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Minister for Health Stephen Donnelly has expressed confidence that 70 percent of GPs will be able to provide the Pfizer and Moderna vaccines to patients in their own surgeries.
There were about 400 smaller practices who may have to provide local solutions such as joining together with neighbouring practices or coming together in a centre or working from the premises of larger practices, he told RTÉ radio’s News at One.
The Minister said that 21,600 doses of the AstraZeneca vaccine were expected to arrive in the country this weekend from a total of 190,000 doses for the month of February. It remained unclear how much of the final quantity of the scheduled 600,000 doses for the first quarter would arrive.
The doses arriving this weekend would be administered to frontline workers early next week, he said. The remaining doses would be given to cohorts four and five including key workers and those with underlying health conditions.
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This situation had always been a possibility so plans were in place, added Mr Donnelly.
Revised rollout
Earlier Dr Colm Henry said there would be a “tricky end point” of the revised vaccine rollout concerning people living in remote areas who would find it difficult to get to a hub.
“We want to roll out the vaccine to everybody from Inishowen to Wexford,” the HSE’s chief clinical officer told Newstalk.
The HSE was considering options for transporting such patients safely to receive their vaccine, he said. “We’ll get there.”
Under new plans being finalised by the health service over-70s will be vaccinated against Covid-19 at large GP practices, primary care centres and dedicated vaccination facilities from the middle of this month.
Following the decision that the Pfizer and Moderna vaccines should be given to those aged over 70 where possible, rather than the more easily stored AstraZeneca product, the HSE has been working on what one source described as a “total re-tooling” of how the vaccination of older people will be handled.
Dr Henry has said the HSE was intent on using the GP network to roll out the vaccine to the over-70s. GPs had a “reach” into every home in the country, through “every highway and byway: he told Newstalk Breakfast.
While it would not be possible to put a freezer (for the vaccine) into every general practice, there was an overlap and the HSE was looking at establishing GP hubs, he explained.
Under the revised plan, GPs with smaller numbers of clients would likely travel to larger practices because of the challenges in transporting the vaccines.
Health officials are examining the impact this would have in areas with lower population densities and for groups such as the over-85s. It is understood that consideration is being given to how this group might travel to get inoculated and whether transport needs to be provided to ensure they get vaccinated.
Dreadful ordeal
Two GPs in the west of Ireland have said that it would be much easier to use the AstraZeneca vaccine for the over-70s in remote areas.
Dr Peter Sloane, who has a practice in Carraroe, Co Galway told RTÉ radio’s Today with Claire Byrne show that he had a number of house-bound patients for whom it would be “a major undertaking” to get to a vaccination centre.
“It would make sense to give AstraZeneca to the house-bound,” he said. “For those people any vaccine would be better than none.”
On the same programme Inishmór GP Dr Marian Broderick pointed out that it would be great hardship for her patients over the age of 70 to get from the island to Galway to a vaccination hub.
“It would be a dreadful ordeal, it wouldn’t make any sense.”
It made practical sense for the vaccine to be brought to the island and for everyone to be vaccinated together, she said. “We expect the HSE to meet the challenge to get the vaccine out to the island for patients.”
Dr Broderick said she had 100 patients over 70 of whom 19 were aged over 85. “We’re determined the vaccine should come to them. “Walking around in Galway for the day would not be practical for them, everything is closed.”
For smaller islands it made more sense to vaccinate the entire population at the same time, she said. But the priority should be the older cohort. Dr Broderick said she would also have to have a locum in place to “do the real work” for the day. “We have to protect the vaccine programme against potential wastage.”
“It would be much easier to use AstraZeneca (on the island), but we will deal with what we’re given.”
Dr Sloane added that there were logistical issues that would have to be clarified about GP hubs - who was going to be responsible for them? Who would have the indemnity? Do GPs go there together or take it in turns? Who would schedule or organise the appointments?
But he was ready to do what was necessary for his patients to ensure they were vaccinated as safely as possible, he said. It did not matter if he was inconvenienced. “I will work with the HSE as my patients are what is most important. We want to get the vaccine to our patients as quickly as possible.
“We need to give people hope. There is a massive psychological boost for people being vaccinated.”
If possible Dr Sloane would like the opportunity to bring the AstraZeneca vaccine to housebound patients. The Pfizer and Moderna vaccines presented a practical problem.
Heathcare workers
Meanwhile, the trade union Siptu has told members that the HSE expected that the “vast bulk” of the priority healthcare workforce categories would receive their first dose of the Covid-19 vaccine by the end of February.
In an update to its 40,000 members in the health sector, the trade union said the HSE had told it that stocks of the new Astra Zeneca vaccine would be used to administer the first dose to priority healthcare workers from next week.
It said the HSE had confirmed it expected to receive delivery of the Astra Zeneca vaccine this weekend and that when these stocks arrived it would “greatly improve” the availability of the vaccine to the priority healthcare workforce.
“Siptu understands approximately 20,000 doses are expected next week and further increases in delivery quantum are expected of AstraZeneca vaccine over the following weeks in February.”
“The HSE has confirmed it will concentrate on completing first dose vaccination of the priority healthcare workforce categories starting from next week. Siptu has been advised the HSE plan for next week includes approx. 8,000 vaccines for mental health and intellectual disability services.”
“The HSE has also confirmed it is completing work on the commissioning of a portal for registration for the vaccine. It is expected to be completed by the resumption of the first dose vaccines and it will have built-in priority allocation software which will allocate appointments as per the national sequencing document.”
Siptu told members that the union had repeated its request to the HSE for a report on which specific groups of healthcare staff to date and whether there had been compliance with the sequencing arrangements set out by the health authority in a document issued on January 12th 2021.
It is understood that the HSE did not provided such a report to trade union at a meeting earlier this week.
The HSE has not replied to questions on this report this week.
Siptu told members on Friday that it had raised concerns “at the reported failure of the HSE to administer vaccines as per their own priority list issued on Tuesday January 12th 2021 and received an assurance the sequencing document for prioritising healthcare workers would be strictly adhered to upon the resumption of first dose vaccinations in the coming days”.