When will you be vaccinated? Four key questions

After a week of blazing international rows, recriminations and uncertainty, plans for the vaccine rollout in European Union countries, including Ireland, have been thrown into doubt. This has put Minister for Health Stephen Donnelly in the spotlight. The row is more about what he has promised than what can be delivered – the latter is a matter for EU-level negotiations.

Here are the key questions:

1. What is the impact of delayed vaccine deliveries? AstraZeneca has warned the EU it cannot meet its first quarter delivery commitments for a vaccine it developed with Oxford University. This vaccine was key to early plans to ramp up delivery in Ireland and to have 700,000 people – including all the over-70s – vaccinated by the end of March. The shortfall might cut the total supply in the first quarter here from 1.4 million doses to a bit less than 1.1 million. That means closer to 550,000 with the required two vaccine doses by end March rather than 700,000. However negotiations are continuing with the company and some more supply may result.

So the current indications are that the end-of-March target to vaccinate all-over 70s will be missed. The Government had said older age groups – over 85s and then over 80s – have priority and so available vaccines could be directed to this older cohort.

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2.What is the impact of the European Medicines Agency decision? The agency has approved the AstraZeneca vaccine for use in the EU for all over-18s. There has been concerns that it might follow the lead of the German advisory committee and say that it should not be given to over 65's. However while the agency did say it could not say for sure what protection it would offer to this group, it still believed it should work well. This will come as a relief for the Irish roll-out plan, as over-70s are next on the list and this vaccine can be delivered via GPs and pharmacies.

The Oxford/AstraZeneca vaccine has already been given to older people in Northern Ireland and the UK.Further trials underway in the US and experience in the UK will clarify its efficacy among this group.

3. What about other vaccines? Ireland was banking on 3.7 million vaccines arriving in the second quarter of 2021 and 3.8 million in the third; it will now need a bit more in these later quarters to stay on track after the first quarter shortfall. One vital issue will be whether a one-shot vaccine from Johnson&Johnson comes on stream, perhaps in late March or early April. Another vaccine from a German company, CureVac, is also in the pipeline and the Commission has held negotiations with US company Novavax, which reported promising results this week. It also remains to be seen how AstraZeneca makes up for the early shortfall and what more Pfizer can deliver.

4. What is the bottom line? The Government had hoped to have all over-70s vaccinated, or at least having had one shot of a two-dose process, by the end of March – along with frontline healthcare workers.The schedule, as announced in December, would have seen all over-65s done by May, all over 55s by the end of June and the rest of the adult population by the end of September, or shortly afterwards. The key 70 per cent population level might have been reached by August. Ministers have underlined this was all contingent on supply, but now face Opposition criticism.

The AstraZeneca decisions could, unless progress is made in talks with the EU, push the earlier deadlines, such as for the over 65s and 70s, back by perhaps a month. However much is now reliant on the Johnson&Johnson vaccine coming on time for the big roll-out after March. If there is a hold-up here as well, the whole plan could be seriously delayed, but the latest results from the company are encouraging.

The Government can control the delivery of the vaccines after they arrive – but when they do land still depends on the European Commission.

The commission now faces criticism for some of its handling of vaccine purchases, explaining its trenchant reaction to the AstraZeneca news this week. With dissatisfaction in EU countries and the UK moving ahead quickly – over 65s in Northern Ireland are now signing up for their jabs – the political pressure will remain in the weeks ahead.