Q&A: Why has Ireland’s vaccine strategy changed, and how will it work now?

What is the Government doing to change its vaccine strategy?

Essentially the programme is moving to an age-based system once those 70 years and older as well as the vulnerable and people with underlying conditions are taken care of. It follows a recommendation from the National Immunisation Advisory Committee (Niac).

But why? Didn’t they already have a clear strategy?

They did but this appears to be all about speed and simplicity. In its report Niac said age remains the strongest predictor of hospitalisation and death. “While there may be a level of increased risk for certain ethnic groups, or certain occupations, the single highest risk factor remains age, and these groups should be prioritised.” An “operationally simple” programme for 16 to 64-year-olds in descending order is the “most equitable and efficient way of continuing the vaccination rollout”.

German town’s ‘day pass’ gambit offers alternative to Covid restrictions

---

France closes schools for three weeks as Covid-19 surges

---

Concern plans to extend hotel quarantine could breach EU citizens’ rights

---

Netherlands cuts nightly curfew by an hour despite rising Covid cases

---

Surely your job defines your risk?

Sort of, but those most at risk on the basis of profession are still covered, at least according to Niac. Frontline healthcare workers have already been prioritised. And while workers in meat-processing plants had a higher rate of hospitalisation in the first wave, this is no longer the case. “There is no evidence to show a significantly increased risk of severe Covid-19 disease, independent of age and other co-morbidities, in any occupational group to prioritise them for vaccination above their age cohort,” its report states.

So everybody accepts this?

Of course not. The new approach has irked many of those who believe they should be further up the queue due to greater levels of interaction with the public. The move has been labelled a “sucker punch” by gardaí and “extraordinarily disrespectful” by teachers. Carers have also expressed concerns, but Niac has said there is “no evidence to support prioritisation” of carers outside of formal healthcare structures.

What do the independent experts think?

Trinity College Dublin immunologist Prof Kingston Mills is not convinced, and said it was "incredible" the Government could justify the move on the basis of simplicity. "There is a strong argument to be made for vaccinating people who are in more contact with people and thereby reducing transmission of the virus."

However, infectious diseases specialist Prof Sam McConkey believes it will work so long as vaccine supply is assured and people can get vaccinated quickly. “When you start chopping a problem into a lot of different criteria it becomes a very complex problem,” he said of multiple recipient categories. “Even occupational grouping is very confusing, but age – I was born in 1975 and nobody can argue with that.” However, he warned that if vaccine supply stumbles and the system slows, current grievances would likely intensify.

Are other countries focusing squarely on age?

In the UK last February, unions representing police, prison officers and teachers were dismayed at plans to base the next round of vaccines on age rather than profession. Sound familiar? But it does vary and it is complex. A study published by the Israel Journal of Health Policy Research noted that Austria, Germany and the UK all prioritised those 80 years and older before moving incrementally to younger age groups. Portugal initially included people aged 50 and older, but only if they had one of a shortlist of chronic conditions. Sweden began by setting the age threshold at everyone over 18 to be vaccinated in the first half of 2021, but in February began to prioritise those above 65.

Okay, so given all of the above, the question remains for many of us: when will I get vaccinated?

That will become clear in time, but it is hoped that the programme will be accelerated in line with increasing vaccine supply from April. The Department of Health is due to inform various age groups when they can expect to be vaccinated in the coming weeks.