Laws may change to ban entry of unvaccinated foreigners

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The Ministry of Health (MOH) has proposed changes to laws determining whether foreign travelers who have not received vaccinations against severe infectious diseases may enter Singapore or not.

The Infectious Diseases Act is up for public consultation today, June 27, 2018, and the alterations that the MOH has suggested gives officials “discretionary powers” to deny entrance to non-citizens who have not been vaccinated, and have them returned to the country of embarkation.

Offers of vaccination, isolation or surveillance no longer need to be given before denial of entry, unlike under current laws, which indicate that only non-citizens who are unwilling to accept vaccination, isolation or surveillance are refused entry and returned to their original embarkation point.

The MOH gave the assurance that travelers who arrive in Singapore and are ill will not be sent back, but will be given necessary medical treatment.

According to the MOH, these discretionary powers are to be used “judiciously” for situations which make vaccination, isolation or surveillance impractical, and that these changes to the law are in keeping with practices all over the globe.

The MOH cited such infectious diseases such as Ebola, bird flu, and Middle East Respiratory Syndrome (Mers), which have spread from one country to another. Furthermore, it is the government’s responsibility to protect the country from local and international infectious illnesses, some of which are newly emergent.

At the moment, people who wish to travel in Singapore are only asked to be vaccinated against certain diseases based on a international agreement of 196 nations which include all member countries of the World Health Organization, the International Health Regulations which was released in 2005.

Travelers to Singapore from countries in Latin America and Africa with incidences of yellow fever are presently required to be vaccinated against the disease, a potentially fatal disease spread by mosquitoes. In the last two years there have been around 100 travelers coming from these countries who have not been vaccinated, and who were monitored via telephone for health updates.

However, whether more infectious diseases will be added to the list of required vaccinations is still unknown. There is the issue of “herd immunity” to consider. Herd immunity is how a population is protected by vaccination, and can fail when the number of unvaccinated people grows larger. According to Professor Ooi Eng Eong, who is from Duke-NUS’ infectious diseases program, “Preventing the proportion of non-immune individuals from exceeding this threshold that makes Singapore vulnerable to disease re-emergence and epidemics is thus sensible.”

If the MOH adds such infectious diseases as diphtheria or measles to the last of required vaccinations for non-citizens, migrant workers may likely be affected, since a considerable number of them did not receive vaccinations against these diseases. This would also have an impact on employer costs for hiring migrant workers.

The proposed changes from the MOH would allow for greater freedoms for individuals in the low-risk category, allowing them to be monitored via texts, calls or video conferencing instead of examination visits, and they may also be permitted to do specific work tasks and visit certain places, instead of being given a strict quarantine and be disallowed from working.

However, if high-risk patients transgress the legal restrictions given them, will receive even tighter sanctions. They may receive a quarantine and be disallowed from leaving the country, with the MOH putting them in isolation.

The MOH is also looking at more extensive ways to reach people in affected areas overseas with health advisories concerning infectious diseases that may affect the general public.