What is Ireland’s plan for vaccinating people against Covid-19?

Q&A: What we know about approvals, supply and who will be prioritised for inoculation

What are Ireland’s plans for vaccinating people against Covid-19?

An implementation plan for rollout of vaccines was published last December, but at that stage details about the authorisation and supply of specific vaccines were sketchy. Since then, more information has come available so we have a better idea of when people might be immunised.

So what do we know now?

About 15 million doses of vaccines are on order for Ireland in 2021 and 2022, more than enough to vaccinate the entire population.

On the supply side, the Pfizer/BioNTech Covid-19 vaccine was authorised last month and administration to healthcare workers started last December 29th. In January and February, a weekly supply of 40,000 doses will be used to vaccinate health staff and residents and staff in care facilities. Both these groups, which are either vulnerable or highly exposed to virus, should be vaccinated before the end of February.

And what then?

This is where things become less clear, with uncertainties surrounding both the supply and authorisation of vaccines. Officials want to start ramping up the programme at this point, but this can only be done if sufficient supplies of authorised vaccines are available to Ireland. They believe millions of doses of vaccine will be available monthly, but only in the second half of the year.

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Pfizer is scaling up manufacturing of its vaccine but for now the company is unable to quantify its supplies to Ireland from March on.

EU regulators have approved a second vaccine, by Moderna, and its US manufacturers have just begun shipping it to EU member states this week. We haven’t yet heard from Irish officials when it will come into play in our vaccination strategy.

The overall speed of the Irish vaccination rollout may ultimately be determined by the fate of the Oxford/AstraZeneca vaccine. This doesn't have the special handling and transportation requirements of the other two vaccines, which require cold storage, and so would be best suited for delivery in the community, for example in GP surgeries, pharmacies or mass vaccinations sites.

Though approved for use in the UK, this vaccine has had a bumpy ride elsewhere, and EU and US regulators have sought more information. The European Medicines Agency (EMA) is due to decide on Oxford/AstraZeneca at the end of this month; before then, it is impossible to say when the broad mass of the population will be vaccinated.

The EMA will also decide on other vaccines, for example from Johnson & Johnson and CureVac, soon but this is not going to impact on supply in the short term.

So when will I be vaccinated?

Your place in the queue is determined by an allocation schedule published in December. After over-65s in care homes and frontline health workers, people aged 70 and older and other healthcare workers are next in line to receive the vaccine.

Vaccination of these groups will likely started towards the end of February, though where and at what pace is still not clear.

The next categories are: people aged 65-69 years; an ill-defined group referred to as “key workers” and people aged 18-64 with certain medical conditions. Next up will be: those living or working in crowded conditions; people working in education; those aged 55-64; workers in other occupations important to the functioning of society; people aged between 18 and 54; and, finally, pregnant women and those under 18.

Can we go any faster?

Given the current limits on supply, there is little point in accelerating rollout right now. Administering the vaccine is relatively straightforward, though it has to be done by a healthcare professional. Well over 1 million adults and children received the flu vaccine last autumn, by way of comparison.

Can anything else be done to improve supply?

Health staff are now getting six doses from a vial of Pfizer/BioNTech vaccine instead of the five originally envisaged, though this is not being factored into official calculations. This means up to 20 per cent more people could be immunised from the same supply of doses.

With Covid-19 rates surging this winter, many countries have looked at delaying the administration of the second dose so that more people can receive an initial dose and thereby be at least partially protected against the virus.

Irish officials have decided not to follow the UK’s lead on this but are keeping the option under review.

Have there been any side effects so far?

Expected common side effects may include muscle pains, headaches, tiredness or swelling in the upper arm. Often people can develop a short-lived fever after a vaccination, particularly after the second dose.

So far, only a tiny number of short-term side-effects have been observed in Ireland.

Will everyone get the vaccine in the end?

At least 70 per cent the population will have to be immunised in order to provide the kind of immunity needed to protect against the virus. But only 45 per cent have said they will definitely get it, so some are hesitant. This problem could get worse after the current surge ebbs away and cases dwindle - ironically thanks in part to people being vaccinated - leading people to lower their perception of threat.

So when will I find out when I can get the vaccine?

If the EMA authorises the Oxford/AstraZeneca vaccine at the end of this month, you can expect to see dates being firmed up quickly for the mass vaccination of the population. If this does not happen, it seems unlikely the average healthy adult will be vaccinated until the autumn.