 ml

  • Boostagen
    • IM
    • 0.5 ml
    • Used ONLY as booster
  • 7 years and older
    • 6 years and below should use DTaP

  • NAIS: During every pregnancy

  • ACIP / SIDS
    • Not had at least 3 doses of tetanus/diphtheria vaccines previously
    • Not had at least 1 dose of Tdap previously
    • Due for 10-yearly tetanus/diphtheria booster (Tdap can be used in place of Td)
  • Pregnancy

  • 1 dose
    • Between 16 and 32 weeks (NAIS / SIDS) / 27 and 36 weeks (ACIP) of pregnancy
    • Repeat for each pregnancy
    • If not given during pregnancy, to give immediately postpartum
    • No minimum interval between doses

  • Rationale
    • Provide newborn with maternal antibodies against pertussis
    • Maternal antibodies wane quickly -- vaccinating too early in pregnancy may not be effective
    • Some evidence that vaccinating earlier (27 to 32 weeks) may improve amount of antibody transfer

  • Other indications
    • Primary series: 3 doses (0, 1, 7 months), in any combination of Tdap or Td, with at least 1 dose of Tdap
    • Booster: 1 dose (either Td or Tdap) every 10 years, especially for HCP or elderly
  • SVL
    • Boostrix
    • Adacel
    • Only applicable during pregnancy
  • Tdap + Polio (IPV)

  • Boostrix-Polio
    • IM
    • 0.5 ml

  • Adacel-Polio
    • IM
    • 0.5 ml
  • 3 years and older
  • NCIS routine schedule
    • 1 dose at 10-11 years old
    • Labelled as "B2" on chart
  • SVL
    • Boostrix-Polio
    • Adacel-Polio
  • 5-in-1

  • Infanrix-IPV+HiB
    • IM
    • 0.5 ml

  • Pentaxim
    • IM
    • 0.5 ml

  • 6-in-1

  • Infanrix Hexa
    • IM
    • 0.5 ml

  • Hexaxim
    • IM
    • 0.5 ml
  • Universal

  • 5-in-1

  • 2 months onwards
  • Upper age limit:
    • Infanrix-IPV+HiB : < 5 years old
    • Pentaxim : not stated

  • 6-in-1

  • 6 weeks onwards
  • Upper age limit:
    • Infanrix Hexa : not stated
    • Hexaxim : < 2 years old
  • NCIS

  • Routine schedule
    • 2 months (D1): 6-in-1
    • 4 months (D2): 5-in-1
    • 6 months (D3): 6-in-1
    • 18 months (B1): 5-in-1

  • Infants born to HBsAg-positive mothers
    • 2 months (D1): 5-in-1  
    • 4 months (D2): 5-in-1
    • 6 months (D3): 6-in-1
    • 18 months (B1): 5-in-1
  • SVL
    • Infanrix-IPV+HiB
    • Infanrix Hexa
    • Pentaxim
    • Hexaxim
  • BCG

  • BCG AJV (LIVE)
    • Intradermal
    • < 1 yo: 0.05 ml
    • 1 yo and older: 0.1 ml
  • From birth
    • Universal
  • 1 dose
    • Given at birth
    • Up to 90% protection against TB meningitis and miliary TB if given in neonatal period
    • Vaccinated children ~ 19% less likely to be infected with TB compared to unvaccinated children
  • SVL
    • BCG AJV
  • Typhoid

  • TYPHIM Vi
    • IM / SC
    • 0.5 ml
  • 2 years and up
    • Travellers to endemic areas
    • Migrants
    • Healthcare professionals
    • Military personnel

  • Mandatory vaccination for food handlers ceased since September 2010
  • 1 dose
    • Booster every 2-3 years if risk persists
  • Not on SVL
  • Cholera

  • Dukoral (inactivated)
    • PO
    • Prepare sodium hydrogen carbonate buffer solution (dissolve effervescent granules in 150 ml of cool water)
    • 2 to 6 yo: pour away half (75 ml) of buffer solution
    • Mix vaccine (suspension) into buffer solution and consume within 2 hours
  • 2 years and up
    • Travellers to endemic / epidemic areas
  • 2 to 6 years
    • 3 doses, 1 to 6 weeks apart
    • 1 booster dose after 6 months

  • 7 years and up
    • 2 doses, 1 to 6 weeks apart
    • 1 booster dose after 2 years

  • Notes for all ages
    • Last dose to be completed at least 1 week before trip
    • If interval between doses exceed 6 weeks, to restart schedule
  • Not on SVL
  • Rotavirus

  • Rotarix (LIVE)
    • PO
    • 1.5 ml
    • Oral applicator syringe or tube form

  • RotaTeq (LIVE)
    • PO
    • 2 ml
    • Tube form

  • Both brands: administer towards inner cheek with child seated and leaning back slightly
  • 6 weeks to 24 weeks (Rotarix) / 32 weeks (RotaTeq)
    • Universal (but not in NCIS)

  • Contraindicated in:
    • History of intussusception
    • Uncorrected congenital malformation of GI tract that may predispose to intussusception (e.g. Meckel’s diverticulum)
  • Rotarix

  • 2 doses
    • 4 weeks apart
    • Start preferably by 16 weeks, but latest by 20 weeks
    • 2nd dose no later than 24 weeks

  • RotaTeq

  • 3 doses
    • 4 weeks apart
    • Start between 6 to 12 weeks
    • 3rd dose no later than 32 weeks
  • Not on SVL
  • Meningococcal

  • ACWY (conjugate)

  • Nimenrix
    • IM
    • 0.5 ml

  • MenQuadfi
    • IM
    • 0.5 ml

  • Menveo
    • IM
    • 0.5 ml

  • Menactra
    • IM
    • 0.5 ml

  • B (recombinant protein)

  • Trumenba
    • IM
    • 0.5 ml
  • Haj requirements

  • Visa requirement for travellers 1 year and older
    • 1 dose of quadrivalent (ACWY) vaccine at least 10 days prior to arrival
    • Conjugate vaccine valid for 5 years
    • Polysaccharide vaccine (not available in Singapore) valid for 3 years
  • Nimenrix

  • Primary vaccination
    • 6 weeks to 5 months: 2 doses, 2 months apart + 1 booster at 12 months
    • 6 months to 11 months: 1 dose + 1 booster at 12 months (and at least 2 months after previous dose)
    • 12 months and older: 1 dose

  • Booster
    • 15 to 55 years: 1 dose if at least 4 years since last dose

  • MenQuadfi

  • 1 year and older: 1 dose
    • Booster can be given, but no manufacturer recommendation for timing/indication

  • Menveo

  • Primary vaccination
    • 2 to 6 months: 3 doses, 2 months apart; 4th dose at 12 to 16 months
    • 7 to 23 months: 2 doses with 2nd dose on or after 12 months, and at least 2 months after 1st dose
    • 2 to 65 years: 1 dose

  • Booster
    • Booster can be given, but no manufacturer recommendation for timing/indication

  • Menactra

  • Primary vaccination
    • 9 to 23 months: 2 doses, 3 months apart
    • 2 to 55 years: 1 dose

  • Booster
    • 15 to 55 years: 1 dose if at least 4 years since last dose
  • Not on SVL
  • COVID-19

  • mRNA vaccines

  • Pfizer (Comirnaty)
    • IM
    • 0.3 ml
    • each age range has own type of single-dose vial

  • Moderna (Spikevax)
    • IM
    • 0.5 mcg / 0.5 ml

  • Protein subunit vaccine

  • Novavax (Nuvaxovid)
    • IM
    • 0.5 ml
    • currently unavailable in SG
  • MOH Circular 67/2025 (24 October 2025)

  • Recommended for vaccination (either initial doses or booster doses) in 2025/2026:
    • 60 years and above
    • 6 months and above if medically vulnerable  
    • Residents of aged care facilities

  • Encouraged for vaccination:
    • Healthcare workers
    • Persons living or working with medically vulnerable individuals

  • Others aged 6 months and above who wish to be vaccinated can continue to do so
  • Primary vaccination

  • 6 months to 4 years  
    • Pfizer: 2 doses (3 mcg each), 21 days to 8 weeks apart
    • Moderna: 2 doses (25 mcg each), 28 days to 8 weeks apart

  • 5 to 11 years
    • Pfizer: 1 dose (10 mcg)
    • Moderna: 1 dose (25 mcg)

  • 12 years and above
    • Pfizer: 1 dose (30 mcg)
    • Moderna: 1 dose (50 mcg)
    • Novavax: 1 dose (5 mcg)

  • Immunocompromised  
    • 3 doses in total, regardless of age
    • 6 months to 4 years: add D3 2 months after D2
    • 5 years and above: 0, 2, 4 months

  • Booster doses

  • 1 dose ~ 1 year from last dose
    • Minimum interval of 5 months
    • Brand and dosage according to age groups as above

  • Recently recovered from COVID-19

  • Wait at least 4 weeks after infection
    • But 3 months is better for greater effectiveness
  • Free under the National Vaccination Programme (NVP) for all Singapore Citizens, Permanent Residents, Long Term Pass Holders and certain Short Term Pass holders
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