Covid-19 vaccines Q&A: Why are targets being missed?

Complex deliveries to smaller GP clinics and interrupted supplies have slowed rollout

The population has been divided into 15 groups for vaccines with priority given to older people, who are more vulnerable to severe sickness and death from Covid-19. Photograph: Alan Betson

The population has been divided into 15 groups for vaccines with priority given to older people, who are more vulnerable to severe sickness and death from Covid-19. Photograph: Alan Betson

 

It is 66 days on Friday since 79-year-old Dublin woman Annie Lynch became the first person in the State to be vaccinated against Covid-19. This week the 500,000th dose of the vaccine is due to be administered, but the rollout has been criticised for failing to hit projected targets.

Where is the State on the rollout of the Covid-19 vaccines?

As of Monday, 446,474 doses of the three vaccines authorised here – the Pfizer, Moderna and AstraZeneca jabs – had been administered. Some 303,550 had received their first dose and, of those, 142,924 people have received a second.

The population has been divided into 15 groups in the queue for vaccines with priority given to older people, who are more vulnerable to severe sickness and death from Covid-19, and to the frontline healthcare workers and nursing home carers and staff who treat and look after them.

The State is still vaccinating the first three groups – adults aged over 65 in nursing homes and other long-term care facilities, frontline healthcare workers and people aged 70 and over.

Next week, the fourth cohort – people aged between 16 and 69 with a medical condition that puts them at very high risk from Covid-19 will start to be vaccinated.

What share of the population has been vaccinated?

About 3 per cent has been fully vaccinated. More than 6 per cent have received at least one jab. For every 100 people, about 8.8 doses have been administered.

How does this compare with other countries?

Ireland is marginally ahead of the average across the EU/EEA, sitting in 16th position out of 29 countries. The UK is the best performer in this region, having delivered first doses to 31 per cent of its population. Israel is an outperformer - with just over half its population having received at least a first dose.

Is the State’s vaccination programme on target?

No. Health Service Executive chief executive Paul Reid said last week that well over 100,000 people would receive a vaccine in the last week of February but the number fell short by more than 17,000. Just 84,000 doses will be administered this week. Family doctors have criticised shortcomings in communications and inconsistencies in the delivery schedules.

So what has happened?

Reid said the HSE had “significant issues” across a range of different GP practices, which are administering the vaccines outside of vaccination hubs in Dublin, Cork and Galway.

In the over-70s age group, the initial vaccinations are concentrating on the oldest, the over-85s. Most of the 72,500 people in this category will have first doses by the end of this week, but the process has been slow because of problems with getting the vaccines out to all 1,400 GP clinics.

The majority of these clinics have had deliveries of the vaccines – or will receive them by today – but there have been problems this week getting vaccines to 65 smaller GP clinics with small numbers of patients aged over 85 who had not “buddied up” with a bigger GP clinic.

There were also errors in deliveries to between 20 and 25 GP clinics in the “cold-chain” distribution. It is understood that this was due to a key staff member in vaccine distribution falling ill this week and an error in delivery scheduling by their replacement.

Other issues have arisen with mix-ups and issues in deliveries that left some GPs with vaccines and, in some cases, patients to receive them but not enough syringes to administer them.

Why is the rollout so slow generally?

Out of 520,000, some 393,120 vaccines – or three in every four – are Pfizer vaccines. They are extremely complex to handle with complicated ultra-cold storage and logistical operations required to manage their distribution around the country. The vaccines are packaged in a way that means matching the right number of jabs to patients requires detailed planning.

In contrast, the AstraZeneca jab can be stored in a fridge and administered simply, but the lack of data on effectiveness among older people has led the State to prefer the Pfizer and Moderna jabs for these. Relying so heavily on the Pfizer jab has slowed vaccinations.

But what about supplies of other vaccines?

The HSE said vaccines from AstraZeneca, which are being given to healthcare workers and will be given to the fourth cohort next week, have been “interrupted” and that supply lines into Ireland have been affected this week and last, and are set to be next week too.

The Department of Health has said there are advance purchase agreements for more than one million doses to be delivered each month for April, May and June with more Moderna, AstraZeneca and the yet-to-authorised one-shot Johnson & Johnson vaccines. These should leave the State less reliant on the Pfizer jab but the HSE has warned about a “high level of unpredictability” on vaccine deliveries with challenges worldwide on supplies.

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