Mobile vaccine clinics increase COVID-19 booster uptake in SG

Taking COVID-19 vaccines on the road through mobile vaccination teams (MVTs) has helped increase the number of people receiving a booster dose in Singapore, according to local research.

MVTs were rolled out nationwide as part of a coordinated and unified approach with the support of the health ministry. The objective was to reach communities with a high proportion of elderly residents who may be unable to travel to vaccination centres.

Each MVT is led by a registered medical practitioner and could operate as a full team comprising four registered nurses and three support staff or as a smaller team including one registered nurse and one support staff member. About 150 individuals can be vaccinated with a full staff.

“Our study found that MVTs are effective even in a highly urbanized setting with significant population density,” said first author Dr Alex Yap from the National Centre for Infectious Diseases, Singapore, and colleagues.

Roaming to selected locations

For the study, Yap and colleagues used data from national vaccination databases. They evaluated the effectiveness of MVTs in terms of increasing the number of first or second COVID-19 booster doses administered across 190 and 114 locations with 287,216 and 373,940 eligible residents, respectively, between 19 January 2022 to 14 January 2024.

The deployment of MVTs resulted in a 24.35-percent increase (95 percent confidence interval [CI], 15–35.45) in the uptake of the first booster dose and a 182.68-percent (95 percent CI, 154.6–218.56) increase in the uptake of the second booster dose. [BMC Glob Public Health 2026;4:3]

In absolute terms, a total of 2,832 (95 percent CI, 1,809–3,846) and 5,347 (95 percent CI, 5,017–5,687) first and second booster doses were administered via MVTs, respectively, during the study period.

Estimates of intervention effectiveness were replicated across subgroups defined by age, sex, and ethnicity. For the first booster dose, the intervention effectiveness (assessed 7 days following MVT deployment) was 119.97 percent for seniors ≥60 years of age, 27.37 percent for men, 23.63 for women, 35.78 percent for individuals with low socioeconomic status, 25.19 percent for those with high socioeconomic status, 30.93 percent for the Chinese, and 18.86 percent for non-Chinese individuals.

For the second booster dose, the intervention effectiveness (assessed 8 days after MVT deployment) was 207.9 percent for seniors ≥60 years of age, 20.65 percent for women, 182.58 percent for men, 224.28 percent for individuals with low socioeconomic status, 183.84 percent for those with high socioeconomic status, 217.26 for the Chinese, and 172.04 percent for non-Chinese individuals.

Overall, the uptake of the second booster was higher than that of the first booster dose, at 2.8-fold vs 1.2-fold, respectively. This disparity may be attributed to several factors, according to Yap and colleagues.

“When the study period commenced in January 2022, first booster coverage was already approaching ceiling levels at 84 percent. In contrast, the second booster rollout began in April 2022, which allowed for a longer time horizon to track uptake and assess the impact of MVTs during this period,” they explained.

“Additionally, the context surrounding the second booster may have influenced uptake rates. By the time of the second booster rollout, public perception and attitudes towards vaccination may have evolved, potentially affecting willingness to receive additional doses,” they continued.

Road to broader vaccination

Considering the continued importance of regular boosting with updated vaccines in mitigating the risk of severe COVID-19 and COVID-19-related hospitalization during endemicity, MVTs can help a lot. For the most part, MVTs make it convenient for people to get vaccinated by bringing the vaccines closer to their residence, according to Yap and colleagues.

Singaporeans of low socioeconomic status pass on seeking out primary care and preventive services, due to a perceived lack of empathy for their day-to-day lived reality from healthcare practitioners as the principal reason. [Fam Pract 2014;31:81-91]

When it comes to vaccinations in underserved communities, a face-to-face interaction with a healthcare professional makes a huge difference. MVTs create an opportunity for increasing trust, Yap and colleagues noted.

“MVTs may enhance public engagement and increase awareness regarding vaccine information, including that receiving the vaccine is free of charge. This directly addresses a gap identified in an earlier study which found that one in four older Singaporeans cited a lack of information on vaccine choices and effectiveness as reasons for vaccine hesitancy,” they said. [Front Public Health 2022;1:904161]

Yap and colleagues pointed out that MVTs can be repurposed to offer not just COVID-19 vaccinations but also vaccines for other endemic respiratory infections, such as influenza and pneumococcal disease. However, they acknowledged that the intervention should be employed alongside policy-based interventions, such as reducing vaccination-related costs and enhancing public education.

“In Singapore, although healthcare services are generally accessible, financial barriers can still impact vaccine uptake, particularly among lower-income individuals. Thus, it is important to reduce financial barriers that prevent individuals from getting vaccinated … while effective education can address misinformation and increase overall awareness about the benefits and safety of vaccines,” they said. [Int J Equity Health 2022;21:82; Soc Sci Med 2022;296:114767]