Ireland's vaccination plan a major step, but there's a long road ahead

With EU approval probably just days away, the need to get organised quickly is pressing

A nurse prepares a dose of the Pfizer-BioNTech Covid-19 vaccine in Puerto Rico. Photograph: Ricardo Arduengo/AFP via Getty

The publication of the State’s plans for introducing Covid-19 vaccines marks a major step towards the resolution of the crisis caused by the pandemic.

There is still a long way to go, but at least now there is a roadmap for administering the vaccines to the bulk of the Irish population over 2021.

An hour before the Government-appointed taskforce published its plans, the European Medicines Agency announced it was bringing forward final consideration of the first vaccine under development, from Pfizer/BioNTech, by a week to next Monday.

Within days, therefore, it is highly likely that a Covid-19 vaccine will be authorised for use in the EU, just as it already is in the UK and the US. The need to get organised quickly could not be more pressing.


The document has plenty of “known and unknown unknowns”. Many of these are not particular to Ireland and have been well canvassed – relating, for example, to the effectiveness of particular vaccines or the risk of rare side effects.

But others are within our gift to monitor and control, and this is somewhat concerning. For example, we do not yet know what our initial allocations of doses will be, even though the first of these may be administered before the end of the month.

Ireland is slated to receive 1.11 per cent of the total quantity of each vaccine for which a purchase agreement has been signed by the EU on behalf of member states. However, most of these 14.4 million doses will not arrive until later in 2021.

Earlier this month the UK said it planned to administer 800,000 doses of the Pfizer/BionNTech vaccine initially, but was targeting more than 25 million people, or 40 per cent of the population, in the first phase of its vaccination programme.

There is no breakdown of this kind, for any of the vaccines, in the Irish document, which talks of three phases – initial roll-out, mass ramp-up and open access – without specifying any dose quantities or dates.

Delivery schedule

Perhaps it will suffice for now for the blanks to be filled in as time passes, but it would be good to know how much of the first vaccine we can expect in probably 10 days’ time. Officials told the briefing they had “yet to hear” from Pfizer on this issue and that delivery schedule has yet to be “closed out”.

Another area of concern relates to the IT needed to back up this mammoth project. Ireland is an outlier in Europe in not having a unique health identifier for everyone, despite plans going back five years. The HSE’s IT systems, despite some improvements in recent years, are dated and fragmented.

So a new system is needed, which must be integrated into existing systems. IBM and Salesforce have been engaged to do this, but contract negotiations have not been finalised.

The HSE says it has a back-up if the new system is not ready by year’s end as planned.

The experience this year with other vaccination programmes – too little supplies of the flu vaccine to meet demand and too much of the children’s flu vaccine because parents remained unaware of it – is also a source of concern. On the other hand, those programmes saw 1.2 million people inoculated without any mishaps.

There are still many uncertainties around the delivery of vaccines next year. We are lucky to have so many jabs so far advanced in development so quickly, but each have different characteristic and handling requirements.

Pfizer/BionNTech is attractive because it came first, AstraZeneca/Oxford has the least demanding storage requirements, and Johnson & Johnson requires only one dose. And that’s before we consider their relative merits in terms of safety, effectiveness, target groups and duration of protection.

It will take the early months of next year to bring some clarity to this situation. What is clear right now is that there will be no-let up in the requirement for social distancing, masks and other measures to protect against the virus, not for many months.

Depending on the level of transmission of infections, that may also mean further restrictions, even lockdowns, to keep Covid-19 under control.