Unvaccinated Texans were about 20 times more likely to die from COVID-19 and 13 times more likely to test positive in September than those fully vaccinated, according to a study released by the Texas Department of State Health Services.

The risk of death was 55 times higher for unvaccinated people in their 40s and 23 times higher for Texans in their 30s compared with vaccinated people in the same age groups, according to the Department of State Health Services.

Singapore announced Monday that, beginning next month, it will no longer pay for COVID-19 treatment for people who are "unvaccinated by choice," as the island nation faces a surge in cases.

"The Government is currently footing the full COVID-19 medical bills of all Singaporeans, Permanent Residents and Long-Term Pass Holders ... other than for those who tested positive soon after returning from overseas travel," Singapore's Ministry of Health said in a statement. "For the majority who are vaccinated, this special approach for COVID-19 bills will continue until the COVID-19 situation is more stable."

"Currently, unvaccinated persons make up a sizeable majority of those who require intensive inpatient care, and disproportionately contribute to the strain on our healthcare resources," the ministry noted.

The new policy will apply to all unvaccinated COVID-19 patients who are admitted to Singaporean hospitals or COVID-19 treatment facilities on or after Dec. 8, according to the ministry.

Singapore has one of the highest COVID-19 vaccination rates in the world, with 85% of its 5.5 million people fully inoculated. But the country's health care system is under strain as it grapples with its worst wave of COVID-19 infections since the start of the pandemic.

The U.S. government's top doctor released a step-by-step toolkit on Tuesday morning to help people combat misinformation about COVID-19 vaccines in their own close circles.

"We need people in communities all across our country to have these conversations," Surgeon General Vivek Murthy told ABC News. "This is not just the government that needs to be engaged in these conversations. If anything, it's individuals who have people they trust in their lives who have great power when it comes to helping them move our vaccination rates in the right direction."

The guide provides a road map for vaccinated people to talk to unvaccinated people who have bought into conspiracy theories or lies that spread on the internet about the COVID-19 vaccines.

Over the summer, the surgeon general issued an advisory that called misinformation an urgent public health threat.

The toolkit, which Murthy hopes will be used by health professionals, faith leaders, teachers or parents with children newly eligible for the shot, is the next step in addressing the ongoing problem. November polling from the Kaiser Family Foundation showed that nearly eight in 10 adults have come across false statements about COVID-19 and have either believed them or been unsure if they were true.

"During the COVID 19 pandemic, misinformation has in fact cost people their lives. So we don't have an option to give up," Murthy said.

The information released Tuesday encourages people to talk in person instead of online. One section is even entitled "If you're not sure, don't share!"

It includes discussion questions and illustrations explaining why people share misinformation or what a hypothetical conversation around misinformation could look like. The recommended approach relies heavily on listening, providing empathy and avoiding shame.

"When talking with a friend or family members, emphasize the fact that you understand that there are often reasons why people find it difficult to trust certain sources of information," the guide states.

-ABC News' Cheyenne Haslett

Pfizer is likely to seek authorization from the Food and Drug Administration for a coronavirus vaccine booster shot for people 18 and older as soon as this week, a government official with knowledge of the situation told ABC News.

The U.S. Centers for Disease Control and Prevention recommended the Pfizer booster shot for certain groups of patients six months after their second dose.

Those eligible patients include seniors, adults with certain medical conditions and adults who work in environments that put them at greater risk for exposure to COVID-19.

-ABC News' Eric Strauss

French residents over the age of 65 must get a booster in order to keep their health pass, President Emmanuel Macron said Tuesday.

The health pass, which indicates a person is vaccinated, is mandatory for restaurants, theaters, museums and similar institutions throughout the country.

-ABC News' Ibtissem Guenfoud