February 29, 2024

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Singapore’s ASAR Transforming Vaccine Safety

In the global fight against the COVID-19 pandemic, the rapid development and distribution of vaccines have been pivotal in safeguarding public health. In Singapore, the government has undertaken a pioneering initiative to ensure the safety and efficacy of these vaccines.

The Active Surveillance System for Adverse Reactions to Medicines and Vaccines (ASAR) Project, a collaboration between Singapore’s Integrated Health Information Systems (IHiS) and the Health Sciences Authority (HSA), represents a groundbreaking approach to vaccine safety monitoring.

The ASAR project is an extension of ongoing efforts by IHiS and HSA to actively monitor the safety of COVID-19 vaccines approved in Singapore. Its primary objective is to empower HSA to proactively oversee the safety of these vaccines, ensuring that the benefits of vaccination consistently outweigh any potential risks. Unlike traditional approaches that rely on spontaneous reporting of adverse events (AEs) by healthcare professionals and companies, ASAR takes an active surveillance stance.

To achieve this, ASAR complements conventional AE reporting with active surveillance, utilising de-identified electronic health records to detect and validate potential safety signals. This data-driven approach allows for the early detection of emerging safety signals and facilitates timely risk mitigation measures to safeguard public health.

ASAR’s contributions extend beyond immediate safety monitoring. By leveraging the findings and investigations from the system, HSA has been able to inform vaccination policies in collaboration with the Ministry of Health (MoH) and the Expert Committee on COVID-19 Vaccination (EC19V). This collaborative effort ensures that vaccination strategies remain aligned with the evolving safety landscape.

The urgency of establishing ASAR became apparent as Singapore embarked on its mission to achieve population-wide immunity through mass vaccination campaigns. The deployment of COVID-19 vaccines to nearly the entire population of Singapore necessitated a robust and active safety surveillance system.

Jalene Poh, the Director of the Vigilance and Compliance Branch at HSA, highlighted the need for an active surveillance system to ensure the early detection of safety signals. Such signals could emerge from the diverse experiences of individuals receiving vaccines, making comprehensive safety monitoring imperative.

The successful implementation of ASAR underscores the significance of cross-government collaboration. This initiative was set in motion well before the approval of the first COVID-19 vaccine in Singapore, emphasising the importance of interoperability and accessibility of databases in the process.

The concerted efforts of HSA, IHiS, MoH, and the Health Promotion Board (HPB) played a pivotal role in swiftly establishing the necessary IT systems and processes for recording all COVID-19 vaccinations. These teams also ensured that the essential datasets were seamlessly integrated into the Business Research Analytics Insights Network (BRAIN), laying the foundation for ASAR’s analytical tools.

ASAR leverages cutting-edge technology, employing artificial intelligence (AI) to centrally aggregate over 2 million de-identified structured and unstructured health records daily. An AI-powered deep-learning algorithm is utilised to detect adverse events related to medicines and vaccines, allowing HSA officers to identify potential links between reported symptoms and administered treatments.

This data-driven approach has significantly enhanced HSA’s capacity to conduct research aimed at improving safety measures for public health protection.

ASAR’s impact on safety monitoring is notable. It has played a crucial role in detecting safety signals early on, such as adverse events like anaphylaxis and myocarditis associated with COVID-19 vaccines. These findings prompted the implementation of risk mitigation strategies, including extended observation periods and post-vaccination recommendations.

Also, ASAR has been instrumental in examining the frequency of serious events like myocardial infarction post-vaccination, providing valuable insights into the overall safety profile of the vaccines. HSA’s transparent publication of safety findings, with 14 safety reports as of February 2023, has bolstered public confidence in the vaccines used in the national vaccination campaign.

Andy Ta, the Director of Data Analytics & AI and Chief Data Officer at IHiS emphasised the potential of electronic health records for safety surveillance. Traditional systems rely on reports from doctors and drug companies, potentially resulting in underreporting and delays. ASAR harnesses electronic health records, offering real-world data for near-real-time safety risk detection and quantification.

ASAR represents a significant milestone in safety surveillance. It is the first nationwide system to employ both structured and unstructured medical records, taken from public acute hospitals and national databases, for active safety surveillance. This secure platform, BRAIN, is at the core of ASAR’s success, providing a modern analytics architecture that can adapt to evolving needs.

As ASAR continues to evolve, it has the potential to serve as a model for safety surveillance beyond COVID-19 vaccines. The collaboration between HSA and IHiS has yielded tools capable of detecting, analysing, and confirming safety signals, and these tools can be adapted for broader use in healthcare.

The adaptability of ASAR and its interoperability with other analytical platforms, including electronic health records, demonstrates its potential to advance safety monitoring across diverse data sources and systems.

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Qlik’s vision is a data-literate world, where everyone can use data and analytics to improve decision-making and solve their most challenging problems. A private company, Qlik offers real-time data integration and analytics solutions, powered by Qlik Cloud, to close the gaps between data, insights and action. By transforming data into Active Intelligence, businesses can drive better decisions, improve revenue and profitability, and optimize customer relationships. Qlik serves more than 38,000 active customers in over 100 countries.

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CTC Global Singapore, a premier end-to-end IT solutions provider, is a fully owned subsidiary of ITOCHU Techno-Solutions Corporation (CTC) and ITOCHU Corporation.

Since 1972, CTC has established itself as one of the country’s top IT solutions providers. With 50 years of experience, headed by an experienced management team and staffed by over 200 qualified IT professionals, we support organizations with integrated IT solutions expertise in Autonomous IT, Cyber Security, Digital Transformation, Enterprise Cloud Infrastructure, Workplace Modernization and Professional Services.

Well-known for our strengths in system integration and consultation, CTC Global proves to be the preferred IT outsourcing destination for organizations all over Singapore today.

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Planview has one mission: to build the future of connected work. Our solutions enable organizations to connect the business from ideas to impact, empowering companies to accelerate the achievement of what matters most. Planview’s full spectrum of Portfolio Management and Work Management solutions creates an organizational focus on the strategic outcomes that matter and empowers teams to deliver their best work, no matter how they work. The comprehensive Planview platform and enterprise success model enables customers to deliver innovative, competitive products, services, and customer experiences. Headquartered in Austin, Texas, with locations around the world, Planview has more than 1,300 employees supporting 4,500 customers and 2.6 million users worldwide. For more information, visit www.planview.com.

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SIRIM is a premier industrial research and technology organisation in Malaysia, wholly-owned by the Minister​ of Finance Incorporated. With over forty years of experience and expertise, SIRIM is mandated as the machinery for research and technology development, and the national champion of quality. SIRIM has always played a major role in the development of the country’s private sector. By tapping into our expertise and knowledge base, we focus on developing new technologies and improvements in the manufacturing, technology and services sectors. We nurture Small Medium Enterprises (SME) growth with solutions for technology penetration and upgrading, making it an ideal technology partner for SMEs.

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HashiCorp provides infrastructure automation software for multi-cloud environments, enabling enterprises to unlock a common cloud operating model to provision, secure, connect, and run any application on any infrastructure. HashiCorp tools allow organizations to deliver applications faster by helping enterprises transition from manual processes and ITIL practices to self-service automation and DevOps practices. 

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IBM is a leading global hybrid cloud and AI, and business services provider. We help clients in more than 175 countries capitalize on insights from their data, streamline business processes, reduce costs and gain the competitive edge in their industries. Nearly 3,000 government and corporate entities in critical infrastructure areas such as financial services, telecommunications and healthcare rely on IBM’s hybrid cloud platform and Red Hat OpenShift to affect their digital transformations quickly, efficiently and securely. IBM’s breakthrough innovations in AI, quantum computing, industry-specific cloud solutions and business services deliver open and flexible options to our clients. All of this is backed by IBM’s legendary commitment to trust, transparency, responsibility, inclusivity and service.

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