We came across this message on a Singapore-based Telegram group:

The post has been making the rounds with the claim that certification to be declared medically ineligible for vaccination in Singapore requires costly MRI (magnetic resonance imaging) and ECG (electrocardiogram) scans.

It goes on to claim that the prohibitive cost is why only 300 people are exempted from vaccination, while the majority either do not have the means to go for the scans or fail to get certification even after spending on the process. Finally, the post claims that the situation is exacerbated by the ‘thousands of displaced unvaccinated people’ who are unable to afford the certification process due to having lost their jobs—implying that the loss of jobs is the result of their choice to remain unvaccinated.

It concludes by stating that the certification process is proof of Singaporeans not being allowed to remain unvaccinated by choice.

While there is some overlap between each statement, the post makes the following claims:

• It is not possible to be unvaccinated by choice in Singapore
• Only 300 people are medically exempted from vaccination
• The small number of medically exempted individuals is due to the cost of certification
• Certification to be declared medically unfit for vaccination requires costly MRI and ECG scans
• There are thousands of unvaccinated people who lost their jobs and are therefore unable to afford the certification process

Only 300 people medically exempted from vaccination?

The claim regarding the number of Singaporeans medically ineligible for vaccination appear to originate from local news reports on 10 Jan 2022, in which the Health Minister Ong Ye Kung is quoted stating that around 300 people were medically ineligible for vaccination. This part of the claim in the Telegram message is therefore true, though it must be noted that the number of people with certified medical ineligibility for vaccination may have grown in the time since the figure was reported.

However, the post’s broader point about the lack of freedom to remain unvaccinated in Singapore is contradicted by the same news reports, in which Minister Ong informs that around 132,000 people aged 18 and above remain unvaccinated. In fact, at the time of writing, it is still not compulsory for Singaporeans to partake in vaccination measures.

What is required for an individual to be considered “medically ineligible”?

While MRIs can cost between $800 and $2,000 depending on the needs of the patient (ECGs are significantly cheaper at between $60 and $80), there is no suggestion from any official or credible sources that MRI or ECG scans are required as part of the certification process for medical ineligibility for vaccination.

As such, this claim is false, along with the associated claims regarding costs, including that it prohibits people from seeking certification and that some people have spent ‘thousands’ but have failed to receive certification.

The relatively small number of people certified ineligible for vaccination may be attributed to the stringent requirements for such certification, which can be found in this document published on the Ministry of Health website.

In short, medical exemptions are only granted to individuals who were unable to complete their vaccination regime due to allergies or a severe adverse reaction to the vaccines, as well as those who recently had a transplant or were undergoing immunotherapy or treatment for cancer. The exemption would be provided in the form of a standard paper doctor’s memo which can be obtained at any general practitioner (GP) clinic, or public or private healthcare institutions.

Unvaccinated = no more job?

While not directly related to the issue of medical exemption from vaccination, the Telegram message’s claim of unvaccinated people who have lost their jobs merits a closer look, as authorities in Singapore have indeed been tightening workplace restrictions for unvaccinated individuals.

From 1 February 2022, all Ministry of Manpower (MOM) pass holders aged 18 and above have been required to meet Singapore’s vaccination requirements to enter Singapore, or to apply for or renew their passes. This measure only affects foreigners as Singaporeans do not require a work pass for local employment.

The major development affecting locals was the removal of the concession for unvaccinated workers to enter the workplace with a negative PET (Pre-Event Test) result; from 15 January 2022, unvaccinated workers have instead been barred from returning to the workplace unless they are certified medically ineligible or have recovered from COVID-19 within the past 180 days. In addition, MOM has given notice that if these restrictions result in unvaccinated employees being unable to perform their contracted work, it would not consider the termination of their employment to be wrongful dismissal.

While there are media reports of individuals who have already had their employment terminated as a result of choosing to remain unvaccinated, the exact size of this population is uncertain. In the most recent update, the Parliamentary Secretary for Health Rahayu Mahzam informed Parliament that 48,000 workers remained unvaccinated as of 2 January 2022, while 52,000 workers had been unvaccinated as of 19 Dec 2021. Without determining the precise number of workers in Singapore who have lost their jobs by choosing to remain unvaccinated, it is not possible to evaluate the post’s claims of ‘thousands’ of people who have had their employment terminated.

The post attempts to draw a direct link between the loss of employment and the ability to afford certification for medical ineligibility. Nevertheless, as the claims about the costs of certification have already been shown to be inaccurate, such links are spurious.

The claims contained within the post piggyback on general gripes about high healthcare costs in Singapore as well as frustrations over the shrinking freedoms for the unvaccinated in Singapore.

While the claim on the number of individuals medically exempted from vaccination is true, the post intentionally obfuscates the costs and the process for the certification of ineligibility. Invoking the cases of unvaccinated individuals losing their jobs as well as the truism ‘to live or die in Singapore you need money’ appears to be part of an effort to direct grievances over living costs against the government’s COVID-19 restrictions and vaccination measures.

While some of the details mentioned in the post have a factual basis, the core claims of the post—those regarding the certification process for medical ineligibility for vaccination—are false.