Cliff Taylor: Reopening plan leaves no margin for error on vaccines

The vaccine rollout is accelerating – but the next six weeks are crucial

Citywest vaccine centre: There are signs the vaccination programme is accelerating and moving to more than 200,000 a week. Photograph: Enda O’Dowd/The Irish Times

Citywest vaccine centre: There are signs the vaccination programme is accelerating and moving to more than 200,000 a week. Photograph: Enda O’Dowd/The Irish Times

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A lot of politics is about people’s expectations. And so the Government, having signalled a slow enough reopening of the economy and society for months, has presented what was agreed this week as a “speeding-up”. In reality, the plan is still gradual enough – for now – with a lot of the riskier reopenings put off until June. But, conditioned by lockdown, we welcome the small freedoms and the hints that by July we might be sitting in pubs, or even have the option of a foreign trip.

Who knows? As we have seen over the past year, predicting what happens next is pointless The vaccine numbers are rising but less than 30 per cent of the over-16 population have had one jab. The best shot – excuse the pun – of reopening working is to get the vaccines out fast. And the latest advice from the National Immunisation Advisory Committee (Niac) does pose some more challenges here, over and above the risk of late supplies with which we are by now wearingly familiar.

There are now signs that the vaccination programme is really speeding up and moving to over 200,000 a week. Whether it can get to the level of 420,000-430,000 a week which will be needed in June to meet the Government targets remains to be seen. But the big vaccine centres are now swinging into action and all 38 should be up and running in May.

This is good. So is the building evidence of just how well the vaccines work, tempered of course by the unpredictable impact of new variants. But there are challenges, too.

Here we come back to expectations. News that Niac gave the green light to the Johnson & Johnson vaccine for the over-50s and lowered the age limit on AstraZeneca to the same level was greeted as a boost to the programme. From a position where AstraZeneca was restricted to over-60s and Johnson&Johnson had not been cleared for us at all, it was. But it also creates new challenges.

Operational factors

One is the short-term one. The 50-59 year olds, next on the list, are the only remaining large group which qualifies for Johnson&Johnson on current guidance. Because much of the supply of this vaccine will not arrive until late May and June, there is a question of how to arrange this. Political hints have been given of starting the 40-49 year old age group at the same time, running the two in tandem and allowing more of Johnson&Johnson to be used on the over-50s. There are a host of operational factors and the Health Service Executive and the Vaccine Task Force are crunching through this over the weekend.

But the bigger message is that restricting this to older age groups creates a few problems down the line. First, it will lead to a lot of leftover vaccines as the summer goes on, because we will be getting AstraZeneca and Johnson&Johnson which – unless the Niac guidance changes – can’t be used.

Leftovers were inevitable as the programme scaled up – like all countries we ordered more than we needed. But knocking out two for the younger age groups could delay the latter part of the programme – particularly in July which was to have been a big month for numbers. The Niac advice does say that the vaccines can be used for younger groups if no other options are available – but this isn’t the same as saying they can be used if there is a danger of slowing the programme down. Or is it?

Knocking out two vaccines for younger groups will certainly make delivery of the programme more complicated. Local pharmacies were being lined up as a delivery route through the summer but these settings are ideal for the easier-to-handle vaccines, especially Johnson&Johnson which – with one shot – is just like giving the flu jab. Local pharmacies may struggle to manage the mRNA vaccines, including Pfizer, the workhorse of the programme.

There is no room for error or delay and a vital six weeks lie ahead

For now the vaccine numbers are building and the Government target of getting more than 80 per cent vaccinated with one dose by the end of June seems just about possible. The second part of the target – 55 per cent fully vaccinated – may be a stretch. After one of the toughest lockdowns internationally, the Government will hope that opening gradually with limited additional activity in the next few weeks will give us some leeway as vaccine numbers build.

We are well behind our nearest neighbours and need to see their reopening in that light. In Northern Ireland, more than 60 per cent of the adult population (and half the total population ) now have at least one dose and 25 per cent have two. They are now opening indoor retail, gyms and outdoor dining. While our balance of first and second doses will be different, in terms of total jabs as a percent of the population, we won’t be where the North is now until – all things going well – early June. By then shops will be open here a couple of weeks, and on June 7th gyms and outdoor dining are due to resume. So we are taking a broadly similar approach.

While we may look jealously across the Border or the Irish Sea, we really need to be cheering their reopening on. It will be the clearest marker for Ireland of what may lie ahead.

It all underlines just how vital the vaccine programme will be. If we want the country open for the summer, the target needs to be more or less met. There is no room for error or delay and a vital six weeks lie ahead. And in the meantime, we watch the UK and other countries ahead of us on the vaccination curve and keep our fingers crossed.

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