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Multi-channel booster rollout increases capacity for confusion

Niac has been slated for speed of decision-making but it compares well with EU counterparts

Compared to the original rollout of Covid-19 vaccines, the campaign to provide booster doses to the population is widely perceived to be halting and inefficient.

The National Immunisation Advisory Committee (Niac), which provides advice on vaccinations, has been attacked in political circles for taking too long to come up with recommendations during the rollout. The Health Service Executive has taken weeks to put some of Niac's recommendations into operation. Meanwhile, snafus and IT glitches have led to queues at some vaccination centres, and high numbers of no-shows at others.

We seem to have forgotten the original vaccination programme suffered months of teething difficulties at the start of the year, mostly due to supply issues. Only in the spring did it get properly into gear, winning massive public acceptance and ending up with Ireland having one of the highest vaccination rates in the world.

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Claims of delays in the rollout of boosters over the last few months do not seem to be borne out by comparisons with other countries. Ireland, with about 25 booster doses administered per 100 people, is mid-table in the international rankings, ahead of Germany, France, Norway, Italy, Denmark and Sweden. The Republic is well ahead of the European average but behind England, Scotland, Wales and Northern Ireland.

In terms of dates, Niac was early into the field with a recommendation to give boosters to over-85s on September 7th. Germany approved boosters for this age-group on September 28th, three weeks later, while Denmark gave the go-ahead for extra doses for over-85s on September 29th.

Niac gave the green light to boosters for adults aged over 18 on November 30th, the same day as Germany and five days after Sweden.

The go-ahead for vaccinating children was given by Niac on December 7th, compared to November 30th in Denmark.

Ireland has a higher Covid-19 vaccination rate than almost all our neighbours apart from Denmark, so the overall level of protection in the community against serious illness is higher than elsewhere in Europe. And most of our vaccines were Pfizer, which offers higher protection and lasts longer than the AstraZeneca doses used widely in the UK.

Meanwhile, the level of demand for boosters is significantly lower than it was for the original vaccine course, even among older and more vulnerable populations. Over 80 per cent of those aged 80 years and up, along with 75 per cent of 70-79 year-olds, have been given a booster, whereas 100 per cent in both categories received the two-shot vaccine earlier this year.

Given most people are mostly protected through vaccination, this is entirely understandable. Demand has picked up only as warnings about the current Delta wave and the imminent dominance of the Omicron variant multiplied.

While the new system isn't exactly first come, first served it seems to be heading that way

The original vaccine rollout largely stuck to a schedule of administering jabs to people in reverse age order. Although it was criticised at the time, it worked well and served to minimise disputes and grievances. Older people generally got their doses from the GPs, and younger age groups were largely dealt with in large vaccination centres.

In contrast, the current rollout of boosters is running through multiple channels – vaccination centres, GP surgeries and pharmacies – at the one time and is increasingly being opened to different age-groups.

While the new system isn’t exactly first come, first served it seems to be heading that way. The capacity for confusion and duplication of effort is greatly increased.

Is it fair? After all, the more boosters given to younger people at walk-in clinics, the longer the wait will be for older people (in their 50s) still waiting for their invitation by text for a booster from the HSE.

Given the plentiful supply of vaccines, though, it is likely that anyone who wants an extra dose will be able to get one in the coming weeks. There might just be some waiting involved.