The millionth Covid-19 booster or third vaccine jab was injected into an Irish arm this week, but the spotlight has been on no-shows for such appointments rather than the progress made.

When Taoiseach Micheál Martin told the Dáil on Tuesday that only 93,000 people had shown up last week for 180,000 appointments for boosters and suggested there was not the “same urgency” for boosters as for the first doses of the Covid-19 vaccines, this resulted in a political pile-on on Martin. He was accused of unfairly blaming the public for the no-shows.

Compounding the problem is the fact that there are many angry people out there in eligible groups who have been waiting anxiously for their boosters.

Hospital Report

The problem with the booster figures, like with so many things related to Covid-19 and the State’s response, is complicated.

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At the centre of it are technical issues in relation to the vaccination programme, where qualifying people can get booster doses through vaccination centres, GPs or pharmacies.

Communications mess

New HSE figures show that last week 93,000 boosters were administered through vaccination centres or other HSE channels, 70,000 through GPs and 25,000 at pharmacies. Problems emerge with how these three channels are tracked: the three different systems do not fully talk to each other.

The HSE cannot see who cancels appointments at GPs and pharmacies. It also does not immediately know who receives boosters from GPs and pharmacies as it can take several days for booster vaccination records to land from GP surgeries and pharmacies.

As a result, these people can subsequently get a text from the HSE calling them to another appointment or encouraging them to attend a GP or pharmacy for the booster. There have been numerous reports of people struggling to cancel appointments they are repeatedly called to.

HSE chief operations officer Anne O’Connor has acknowledged the problem with “joining the dots” between the three different channels.

All this has created a communications mess at a time when scientific evidence is pointing to the importance of getting booster doses to protect against the new Omicron variant.

Another problem for the HSE is that some people have contracted Covid-19 since their second vaccine doses and so cannot get their booster dose for six months.

Given that more than 300,000 people have been infected here since June, there is an unknown but possibly considerable number who cannot receive a booster yet, regardless of the number of times they are called for an appointment.

The HSE has privately acknowledged this problem too and will be introducing a system where affected people can text back the word “Covid” to messages calling them to booster appointments.

They would then not be offered an appointment for another six weeks, giving the HSE time to allow the two systems covering the vaccinated and infected lists to “talk to each other”.

Rescheduling

Even accounting for the technical problems and the eligibility criteria in relation to the required five-month gap since second doses and post-infection timing, the HSE has said that, for some people, there does not appear to be the same rush to get boosters as there was for primary doses.

Those involved in the vaccination programme say some people are cancelling or even looking to reschedule booster appointments multiple times because the time given does not suit them.

Take-up figures bear this out. Even though boosters have been available to some groups for several weeks, significant numbers of certain age cohorts still have not got their boosters.

As of recent days, the numbers yet to received booster doses include 15 per cent of those aged 80 and over, 22 per cent of people in their 70s, and 28 per cent of healthcare workers.

Fixing the system will be essential before the vaccination programme becomes even more complicated with the rollout of boosters to the 620,000 people in their 50s from today and first vaccine doses to 480,000 five- to 11-year-olds in the coming weeks.