Vaccine rollout to be ‘reset, not revamped’ after AstraZeneca decision – Reid

The HSE will be "resetting rather than revamping" the State's vaccination rollout following the decision to restrict the AstraZeneca Covid-19 vaccine to the over-60s, chief executive Paul Reid said.

Acting chief medical officer Dr Ronan Glynn, speaking at the same online conference, said it was "too early to say" what impact the decision by Johnson & Johnson/Janssen to delay the European rollout of its vaccine will have on the State's immunisation plan and lifting of public restrictions.

The vaccines, two of four authorised for use in Ireland, form a critical part of the Government's vaccination plan that is key to easing lockdown measures in the coming months.

The single-dose Johnson & Johnson vaccine is seen as particularly essential in the fight against Covid-19.

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Dr Glynn said that the European Medicines Agency (EMA) was reviewing concerns about reported cases of rare blood clots in vaccinated people in the US, and that he would be discussing the matter with the State's medicines regulator, the Health Products Regulatory Authority (HPRA).

Mr Reid said the HSE would have to “wait and see” what the EMA says about the Johnson & Johnson vaccine after it decided to delay the European vaccine rollout.

Volumes of Johnson & Johnson doses to be supplied over the next couple of weeks were “relatively low” but it would make up 605,000, or 15 per cent of the projected 3.9 million doses delivered in April, May and June, while AstraZeneca made up 21 per cent, or 813,000.

Speaking to the RCSI University of Medicine and Health Sciences annual conference on Tuesday afternoon, Mr Reid said that the HSE had another 24 hours to develop a plan for the Government which sets out how it is going to "reset" the programme based on the "fundamental change" as a result of the decision on Monday night to restrict use of the AstraZeneca vaccine.

Blood clotting

"I will expect that we will be resetting rather than revamping the whole programme. It is about the channels of delivery," he said, in the wake of the National Immunisation Advisory Committee (Niac) decision to restrict use of the vaccine over possible links to blood clotting.

The HSE would have to “realign our operating model” because the AstraZeneca vaccine was originally going to be administered to medically vulnerable people through GPs, he said.

“Now we have to look at that very differently. We are going to recalibrate, reset the model for it,” Mr Reid said.

He pointed out that the HSE had to change the vaccination model 23 times over a 15-week period due to issues with supplies of the vaccine and changes to guidance on vaccine use.

Dr Glynn told the conference that the country would not see the protective benefits of vaccinations across the population “for some weeks to come.”

“In the pandemic to date, half of the people hospitalised and 70 per cent of admissions to critical care have been aged less than 70 years of age and the majority of that younger cohort have not even begun to receive vaccinations at this point,” he said.

“So, in broad terms, the next six weeks remains a critical window.”

Roughly seven million doses of the Johnson & Johnson vaccine have been administered in the United States. Among these, six cases of a rare kind of blood clot, cerebral venous sinus thrombosis, was reported along with low levels of platelets.

Symptoms

The cases all occurred in women aged between 18 and 48, with symptoms occurring 6 to 13 days after vaccination, according to the US Food and Drug Administration (FDA).

The regulator is “recommending a pause in the use of this vaccine out of an abundance of caution” pending a review of the cases, the FDA announced in a statement.

The European Commission said it was in contact with the company over the issue and that the vaccine steering board, made up of representatives of member states, would work to co-ordinate a common EU approach to the issue.

In a statement, the HPRA said: “The EMA stressed that these reports point to a ‘safety signal’, but it is currently not clear whether there is a causal association between vaccination with Covid-19 vaccine Janssen and these conditions.”

Reflecting on the Covid-19 pandemic, Mr Reid told the conference that the severe impact of the virus on lives in nursing homes was “something that personally struck me quite hard”.

“We all need to be honest and open and reflective about what is it we could have done differently and what is it that we need to do differently for the future,” he said.

There was a “big lesson” to be learned around the preparedness of congregated settings and nursing homes in particular to cope with a pandemic, he said.

This included looking at whether there should be investment in longer-term care of older people at home and in the community rather than public or private investment in healthcare.