Boosters: Vaccine centre opening hours extended and 15-minute post-jab wait shelved

Opening hours at Covid-19 vaccination centres are to be extended and the 15-minute observation period after a person receives a jab is to be shelved in order to address the rising threat of the Omicron variant, Minister for Health Stephen Donnelly has said.

In a significant acceleration of the booster programme, the Health Service Executive (HSE) told GPs and pharmacies it will be providing immediate support to allow them meet a likely surge in demand.

It came as Mr Donnelly agreed with a suggestion that the impact of the Omicron variant on hospitals could be as bad or worse than the post-Christmas surge last year, with preliminary modelling showing the situation is “very stark”.

Dr Denis McCauley, chairman of the GP committee of the Irish Medical Organisation, has said removing the requirement for people to wait 15 minutes after vaccination would allow GPs to double the number of patients they could give boosters to.

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The change came as GPs were told they can start administering booster vaccines to all adults, though they should continue to prioritise older and more vulnerable patients.

In a statement Minister for Health Stephen Donnelly said that the measures would assist the HSE in achieving “maximum delivery” of vaccines and included:

• Extending the hours of our vaccination centres from 8am to 8pm, seven days a week, operating both walk-in and appointment-based clinics;
• Increasing capacity in vaccination centres (for example, UCD vaccination centre increased from 10 to 15 booths);
• Opening of new vaccination centres including, Richmond Barracks and RDS in Dublin, and a further centre opening in Cork City in early January;
• Expanding GP participation from more than 75 per cent to full participation nationwide, with practices only delivering urgent care outside of the booster programme – this will double the weekly booster doses administered by GPs;
• Increasing the number of pharmacies participating in the programme to 700 this week and aiming to further increase to 1000 participating pharmacies;
• Widening the programme to those aged 40+ from the week starting December 27th;
• Starting the primary vaccination of high-risk children aged 5-11 on December 20th (through paediatric hospitals), opening online registration for children with underlying conditions during the week starting December 27th, with the programme extending to all 5-11 year olds in January;
• Enhanced support from the Defence Forces and other areas of the public service providing a range of supports in vaccination centres.

Mr Donnelly said that Ireland has continued to be a frontrunner in the delivery and uptake of Covid-19 vaccines internationally.

“With over 1.2 million booster doses administered to date, we are currently operating an advanced hybrid model of delivery in Ireland to ensure those who are most vulnerable to Covid-19 are further protected. In advance of the festive season, I have asked that the HSE update the programme to maximise delivery. It is the intention that we will deliver an average of 300,000 booster doses a week in the coming weeks,” he said.

“I am also pleased to announce that vulnerable children aged 5-11 will begin to be offered an appointment from next week and the booster programme will commence offering appointments to those aged 40-49 on the week commencing 27th December.”

Mr Donnelly told RTÉ News on Wednesday that the Government had sought guidance from the National Immunisation Advisory Committee on the observation period matter and the group recommended it be shelved.

“The recommendation to me is that we waive that 15 minutes and I have accepted that recommendation,” he said. “Particularly for our GPs and pharmacists, they signalled it would be very useful in terms of being able to vaccinate more people.

“It’s something we looked at again with the impending threat of Omicron, to just get as many people boosted as possible.”

On reaching a target of 300,000 jabs a week, Mr Donnelly said: “Next week is slightly different in that people will be taking a few days off. We’re only closing the vaccine centres for two days: Christmas Day and St Stephen’s Day.

“The GPs and pharmacists will need to take a bit of time off, so next week is unusual in that way, but essentially what we are doing now is deploying so that we can get to 300,000 per week and keep growing from there.”

On extended opening hours for vaccine centres, he said: “It’s about opening them as long as possible, adding new centres, there may be pop-up centres and basically getting the volume, for every hour they’re open, up.”

He said opening hours are different for each centre and people should also check when walk-in centres are opening in their counties.

Expanded rollout

At present, boosters are being administered to people aged 50 and over, residents of nursing homes and long-term care facilities and those aged 16 and over with an underlying condition or who work in health.

Under new rules, the HSE has told GPs they may now “in next order of priority” offer boosters to pregnant women aged 16 and over, people aged 40-49 years and people aged 16-39 years in descending order by 10-year age cohort (30-39, 20-29 and 16-19 years).

A similar letter was sent to pharmacies on Wednesday but was later recalled by the HSE. A spokesman said it had been sent out to pharmacies in error.

GPs have been told they can move down to younger age groups once they have administered vaccines to their 50-59-year-old patients, he said.

A revised letter sent to the sector tells pharmacies to administer boosters to the over-50s, healthcare workers, people with underlying conditions and pregnant women, but makes no mention of younger age groups.

GPs offering booster doses are to set aside routine work for the next two weeks as part of the plans to accelerate the rollout, according to Dr McCauley. Doctors will continue to deal with urgent cases.

HSE managers are due to contact individual GP surgeries and pharmacies over the coming days to ensure they have sufficient stocks.

Deliveries of extra supplies are expected to take place from Friday up to Thursday, December 23rd.

Pharmacies have been told they can have a “one-off unscheduled delivery” to provide them with sufficient stocks to last 30 days.

Family doctors have been told they can vaccinate all adults while “at all times trying to prioritise the medically vulnerable and the older age groups as much as is practical”, according to Dr McCauley.

Urging people to put a booster “on their Christmas list”, he said patients should check with the website of their practice for an update on how to access a shot. Some patients would be contacted by their doctor but others may be able to make online appointments.

‘Stark situation’

In relation to the possibility of new restrictions being introduced to curb the spread of the Omicron variant, Mr Donnelly said the Government would wait to hear the advice of the National Public Health Emergency Team (Nphet).

“What we know about this variant so far is very sobering,” he said. “We know it is far more transmissible than Delta. We know it is still making people sick. There is a question as to how severe it is in terms of hospitalisations, but we certainly are taking it very seriously.”

He was asked about comments by the English chief medical officer Chris Whitty that suggested the impact on hospitalisations will to be as bad if not worse than last winter and if Nphet modelling predicts a similar impact here. Mr Donnelly replied: “We could well see that, yes.”

He said that Prof Philip Nolan provided some preliminary modelling on Tuesday night “and the reality is the situation is very stark with Omicron”.

Mr Donnelly said he didn’t have the exact figures with him for how many cases per day are being predicted by Nphet’s preliminary modelling, but said the ranges are “very, very wide”.

“Based on what we’re seeing in the UK, it’s reasonable to assume that we are looking at a very high number of cases in the coming weeks,” he added.

Mr Donnelly declined to offer an opinion on how severe any new restrictions recommended by Nphet will be, saying “it wouldn’t be helpful for me to speculate now”.

It was put to Mr Donnelly that it will frighten elderly people that the modelling could be similar to last year. He replied: “Let me be very clear – when you were asking me is it potentially similar to last year in terms of the number of cases, yes, it could well be.

“It could be more in terms of the number of hospitalisations. Yes, that is entirely possible.

“The huge difference to last year is the vaccines and the boosters.”

He said: “Ireland has the highest level of vaccination for people over 60, 70, 80, anywhere in Europe. We’re also seeing a really strong response to the booster programme as well.

“So the level of protection that is being afforded by the two primary doses, but also by the booster, is absolutely huge.”

He encouraged anyone in older age groups that haven’t got their booster jab to get one.

Mr Donnelly also said that the “working hypothesis” is that the booster “significantly increases protection against severe illness” including Omicron cases.

In relation to Omicron, Mr Donnelly said: “There are some things we still don’t know, some really important questions like how much severe illness in terms of hospitalisations and those who end up in critical care.

“Obviously mortality is one of the things we just don’t know yet but there are things we do know which are serious. We know that it is far more transmissible than Delta. And we can see the evidence obviously in the UK now reporting their highest cases.”

‘Tired but willing’

Dr McCauley said doctors were “tired but willing” to do their bit to ensure as many people get a booster as possible.

Booster shots are being offered in 700 pharmacies this week, up from 550 last week and 470 the week before. This is still short of the 1,000 pharmacies that took part in the original vaccine rollout, but Darragh O'Loughlin, secretary general of the Irish Pharmacy Union (IPU), said he hoped to match this number early in the new year. There are about 1,900 pharmacies in the State.

Earlier IT issues that prevented communications between the databases of people vaccinated in pharmacies and those attending HSE vaccination centres have been resolved, Mr O’Loughlin said. Information about a person receiving a booster in a pharmacy is now transferred to the HSE system within minutes so duplication of effort is avoided.

Pharmacies administered 10,000 boosters on Tuesday, and 45,000 last week, up from 17,500 two weeks earlier.

December is the busiest time of the year for pharmacies, he pointed out, and outlets will continue to dispense prescriptions while also administering booster shots.

The IPU has asked the Department of Health to allow pharmacy students administer vaccines as part of the acceleration of the programme.