Vaccine rollout ‘significantly impacted’ by uncertainty over supplies

HSE briefing document describes ‘changes to supply forecasts for all four vaccines’

HSE chief clinical officer Dr Colm Henry: ‘We have faced many planning challenges with changes in supply, cohort definitions and clinical guidance in relation to specific vaccines.’  Photograph: Nick Bradshaw/The Irish Times

HSE chief clinical officer Dr Colm Henry: ‘We have faced many planning challenges with changes in supply, cohort definitions and clinical guidance in relation to specific vaccines.’ Photograph: Nick Bradshaw/The Irish Times

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Uncertainty over supplies has remained a “top programme risk” associated with the rollout of Covid-19 vaccines, the Health Service Executive has told the Oireachtas health committee.

In a briefing note supplied to members before the appearance of senior HSE officials on Tuesday, the HSE wrote that since the start of the programme, there have been a “significant number of changes to supply forecasts for all four vaccines”.

The briefing document for the committee outlines how a decision taken last week to restrict the use of the AstraZeneca vaccine to the over-60s has had “a significant impact on the vaccination programme” as “new intake” healthcare workers and vulnerable cohorts had been earmarked to receive the vaccine in the coming weeks.

“As a result of the change most people in those allocation groups cannot now be vaccinated with AZ. This has required a major reorganisation of the vaccination programme.” However, the health service briefing says it will “minimise the impact of this” by targeting mRNA vaccines to people in those groups who are under 60.

Out of sequence

The HSE aims to substantially complete vaccination of those aged 70 and older this week. The document also confirms that those who received their first dose of the vaccine out of sequence will be given a second dose as the HSE is “ethically obliged” to do so.

It outlines that 1,502 people have been recruited as vaccinators so far, with an additional 2,404 in the recruitment process, while “no final requirement” for the number needed has been set as it will be “contingent on capacity from other vaccination channels”. At the moment, the recruitment programme is aimed at “targeting new resources and individuals for vaccinator roles... rather than targeting existing healthcare workers.”

While pharmacists are in dialogue with the HSE, the briefing flags that uncertainty around the Johnson&Johnson vaccine has impacted on the vaccine distribution plan. It outlines that those aged 59 and under who are key workers to the vaccine programme, as well as those aged 16-59 with medical conditions that place them at a high risk of severe Covid-19, will begin being vaccinated in early May.

Administering

Dr Colm Henry, the HSE’s chief clinical officer, will tell the committee that over 1.2 million vaccines have been administered, and the HSE is regularly administering 95 per cent of available vaccine within seven days of delivery.

“There has been variability between manufacturers which can cause further complications to our operations team,” he will say. “We have faced many planning challenges with changes in supply, cohort definitions and clinical guidance in relation to specific vaccines.”

Of 37 vaccination centres planned, 19 are operating and this will increase to 26 over the remainder of this week. Meanwhile, the early evidence of the positive impact of the vaccine programme has been illustrated through reduced mortality, disease and hospitalisations.

Prof Karina Butler, chair of the National Immunisation Advisory Committee (Niac) will tell the committee that due to the speed of development and rollout of vaccines, “it can be expected that there would be many changes to any recommendations”.

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