Are there enough vaccinators for the peak weeks ahead?

As the campaign steps up, pharmacists have yet to administer a single dose

Justin Trudeau, Canada’s prime minister, receives a dose of the AstraZeneca Covid-19 vaccine in a pharmacy in Ottawa, Ontario, Canada. Photograph: Adrian Wyld/CP/Bloomberg

Justin Trudeau, Canada’s prime minister, receives a dose of the AstraZeneca Covid-19 vaccine in a pharmacy in Ottawa, Ontario, Canada. Photograph: Adrian Wyld/CP/Bloomberg

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Last week, images circulated internationally of Canadian prime minister Justin Trudeau at a pharmacy in Ottawa, sleeve rolled up, vaccine syringe stuck in his tattooed arm.

While the photo helped publicise the vaccination campaign of a country far away, it irked pharmacists here who are looking on as colleagues abroad play leading roles in the vaccination drive.

As Ireland’s unprecedented vaccination programme prepares to step up several gears in the coming weeks, authorities maintain sufficient recruitment is in place but the process has not been free of tension.

Darragh O’Loughlin, secretary general of the Irish Pharmacy Union (IPU) who is quick to reference the Trudeau photo op, says that despite being mentioned in the early vaccine strategy, pharmacies and their expert staff have yet to administer a single dose.

“It feels like at that stage they started isolating pharmacists. It feels like that in retrospect,” he says of the health authorities’ apparent prioritisation of more than 30 vaccination centres around Ireland set to step-up services as supplies increase in the weeks ahead.

About 2,000 pharmacists are trained and ready to go and about 1,200 pharmacies have made themselves available to give the vaccine, according to the IPU. It says that aside from an ability to administer injections, community pharmacists can offer reassurance in an era of heightened vaccine hesitancy.

“It’s deeply frustrating that we haven’t done one vaccine in a pharmacy despite the fact we did 300,000 flu vaccines last October,” O’Loughlin adds.

The HSE maintains it is working with the sector. Much of the problem appears to lie in the technicalities of storing and administering highly valuable stocks that require specific handling.

“At the moment... we’re under capacity with our other channels in terms of general practice and the vaccination centres but we clearly want to get pharmacists on board,” Damien McCallion, the HSE’s national lead on the vaccination programme said on Thursday.

The IPU says vaccine handling is not necessarily an issue at community level (they can survive in specialised fridges on site for a limited time) but in the meantime the HSE is pushing to find enough specialised staff to stick needles in arms though its centre network.

Figures supplied to The Irish Times show that between 1,500 and 2,600 full-time staff (based on whole time equivalents) will be required for its Centralised Vaccination Clinics. The recruitment drive has to date received more than 3,600 “eligible applications”, while at least another 1,300 are coming via agencies.

All are being processed and trained. This week there are 864 full-time staff (equivalents) in place, more than required based on current vaccine stocks, and “with a greater number of candidates nearing the end of the clearance process”. The HSE say 1,474 more candidates’ start dates are to be confirmed by centres over the coming weeks. In short, the message is that staffing preparations are in good health.

The employment process will remain open with those hired available for the duration, at least in principle. Such a mass mobilisation of staff is seen as critical, particularly as vaccine doses increase and as, according to sources in the medical community, GP surgeries are expected to lighten their own loads once older and vulnerable cohorts receive their shots.

To date 30 vaccination centres are open around Ireland with six more due next week and two more after that, bringing the total to 38.

“Certainly as we head in towards May and later into June the indications of supply are really strong. We will be mobilising our vaccination centres, working with our GPs and, at a point in time, pharmacies also to meet those volumes that come at us,” the HSE’s chief executive Paul Reid told RTÉ on Thursday.

Regional variations

As more people begin arriving at mass centres, nurses are expected to account for the majority of vaccinators. Tony Fitzpatrick, head of industrial relations at the Irish Nurses and Midwives Organisation (INMO), who expects 1.4 million doses of vaccine to arrive in May alone, said the early programme has benefited from teams of highly trained vaccinators. Notably, school inoculation teams have looked after staff and residents in long-term care facilities at the onset of the programme earlier this year.

But what makes the national push particularly interesting is the wider range of healthcare experts signing up to administer injections. As well as pharmacists, doctors and nurses, statutory instruments issued by the Department of Health over recent months mean that physiotherapists, emergency medical technicians (EMTs), dentists and optometrists are all eligible to sign up for centre-based work. Medical, dental, nursing and midwifery students are also expected to be included soon, according to industry sources.

Dr Denis McCauley, head of the GP committee at the Irish Medical Organisation (IMO), who noted more than half of vaccines to date had been administered in surgeries, believes the scale of the operation means “regional variations” in its effectiveness are likely, an expectation supported by almost every professional body involved.

With more than 200,000 vaccinations per week due by May, the sheer numbers involved render it impossible to predict how smooth things will run but there is no shortage of appetite to roll up sleeves.

Redeployment

“The indications are that across the health professions people are keen in assisting and helping out. I think there is a lot of good will,” said Fintan Hourihan, chief executive of the Irish Dental Association (IDA), although that profession, like pharmacists, has had its share of frustrations.

As well as a perceived delay in getting fully vaccinated, dentists anticipate having to offer their expertise in vaccination centres as opposed to their own practices. That brings its problems, as reflected by just 160 expressions of interest in the vaccination campaign by early April out of almost 3,000 registered practitioners.

Optometrists thought hygienic spare rooms in practices would make their participation a “no brainer”, according to John Weldon, president of the Association of Optometrists Ireland (AOI), who said its members are “doing it from an altruistic point of view rather than looking for another job”.

Although exact figures are unknown, it is expected that somewhere in the region of half of Ireland’s roughly 700 practising optometrists have made themselves available.

It is not just the national recruitment drive filling posts – vaccinators are also being sourced locally, from agencies and through redeployment within the HSE which has the largest pool of trained professionals. Qualified volunteers too are welcome, side stepping formal recruitment structures.

Those applying for employment as a vaccinator, however, will qualify for fixed pay scales sanctioned by the Department of Health running in various salary bands between €35,000 and €50,500 on agreed rosters. Flexible contracts are being offered depending on the availability of candidates, and the HSE has had considerable levels of interest in part-time roles.

“The profession of the candidate does not have a bearing on when they are recruited,” a HSE spokeswoman said, “it is the availability of the vaccinator that is one of the most important elements.”

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