The Communicable Diseases Agency (CDA) and the Ministry of Health issued circular CDA-GEC-0020-2026 on 7 October 2026. It confirms two changes for all licensed healthcare providers and registered medical practitioners, both effective 12 October 2026. Here is what matters for day-to-day practice.
The two headline changes
- COVID-19 vaccination moves into the National Childhood Immunisation Schedule (NCIS) and National Adult Immunisation Schedule (NAIS), transitioning from the National Vaccination Programme (NVP). MOH frames this as a shift from pandemic emergency response to a sustainable long-term programme.
- Vaccines are updated to the XFG variant for 2026/2027, replacing the LP.8.1 versions.
The Expert Committee on Immunisation (ECI) reviewed the 2025/2026 recommendations and advised that they remain unchanged. Who should be vaccinated has not changed; where the vaccine sits in the national schedules has.
Who is recommended to be vaccinated
- Individuals aged 60 years and older
- Medically vulnerable individuals aged 6 months and older
- Residents of aged care facilities
Healthcare workers and people living or working with medically vulnerable individuals are encouraged to consider vaccination. Anyone aged 6 months and older who wishes to be vaccinated can continue to do so.
Medically vulnerable includes: diabetes; heart conditions (heart failure, ischaemic heart disease, cardiomyopathy); chronic lung disease including severe asthma; chronic liver disease including cirrhosis; chronic kidney disease at any stage including dialysis; chronic neurological conditions including stroke; cancer on active treatment; blood conditions such as thalassaemia and sickle cell anaemia; immunodeficiencies including HIV; obesity (BMI ≥ 30); genetic or metabolic conditions including Down’s syndrome and cystic fibrosis; non-cancer immunosuppressive treatment; and pregnancy in any trimester.
Dosing schedule
Unvaccinated individuals
- 6 months to 4 years, not moderately to severely immunocompromised: two doses, eight weeks apart.
- 5 years and older, not moderately to severely immunocompromised: one dose.
- 6 months and older, moderately to severely immunocompromised: three doses; dose 2 eight weeks after dose 1, dose 3 eight weeks after dose 2. No referral form is needed for the third initial dose.
For the two-dose paediatric series, the second dose may be given earlier than eight weeks for those at risk of exposure or severe disease, but not before the minimum interval (21 days for Pfizer-BioNTech/Comirnaty, 28 days for Moderna/Spikevax). If a child has had documented COVID-19 infection, providers may use clinical discretion, in discussion with parents, to give one initial dose instead of two. A child whose second dose falls due on or after turning 5 should still receive it at the 5-year-old dosage.
Vaccine and dose by age (initial doses)
| Vaccine | Age | Initial dose |
|---|---|---|
| Pfizer-BioNTech/Comirnaty | 6 months to 4 years | Two 3 mcg doses |
| Pfizer-BioNTech/Comirnaty | 5 to 11 years | One 10 mcg dose |
| Pfizer-BioNTech/Comirnaty | 12 years and older | One 30 mcg dose |
| Moderna/Spikevax | 6 months to 4 years | Two 25 mcg doses |
| Moderna/Spikevax | 5 to 11 years | One 25 mcg dose |
| Moderna/Spikevax | 12 years and older | One 50 mcg dose |
Previously vaccinated individuals
An additional dose is recommended at around one year, and at least five months, after the last dose. Immunocompromised patients can be considered for an additional dose from five months after their last dose, in consultation with their treating physician.
| Vaccine | Age | Additional dose |
|---|---|---|
| Pfizer-BioNTech/Comirnaty | 6 months to 4 years | One 3 mcg dose |
| Pfizer-BioNTech/Comirnaty | 5 to 11 years | One 10 mcg dose |
| Pfizer-BioNTech/Comirnaty | 12 years and older | One 30 mcg dose |
| Moderna/Spikevax | 6 months to 11 years | One 25 mcg dose |
| Moderna/Spikevax | 12 years and older | One 50 mcg dose |
Moderate to severe immunocompromise
The three-dose initial series applies to: transplant patients on immunosuppressive therapy (solid organ and allogeneic stem cell); cancer patients on active chemotherapy or immunosuppressive therapy; haematological cancers; non-cancer immunosuppressive treatment; end-stage kidney disease; and advanced or untreated HIV.
After recent COVID-19 infection
Vaccinate at the recommended interval after any previous dose and at least 28 days after infection. An interval of three months from infection is recommended for better effectiveness.
The XFG vaccines: availability
- 12 October 2026: Pfizer-BioNTech/Comirnaty for ages 12 and older; Moderna/Spikevax for ages 6 months and older.
- 2 November 2026: Pfizer-BioNTech/Comirnaty for ages 6 months to 11 years.
Practical note: for children under 12, Moderna is available from 12 October, while Pfizer paediatric stock follows on 2 November.
Precautions to counsel on
- Myocarditis: advise males aged 12 to 29 to avoid strenuous physical activity for one week after any dose, and to seek prompt medical attention for chest pain, shortness of breath or abnormal heartbeats. Anyone diagnosed with myocarditis or pericarditis after a COVID-19 vaccine should not receive further doses of any COVID-19 vaccine, mRNA or non-mRNA.
- Anaphylaxis to an mRNA vaccine or its components (including PEG): do not give the same type again. Consider a non-mRNA vaccine instead.
- High-risk hypersensitivity after a previous mRNA dose (urticaria or angioedema within 4 hours, or mucositis or bullous eruptions at any time): do not give an mRNA vaccine again.
- For patients with a history of allergic reactions (under 4 hours) to any other COVID-19 vaccine, or any anaphylaxis, observe for 30 minutes after vaccination with a suitable alternative vaccine.
- Pregnancy and breastfeeding: women planning to conceive, who are pregnant (any trimester) or breastfeeding can be vaccinated.
Subsidy, booking and MediSave
- COVID-19 vaccination stays fully subsidised for Singapore Citizens, Permanent Residents, Long Term Pass Holders and certain Short Term Pass Holders (pass validity of at least 60 days) at participating CHAS GP clinics, polyclinics and Mobile Vaccination Team sites, until further review.
- Because it is fully subsidised, it is not claimable under MediSave 500/700 (or the MediSave Chronic and Preventive Care scheme from 1 January 2027) until further review.
- Patients can book at participating GP clinics via vaccine.gov.sg/covid, or at polyclinics through HealthHub. Healthier SG enrollees are encouraged to visit their enrolled clinic.
Record submission: a compliance point
All vaccination records for vaccines in the NCIS and NAIS must be submitted to the National Immunisation Registry (NIR) or contributed to the National Electronic Health Records (NEHR). With COVID-19 now in the schedules, providers should make sure COVID-19 records are submitted. If your clinic uses an NEHR-contributing EMR or CMS, confirm that COVID-19 vaccination records are flowing through to NEHR, which forwards them to NIR. The circular points to MOH Circular No. 52/2023 for details.
Other updates
The Health Promotion Board’s Child Health Booklet will be revised to reflect the updated NCIS table and will be available on Parent Hub from 1 January 2027.
Checklist for your clinic
- Confirm your stock switches from LP.8.1 to XFG vaccines from 12 October (paediatric Pfizer from 2 November).
- Update patient recall for high-risk groups at around one year, and at least five months, from the last dose.
- Check that your EMR contributes COVID-19 vaccination records to NEHR.
- Brief staff on the myocarditis and hypersensitivity precautions.
- Remember: no referral form is needed, including for immunocompromised patients needing a third initial dose.
Source: MOH/CDA circular CDA-GEC-0020-2026, “Inclusion of COVID-19 Vaccination in the National Childhood Immunisation Schedule and National Adult Immunisation Schedule and the Updated 2026/2027 COVID-19 XFG Vaccine”, dated 7 October 2026, including Annexes A to C. This is a summary for general information. Please refer to the full circular for the authoritative detail, and use clinical judgement for individual patients. Enquiries on the circular can go to go.gov.sg/CDAFeedbackForm.