The first 21,600 doses of the AstraZeneca vaccine have arrived in the State and have been delivered to the HSE .

In a tweet Minister for Health Stephen Donnelly said it was a “big day” as the first doses of the Covid vaccine had come from Belgium. The doses were delivered to the HSE’s national cold chain store in Dublin. Mr Donnelly posted a video showing a refrigerated lorry reversing at the facility. He said the first doses would be given to healthcare workers on Monday.

The vaccine is much easier to manage than other approved vaccines because it can be injected by a GP or a pharmacist straight out of a fridge. It is just over a week since the the European Commission granted conditional marketing authorisation for the use of the AstraZeneca vaccine for over-18s.

Hospital Report

However Irish public health officials decided this week to favour the Pfizer-BioNTech and Moderna vaccines for the over-70s over the AstraZeneca jab due to a lack of data for their effectiveness in older people.

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This led to a revision of plans for administering the Covid-19 vaccine to those over the age of 70 were worked out following talks between the HSE and the Irish Medical Organisation (IMO).

Doctors hope to have all over 85s vaccinated with the Pfizer-BioNTech and Moderna by March 8th with second jabs administered exactly a month after the first shot, Dr Denis McCauley , chair of the GP committee of the IMO said on Saturday.

A number of large-scale vaccination clinics are to be established in Dublin, Cork and Galway under new plans .

The first of these clinics will be set up at Dublin City University (DCU) where patients attached to 121 practices across the capital will receive the Pfizer or Moderna vaccine. However most patients over the age of 70 will still receive the Covid vaccine from their own family doctor practice.

HSE chief executive Paul Reid said on Saturday that GPs will start administering the Covid-19 vaccine to people aged over 85 in nine days time on February 15th.

If more vaccine supplies can be secured, it could be done more quickly, Dr McCauley told RTÉ Radio One’s Saturday with Katie Hannon. “It is good news,” he said.

But he warned issues have yet to be resolved with some smaller GP practices who would be unable to host the vaccines. In some 30 per cent of practices - which he said look after “quite a small number” of patients - because of their size “getting the vaccine to them is technically not possible so we have to find solutions for these.”

GPs would be contacting patients at these practices, sometime after a mass webinar for Ireland’s family doctors on Tuesday to outline the plan in more detail.

Two proposed solutions for smaller practices are for patients to travel to another nearby larger GP practice, mainly in rural areas, while in urban areas smaller practices would come together in one “suitable building”.

Other issues to be addressed include vulnerable patients who can not leave their homes, including those who are bed-bound. The Pfizer-BioNTech vaccine would not be suitable in these cases but it is hoped a “more mobile vaccine” is approved for use in such cases“within a number of weeks”. He was referring to the Oxford/AztraZeneca vaccine currently not recommended for older age groups due to lack of data.

In a bulletin to its members on Friday night, seen by The Irish Times, the IMO said some 72,000 people over 85 will be first to be vaccinated, the first of 490,000 over 70s around the State. The over 85s are to be vaccinated in three week-long slots, starting on February 15th “during which time the objective is to vaccinate patients over 85 and then continue on with the age schedule”.

Buddying up’ system

Patients will all receive two doses of either Pfizer or Moderna. The vast majority of patients will be vaccinated in their own GP practice – some 70 per cent of GP practices will see their patients vaccinated on site – with deliveries through the HSE’s cold chain to all practices with more that 200 over 70s.

Those practices will need to have a registration area, a refrigeration area – which will double as an area for vaccines to be reconstituted – and a vaccination area and an observation area. These will be managed by GPs, admin staff and nurses.

However, for practices with fewer than 200 over 70s – some 400 practices – vaccinations will take place on two pathways. The first will be through GP vaccination clinics, and the second pathway is through a “buddying up” system.

The vaccination clinics in urban centres will be at agreed locations – among the first of these will be in DCU, where 121 practices will come together to run clinics. Booking, registration and payment will happen through GPs own practices – with doctors told “the only change is the venue at which the patient will receive the vaccine”.

The clinics will operate “in the agreed age phases until all these patients are vaccinated and at the 28 day intervals”. They will run at the weekend.

The “buddying up system”, outside urban centres, will also involve practices with fewer than 200 patients over 70, who will be paired with a larger practice in their area. Patients from smaller practices will attend the larger practice, but will be dealt with by their GP and his or her staff.

Indemnity arrangements

In order to facilitate planning, GPs will be asked to identify and register the patients over 70, in each age cohort, and invite them for vaccination at the relevant venue – either their own practice, a vaccine clinic, or a “buddied up” practice.

Once that process is complete, the order of vaccines can be placed and syringes, needles and vaccine cards will be delivered. GPs will have a delivery every two weeks.

According to the IMO, indemnity arrangements will cover GPs and practice nurses. Members were told the hope is that all GPs and practice nurses will be vaccinated prior to the programme beginning – those not vaccinated will be facilitated through acute hospitals.

They will be given the AstraZeneca vaccine – except where they have been given a different vaccine first, in which case the same will be given in a second dose.